Managing The Patient On Stall Rest

In order to best care for a confined horse, you need to know how a change in his exercise pattern can affect him.

The show season is going smoothly when suddenly your horse comes up lame. After a thorough exam, the veterinarian recommends the treatment: stall rest.

Finding out that your partner is out of commission for a few weeks or even months can be difficult, but the road to recovery doesn’t have to be.

Some of the things requiring stall rest include fractures and post-operative repair, soft tissue injuries (tendons, ligaments and muscle damage), and post-operative recuperation (such as following a colic surgery). While all horses react differently to confinement in a stall, most are able to adapt to stall rest even if they are initially unhappy with it.

“People have great empathy for horses when they’re confined because we think of ourselves being constricted to bed and how bored we would be,” said Shauna Spurlock, DVM, an equine internal specialist who, along with her husband, surgeon Gary Spurlock, DVM, owns Spurlock Equine Associates in Lovettsville, Va. “But I think often we underestimate how well horses accept routine. Once they know what the new routine is, most horses adjust to it very well and with minimal problems.”

“A horse is a special kind of athlete because, unlike humans, it doesn’t detrain quickly,” explained John Pagan, Ph.D., an equine nutritionist and the president of Kentucky Equine Research, Inc.

But that doesn’t mean that two to six months of confinement in a stall won’t have some effect on a horse’s body.

When in consistent work, a horse’s skeleton absorbs and produces bone in response to a signal/stimulus received during exercise. But when completely immobile, the skeleton de-mineralizes and begins to waste away.

“The skeleton doesn’t need a lot of stimulus,” emphasized Pagan. “So hand walking or turn-out in a small paddock is best.”

In most instances, taking a horse out of its stall to move it to another stall in the same barn or taking it right out the barn door to graze isn’t detrimental to the healing process, so long as the handler can retain control of the horse. But hand walking as “purposeful exercise” (like doing laps around the indoor arena) can be detrimental to the recovery process.

“I think it’s important that a person distinguishes [with their veterinarian] between hand walking as part of the rehabilitation and hand walking just outside the stall for grass,” clarified Gary.

So what if hand walking as purposeful exercise or restricted turnout is not an option?

“If a horse can’t hand walk, then upon rehabilitation the rider must be aware that while the horse may be capable of long work, his skeleton may not,” said Pagan, who, for this reason, recommends giving a horse as much exercise daily as the underlying problem can reasonably tolerate.

Brendan W. Furlong, who has served the U.S. Equestrian Team in various capacities for more than 15 years while maintaining his own practice, B.W. Furlong & Associates, in Oldwick, N.J., agreed. “Because horses are athletes by nature, when they are on complete stall rest they experience a wastage of muscle, a loss of bone density and an improper functioning of the hoof, so restricted exercise is preferable,” he said.

In cases where limited exercise is an option, walking under tack (and maybe with draw reins) can be a useful exercise because the rider, assuming he’s competent, should have more control than on the ground and can encourage the horse to use certain muscle groups. Hot walkers are also an option because they allow a person to set the machine at a controlled speed for a controlled length of time.

Horses that are able to spend some time outside during the recuperation process, even if it is strictly limited, are at a lower risk for developing respiratory disease. Chronic exposure to dust and barn mold (especially if a horse is bedded on dusty straw or shavings, or if he’s kept in the barn while it is mucked out) can contract inflammatory airway disease, also known as “heaves,” or recurrent airway obstruction. Nasal discharge, chronic cough and respiratory difficulty, marked by a prolonged labored expiratory phase of respiration, are the typical symptoms of a horse with RAO.

“When I treat a horse for respiratory disease, I often make recommendations about increasing ventilation and reducing the amount of dust in the environment, like soaking hay or using chopped hay silage. If the disease goes untreated, a horse can have long-term effects like reduction in the intake of airflow because of bronchoconstriction [similar to asthma] and a reduced lung capacity,” warned John Nolan, DVM, founder of Piedmont Equine Practice, Inc., in Marshall, Va.

Avoiding Colic And Weight Gain
A healthy horse requires a diet comprised of varying quantities of energy, protein, minerals, vitamins and water on a daily basis to maintain a healthy, functioning state, but when a horse’s exercise program changes, so must the components of his diet. When standing in stalls for long periods of time and not exercising, horses don’t use many calories, therefore making an adjustment in diet is necessary. While extra hay may help combat boredom, it’s not always the best solution.

“Exercise is one of the key components of intestinal function, and if you increase a horse’s hay because it provides them with mindless occupation, they eat more than they need to, and that, combined with decreased exercise, will lead to food accumulation in the large colon,” said Gary, who added that horses with a history of impaction should be bedded on shavings instead of straw to prevent them from eating the straw out of boredom.