Rehabilitation post op - dreading it...

Bav

Bav

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The horse not me.
3 weeks post op is Tuesday, one week post staples out (I need to confirm whether the rehab plan I received from Rossdales is actually for the date of her operation, the date I brought her home or when she had her staples out because I've had conflicting advice)
Mare had lateral hind splint bone out for sequestrum.
I'm supposed to be hand grazing for three weeks but she much prefers standing on her two back legs and going right up. Considering she is a fruity mare at the best of times and she's been on full blown box rest for 13 weeks, you'd think that she would want grass. Nope.
She's started to go mad inside her stable. Kicking the partition the minute horses are brought back in from the field and although she's not climbing out she has started bunny hopping and generally being a prat when there's lots going out. I can't blame her or be angry because I'd be the same after this amount of time.

She's on 2mls Sedalin twice a day but it's making no difference. I don't particularly feel safe grazing her. But it's only going to get worse/be the same when we reach the next mark of going out in a small paddock.
Last time she had box rest she had practically an entire tube of Sedalin and still turned herself inside out when in the field. I'm absolutely dreading it. The vet suggested, when the time comes, maybe getting on her and walking her for ten minutes but I can't even lead her to the grass next to the mounting block without her throwing an absolute fit so how am I supposed to get on?
Gah!! She needs to go out in the big field and get it out her system. But equally she can't because she needs to heal!!?? I worry in the small paddock she'll be more likely to injure herself skidding in the small area and turning sharp circles.

Why are horses so difficult?? What do you guys do when you have to rehab a skitzy horse?
 
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Mine absolutely could not cope with box / small paddock rest (tendons) even on copious doses of ACP - in the end we just chucked him out on the basis that galloping in a straight line was better than spinning/ box walking / weaving for hours at a time.

If I had one similar again I'd turn it out 24/7 (to avoid the morning hooley) with the oldest, slowest company I could find to try and keep the peace - but I think you need you vet's advice.

I feel your pain!!!
 
In your situation, I would turn her away and turn my back! Splint is a better bet than tendons.
 
I lead them from another horse with a second person on a third horse .
Fatty is on box rest ATM we even trot him up from another horse .
 
Not advice but followed your posts with your mare and you've had rotten luck I'm sorry. I would say though that when Basil turned savage/dangerous after extended box rest when he was younger his owners sent him away for rehab. Sometimes it's better to just let professionals deal with it where they have the correct set up.
 
Thankyou for all the replies I really appreciate it!

I know she's never had anything life threatening so my problems don't compare to ones I know my lovely fellow posters have had to endure. But on one hand that makes it soooo much more depressing! This is the second horse I've owned that's required surgery to remove the exact same bone on the exact same leg. But this mare just isn't coping and it's turning me into a frazzled mess!

Turning my back sounds like a good plan, ignorance is bliss! In all honesty my vet has been fairly good with the whole thing. But is sooo vague with her rehabilitation. I suspect that's because she too doesn't really know what to suggest. In her own words Fizz's recovery isn't going to be 'conventional.'

Apart from the wopping bill I received from the hospital, part of me was slightly relieved they kept her for an extra week, so they could deal with her 'hand grazing' at the beginning. Hence why she was sent home with tubes of Sedalin 😂
 
ycbm said:
In your situation, I would turn her away and turn my back! Splint is a better bet than tendons.
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This ^^^^ wish I'd done this with my old palomino, I tried walking in hand, and riding but nothing calmed him down and we then went for a small paddock gradually getting larger, but he didn't recover from him injury. If I'd turned him away from day 1 I think there would have been a better chance.
 
An Arc Equine worked very well when I had a TB on 3 months box rest and restricted walking. He was completely chilled, until I stopped using it, then was a different beast! You can hire them.
 
I presume she's being led in a bridle with you wearing a hat and gloves as standard? Rehab is so frustrating isn't it. Can you build a stable sized pen in the closest field to the stables (double fence it and make the fencing as tall as possible), really dope her up and turn her out that way? She shouldn't be able to get up any speed in a pen that size and you can gradually increase the size of the pen and lessen the sedative? Alternatively you could just chuck her out and hope for the best. Either way is nerve racking I think! I hope it works out well for you.

Ets- it might be worth being firm with the vets to get some clarification around their expectations going forwards to. Luckily in my experience, most are sympathetic to not going by the book as they understand the horses haven't read the book!
 
Mine had splint bone surgery with around 14 weeks total box rest, he would never have grazed in hand it would have been totally unsafe for both of us, he was walked, on sedalin, round the yard staying on the hard ground any steps onto soft resulted in explosions, I knew he would be worse on daily turnout he would have had a daily explosion and probably not settled as there was not much grass at that time of year so I told my vet that he was going to be turned away in a field that was full of grass but not accessible from the yard so he was transported there, he was sedated by the vet and turned out with a sensible friend and left for 4 weeks, yes he did go a bit mad despite the sedative but soon got his head down and relaxed far better than he would have if he had come in every day.

He healed up well, came back to a careful rehab plan and the leg is fine now, as long as the would has healed well and they have had some in hand walking to condition the limb there is not too much risk of further injury by turning away and it certainly reduces the daily explosions which are probably worse for all involved, vets can be a bit vague if circumstances do not allow the "perfect" plan to be followed but in reality we have to do the best we can, be flexible and realistic.
 
Don't envy you, these things are never easy, even with a horse that tries to be co-operative. Friend of mine had a horse with a similar injury and they used a horse walker in the early stages of rehab, as hand walking just wasn't safe for anyone. Might that be an option or are the constant circles not a great idea? Only other suggestion is you could try domosedan as an alternative to the sedalin, I have found it much better, although you do need to get it under the tongue rather than down the throat. But if she's that wired, oral sedation just might not work I guess. Very best of luck however you decide to go, and please prioritise your own safety, if you get injured it won't be any help to her!
 
Get onto the vet and understand exactly what the hand grazing is there to achieve .
If she has to be moved for the recovery of the injury ( as you need to do with a tendon injury) then walk her you must .
But grazing is diffcult the one we have on box rest the minute is very diffcult I would not hand graze it's a recipe for silly behaviour and a bang on the head .Dormosedan gel Gives you a more shorter but more profound effect it worth considering that .
Over the winter I had one in plaster it had epic quantities of sedation the horse who had not been stabled for two years would not have got through it without sedaline and dormosedan and we used industrial amounts .
I think you need to understand why your hand grazing if it's just for a bit of movement and because it's nice for her don't do it just shut her in her stable and get tell her to get on with it .
Or miss the grazing and just do the walking even if it just round the yard
On the wound I would consult a acpat trained Physio about using massage to stop the skin round the wound from getting stuck, you need acpat Physio because they will have learnt the techniques on people but it can really make a difference to the final event .
Other things and you have to know your horse some are best if you but a breaking roller and side reins on them it you need to know your horse .
If it's grazing because it's nice for the horse don't do if it's not safe my horse was tied up in a eight by six space for ten weeks not nice a the time but he's alive and happy now .
Have a think about what you can achieve and how put there's no point in turning the horse into the field with a wound site like that you might as well have saved the money for the operation .
No body likes managing box rest it's hard hard work time consuming and dangerous at times I can manage a fully fit competition horse on less time than I spend on a horse on box rest .
Think of what system will work best get into a routine and stick to it the time will pass and you will get through it .
 
OP, you know your horse & how she might react.
One re-hab ISH/Cob I had, we only managed a week of walking after box rest of 8 weeks following tendon work.
Vet (old pragmatic type) advised getting on as mare becoming rather dangerous in hand, so I did & after the 1st boing, mare then settled into this. However, I was a LOT lighter then and younger (invincible??).
Vet actually held her for me to get on & luckily my yard has no 'soft' but straight out onto hard but unmade lane.
This mare could be a right tit on the soft, but had never misbehaved on the hard, so I did trust her a little. We made week 6, but I wasn't happy with the healing, so shoved her in the box & dropped her off at a friends retirement yard for 24/7 turnout with no comings & goings to excite her. (like BP did above).
Brought her home in the July & put her on the hunting fitness regime so lots of walking etc & we managed 8 days dragging before xmas :)

Hope you can get the right regime for her, as every one is different.
 
Are there any vets on here atm?

I am genuinely puzzled. The splint bone is just a relic from the past evolution of the horse, isn't it? It hasn't got a job, which is why it can be removed if it gets broken and won't heal. So if the wound is fine, why is a lengthy period of box rest and rehabilitation needed after taking it out?
 
ycbm said:
Are there any vets on here atm?

I am genuinely puzzled. The splint bone is just a relic from the past evolution of the horse, isn't it? It hasn't got a job, which is why it can be removed if it gets broken and won't heal. So if the wound is fine, why is a lengthy period of box rest and rehabilitation needed after taking it out?
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Poss depends on any tendon & ligament damage done at same time?
Had almost all of the splint bone removed on one but had a deep tendon injury too as was kicked, that was the issue on re-hab, required 4 weeks box rest total, then box kept with 10 weeks of walking - with trot on the last 2 weeks at that time.
 
ycbm said:
Are there any vets on here atm?

I am genuinely puzzled. The splint bone is just a relic from the past evolution of the horse, isn't it? It hasn't got a job, which is why it can be removed if it gets broken and won't heal. So if the wound is fine, why is a lengthy period of box rest and rehabilitation needed after taking it out?
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It's significant wound and it takes time to heal if you want a good result you need to restrict movement .
It takes time for the site were they remove the bone to remodel and movement needs to be restricted during that
Mine had twelve weeks box rest after she came home the leg was imobised and in a pressure bandage at first it was a fantastic result, invisible wound healing skin completely free over the wound site she went on with her life as if it never happened.
 
The wound is of no depth to speak of though, GS, is it? And the bone has no function and doesn't move, so I don't get the remodelling, either. I wonder if any research has actually been done into horses returning to full work after a splint bone removal with no significant tendon damage. We do seem to be box resting horses more and more these days, and I can't help feeling a lot of it is to do with conservative management so that vets can't be sued if it doesn't work out.

Still hoping for a vet to enlighten us.
 
ycbm said:
The wound is of no depth to speak of though, GS, is it? And the bone has no function and doesn't move, so I don't get the remodelling, either. I wonder if any research has actually been done into horses returning to full work after a splint bone removal with no significant tendon damage. We do seem to be box resting horses more and more these days, and I can't help feeling a lot of it is to do with conservative management so that vets can't be sued if it doesn't work out.

Still hoping for a vet to enlighten us.
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I think that's nonsense more and more horses are having procedures that were simply not possible ten years ago they survive things and go on to have normal lives that would have had then shot not that long ago .
Vets need to give you the advice that gives you the best gold standard aftercare plan that get you the best result for the money you have spent on a horse . In OP's case the horse could not have survived in days before Surgery became roultine .
I rather have a conserative cautious vet that a one with a bung it out attitude.
I certainly think the vets I work with are much more open to the use of small pens and the like rather than the full box rest thing .
Your horse breaks a splint bone you are warned in advance what you will need to achieve post op ( although I think OP's vet has failed in the this respect because OP is not clear about what this hand walking and grazing is trying to achieve )
Box rest is fact of most horses lives in a normal lifespan most horses will,probably have a run in with injury and end up banged up as an owner you prepare for it suck it up and get on with it .
But it's so much easier if people need to teach horses to accept restriction before disaster strikes I think there are certainly more horses who have not been taught to have an easy relationship with the stable that's down to us as the owners .
 
I'm following this with interest. My youngster has recently snapped the splint bone on her near hind about 1cm from the botton end. Vet says he's seen '100's' of equines with a similar injury, and less than 6 have needed surgery or been compromised by the injury. She's been scanned as well as x rayed, and the fragment is well clear of the suspensory so we've been advised to crack on. She's always been sound on it, but there was a fair bit of swelling initially.

The OP's horse had sequestrum of the bone fragment though, which is unfortunate.

I agree with the general feeling that full box rest is often over prescribed, though.

ETA. Good luck with yours, OP. I hand walked a previous horse in an Equiami, it can be adjusted loosely enough to be suitable for walking but gives extra control and can remind a horse of its manners.
 
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ycbm said:
The wound is of no depth to speak of though, GS, is it? And the bone has no function and doesn't move, so I don't get the remodelling, either. I wonder if any research has actually been done into horses returning to full work after a splint bone removal with no significant tendon damage. We do seem to be box resting horses more and more these days, and I can't help feeling a lot of it is to do with conservative management so that vets can't be sued if it doesn't work out.

Still hoping for a vet to enlighten us.
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I looked for the plan I was sent but it has been several years and is long gone, from memory post op it was 10-14 days total box rest, was told not to take him to tie up outside even to muck out, to allow wound to heal in a pressure bandage that gradually became lighter, stitches removed at 14 days then lightly bandaged and walking each day commenced with a view to daily restricted turn out after 3- 4 weeks walking to tighten everything up a bit, mine had been on 6 weeks rest before the op so by then almost 3 months of barely moving which is putting ligaments and tendons unrelated to the injury at risk if they go out and mess about.

At the time I had nowhere that was suitable for restricted turnout, no grass in the easy to get to places that were dry and safe so we increased his walking and then turned away as already said.
The splint fracture itself is not a major issue it is the surrounding tissue that is vulnerable, if mine had happened in spring or summer it would have been easier to keep out but mid winter on wet clay it is not easy to get them out so we did what was best at the time.

I don't understand why the OP is supposed to be hand grazing if it is not safe, it achieves very little, mine could barely walk without getting wound up and when he did rear a few times it was set off by being allowed a quick pick of grass so that stopped straight away to keep us both safe.
 
The OP's horse had sequestrum of the bone fragment though, which is unfortunate.
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I am in no way suggesting that the OP's horses didn't need the operation, just in case anyone thinks what I'm about to write means that I do.

I have had two horses with sequestra. In the first case a Canadian trained vet said 'let's wait and see' and it was reabsorbed and the horse came sound in weeks. The sequestrum in that case was on the side of a cannon bone, the size of a thumbnail.

The second was a similar size on the inside of a forearm. The vet insisted it had to be taken out, but I refused to allow her to operate on a sound horse. The wound she said would never heal unless she operated closed with no scar a few weeks later. She was visibly shocked when she saw the horse out competing.

I Googled some interesting pictures this morning of very big pieces of splint bone reabsorbing.

I just can't shake the feeling that we sometimes intervene because we can, when nature is a great healer, with time.

I don't know if it is still the case, Goldenstar, but twenty years ago I was told by French people that French vets do not use box rest nearly as much as British ones. I think it's a subject worth discussing. I'm sorry you think it's nonsense.
 
I feel for you OP - my mare wouldn't box rest for a simple wound.

Healing has taken longer but myself and the vet have resigned ourselves to the fact that her wound management is also going to be unconventional.

Against the vets wishes I put her in the sand school with a friend and a pile of hay - much happier this way.

Any way of being able to think outside the box op? Maybe making a small paddock for him and a friend with a nice pile of hayledge? Or sending him to a pro/rehab yard or even retirement livery where he can just be turned away?
 
There's a recent ish post on here about my boy being an utter nightmare (and thanks to all the people who replied to me!) whilst on the 'controlled' rehab. Mine was all over the place, both ends bounced and a good session was one where one foot was on the floor at all times and I was happy if none of the feet reached my eyeline.

I agree with those who say find out why the grazing - was simply never going to happen in my case. He lost his brain on any kind of soft ground. Was walked in the car park for as long as it was safe. At 5 weeks of walking it became too dangerous (even with sedalin) and so he was put in an indoor pen cobbled together in the corner of the barn that was about 20 x 15 where he stayed for another 3 weeks. He was fine inside the barn so he did very short walking, but any attempt to leave the barn was bonkers.

My vet saw his behaviour when they came for one of his check ups and asked me to trot him up, and at their suggestion came out and sedated him with 'proper' stuff when we turned him out into his small paddock. We then fed him 30 sedalin for the first few days (he had to come in at night), but he was a different horse when he was allowed back out . I just made sure he was never the last to go out but within a week was doing the walk both ways in a head collar.

Also vet sedated him and all his mates when he went back out in the main herd (they are all mine and my sisters!) to prevent crazed honing.

I had my first canter on him in 5.5 months at the weekend. :D

Good luck, it's awful when you are just trying to do your best for them, but they don't know it.
 
ycbm said:
I am in no way suggesting that the OP's horses didn't need the operation, just in case anyone thinks what I'm about to write means that I do.

I have had two horses with sequestra. In the first case a Canadian trained vet said 'let's wait and see' and it was reabsorbed and the horse came sound in weeks. The sequestrum in that case was on the side of a cannon bone, the size of a thumbnail.

The second was a similar size on the inside of a forearm. The vet insisted it had to be taken out, but I refused to allow her to operate on a sound horse. The wound she said would never heal unless she operated closed with no scar a few weeks later. She was visibly shocked when she saw the horse out competing.

I Googled some interesting pictures this morning of very big pieces of splint bone reabsorbing.

I just can't shake the feeling that we sometimes intervene because we can, when nature is a great healer, with time.

I don't know if it is still the case, Goldenstar, but twenty years ago I was told by French people that French vets do not use box rest nearly as much as British ones. I think it's a subject worth discussing. I'm sorry you think it's nonsense.
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I do think it's nonsense to suggest that vets suggest box rest to avoid being sued they suggest box rest because it's the best choice in the situation .
If the owner can't achieve that well they they have work round what's possible .
I still can't work out why OP's horse needs hand walking for grass ,if it's coliced during the OP recovery it would be safer for OP to pull it grass and feed it in the stable .
There's no point in having it out the box fooling about and causing inflammation of the OP site .
In the old days horses diffcult to lead in hand during box rest had their shoes off and mega trim that slowed them down I saw that in my teens with racehorses .
 
Is there anyway you could set up a pen. My girl is on box rest at the moment ( only been 2 weeks and can be walked for 10 mins per day so nothing compared to yours!). But we have a stallion pen in the field which is quite small and obviously very high. The vet was happy for her to go out in there everyday as it is not much bigger than a stable. She can't have a hooley, but being in the routine of "going out" when the others do has helped her stay really calm. There is no grass in the pen so she has hay and doesn't really move at all!
 
Hi guys! Some definite food for thought on here!
It's been such a frustrating time as it took 8 weeks for them to decide to operate! I kept getting her re-x-rayed and told to wait just a little bit longer. A little bit longer. I understand the need to allow the body to try and heal itself but 4 weeks from the day she was kicked everybody was still sitting on the fence and in retrospect I wish they'd spoken to a surgeon then instead of waiting yet another 4 weeks. So in total, as of today we are 13 weeks since the injury happened and tomorrow will be 3 weeks post op.

I spoke to my vet this morning as this whole situation is stressing me (and I've been through it before, exact same bone and leg on a previous horse that also needed surgery) but this mare is just not playing ball. Again the suggestion was to up the Sedalin twice a day and carry on and then really dope her up in two weeks (at which point she can be turned out in a small paddock or walked in hand twice a day) but I just can't see it happening. Certainly not without costing me an arm and a leg in sedation. I could do with taking it myself!!
Soft ground or hard ground makes no difference and this morning she was waving her front legs around in her stable and managed to mangle one front shoe as well so I've had to gaffer tape it up until my farrier can get here. Arghhh!!

I think the hand grazing is just to break her into coming out of her stable in all honesty. Part of me just wants to keep her shut up in until she can be walked properly (har-har) or go out (again har-har) but it's such a vicious circle because the less I bring her out the worse I think she'll get. I think she might possibly be better once on, but I can't imagine how the heck I'd get on when two steps out she's on her back legs! The thought makes me feel somewhat ill.

The wound itself looks good, it's bone dry absolutely no discharge from anywhere, only small thickening of the leg, hardly a bump or a lump at all! It's scabby and looking a bit scaly from where she reacted to the clipper oil they used and when they scrubbed her up for the surgery. And this morning it was hot, but it's quite mild here in the midlands and the vet has still been wanting her in five hundred layers of cotton wool bandaging. I did tell the vet that I have swapped stupidly thick cotton wool for some gamgee and she was happy enough with this as I'm sure we are just cooking the leg now.

I presume (as there is no bone to actually heal) we are just trying to allow the tissue and ligaments and what have you to all knit back together and heal.

Gosh I hope she comes right it's been a dream of mine to BE80 and she's such a cracking horse when in full work.
 
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You will get there .
I just Went into the house and cried when I was told my horse would need to go into plaster he had not been stabled overnight for two years but I kicked myself up the backside and made a plan my fit young friend built the 'crate 'and in he went the night before the plaster went on .
I used masses of sedative we just kept him on it until he got his brain round the fact did not matter what he did we were leaving him in there and in time he entered a state of learned helplessness it was not a nice experiance but he's alive and sound and waiting to start work again and guess what he's happy in the stable now !
Every cloud has a silver lining .
TBH I think you will have to suck up the sedative costs forget the leading out and then turn out sedated when the vets happy and leave her to it .
On stabling it's my experiance on balance they are better in an internal stable were they can't see out and get excited I also think some need small stables were it it's just less fun winding yourself up .
I am harsh I tie them and leave them to get on with it .
But I always provide company for them ,mine that was in plaster was tied facing the bars of the box next door with another horse tied facing him in time as he settled we left the other horse loose with its hay net directly on the other side of the bars .
We did have to put the next companion horse going in to a stint into the stable before we took the other one out at first.
The whole thing was a complete chew I was with the horse part of every hour until two am and started again at six at first I was exhausted .
But he is alive and sound although time will tell when he works .
You will get through this .
 
I do think it's nonsense to suggest that vets suggest box rest to avoid being sued they suggest box rest because it's the best choice in the situation .
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Vet has two choices, box rest or not box rest.

Vet has no evidence to suggest that one will produce a better outcome than the other.

If vet says box rest and horse does not come sound them there is no chance of it coming back to haunt them that they did not take the conservative approach.

If vet does not prescribe box rest and the horse does not come sound vet leaves themself wide open to being sued for not taking the conservative approach.

I am very surprised that you think that scenario is nonsense, because I'm certain I've seen it with my own eyes more than once.

I'll give you one example of several. A horse of mine was discharged from hospital after being treated for an infected wound that was close to the hock joint but did not affect it. X rays and ultrasound all clear. His discharge papers said to keep him in until a review in two weeks at home. The wound was clean, healing and miniscule. The horse was sound . I cancelled the follow up visit and turned the horse out.

OP, I hope things progress well whatever you decide to do.
 
What would be people rather have a conservative and careful vet or a hey bung it and see what happens vet .
Some might think it because they are afraid of being sued but it's much more likely IMO that they take the careful belt and braces line to try to guarantee you the best result for your money and the horse the best result for its soundness .
If people choose to ignore their vets advice that up to them it's their money and horse to risk wasting .
Personally when I have put a horse through surgery or put in plaster I do every single thing I can to get the best result and that includes the hated box rest .
I know why people hate box rest the horses don't like it , its very hard work and ties you to yard with not much fun to be had .
I do think OP's vet needs to give her better advice so she's clear about why they want this hand walking and grazing .
The worst bit of C's recovery from the KS surgery was defiantly the hand grazing but we got through it . In that case it was necessary because it's done the encourage the neck to be lowered while the horse is moving so I had to get on with it but in OP's case I am not sure she can't get away without doing it .
OP have you got one of those snack ball things C loved that I filled it with grass nuts and he rolled it about .
 
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