KS Surgery Rehab

[HopOnTrot]

My mare is having KS surgery tomorrow. Diagnosed a year ago and re-X-ray shows further changes. She is having the ligaments between 4 processes cut.

2 weeks box rest followed by 6-8 weeks non-ridden rehab.

We don’t have a school so I will have to rehab in the field. I'm looking for ideas and thoughts on how best to rehab her. We have a local water treadmill and I think a local equine swimming pool too (although I need to investigate further).

I can long rein her round the local lanes. I could probably hire a school for lunging too if the ground is too wet to lunge in the field (she loves a buck and a fart on the lunge so this will be MUCH later in rehab).

Going to email physio and see what she recommends too. Horses are kept at home so I can do little and often with her. I also want to have a list of questions for the vet so any experience will be greatly appreciated. Are there any alternative therapies I should be looking at? (I've heard INDIBA Equus mentioned).

I'm in no hurry to get back on, she's a quiet 20 year old pony who does one lesson a week and lots of hacking, I just want her to feel comfortable for her remaining years. If we don't jump again that's not an issue (tbh now I am older we have no desire to go above 60cm anyway!)

What's the best way to set up her stable for her return? We have soft EVA mats and a small bed as they don't come in for long, but I'm going to build her a bigger bed for her 2 weeks of box rest. Can I use a treatball? Haynets or hay on floor etc? She also has EMS so I have to be careful with her sugar intake so things like a Likkit won't work. Will she prefer quiet or a radio on?

Sorry for the brain dump, I'm just aware of how important rehab is and whilst we had hoped to avoid surgery, it seems that what we've done to date hasn't been enough to keep her comfortable.

 

[HopOnTrot]

Wound care too!

 

[Lamehorses]

Mine was discharged with vet instructions for rehab. This mainly involved lunging in a pessoa
My physio tore up the sheet & gave me lots of groundwork postural work.
Search the likes of Jec ballou, visconte cocozza.
Daily stretches, pole / postural work & miles of long reining.
The importance is quality of work not quantity. Your horse needs to learn to use their body correctly.
Mine had 8 bone shaves & i didn't start riding for a good 6 + months, despite my vets instructions suggesting 3 months.
Good luck & expect backward steps for a while.
I'm 3 years post surgery & really happy did the surgery after spending 12 months being unsuccessful rehabing without.

 

[Birker2020]

My mare is having KS surgery tomorrow. Diagnosed a year ago and re-X-ray shows further changes. She is having the ligaments between 4 processes cut.

2 weeks box rest followed by 6-8 weeks non-ridden rehab.

We don’t have a school so I will have to rehab in the field. I'm looking for ideas and thoughts on how best to rehab her. We have a local water treadmill and I think a local equine swimming pool too (although I need to investigate further).

I can long rein her round the local lanes. I could probably hire a school for lunging too if the ground is too wet to lunge in the field (she loves a buck and a fart on the lunge so this will be MUCH later in rehab).

Going to email physio and see what she recommends too. Horses are kept at home so I can do little and often with her. I also want to have a list of questions for the vet so any experience will be greatly appreciated. Are there any alternative therapies I should be looking at? (I've heard INDIBA Equus mentioned).

I'm in no hurry to get back on, she's a quiet 20 year old pony who does one lesson a week and lots of hacking, I just want her to feel comfortable for her remaining years. If we don't jump again that's not an issue (tbh now I am older we have no desire to go above 60cm anyway!)

What's the best way to set up her stable for her return? We have soft EVA mats and a small bed as they don't come in for long, but I'm going to build her a bigger bed for her 2 weeks of box rest. Can I use a treatball? Haynets or hay on floor etc? She also has EMS so I have to be careful with her sugar intake so things like a Likkit won't work. Will she prefer quiet or a radio on?

Sorry for the brain dump, I'm just aware of how important rehab is and whilst we had hoped to avoid surgery, it seems that what we've done to date hasn't been enough to keep her comfortable.

I wouldn't recommend swimming for your horse, but a treadmill would be much better. Horses tend to swim in a upside down banana shape when they swim so this is the last thing you need. I would also invest in a PAP training band - they do not need to have a saddle to use this. Initially you need to start it off very relaxed and then over a few weeks make is shorter so the horse uses itself more but I'd check with your physio that this is a good idea first. https://fmbs.co.uk/product/pap-training-bands/

 

[ihatework]

Devil is in the detail on this type of rehab, your vets will advise (have a load of questions ready written down or else you will probably forget!) but importantly get you physio to show you … sometimes the success of the exercise is really subtle.

You deffo won’t want to be swimming a KS horse. Treadmill possibly but again the operator needs to be really clued up.

 

[HopOnTrot]

Great, thank you. I've started a notebook with a list of questions for the vet! No swimming then and possibly treadmill later on in rehab.
Re: Pap pad, I assume that will fit on a 13.2 in 5ft6 rugs? I will speak to vet/physio before starting anything of course.

I've never had a horse requiring surgery or rehab before (although we have had 12 months of carrot stretches that helped initially) so I want to make sure I get it right, also because I don't want to have to explain to my husband how much replacement horses currently cost, both of ours were under £1k!

Any good resources to read about it?

 

[tyner]

Something that I think is key on box rest is nutrition, especially for the connective tissue and wound healing.

When mine was on box rest I started giving turmeric for the anti inflammatory properties and it made me feel better. I don't know how good the research is for horses but I thought it can't do much harm and the human research is compelling "Natural compound found in spice may reduce excess stomach acid as effectively as omeprazole, first study of its kind finds". It's cheap and he likes it.

I also supplemented with calcium but you might not need to, check your feed and other things you have so you dont over supplement. "A Review of Three Decades of Research Dedicated to Making Equine Bones Stronger: Implications for Horses and Humans". Calcium is cheap. Also good on stomach and good for connective tissue.

Especially for an older horse want to make sure she is metabolizing all those good things so she can heal, the skin things like copper, zinc, iodine and of course vitamin E are important. Vitamin E especially if she's inside and on hay/haylage. Natural vitamin E is worth it.

My horse was a state when he got out of hospital. I was feeding all the right things but coat still not great when in recovery. Exhausting other options what really gave mine a bloom was Naked Horse Skin and Coat supplement. I don't know what they put in it and it's stupid expensive and comes in a dumb bright orange box that I feel like an idiot accepting from the Postie especially when it says '"Naked Horse" emblazoned all over it but it does something magical to them. I hate myself each time I open the box and the gift wrapping paper explodes everywhere. I'm still buying it months later because as soon as he goes off it is noticeable and I am weak.

 

[HopOnTrot]

I need to get more shavings tomorrow morning so I’ll add supplement shopping to the list! She just gets a basic balancer at the moment!

 

[HopOnTrot]

Looking at her balancer it seems pretty comprehensive which is sad as I fancied the orange gift wrapped supplements!

 

[Birker2020]

I did long reining in copious amounts. I did lots of equisage massage and had the physio attend him. I also lunged him on the flat and then eventually over raised poles as well as a whole raft of other ground work exercises over a four month period including Labyrinths and reining back between poles, walking over raised poles, trotting over raised poles. He got really good at it and would follow my leg movements, he actually used to step in time to me using which ever front leg I raised first. Incredible.

 

[ownedbyaconnie]

Have a look at my thread about ks rehab.

I’ll have to dig mine out but from memory this was mine.

2 weeks pure box rest.
4 additional weeks box rest with walking in hand on a flat surface, straight lines, twice a day.
Turn out in a small paddock (mine went out 24 hours as that was what she was used to and she is a sensible pony but most people stuck to day or night turnout)
Turned out in normal paddock once trotting under saddle (I have a feeling this is cause my pony is again very sensible and only interested in reading, I think my vet tends to say once cantering).

In hand walking
After 2 weeks box rest: twice a day 10 mins in hand on a hard surface in straight lines.
Each week up by 5-10 mins until at 40 mins twice a day.
Then move to one walk per day for 40 mins and one ride per day in walk at 30 mins.
Next week do 40 mins walk
50 mins walk
50 mins walk and 5 trot
Then the following weeks I added 5 trot and reduced walking to 30-40 mins till I got to 40 mins trot and then added in some canter.

The whole process from surgery to being signed off was probably about 6 months. It’s a long, slow process but done correctly it completely changed her way of going, her stature etc. I did a tiny bit of lunging at walk with no gadgets but tbh hate lunging and the one person I know that stuck to the lunging then has stifle problems.

She had regularly physio too, maybe every 4 weeks.

I also did things like fed hay from the floor to encourage her to stretch over her back rather that the awful position eating from a net puts them in.

And keep an eye out for ulcers. The whole surgery/box rest/having been in pain from the KS means a lot of them get it. And don’t be surprised if you end up lame somewhere else like hocks, coffin joints etc as the way they move to brace against the KS pain often causes issues elsewhere from compensating.

 

[HopOnTrot]

Vet has said no saddle until at least week 9 following a further vet visit To sign off. Physio is booked for week 3. Pony is super calm and sensible (and used to living out with her sensible friend) so hoping she can go out in a tiny paddock after the 2 week mark (vet appointment that day to remove stitches so I will confirm).

Pleased to hear you didnt do much lunging, we have no school! Vet’s plan has a load of lunging from week 5 but as we don’t have an arena I’m hoping resistance bands and long lining/in hand will be okay (I’ll be fit by the end of it) I’ll have to hire a school for lunging in canter as it will be December by then!

Gut health is a concern as she took 8 hours to poo when she got home, now she’s on soaked hay poo is very wet and it stinks. Did you feed a supplement to help this?

Vet has said no haynets which is hard with an EMS fat pony so I’m feeding her small amounts of soaked hay every couple of hours. I’ve ordered a slow feeder so I can give her balancer and chaff to break up the day, she has a treat ball too with her balancer.

Vet and physio are happy for carrot stretches and belly lifts to start so we’re doing them twice a day.

It’s certainly a commitment!

 

[ownedbyaconnie]

It’s a huge commitment but well worth it. You’ve chosen a crappy time of year though

I didn’t at the time and she was diagnosed with awful grade 4 squamous ulcers but had treatment and is now on aloe Vera and equimins fibre digester and touch wood hasn’t had another flare up. I see a lot of people have success with ponease also.

 

[HaylStorm]

Hey @HopOnTrot
Just wondering how you are getting on? My horse is on week 5 post-surgery and my plan sounds similar to the one you were given. Hope your rehab is going well so far

 

[HopOnTrot]

@HaylStorm vets tomorrow to get stitches out. I’m praying she can go out in a tiny paddock as box rest is exhausting!

Half term this week so physio is here next week so hoping to refine the rehab plan depending on her findings.

How is your rehab going so far?

 

[sport horse]

We had one done about a year ago and it is back jumping 1.30+. Follow vet instructions carefully - I too think nothing for first couple of weeks. Then straight lines, water treadmill was great. A really good physio with experience of rehab.

 

[HaylStorm]

@HopOnTrot our rehab is mixed so far! Long reining is going well but she has decided she is NOT interested in doing her carrot stretches anymore.. we have had a first water treadmill session and will continue with those. We have a review in 2 weeks to see about getting back on board which seems very soon! How are you getting on?

 

[HopOnTrot]

We had our first physio appointment last week, she was pleased that mare was tracking up more than last time she saw her. Lots of muscle pain to be treated but on the whole she was really pleased.

We started a couple of little in hand trots this weekend (no long reining as I can only find one lunge line, I suspect the other was used to tie up the gobby terrier at one point!) and I’ve started turned her out over night in a small paddock as she’s sensible out in the field and as she’s an older lady I don’t want her stabled for too long.

On the whole feeling very positive.

Also when walking in hand I can get her to lower her head by putting my hand underneath her nose. Doing this walking up a hill will be a good exercise, I think? No pressure involved, just asking her to lower her head.

I’m going to be so fit by the end of all this hand walking, especially with two dogs and a child on the lead rein!!!!