Box Rest - Advice Please

Ellietotz

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Good morning all,

I just wanted to follow on from my previous thread about my mare being lame with unknown causes.

Briefly, about two years a go now, she had her hind limb suspensories scanned which were fine, her entire hind legs xrayed including feet with low grade osteoarthritis found in both pasterns in a low motion area but was told this shouldn't cause an issue and a tiny bone spur found in left hock. Her back was also xrayed with nothing found and her SI joint injected as a precaution but this made no change in her movement.

She still moves this way now but it only flagged up to me recently as she was looking slightly more lame on what I thought was the front right but the vets confirmed that the head bob is actually coming from the back left. We initially thought arthritic knees too but as there is no heat in them now and the vet has confirmed the lameness is on the back end, we have somewhat ruled this out for now but it wouldn't be a surprise if she was a little arthritic there too which box rest wouldn't solve either and probably better to keep her moving.

Anyway, my insurance has basically made her entire body exempt from all of this now and written off all conformation related issues too so I cannot afford to get anything else looked into.

The vet has suggested box rest for 2 months, then 2 months in slightly bigger paddock and the last 2 months in regular paddock as he thinks she is bilaterally lame on the back but slightly worse on the left hind, then see how she is as we can't investigate further.

Her PSSM type 2 panel test also came back negative for p2, p3, p4 and pX.

However, the reason I am asking is because some absolute idiots decided to have a firework display in the field opposite to her where she is box resting which resulted in her escaping last night. I'm not usually opposed to fireworks but when it's somewhere surrounded by horses and livestock without any notification, it has annoyed me quite a bit when I could have prepared. When I got there, she had ripped through the electric fencing, dripping in sweat and wouldn't stop jogging/cantering around so I'm back to square one probably and wondering if there is any point to all this as we don't really know what we are looking for or able to see if any improvement is happening. I did take off her shoes too which doesn't seem to be causing her an issue and she didn't look lame trotting round last night.

I put together this Youtube video of her over the last few years and wondered if anyone thought her gait looks any different? Bearing in mind, the first clip from 5 years a go was her second time ridden after 5 years as a field ornament so if that makes no difference, I don't think 6 months will and I'm wondering if this is truly just structural.


She does struggle having her back legs stretched forwards but this may be because she doesn't move like that so the muscle isn't prepared to stretch that far. Rather like doing the splits if you aren't trained to? I don't know, just thinking aloud. I'm just honestly not sure what the point of all of this is if her scans and xrays all came back fine too. Ridden wise, she loves going out for hacks, that's all we do and she is always full of energy, she doesn't seem sore after, actually moves a lot better after it seems once warmed up and I feel if something was wrong, her muscles would be sore possibly? And she certainly wouldn't want to gallop everywhere I'd like to think.

I've sent the video to the vets too but won't hear back from them for a while.

Advice is appreciated as always, thank you.
 

ihatework

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I’m getting deja vu here.
I appreciate it must be quite stressful for you and all you want is a sound happy horse.

The way I see it, and I may well be wrong, is you have a very sweet mare. She is conformationally compromised, has a history of mild arthritic changes 2 years ago (unsurprising and you may have more going on now). She is a scratchy mover and I’d put that partly down to conformation and partly down to lameness, most likely in all 4 legs to varying degrees.

Older horses with history and not blessed with perfect conformation will need ongoing management to be kept in work. I’m not anti working lame horses, they are generally better if kept moving and provided their attitude is bright alert and happy then in this type of situation I’d be supporting the horse on bute and Cartrophen and doing gentle low impact work, if you are not in a position to be spending out more on diagnostics.
 

Ellietotz

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I’m getting deja vu here.
I appreciate it must be quite stressful for you and all you want is a sound happy horse.

The way I see it, and I may well be wrong, is you have a very sweet mare. She is conformationally compromised, has a history of mild arthritic changes 2 years ago (unsurprising and you may have more going on now). She is a scratchy mover and I’d put that partly down to conformation and partly down to lameness, most likely in all 4 legs to varying degrees.

Older horses with history and not blessed with perfect conformation will need ongoing management to be kept in work. I’m not anti working lame horses, they are generally better if kept moving and provided their attitude is bright alert and happy then in this type of situation I’d be supporting the horse on bute and Cartrophen and doing gentle low impact work, if you are not in a position to be spending out more on diagnostics.

Thank you and I apologise that I'm asking the same questions. I just feel torn with what the vet said and actually if there is any need for the box rest at all.
 

ihatework

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Thank you and I apologise that I'm asking the same questions. I just feel torn with what the vet said and actually if there is any need for the box rest at all.

I think the vet is probably in a difficult position as they know they can’t do what they would like to do, given you can’t fund it. So they are most likely just doing their best in difficult circumstances.
 

Errin Paddywack

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Personally, unless there was very definite need for box rest I wouldn't. She is known to have arthritis albeit fairly low grade at the moment. Arthritis needs movement, keep her shut in a box and it may get worse. I know I have to keep moving or I really stiffen up. Arthritic joints need strong muscles to support them and you don't get those by standing still.
 

Ellietotz

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Personally, unless there was very definite need for box rest I wouldn't. She is known to have arthritis albeit fairly low grade at the moment. Arthritis needs movement, keep her shut in a box and it may get worse. I know I have to keep moving or I really stiffen up. Arthritic joints need strong muscles to support them and you don't get those by standing still.

I agree. I wonder if maybe he thought it was a ligament possibly but to me, her movement looks the same over the years.
 

Pearlsacarolsinger

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Honestly, if the vet can't really say why he is recommending box-rest and what improvement he expects it to make, I wouldn't want to confine an arthritic horse, she really needs to keep moving. I would ask about maintenance dose of bute/Danilon and leave her out as much as possible, with light hacking for as long as you are both comfortable with it. I had miraculous results with magnetic legwraps with one horse, years ago, on a friend's recommendation, although no other horse has responded as well since but as they are not that expensive, I would give them a go with your horses, OP. I doubt that you are going to be able to make much difference to her way of going now, she is too old, really.
 

SEL

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Mine has known tendon / ligament issues (suspensory on left hind, probably DDFT on right fore - navicular damage on x ray) along with her arthritis and PSSM and none of the vets from 2 different practices have ever recommended box rest. In fact one of them said they rarely recommend it now apart from dealing with acute injuries / problems which need that immediate rest.

Can you go back to the vets after last night's escapades and ask again why box rest and would it not be better to have her out and moving, albeit in non ridden work?
 

irishdraft

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Personally I wouldn't be box resting this horse the vet carnt find anything significant wrong other than a bit arithic sorry if I've misunderstood and you say the mare loves going out and is happy and not sore ?
 

Ellietotz

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Personally I wouldn't want to box rest an arthritic horse, especially for that length of time. The muscles will atrophy and you may end up with more issues than you started with. Have you ever had her hocks medicated?

No I haven't as we never found anything on the xrays to justify medicating them unfortunately.
 

Ellietotz

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Honestly, if the vet can't really say why he is recommending box-rest and what improvement he expects it to make, I wouldn't want to confine an arthritic horse, she really needs to keep moving. I would ask about maintenance dose of bute/Danilon and leave her out as much as possible, with light hacking for as long as you are both comfortable with it. I had miraculous results with magnetic legwraps with one horse, years ago, on a friend's recommendation, although no other horse has responded as well since but as they are not that expensive, I would give them a go with your horses, OP. I doubt that you are going to be able to make much difference to her way of going now, she is too old, really.

This is what I was wondering really, she is croup high and long so her conformation is really not in her favour with quite straight back legs too. She has never learned to use herself properly so it must be really hard work to actually do it and at her age, it's unlikely she ever will be able to really bring herself underneath properly. It's just not natural to her. I am happy to give her one Danilon a day just to take away any pain she might be feeling. I have got a box of it that the vet gave me but I was reluctant to use it due to her having ulcers before. Other than the movement though, she doesn't seem to be in pain so I'm just torn about whether it is needed or not. She is on the vets joint supplement too.
I've thought about magnetic leg wraps but I wasn't really sure what location to aim for!

ETA: I did put her on the Danilon for about two weeks and it didn't make any visible difference so I'm not sure her way of going is due to discomfort or pain there either.
 
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Ellietotz

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Mine has known tendon / ligament issues (suspensory on left hind, probably DDFT on right fore - navicular damage on x ray) along with her arthritis and PSSM and none of the vets from 2 different practices have ever recommended box rest. In fact one of them said they rarely recommend it now apart from dealing with acute injuries / problems which need that immediate rest.

Can you go back to the vets after last night's escapades and ask again why box rest and would it not be better to have her out and moving, albeit in non ridden work?

That's really interesting to know.
I have emailed the vets again to explain what happened last night and whether it was worth being on box rest when I don't know if there is any improvement being made/what we are doing it for.

I forgot to mention, the little sod did escape a week a go for only a few minutes luckily but I got some of it on camera as I returned to find it prancing around. She had just gone barefoot too, she looks pretty happy with herself in my opinion!

 

Ellietotz

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Personally I wouldn't be box resting this horse the vet carnt find anything significant wrong other than a bit arithic sorry if I've misunderstood and you say the mare loves going out and is happy and not sore ?

That is correct, she seems happy in herself and not sore other than the awkward way of going.
 

Ellietotz

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I released her from her prison last night. She trotted around happily, excited to be free. Her gait was just her normal, possibly a bit stiff but it was pitch black so couldn't quite see so clearly probably not doing anything good being in anyway and better to keep her moving.

 

Slightlyconfused

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Honestly she looks like one of mine sometimes. He is 16:3 has very straight hind legs, croup high and chunky and he has broken himself for the third time in three years.

Five years ago he fell over and tore a middle stifle ligament so time off and rehab, came back from it ok but we also found arthritis in both hind stifles and he sometimes locks up on his LH and is crippled for a few strides when getting up from laying down then walks it off.

three years ago he tore his medial RH suspensory branch, box rest didn't work so we lobbed him out and ignored him other than body checks and hooves picked out for 8 months. Came back sound and slowly back into work, which is hacking with a bit of schooling but working as properly as his body allows.

Start of this year he did his lateral RH Suspensory branch, mildly which healed quicker and walk work by middle of april with a bit of trot by middle / end may.

Went lame again two months ago and his RH is sound but he has now done his LH Medial suspensory branch so winter off and see what happens.

I also have the added issue is that he is a prat in the field, mentally he is a 12:2 lightweight sports pony not a 16:30 700 is kg beast so tries to pull the shapes his body cannot handle. Under saddle he is a dope on a rope so his injuries are done in the field. He is 17 and has given us lots of fun so if he ends up being retired then so be it. He also has arthritis in all four fetlocks and some funky floating sidebone on a front leg.

What I am trying to say is sometimes they just keep breaking and there is nothing you can do about it. When he is stiff he has the same stilted walk and trot, when he is sore he just backs off. She seems happy in the field, if a bute trial hasn't changed anything is she in pain or is it just her?

Have you had any thermal imaging done? I know a lady who works with Vet IR and are very good. They will not report on the day but send the images to a vet to look at and report. It might be another option to see if they can see an area to look.

Also if you vet is really struggling to see it then maybe also have a look at these?
They have some brilliant videos on their FB page.

http://www.centaurbiomechanics.co.uk/gait-analysis/


I know its more money but it might give another answer / view for you as to your net port of call.
 

SEL

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I know you've had the PSSM tests done but she does have that short behind motion that's common with it - & also with a host of other problems! I see much less sound horses in full work daily though ?

If you've got a physio on board have you been given stretching exercises? I had to start small and use treats as rewards with my pssm mare but she's gradually starting to stretch out her tight hamstrings and it's making a big difference with her stilted action.
 

Ellietotz

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What I am trying to say is sometimes they just keep breaking and there is nothing you can do about it. When he is stiff he has the same stilted walk and trot, when he is sore he just backs off. She seems happy in the field, if a bute trial hasn't changed anything is she in pain or is it just her?

Have you had any thermal imaging done? I know a lady who works with Vet IR and are very good. They will not report on the day but send the images to a vet to look at and report. It might be another option to see if they can see an area to look.

Blimey, sounds like you've been through the mill a bit with yours.

I guess the thing is, she's never looked any different really, I don't think? From my video compilation in the original post, she's always had that weird short paced stride. She was slightly more head bobbing, very mildly, over the last couple of months and the vets thought it was back left from the video but when they actually saw her in person he agreed she had an odd movement but likely to be structural and didn't think there was any obvious lameness going on, or whatever it was was just very mild. The head bob seems to have gone now too just before box rest and she was looking loads better after exercise.

The bute trial didn't change her at all, she doesn't look or act like she is in pain, she isn't tight or stiff on her muscles anywhere from compensating that I could find now either. I do strongly wonder if it really is just her way of going.

I've never had thermal imaging done, I'm just really not sure whether its worth throwing more money at it when I think in my heart, there isn't anything there I can fix and I'm better off just seeing how she goes in the field and/or perhaps very light hacking like once or twice a week for under an hour.

It's hard because to some, she does look awkward and uncomfortable but when she actually moves properly, she can look lovely! It just makes me question if anything is hurting her all the time!
 

Ellietotz

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I know you've had the PSSM tests done but she does have that short behind motion that's common with it - & also with a host of other problems! I see much less sound horses in full work daily though ?

If you've got a physio on board have you been given stretching exercises? I had to start small and use treats as rewards with my pssm mare but she's gradually starting to stretch out her tight hamstrings and it's making a big difference with her stilted action.

I agree and it was one of the reasons I thought she had PSSM. However, her long body, short straight legs and croup high conformation might be what is actually causing that short behind gait perhaps? I ran out of vitamin E for about a week because post was taking ages to come and it honestly made no difference strangely, she still felt spongey so now I'm not sure if she does have it all. I've never truly seen her tie up that I know of either other than being a little stiff after a long ride on one occasion which I put down to this. I'm just second questioning everything I thought was PSSM related. The warmer rugs has helped though.

Yes, got a physio and she is really good with her. She has no issues doing carrot stretches and her front leg stretches are much better. Perhaps I will try working on her hamstrings like you say as they are definitely tight, probably from lack of use most of the time and I think trying to increase the muscle elasticity will hopefully help, not sure why I haven't thought of it before! Thank you!
 

Slightlyconfused

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Blimey, sounds like you've been through the mill a bit with yours.

I guess the thing is, she's never looked any different really, I don't think? From my video compilation in the original post, she's always had that weird short paced stride. She was slightly more head bobbing, very mildly, over the last couple of months and the vets thought it was back left from the video but when they actually saw her in person he agreed she had an odd movement but likely to be structural and didn't think there was any obvious lameness going on, or whatever it was was just very mild. The head bob seems to have gone now too just before box rest and she was looking loads better after exercise.

The bute trial didn't change her at all, she doesn't look or act like she is in pain, she isn't tight or stiff on her muscles anywhere from compensating that I could find now either. I do strongly wonder if it really is just her way of going.

I've never had thermal imaging done, I'm just really not sure whether its worth throwing more money at it when I think in my heart, there isn't anything there I can fix and I'm better off just seeing how she goes in the field and/or perhaps very light hacking like once or twice a week for under an hour.

It's hard because to some, she does look awkward and uncomfortable but when she actually moves properly, she can look lovely! It just makes me question if anything is hurting her all the time!



They like to keep life interesting.

To be honest, if she was mine with how little she has changed over the years, I agree the tail looks a happier tail in the recent pictures, I wouldn't box rest I would look at something like straightness training, ground work (lateral pole work) and add in some proprioception work and just slowly work her in a way that will benefit her body and see what happens.

You will soon notice a change if things start to hurt.

A few years ago one of mine was on and off not right behind but the vet couldn't work out where. So we rode him until he broke a bit more, sounds not nice but other wise we would just keep throwing money at him. We found out where he had injured himself and fixed him.
 

Ellietotz

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They like to keep life interesting.

To be honest, if she was mine with how little she has changed over the years, I agree the tail looks a happier tail in the recent pictures, I wouldn't box rest I would look at something like straightness training, ground work (lateral pole work) and add in some proprioception work and just slowly work her in a way that will benefit her body and see what happens.

You will soon notice a change if things start to hurt.

A few years ago one of mine was on and off not right behind but the vet couldn't work out where. So we rode him until he broke a bit more, sounds not nice but other wise we would just keep throwing money at him. We found out where he had injured himself and fixed him.

That sounds like a good idea. Thank you.
I did exercise her quite hard everyday for 6 days just before box rest as a test and she wasn't looking any worse in my opinion. She was a little touchy around the hind pasterns but I wasn't sure if this was normal to her or not. We usually go on quite long hacks, even after a 3 hour one at the beginning of summer, she was absolutely fine so I'm hoping light hacking will be okay for her. I'll look into hind leg/hamstring exercises I can do to see if I can improve this. Her hamstrings are usually the main thing that I find are tight.
 

Ellietotz

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I would stick her on some bute and retire her to the field. She's lame, looks to have been pretty compromised throughout the time you have owned her and I don’t see how much intervention with not much money can realistically do much good

But there's nothing to show she is actually in pain? The bute didn't make any difference to her before. She still moved the same.
 

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I wouldn't box rest I had a mare very similar didn't look right was diagnosed with arthritis is hocks and stifle at 14, I still rode her lightly she was a very forward happy go lucky horse that enjoyed a jolly round the woods, I kept her in light work a little trot canter but she was on Bute, I found the gentle exercise helped she was much worse without it even with just turnout, I would just see how she goes, this was nearly 20 years ago so I know treatment and diagnostics have changed but if you have no insurance it doesn't sound like it's worth just chucking money at her, everyone sometimes copes with a bit of discomfort some cope better and enjoy doing something regardless, you have done your best for her you have been a good owner.
 

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I wouldn’t imagine box resting will do any good here really. How old is she? She’s certainly not sound and I’d probably be tempted to retire her to the field on some Bute given her history and how she looks, but if you really want to continue riding her, perhaps tootle out in walk a few days a week for a gentle hack.
My PSD, hock arthritis and SI joint disease horse will trot a little short behind for the first few minutes on a circle if she is worked straight from a night in the stable (always sound on the straight). Box resting her would not work at all and I almost make sure she goes out for a few hours before she works.
 

9tails

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Does she have any bodywork treatments? While she is obviously conformationally compromised, unlocking the muscles that may have tightened up to compensate may loosen her off a bit.
 

ester

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Its not just her confo that is causing what you see, I'm genuinely surprised at how poor she has been behind since the start and she is probably a case of diagnostics can only show you so much.

I would not consider doing any straightness training with her, it requires them to move the weight behind and it would be unfair to ask that of her.
 

Northern

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ET, you seem to be going around in circles and have been for months. All your asking for advice threads end up the same way.
Your mare is lame, likely in multiple limbs. IMO she's not moved comfortably for years. She may seem happy, but that is likely because consistent low level pain is her "norm". I applaud you for trying to figure out ways to help her, but you're up against a brick wall if you are unwilling (or can't) spend the money looking into it. I understand that is your situation! But sadly you need to come to terms with the fact that it is not ethical to continue to use her as a riding horse in this state.

Your vet has suggested box rest, because that is their standard treatment advice for owners unwilling/unable to do further diagnostics on the horse. Rest can improve acute tendon/ligament/muscle issues, so that is covered. What else can they do? Vets don't have xray vision, as much as we would like them to have! For what it's worth, I would not box rest a horse like this with confirmed arthritis probably progressed), I would chuck her out in a field to live her days and monitor her comfort levels as appropriate if unwilling to investigate further.

I understand money is an issue, but there are ways around this. You can discuss payment plans, 0% credit cards, you can throw her out for a year and save up. Supplements/chiro/massage/magnetic wraps (though they have their place) is throwing away money you could spend on basic diagnostics and pain relief for this horse.

I really understand your dilemma, I have been there. Not knowing what is wrong and dithering around trying things and getting 24235 different opinions WILL drive you crazy, it certainly did to me!
 
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