Soft Tissue Rehab - Not started undersaddle

[piccolopony]

I’m going to try to be as concise with this as possible but I’m looking for some collective experience. To start, I just want to note that I’m working closely with my vet and we’ve made some great progress. I’ll also note that I’m new to rehab or this amount of stall rest because knocking on wood in my 24 years of experience owning horses I’ve never dealt with an injury this serious before. I have a plan, but I’d love some thoughts and experience to make sure I’m heading in the right direction.

I got a new horse at the end of October this past year. As horses do, within 2.5 weeks of bringing her home (during a very slow and careful introduction to another horse) she sustained a kick to the inside of her right hock which was later diagnosed as a fracture of the Talus and collateral ligament damage via CT and ultrasound with some sets of x-rays thrown in. She was 4 years old, now 5 and is not started under saddle. She also was not experienced at longeing (we were working on that) prior to her injury.

Based on advice from my vet and the lameness expert at the UofM (where we got the CT done) she has been on 6 months of stall rest with daily hand walking since basically the beginning and has been an absolute superstar and, until recently, we haven’t needed any pharmaceutical help. We started at 10 minutes of hand walk and have built up to over an hour. At the 6 month mark (about two weeks ago) we started adding some trot and she has been sound so far (yay!!!). I’m having a tough time finding anything about rehabbing a collateral ligament of the hock specifically so I’m going with more general advise around soft tissue rehab and planning to very slowly build up trot on a straight line.

Most of this work so far has happened indoors because she’s in WI (I live in MN) and because of how slippery it can be here we haven’t been outside until recently when the snow melted and the outdoor arena footing dried out. As you can imagine going outside for, basically, the first time in 6 months is quite exciting especially when you’re a five year old mare and it’s spring.

Per my vet, I can turn her out as of the 6 month mark (May 10th) but with how explosive she can be with stuff happening outside I’m worried that could be disastrous. I think the issue we’re both grappling with is just that I’m fairly limited in how far I can go with rehab because she isn’t started under saddle. While we were hand walking (all winter every day) I taught her how to ground drive at the walk. I have not tried it at the trot yet. I do have Ace and have been playing around with the dose but at 2ccs she had a pretty big blow up when I was walking her in the outdoor a few days ago. Since then I’ve walked her outside a couple of times without Ace and yesterday she was foot perfect, today we had a pretty big blow up again.

My question, if she were yours how would you get her rehabbed/prepared for turnout at this point?

[Bluey]

@piccolopony

I’m going to try to be as concise with this as possible but I’m looking for some collective experience. To start, I just want to note that I’m working closely with my vet and we’ve made some great progress. I’ll also note that I’m new to rehab or this amount of stall rest because knocking on wood in my 24 years of experience owning horses I’ve never dealt with an injury this serious before. I have a plan, but I’d love some thoughts and experience to make sure I’m heading in the right direction.

I got a new horse at the end of October this past year. As horses do, within 2.5 weeks of bringing her home (during a very slow and careful introduction to another horse) she sustained a kick to the inside of her right hock which was later diagnosed as a fracture of the Talus and collateral ligament damage via CT and ultrasound with some sets of x-rays thrown in. She was 4 years old, now 5 and is not started under saddle. She also was not experienced at longeing (we were working on that) prior to her injury.

Based on advice from my vet and the lameness expert at the UofM (where we got the CT done) she has been on 6 months of stall rest with daily hand walking since basically the beginning and has been an absolute superstar and, until recently, we haven’t needed any pharmaceutical help. We started at 10 minutes of hand walk and have built up to over an hour. At the 6 month mark (about two weeks ago) we started adding some trot and she has been sound so far (yay!!!). I’m having a tough time finding anything about rehabbing a collateral ligament of the hock specifically so I’m going with more general advise around soft tissue rehab and planning to very slowly build up trot on a straight line.

Most of this work so far has happened indoors because she’s in WI (I live in MN) and because of how slippery it can be here we haven’t been outside until recently when the snow melted and the outdoor arena footing dried out. As you can imagine going outside for, basically, the first time in 6 months is quite exciting especially when you’re a five year old mare and it’s spring.

Per my vet, I can turn her out as of the 6 month mark (May 10th) but with how explosive she can be with stuff happening outside I’m worried that could be disastrous. I think the issue we’re both grappling with is just that I’m fairly limited in how far I can go with rehab because she isn’t started under saddle. While we were hand walking (all winter every day) I taught her how to ground drive at the walk. I have not tried it at the trot yet. I do have Ace and have been playing around with the dose but at 2ccs she had a pretty big blow up when I was walking her in the outdoor a few days ago. Since then I’ve walked her outside a couple of times without Ace and yesterday she was foot perfect, today we had a pretty big blow up again.

My question, if she were yours how would you get her rehabbed/prepared for turnout at this point?

We had a young horse, already showing, that was kicked on his hock and had similar situation.
He also had to have surgery to clean the hock out.

Our vets recommended the local rehab barn, that has a horse water treadmill.
Horses were put out in larger and larger pens and smaller turnouts individually, where they really didn’t want to blow up big time.
Vet went by regularly to see horses there and kept an eye on its progress.
Worked great for our horse, water exercise was tiresome but protected that hock rehabbing and was much easier on the handlers than hand walking a kite impersonating horse.

Maybe ask your vet for such a place locally, if your horse’s injury could go that route?

Could you start ponying your horse from a Steady Eddie type?

Our horse ended up sound for light use, although his hock looks large.
He has been a good trail and cattle gathering horse for a friend for some years now, just not for hard work, then he comes up at times, not always, sore next day.
Vet said careful, sensible riding would keep him as sound as possible, better than retiring him.

Now, he was a fully trained horse, not one not yet started under saddle.

[IPEsq]

Generally, the rule I follow for rehab they involved long stall rest is not to turn out in anything that can really get moving in until they are cantering in a controlled environment. But in your case, I don’t think much lunging would be great for your injury, and if she wasn’t great at it to begin with, that will be a process.

You are right that straight lines are good. I would start trying to ground drive her in trot. You can position yourself more to the side for more control (to steer her onto the double lunge if you need leverage).

Since cantering under saddle would be a long ways off, could you make her a small, stall sized paddock with some pharmaceutical help to get her outside? At least you have been doing a significant amount of walking. But the risk at this stage is not only the initial injury but every other part that lost condition during the rest period. And if you add speed and likely height with some cavorting around, you could injury really any soft tissue structure. To be safer you could at least confirm on imaging that the initial injury is healed first. If so, try to introduce some more speed in hand, even if in the indoor still for less outside stimulus. Then venture out. Is there grass outside yet?

And BTW I feel your pain as I’m heading into month 5 of stall rest with my horse for a fracture, and he’s only walking 15 minutes inside right now. He’s well trained and older (10) but it’s not easy after so long cooped up for any of them.

[cnd8]

I think I’d second the notion of sending her to a rehab facility with a treadmill and/or aqua-tread or swimming set up. This would be the safest means to strengthen her back up, for sure.

[quietann]

My mare had a different problem and surgery, but when we started turning her out, it was in a pen made of panels, about the same square footage as 3 stalls, IIRC. She had 3cc Ace on board, and her pen was near the barn so barn workers could bring her in if she started getting silly. That started with 30 minutes turnout and worked up to all day, expanding the pen as we went along. Eventually she did not need the Ace. Horses can “break through” any sedation, though.

For soft tissue injuries: do you have an area with a hard surface to walk her? My vet wanted my mare worked outside on paths, blacktop, and other hard surfaces as much as possible. It is better for healing soft tissues than most arena footing.

[trubandloki]

I am sure you thought of this but another thing to add to your small turn out when you get brave and try it is something that she can not resist eating. Grass if that works for her, extra fancy hay maybe. Something that keeps her attention that might limit her desire to blow up.

[piccolopony]

Thank you all for your suggestions and for taking the time to read and lend some help. I truly appreciate it.

Regarding a rehab place, while I would absolutely adore handing her off to the experts and saving myself the 1.5 hour round trip to the barn every day a highly qualified rehab facility is unfortunately not in my budget. If (again knocking on wood) this ever comes up again further out in the future I will be going that route if at all possible. I’m exhausted.

I love the idea of getting her started with some trot while ground driving/long lining. I may test that out tonight with a bit of Ace to see if I can get a few calm trot steps and go from there.

I also appreciate the ideas about the smaller pen. It will likely mean I need to purchase some panels which I can do, I just have been hoping to avoid that since they’re expensive for one time use. I’ll talk about it again with my barn owner (who is a saint by the way) and see if we can figure something out. Ultimately, especially with you all weighing in, I think that likely is the safest option when turning her out for the first few times. I love the idea of some extra tasty food to keep her occupied. I’ll see if I can pick up some extra tasty alfalfa to help her transition to being outside. Maybe she won’t even notice that she’s outside at first

Regarding the footing, our indoor is pretty compact at this time of the year. The outdoor is a bit deeper but still not deep by any means. I did check both with my vet and he wasn’t worried but I have been airing on being extra cautious so I appreciate that feedback.

[trubandloki]

Depending on where you live, check to see if you can buy used panels and once you are done with them someone might be willing to buy them off you.

[IPEsq]

Depending on your paddock setup, you might also have an option of portioning a piece off with hotwire tape or similar. It is likely to be weeks/months of small turnout, if that helps you justify the headache/expense. They still notice their freedom as you increase the size.

[joiedevie99]

If you can ground drive her at the trot with ace on board, that would be great. If not, I’d secure a smallish, but not too small, quiet, flat paddock that she could move to 24/7. Lean on drugs, hay, and calm neighbors for the first few days.

[Bluey]

If you can find a safe line or corner then you don’t need quite so many panels, just enough for two or three sides, let the other wall or fence be part of your pen.

As you walk your horse, make a point at first to go into that space, where you have good food and let horse get used to go in there to eat, so when going in there to turn out it will first think eat, not hi-ho-free to run and buck.

[Xanthoria]

Try dormosedan. Worked better than ace or rompun for me rehabbing an unstarted 2yr old. Agree with those who say send to a rehab facility but if you DIY long lining and ponying are good ideas. I hand walked my “meat kite” on a chain and pretty heavily medicated, gradually letting out the line over time until we were lungeing in a big arena (no circles). Prior to rehab mine didn’t even lunge.

Good luck. You won’t get a medal but you deserve one!

[piccolopony]

Thank you again everyone! I so appreciate your help and support with this and the new ideas and suggestions have been super helpful.

We’re picking up panels for a smaller outdoor space tomorrow and I’m slowly upping the trot in hand while continuing to experiment with Ace. She’s continuing to be good overall with just a little bit of air time but she’s honestly pretty polite about it. I can tell she just can’t help herself. We’ve had a dip in temps so we’ve been sticking to the indoor again because a 20-30* temp drop with wind isn’t super helpful with spring time rehab

If we continue to struggle I’ll talk to my vet about Dorm as something to try. That’s a great suggestion

[findthedistance]

I’m seconding dorm. My mare blows right through ace (looks sedate until the introduction of a stimulus), so she got a dose of dorm gel every morning before her round pen turnout when we were rehabbing a suspensory. If she “woke up” outside, she was quiet all day. She just couldn’t handle the glorious moment of having her halter removed without the good drugs onboard.