Updated 10/1: back to work! With the NQR horse

[fivestrideline]

I’m sure y’all are tired of hearing about Mr NQR, but here we are. TL;DR at the bottom.

Anyways, my 11YO OTTB gelding has been at the rehab farm for 13 months following a suspensory injury. Well, we suspect the injury was earlier, but let’s call it 13 months. We did the full protocol (stall rest, progressive loading, all of it) for 8 months before the mental wheels fell off and I pulled his shoes and kicked him outside to 24/7 turnout. He’d barely made it to trotting under saddle, because he was just wild and very body-sore despite everything we tried.

He’s had 5 months of turnout, barefoot living, and massage since then, and he’s really looking and feeling great (he’s in 0 work though. This is based on the bodyworker and my BO’s opinion). I miss being able to go out and groom him, so I found a barn near my house that will keep him on fancy pasture board.

My ultimate goal is to ride him again on trails or whatever he can handle - I’m trying to decide if I should attempt to put him back to work now or wait until the spring. I’ll be continuing the bodywork and taking it slow, but I don’t want to jump the gun just because he’s close enough for me to go see him.

Contributing factors: horse has KS, and his soreness is concentrated at the lower lumbar area according to the bodyworker. It used to be his whole spine and SI, now it seems to be clinging to his lumbar area. I have not done any treatments for this, and TBH I’m not looking to spend $$$$$ on him anymore. Adequan or legend or some mesotherapy are about as much as I want to do. I also do not have a custom saddle for him (the fitters want him working first, which, yeah, but also I can’t ride in an ill-fitting saddle), but I do have a setup that’s “pretty good”.

So, WWYD? Put the horse back to work now (plan TBD, but starting with lots of handwalking) and see how it goes, or wait until the spring for a full year since I kicked him on Dr Green? Would an extra 6 months make a difference at this point? I really don’t want to go down too many new rabbit holes, but would it be worth it to get the vet out to do some pain-cycle breaking back injections or do Adequan? Should I just cool my jets and wait for spring to start him, which is easier said than done since I’m a one horse gal for at least another year?

TL;DR: horse has been rehabbed for a suspensory injury for 8 months, followed by 5 months of Dr Green when the stall rest was wrecking the rest of his body. Would it be too soon to start him back to work now, or should I wait until spring (aka a year of Dr Green)?

[Renn_aissance]

If he was previously sound enough to trot under saddle and you have no reason to believe that has changed, it will be hard to hurt his suspensory by putting him back under saddle at the walk and starting the progressive loading protocol again. If you want to be cautious about it you can walk all through fall and really focus on his topline development and see how he responds before making any decisions about what to do next. It will at least give you information about what he can tolerate and what you can do in the spring.

[Mersidoats]

I see no harm in walking, lots and lots of walking, starting now. He is in turnout, he is sound at the moment. Start low and slow, maybe 15-20min, add 5 minutes a week. Walk on the flat, walk on mild inclines, add some walk poles after a month, walk on terrain. Any time you introduce a new walk challenge, start with hand walking, then ridden.

The key will be slow. If you think you can move up in minutes or challenges, wait a few more days. Take it from someone who rushed a rehab and paid for it.

[outside_leg]

You say he’s still back sore, so I don’t think restarting him now is a good idea. If you can’t get the back feeling good, it will likely just lead to him compensating or acting out, and could cause further strain or injury. Just my two cents.

[Tha_Ridge]

What do this horse’s hind feet look like? I’d probably start tack walking with equibands or something similar.

[danhelm441]

When you say “mental wheels fell off” do you mean he wasn’t responding well behaviorally to the rehab work? If so, I would be nervous about trying to go straight from no work to tack walking. He might have too much energy and too many feeling to hold it together for all that, particularly with the season change coming up. What about a groundwork fitness program? Lunging in side reins, adding in poles, and building up his work ethic and top line without having to worry about saddle fit or your own personal safety? You could even take up ground driving. Then you’ll both be super fit and ready to rock and roll in spring. My horse and I learned to ground drive last year when I didn’t feel safe or confident riding him, and I have to say we both loved it and I still like to do it to warm up before I hop on. It’s a ton of fun and a good workout.

[Inimitable]

Groundwork! Handwalk in an equiband, teach him to long line/ground drive if you haven’t already. But I’d throw him in an equiband any chance you get. See if you can open up that lumbar a bit before you get back on him. Then throw the tack on him and start walking, walking, walking (in an equiband, lol) … then trotting, etc. You know the drill. You’ll have a pretty fit horse in the spring and a good idea of what his physical limitations, if any, might be going forward.

[fivestrideline]

@danhelm441

When you say “mental wheels fell off” do you mean he wasn’t responding well behaviorally to the rehab work?

Well, specifically the stall rest. He couldn’t handle the confinement and was becoming unmanageable on the ground and under saddle. We kicked him out and I have my sweet, quiet horse back. He generally likes a job, and can sit for however long between rides (mentally) and be bareback-and-halter-with-dead-beginner-roommate safe.

It’s more the risk of pushing him too fast for his legs/back/stifles that worries me. I don’t want to get on him too soon or start lunging or doing too many hills in hand or etc etc.

[fivestrideline]

@Tha_Ridge

What do this horse’s hind feet look like? I’d probably start tack walking with equibands or something similar.

I do not have super recent pics, but this is my NPA horse that I’ve fought tooth and nail to fix. He looks much better, but I don’t have recent X-rays (I put a halt on his non-emergency vet expense account).

I do have an equiband system and he tolerates them perfectly.

[fivestrideline]

@outside_leg

You say he’s still back sore, so I don’t think restarting him now is a good idea. If you can’t get the back feeling good, it will likely just lead to him compensating or acting out, and could cause further strain or injury. Just my two cents.

This is a big worry. To be fair though, he’s also got 0 muscle and stands around with his belly hanging down and generally not carrying himself. So I wonder if building up his abs and back muscles would help? I will certainly start with hand walking and light lunging, before getting on.

[Libby2563]

I would start him back slowly now, even if you mostly walk for a long time. Obviously if he shows signs of back soreness or lameness you can always stop. I kind of feel like at 13+ months post injury and 5 months of full turnout his suspensory probably is what it is, so you might as well find out what you’ve got and try to build some topline. If he’s safe and progresses comfortably you could enjoy some nice fall trail rides as a mental reset for you both.

[fivestrideline]

@Libby2563

at 13+ months post injury and 5 months of full turnout his suspensory probably is what it is, so you might as well find out what you’ve got and try to build some topline.

I’m realizing it’s his back and miscellaneous potential for issues that are scaring me more than the suspensory.

[Mersidoats]

Thinking about the back soreness thing - you’re going to have to address this. Whether it is bodywork, equiband work, veterinary treatment, a combination of all of them, you can’t just “hope it gets better.”

Also, if he was NPA and you pulled his shoes, he may be NPA again. I’d put him back in shoes. Before you progress beyond walking for 15 minutes, I’d get rads.

[fivestrideline]

@Mersidoats

Also, if he was NPA and you pulled his shoes, he may be NPA again. I’d put him back in shoes.

We pulled the shoes in order to address the NPA - several highly recommended farriers in all kinds of $$$$$ shoeing packages couldn’t fix it or made it worse. Balanced barefoot trims (NOT by a trimmer, but a farrier) + me rasping his toes has made a huge difference. The toe drag is gone, his cannons are back to vertical, and externally the foot has improved significantly in angle.

That said, it probably is a good idea to get new rads of his feet to check progress. And hoof boots are on the menu so we can go out and walk the rockier trails.

Also, he gets monthly bodywork which has made a HUGE difference - I use it as a divining rod for how he’s feeling. We have learned he cannot tolerate extended stalling (even daily stalling) and is very particular about his hoof angles. We have made SO much progress with him that I’m also terrified to change anything at all. Bodyworker is a godsend, TBD on any other modalities, but I’m open to trying things.

[fivestrideline]

On that note (sorry for the barrage, I finally got some time off to think) - how much work does a horse need to be in to see if a given treatment is working?
Any at all?

Shockwave and mesotherapy have been suggested to me, or SI injections, but the horse is currently bumming around a pasture so I’m depending upon the bodyworker and my own hands-on observations to determine if he’s better or worse. I’d hate to dump a ton of cash into XYZ and then never know if it helped or not because the horse is just standing around (or just hand walking). But I also don’t want to create problems by not digging enough.

Is there any guideline to this? I hate to say it, but the horse is not a derby contender on any day, more of a 2’6” local type - he’s got a home for life with me but I have to draw a line in the sand at a certain point. He’s also the reason I haven’t ridden or pursued any goals in years - he’s eating every spare horse penny I have at the moment. So while I want him going because it would be nice to RIDE my one horse, I also don’t want to burn every last drop trying to get him to be something he’s not. Those pennies could be squirreled away for the next horse.

There has to be a middle ground somewhere, right?

[Gardenhorse]

@fivestrideline

@outside_leg

You say he’s still back sore, so I don’t think restarting him now is a good idea. If you can’t get the back feeling good, it will likely just lead to him compensating or acting out, and could cause further strain or injury. Just my two cents.

This is a big worry. To be fair though, he’s also got 0 muscle and stands around with his belly hanging down and generally not carrying himself. So I wonder if building up his abs and back muscles would help? I will certainly start with hand walking and light lunging, before getting on.

I think building his muscles and moving more correctly is likely to help his back. I would hand walk for a week or two, gradually adding time until you’re up to ~30-40 minutes. Then hand walk with Equibands for a week or two (starting with the Equibands for a few minutes at the beginning and gradually building up to using them the full 30 minutes). Then start tack walking with the Equibands.

[vxf111]

If there’s ever been a horse that would benefit from ground driving and the Equicore before under saddle work, it’s this one!

[Posting_Trot]

I’ve never rehabbed a horse with this kind of injury, although I’ve done other rehabs. So that’s a caveat.

But. I wouldn’t lunge this horse at all for many months. I’d handwalk and do groundwork over poles, take him for long walks (in hand) in the woods, if that’s feasible, walk patterns with cones, etc. In other words, I’d do an awful lot of walking.

You might progress to using the Equibands when you’re walking in the arena, but I wouldn’t start with them either. For a couple of months just let him walk how he’s going to walk, and ask him to pay attention to the stuff on the ground, to the terrain, and to you. I wouldn’t even put a saddle on him for a couple of months, although you might want to walk him in a bridle.

Just plain old walking is an amazing exercise for horses.

Good luck with the rehab!

[IPEsq]

What is his turnout terrain like? How large? How much he challenges his body on his own and walks on his own may influence how quickly the process will take.

I would introduce the Equibands with a surcingle and probably walk in hand for at least a couple of months with it, getting him up to 30-45 minutes in them every other day tops, and adding poles or other terrain challenges, also not every day. And those first get introduced with no bands then do them with bands. Keep an eye on his tolerance.

If that is going well, replace surcingle with saddle and again keep going in hand and monitor his tolerance.

After that, you can either go to tack walking or some longeing. When adding trot with the Equibands you have to start over to some extend with the amount of time. If he is quiet and back seems ok and saddle fit seems reasonable, I’d go with tack walking as the first step, personally. But you may need to go back to alternating days again.

Whether you start now or later, it’s going to be slow, slow, slow with back issues. I also think there is benefit to doing this when it is not cold out or at least not cold overnight. Cold is not good for these back pain horses. And the spring crazies are also not my favorite to deal with for rehabs.

[fivestrideline]

@IPEsq

What is his turnout terrain like? How large? How much he challenges his body on his own and walks on his own may influence how quickly the process will take.

He will have 5+ acres of hilly pasture (well, as hilly as we get here). There is also no ring currently, so all work will be done in the pasture or on the trails. There is a round pen.

@IPEsq

I would introduce the Equibands with a surcingle and probably walk in hand for at least a couple of months with it, getting him up to 30-45 minutes in them every other day tops, and adding poles or other terrain challenges, also not every day. And those first get introduced with no bands then do them with bands. Keep an eye on his tolerance.

This is a great example of what I’m looking for. Daily work but mixing it up.

@IPEsq

I also think there is benefit to doing this when it is not cold out or at least not cold overnight. Cold is not good for these back pain horses. And the spring crazies are also not my favorite to deal with for rehabs.

Cold is indeed a consideration, but I’m looking for a BOT back pad and keep him bundled up. Luckily knock on wood spring doesn’t usually rile him up. He really is a chill guy, when he’s happy.