FACT SHEET No.6

BOX REST: HELPING YOUR HORSE TO COPE

Why box rest?

It is common in human medicine, especially in the case of limb injuries, to confine the patient to bed for a period of time in order that the damaged tissues can be immobilised while healing takes place. Unfortunately this is not possible in the horse so the next best thing is box rest. Uncontrolled movement significantly impairs the healing of tissues. Wound edges move, leading to opening of the wound and the formation of exuberant granulation tissue (proud flesh) which can delay healing for months. Tendon and ligament healing is disrupted leading to large unstable scarring of the effected structure which then has an increased likelihood of breaking down when the horse returns to work. Bandaging (especially of the foot) becomes loosened and dirty leading to contamination of the bandaged structure.

Types of box rest

• Simple confinement to a loose box: the commonest form
• Confinement to a loose box and physiotherapy, e.g. limb stretching exercise performed by the owner/physio/vet
• Confinement to a loose box and tethering in the box: this is to prevent the horse from lying down and is only rarely used, for example in cases of pelvic fractures and in some severe knee wounds
• Confinement to a small yard or very small paddock: this allows limited movement by walking only and is useful in the rehabilitation stage
• Box rest followed by walking in hand: this allows controlled mobilisation of healing tissues. The tissues are loaded in a controlled fashion allowing gradual strengthening. In tendon injuries controlled loading ensures that the tendon fibres heal along the lines of stress, thereby reducing the risk of a second breakdown.

'My horse will go mad if its confined………'

Experience shows that even the most highly-strung horse will readily adapt to box rest provided some simple rules are followed. Owner's fears in this regard are often unfounded. Most horses after a few days or a week if correctly managed will 'switch off' and resign themselves to their fate. A few management changes may be necessary to help the horse to adjust to it new regime. Depending on your circumstances and the facilities available you may or may not be able to satisfy these recommendations

• Provide equine company. Even simply putting a retired family pony in an adjacent loose box, especially in situations where the confined horse can see its companion all of the time (use stable partitions which are not solid) will contribute enormously to the wellbeing of the confined horse. Alternatively other horses you own can occupy the adjacent box on a shift system. This is extremely effective. Sometimes a pony or other quiet horse can be borrowed from friends as company In the later stages of the confinement period the pony and confined horse can be kept together in a large yard.
• Provide a stable mirror. Research has shown that separation anxiety can in many horses be significantly reduced by fitting a stable mirror. The horse perceives its reflection as another horse. The mirror should be sited away from where the horse is normally fed. Mirrors are available made from stainless steel (www.jacksonarenas.com) or less expensive acrylic.
• Reduce hard feed to a minimal amount. The best feed for box-rested horses is chaff to which a handful of nuts or coarse mix is added. Be generous in feeding chaff as the act of feeding seems to provide some psychological comfort for the horse and occupies it for part of the day. A full bucket of chaff twice or three times a day is ideal. Horses recovering from severe wounds or laminitis may need additional feeding: your veterinary surgeon will advise.
• Ensure continuous access to hay/haylage. Eating rate can be reduced by placing one net inside another or using small mesh nets.
• Another useful way of occupying stabled horses is to use the Snack-a-Ball (www.robinsons-uk.com). This is a large ball in which some hard feed (for example high fibre cubes) is placed. By rolling the ball the horse causes small amounts of food to fall out of the holes at the side. Horses will spend hours playing with the device.
• Minimise disturbance. Horse are more likely to become anxious if adjacent horses are being taken away to be turned out or ridden especially if at irregular intervals. If possible stable the horse well away from places of equine activity (stable yards, arenas etc.). While in theory yard activities will distract and divert the confined horse the disturbance caused may outweigh the advantages
• Be careful when mucking out. All veterinarians can recall occasions when box-rested horses have barged past or even jumped over wheelbarrows or suddenly 'exploded' when tethered outside the stable (often for the most innocuous reason) and run free until caught, thereby undoing the benefits of weeks of confinement. It is strongly recommended that when mucking out the horse is first shut in an adjacent loose box. Alternatively a chain or similar device can be fixed across the doorway.
• Remove the shoes. Pick out the feet once daily to prevent thrush developing. Have the feet trimmed every 6-8 weeks unless the veterinary surgeon advises otherwise.
• Sedative drugs given by mouth are occasionally used in the early stages to help the horse to adapt.

How Long in the Box?

The duration of the period of confinement varies enormously depending on the reason why the horse is being box rested. This may be a short as a week in the case of simple injuries or foot abscesses, or as long as six months in the case of pelvic fractures and other major injuries. Your veterinary surgeon will advise you of the appropriate length in your case.

Hand Walking

The controlled mobilisation offered by hand walking is frequently used during the rehabilitation phase. Horses, which have been confined for even a short period, may be very excitable when walked in hand so some simple rules must be followed.

• Always use a bridle (rather than a head collar) or preferably a Chiffney bit.
• Use a long lead rope (e.g. a lunge line). Horses will often rear and buck if startled and it is essential that the handler can stand well clear of the horse while remaining in control
• Be prepared for an 'explosion'
• Consider sedation for the first few occasions. We can supply an oral sedative.
• Choose a quiet route and time. Avoid obvious 'inflammatory' situations e.g. barking dogs etc. In the first instance just walking the horse round a yard or arena may be preferable to using a road.
• Some horses are safer if ridden rather than walked. This may not be appropriate for certain injuries so please follow our instructions.

Turning Out

The temptation to take the horse out 'just for a few mouthfuls of grass' or to turn it out ('it will only just graze quietly') must be resisted, as all the benefits of the box rest period can be undone in a few minutes. Even the most stoical horse can explode after a period of confinement.

When the horse is finally to be turned out we strongly recommend that the horse be sedated for the initial turnout. Prepare carefully for the event. There should be no horses in the field or in the adjacent fields to 'wind up' your horse. The horse should be hungry (starve overnight) so that it will put its head down and graze straight away. The application of boots to all four legs is prudent. Oral sedation is often too unpredictable for this purpose. An intravenous sedative injection is much preferred, as it is very reliable.

 

DISCLAIMER
This factsheet is intended for use by registered clients of EqWest only. The advice offered is general advice only. EqWest clients who wish to discuss the individual circumstances of their horse should contact the Clinic.
To speak to a vet please phone between 8.30 - 9.30 am on weekday mornings.

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