Stall Rest- Losing our minds

[alekezam]

My 20 yr old thoroughbred gelding is on stall rest for a stifle ligament tear. He normally lives out 24/7 and has not been managing well. It’s been 5 weeks (started beginning of January) and he still paces a lot in the stall. Against the vets best wishes, we immediately started him in a small pen outside for the day in the field with his herd, and a stall at night with a friend as 24/7 stall rest was not doable. Unfortunately both have stressed him out to no end.

He paces inside, he paces outside (not as bad but isn’t super happy). Just spins himself in circles even with friends inside. He has multiple haynets in his stall to simulate grazing, as well as a likit toy (which he doesn’t care for). He was on a good dose of trazodone but I am currently weaning him off of it because honestly, I don’t think it was helping. Maybe for a couple hours, but he’s in a stall for at least 12 hours so by the morning he’s pacing and worked up.

We have ace on hand, but again it’s not something that will last the full time he’s inside. Thankfully he’s very sane for handling, but he just doesn’t like being in. He gets no ‘traditional’ grain, just beet pulp and haycubes and regular hay. He gets magnesium as well to try and help.

I’m losing my mind trying to to figure out ways to help him handle this all better. Vet has said we could try other medications, but I’m hesitant to try anything that won’t actually last the full 12 hours he’s inside. It’s all well and fine if it works for half the night, but what about the other half?

We have at least another 7 weeks of this, and then his stifle gets rechecked. I’m not sure what the best course of action is. I fear he’s not making his stifle any better, but I’m also worried for his wellbeing as he’s just so stressed and has lost weight.

I’m in Canada, so some products can be difficult to get. I was so hoping he’d settle by this point and get into the routine, but he just hasn’t. Every morning his stall is a mess because he just paces. I would love any suggestions anyone might have I know as well there’s a lot of topics on stall rest, but it’s nice to have specific answers to my situation.

[cilla1]

Does he usually run around a lot when he’s normally outside? I think endless pacing in a small area is maybe worse than quietly grazing outside. Can you set a smaller area in his normal pasture maybe with a calm friend?

[ATXmom]

We’re just coming to the end of a lengthy stall rest/rehab. I don’t have much advice but feel your pain! We survived (just barely!) on reserpine and Ace.

Can you rig up a small pen attached to his stall so he can go in and out as he pleases? We didn’t have that available, so our horse was on straight up stall rest until he was cleared for the rehab facility.

If there is a facility near you, I might consider that. Our horse was completely intractable a few weeks into his layup but when he went to rehab, he settled down enough to come off the drugs. I think some horses are just better when they are in a very structured environment and all on the same program. Plus the rehab folks are generally more experienced in dealing with stall bound horses.

I hope things get better for your boy

[JB]

Trazadone saved me and my guy, literally. Has your vet mentioned that at all? It’s a twice a day deal, it’s not super cheap but it’s pretty manageable especially if you can get it online with an Rx from your vet

[Demerara_Stables]

Obviously I know nothing about your horse’s particular injury, but when my mare had a check ligament injury it was recommended that she stay on turn out as long as she was quiet because she does the same thing. She is not a candidate for stall rest at all. Do you think he would stay quiet if turned out with one buddy or maybe in a large field (if available) next to his friends? Good luck!

[NaturallyHappy]

When one of mine was on stall rest for colic surgery, I hand grazed him the entire time the other horses were out on ace. I know that is not possible for most people, but that’s what we did for a month. Then we moved to a round pen. EPIC fail, even w ace. What worked for us was turn out in his regular field w one quiet friend on ace. We did have to “top him off” instead of letting it wear off. I hope this is helpful somehow.

[alekezam]

We tried trazodone for 5 weeks, I don’t think it made a difference even with trying different doses. He needs something that is effective for the full 12 hours he’s in a stall everyday and unfortunately it seems like most things don’t last that long. Thanks!

[alekezam]

He currently gets turned out in a small pen next to his herd but unfortunately if they move too far away he gets stressed. It’s extremely muddy right now so turning him out completely isn’t ideal.

[JB]

So weird, though I know everyone reacts a bit different to all drugs. I did 1800mg (which was the lower end of roughly 2.5mg/kg) twice a day every day, and it was night and day difference. The first 2 doses were higher than that, and evvvvvery now and then I gave him a higher dose if life was extra rough, but generally, it was a lifesaver.

[Demerara_Stables]

Ah bummer. I understand about the mud. Is he able to hand walk? Maybe getting him out a couple of times a day to get him physically and mentally tired will help?

I’ve heard people have had good results with reserpine, and I’ve personally had good results with CBD. In fact, one of my mares that normally doesn’t get CBD got a scoop of it a few nights ago and she was OUT. I thought she was sick she was so sleepy. I use https://mikkoschoice.com/.

[theresak]

I used reserpine - we dosed daily over 7 (?) days to get to the level of sedation I wanted and then topped up weekly. As stall rest went on, I had to decrease the number of days between reserpine doses. It didn’t solve my horse’s stress and anxiety but it did keep him from spinning constantly in his stall. We had some loose poop throughout due to reserpine but I think it can be a very severe side effect you need to watch for.

Ultimately the stall rest made my horse more herd-bound and anxious and I vowed to never do complete stall rest again with that horse or a horse like him unless it was life or death or <2 weeks. If I had to do it again, I would just have kept him in his normal turnout and herd.

[sascha]

If there is an antique on the property who can be ‘sacrificed’ that can work really well. Set up both indoor and outdoor stalls where they not only see each other but can touch and groom each other. Supervise at first to make sure it’s going to work of course. I would never have figured this out if an antique had not become injured and required indoor stall rest at the same time my horse was on stall rest. They spent the day beside each other in the foaling stall with a 3-board fence type divider between them. They spent a lot of time over that fence with muzzles on each other’s withers. The barn was a lot quieter and calmer.

Also, re-evaluate the ‘need’ for increased magnesium. It can be VERY hard on the guts. When the guts are annoyed, the whole horse gets stressed because of discomfort. If I were you, and I’m not, I’d cut the Mg and add a stomach buffer for a few days to see if there is any chance in level of agitation. That helped my own horse a fair bit. I thought I was helping with the Mg, but it turned out I was not.

[Syrynx]

Starting month 4 of stall rest with a guy who was out 24/7 before I brought him home. We started by using oral ace and then switched to reserpin. He does still pace a bit, especially when his neighbor gets turned out. There are 2 horses in the barn with him who are on night turnout, so there’s always another horse w/in sight which I’m sure helps. And he’s right by the door so he sees all the comings and goings.

The current prognosis is tack walking in a couple of weeks, then supervised turnout starting in March.

[alekezam]

He was getting 15 tablets of 150mg trazodone twice daily, and it seemed to help the first week for the first few hours, but since then he just seems to not care- even his vet is surprised by it.

[alekezam]

I’m really questioning if stall rest is worth it at this point . I just don’t want him to be in pain if we left him in the herd due to his stifle ligament tear.
I’m pretty sure my vet will recommend trying reserpine next, I’m just worried about upsetting his gut further.

[alekezam]

Thank you for the tip on magnesium! I’ll try cutting it out. I have definitely thought he could be more worked up due to any discomfort involving his gut. What stomach buffer did you use?

[alekezam]

Month 4! I’ve barely done a month, 4 sounds awful. Good luck! I wish we could explain to them that we’re just trying to help.

[alekezam]

It depends on the day . Some days he is perfectly content in his small pen, other days he loses it if his herd is slightly further than what he would like. Unfortunately it’s a very small barn with only 9 other horses, and no one is really willing to also subject their horse to small pen turnout.

[JB]

@alekezam

He was getting 15 tablets of 150mg trazodone twice daily, and it seemed to help the first week for the first few hours, but since then he just seems to not care- even his vet is surprised by it.

Well pewp, yeah, sometimes that just happens I would work to manage the horse you have, over strictly managing his injury, as has been discussed. What’s the most “out” he can have with the least risk to his recovery, and go from there. I feel for you!!

[sascha]

@alekezam

What stomach buffer did you use?

I used Sucralfate because I’ve always got it on hand and it works really well for my horse.