Box Rest Blues/Drama - Some Advice Please?! :(

[AGray825]

Hi all!

Not actually that new to this forum (was here and number of years back under a different name)! But I've returned desperately seeking advise or opinions on this...

So for our history: Monty is my young ISH (4yo, not officially backed but been sat on), who a few months back started being slightly lame (1/10th), had vet out to check who suggested possible footsoreness (due to hard ground and his super flat feet ) and wanted my farrier to put shoes on him. I said 'okay then' and off i went to contact farrier who couldn't come out to shoe him for a number of weeks for a variety of reasons, I said 'should i get another farrier to do it' but my normal farrier insisted he be the one to shoe him first because he knows his feet! (been trimming them since he was 15months)

ANYWAY... as fate would have it, we had to cancel and postpone the appointment (Monty was obviously not doing work at this point) due to my older boy being my more immediate issue as he had contracted front tendons and on the day of the appointment had to be taken to Cambridge Equine for a last ditch effort to save him with experimental treatment... two weeks later he suffers severe intestinal colic and had to be pts anyway... worst day of my life but at least I was able to hold him and say goodbye to him at the end

So Monty wasn't actually shoe'd for a good month or so from when the vet had suggested it. Lameness hadn't gotten any worse so thought 'annoying but he's not doing anything so we'll deal'
Then after the shoeing (which farrier was hesitant to do anyway since he didn't think it was footsoreness) he went downhill. Day after I had a different vet (same practice but normal vet was on holiday) come out and she didn't listen to a word we said when we tried to tell her he was lame before the shoes went on, blamed the lameness on the shoes and ripped the shoe off the sore foot and suggested box rest until normal vet came back from holiday to do a lameness workup.

Needless to say two days later he went hopping lame and I called the emergency vet. He came out, initially suspected an abscess, but thought 'let's just x-ray him first to be safe' and x-ray showed that he had a fracture on the wing of his pedal bone

X-rays were sent to NEH who recommended surgery as while the fracture was not displaced, it was more 'apart' then they were comfortable with and wanted to give him the best chance of a return to full soundness.

So off he went, surgery was uncomplicated, stayed at NEH for just over two weeks (£5k down the drain because stupid me postponed insuring him... no need to say anything, I'm slapping myself enough as it is!) and they then prescribed another 4 weeks of complete box rest (no in hand walking, just stay in the box)

Normal vets came out to re-x-ray last week and turns out he's managed to shear the screw. Fracture's looking okay but the screw is broken in there. Likely because, within the last couple of weeks, he's been kicking at the doors and walls, bucking and rearing in the middle of the box, generally being a prat! He is, however, walking sound in a straight line and on a 20m (ish) circle.

So now for my dilemma (if you want to skip the history bit)

Normal vet that diagnosed the fracture and knows Monty very well recommends restricted turnout with Sedalin for the first couple of days of turnout and then see how he goes.

NEH vet that performed the surgery would rather he be kept in for another 6 WEEKS! (Even though he's likely caused himself more problems in the box anyway) and for him to have special glued shoes that will cup the foot apparently and keep everything in place, to be put on by NEH's farrier.

Today we tried to load him to take him back to NEH for the shoeing and a re-examination and it was impossible! He'd been dosed with calmer, bribed with foot and all he was doing was pratting about, kicking, rearing, dancing around the ramp and made himself sore in the process. We gave up and cancelled the appointment at NEH and now I'm waiting for a phone call from the vet there (been 2 hours and heard nothing yet!)

So I'm all for the shoeing, but what would you do about the turnout? I think he's losing his mind in the stable, I've given him toys and company and a radio but he's getting frustrated and angry to the point where going in there with him is almost dangerous if you don't give exactly what he wants!
But I know fractures don't heal the same as tendon/ligament damage and I don't want to set his recovery back anymore than it already is!

If you made it through all of this thank you! And any advise or opinions would be really appreciated because I'm at the end of my tether here...

 

[ihatework]

You have been through the mill on this!
If you are going to continue box rest (which I might try to do for a bit longer) then you need to discuss some better, longer acting sedation. If there are specific times of the day that trigger prattish behaviour (e.g. Feeds / turning out) then I would cross tie for those.

Turning out and praying isn't wrong - I've done it plenty - but in this case I'd be inclined to try and get the box rest working. Any chance the remedial farrier could come to you?

 

[Orangehorse]

I really feel for you. Vets blithely tell you to box rest and your normal calm horse turns into a raving lunatic. Some seem to cope OK and the ones you might expect to be bad are OK and the dope on a rope quiet one can't stand it. I have never had to deal with such a long period of box rest.

Mine had box rest, but could be grazed in hand. When returning to work he went mental (heaven knows how he didn't re injure himself or cause me/him damage) and in desperation I sent him to a livery stable for a rehab, where the YO was very surprised at his appalling behaviour as he is normally very calm and quiet.

I think you have to say to your vet that he is risking more damage by being in and can he have an "outside" stable in a pen and have sedation. Mine was given Bromide every day as prescribed by the vet it was only about 1 teaspoon every day and is out of the system in 24 hours. He was on that until he came home after about a month, he was stabled BUT he was also being exercised until he could do 1 hour's work. Beware colic when first administered. Vet said it is what is given to TB colts when breaking in.

 

[AGray825]

Thank you both for your replies!
Still haven't heard from the vet yet (we're next on his list according to the secretary!) but I've bitten the bullet and put him out in a tiny paddock with half a tube of sedalin gel (as per normal vets instructions)

Very very calm at the moment and grazing happily (had a terror moment when he rolled and almost got himself caught up in fencing ) but will keep fingers cross at the moment and if NEH vet is absolutely insistent on more box rest then I'll have to comply but at the moment he seems okay. Will have another check on him in half an hour (benefit of having him at home!)

If this works he'll be out for 8 or so hours, then back in again overnight, that way I can make sure we have no flare ups or anything. Also I'm going to switch him from Placid to ProKalm to see if that has a stronger effect (I'd rather not give him too much sedative-type drugs because he's extremely sensitive to it)

 

[doodle]

Robin was horrendous on box rest. Spinning, rearing, bucking, threatening to jump out of the window, throwing himself at the door. He was sedated every day with little help. After 7 weeks I asked the head vet to come. He took one look and said it couldn't continuum. He iv sedated him, we made him a tiny pen in the field and he went out, still coming in at night. We had a long blunt chat and accepted it could go very wrong and if it did then pts would be discussed. He was happy going out in the day only for about 10 days then started getting upset at night so he went out full time. The only issue I had was when I moved his pen to fresh grass, he forged himself and gave himself colic. From now on if he needs box rest he will have a pen in the field of be pts.

 

[texel]

Certainly a tricky situation; not easy for horses to cope with box rest and it can certainly and quite understandably cause them to freak out as they have evolved to move. Some just cannot tolerate box rest they can't understand the need of course.

Can you perhaps cordon off an area infront of the stable so that your horse still has a restricted area but can choose to be outside of the stable ? Or a field shelter with an area fenced off with electric fencing ? It may help to get him a small companion he can see nearby ?

You could place apples in a bucket of water to give him some amusement he can play the apple bobbing game, there are other 'toys' you could try and maybe a mirror ? a selection of small holed hay nets ?

All the best x

 

[Sparemare]

A tiny paddock sounds the best solution if he can stay calm.

 

[AGray825]

So a bit of an update on this:

We gave him a small paddock outside. Initially gave him the Sedalin but he went really weird on it so I didn't want to risk anymore of that knowing his sensitivity to IV sedation!

Unfortunately the little brat managed to break out of the small paddock and ran out in to the big paddock

Right now we're letting him have the bigger paddock on his own. All he's doing is grazing and plodding about the field and then coming in with friends at night (which in my mind is far less damaging than constantly kicking the doors and walls) and his mental state is significantly improved.
So far he looks no sorer than he was on box rest (and obviously at the first hint of him looking any sorer than back in the box he goes). If anything he looks slightly improved compared to how he was before (I assume because his muscles have been allowed to loosen up) and can turn on the bad foot a lot better than before.

He's essentially now got all the time he could want to let nature do the rest of the healing. Any more time in that box and I'm convinced he'd have gone completely raving mad. It was already at the point where he was becoming nearly dangerous to go in with!

Is this sensible, or do you think I've done the complete wrong thing? I'm stressing myself out now thinking about all the way this could go wrong!

 

[wyrdsister]

Not the same injury, but I had to turn out one of mine immediately post kissing spine surgery. She was hurling herself around the box. Started going up vertical and bunny hopping on both hind legs. Vet who did the surgery took one look at her, gave me a tube of Sedalin and said "Put it in the field before it kills itself or you!" Her recovery was longer than it would have been on box rest, but recover she did and with her sanity intact. I lost her 12 months later to hind leg issues where surgery and protracted box rest were the only options. Vet and I accepted she'd never tolerate it :-( I've since rehabbed a few other issues without box rest, either a pen or larger turn out and they've done fine. Quiet is best.

 

[Landcruiser]

I winder when and how the fracture happened? Does your vet have any idea?

I also question why the vet would ask you to put shoes on a barefoot horse not in work. If the horse was lame due to being "footsore" did the vet not think to address the problem not the symptom? All shoes will do is to mask the problem, whatever it is. And exacerbate the problem over time.

Lastly, I question why vets advise box test so flipping often. Keeping a horse in solitary confinement, literally in a box, causes stress and distress, which does nothing to help healing, let alone when they start cavorting round and kicking in such a tiny space.

Many times, there are other, better ways than "This is what we've always done". I wish more vets would consider this...

 

[JoandGuy]

Hi, I have a 5 year old on potentially 6 months box rest! Vet has mentioned he could go out in stable sized pen, where did you get yours from? I've looked online but can't really find any affordable options!

 

[AGray825]

Do you mean did I get the pen from? Cause the pen he lasted two days in before breaking out of was just electric fencing and tall plastic poles.
Monty was a bit of a special case in that he'd been in two months already and couldn't cope with still being in a small area. I have used electric fencing and poles successfully before with my old boy after 5 weeks box rest! That's the cheapest option imo but it is worth making sure the charge on your electric tape is strong!

 

[AGray825]

Not the same injury, but I had to turn out one of mine immediately post kissing spine surgery. She was hurling herself around the box. Started going up vertical and bunny hopping on both hind legs. Vet who did the surgery took one look at her, gave me a tube of Sedalin and said "Put it in the field before it kills itself or you!" Her recovery was longer than it would have been on box rest, but recover she did and with her sanity intact. I lost her 12 months later to hind leg issues where surgery and protracted box rest were the only options. Vet and I accepted she'd never tolerate it :-( I've since rehabbed a few other issues without box rest, either a pen or larger turn out and they've done fine. Quiet is best.

See that's about the stage we'd got to when I decided to put Monty out. How he managed to do canter stride in a stable I'll never know! I'm hoping when he's sees his surgeon next week he won't have any complaints about his progress. I accept it won't be as fast as it would be on box rest but I'd rather it take a year and him keep his sanity, rather than it take 6 months and having a dangerous horse at the end of it!

Sorry to hear about your girl though But at least your thought of her comfort as priority. I know a lot of people that wouldn't have done that.

I winder when and how the fracture happened? Does your vet have any idea?

I also question why the vet would ask you to put shoes on a barefoot horse not in work. If the horse was lame due to being "footsore" did the vet not think to address the problem not the symptom? All shoes will do is to mask the problem, whatever it is. And exacerbate the problem over time.

Lastly, I question why vets advise box test so flipping often. Keeping a horse in solitary confinement, literally in a box, causes stress and distress, which does nothing to help healing, let alone when they start cavorting round and kicking in such a tiny space.

Many times, there are other, better ways than "This is what we've always done". I wish more vets would consider this...

I'm not entirely sure when or how it happened. He's always been a gangly clumsy thing, legs grew far too fast for his body! It could have been a few months before when my mum's TB was put down in the field and he went absolutely mental round the field.

Honestly I ask myself the same question about my vets. Not so much about the putting the shoes on in the first place (though I wish I'd listened to my farrier instead because he wasn't keen on putting shoes on in the first place)
I'm super angry about the second vet that ripped the shoe back off without listening to what had happened previously. Frigging visit cost me over £100 and all I, personally, think she did was separate the fracture and cause the need for surgery! (not that I can prove that but still...)

So far all things look positive on the turnout front. Looks no worse in his stride (even though he's stupid and keeps wanting to trot and canter! ) and there's no heat or swelling anywhere so I think we're safe! (Let's see what's said next friday )