Stall Rest: Laid Up or Losing It?
Staring at the same four walls for days--or weeks--on end is never a welcome prospect. For some horses, however, it's just what the doctor ordered. Stall rest--a term that all horse owners and stable managers dread--is generally prescribed following severe injury such as fractures, large wounds, surgery, and in some cases of lameness. How strictly imposed the stall rest is depends upon the severity of the diagnosis.
"Let's say you have stitches over an area that, with a lot of movement, will rupture," illustrates James Pelura III, DVM, MS, of the Davidsonville Veterinary Clinic in Davidsonville, Md. "In that instance, confining the horse to just a small paddock would be good. It depends on the injury, and how much movement is going to cause an exacerbation of that injury."
"There is a little bit of range (when it comes to) stall confinement," says Clifford Honnas, DVM, professor of orthopedic surgery and lameness at Texas A&M University's College of Veterinary Medicine. "For example, with some cases of joint surgery, I will confine the horse to a stall for 30 days, but I will allow the owner to take the horse to a little patch of grass and let them munch for 15 or 20 minutes. It's not going to do anything to rehabilitate the joint, but it helps keep their minds right. They get so much energy pent up from being in a stall and having nothing to do."
One of the most severe cases that Pelura has treated involved a patient recovering from elbow surgery. The stitches were in an awkward place and would tear if the horse bent his joints to get up and down. To prevent this from happening, the horse wasn't just confined to his stall; he was cross-tied as well. The stall rest lasted for 30 days.
"We did some extreme things," Pelura recalls. "We cut extra windows in the stall so it was open, and we had him in a position so he could see his buddies out in the paddock next to it." The horse's hay and water were placed in an easily accessible location, and plenty of human interaction was prescribed. "There were a lot of people grooming him, talking to him, and giving him treats so that he could relax."
When she spoke to The Horse, Kathy Lovingood, co-owner of Lovingood Springs Farm in Louisville, Tenn., was nursing a Saddlebred for an eye injury. In this case, Lovingood imposed stall rest for practicality's sake--the horse was being medicated six times a day. "He might be able to go out in the field, but I can't go and catch him every time I need to put medication in his eye," she explains.
With a barn full of horses in her charge, Lovingood is meticulous about managing the administration of medication. "When you have several different medicines and you must give them (to the horse) at different times of the day, you need a record," she says.
At Lovingood Springs Farm, a record is posted on the horse's stall, detailing dates, times, the prescribed medicine, and the dosage. When the medication is administered, the person responsible must initial the appropriate slot.
"This way, the owner can see who has medicated the horse, and the stable manager can keep an eye on the medication," Lovingood explains.
Arguably the largest issue surrounding stall rest is keeping the horse calm enough so that he heals properly. After all, a stressed-out, frantic horse is hardly a candidate for a winning recovery. Half the battle can be won with appropriate food.
"You want to minimize the amount of energy in their feed," advises Alan Goldhahn, DVM, of Lodi, Calif. "You want to take away the grain and decrease the amount of protein in the hay because they are not going to be expending much energy--and you certainly don't want them to. You want to keep them as quiet in the stall as you can."
It is also advisable to decrease carbohydrates due to the lack of activity and need for energy.
Pelura notes that strategic feeding can help achieve several goals. "If they are given a lot of hay, it helps to keep their bowels moving, but it also keeps them from becoming bored," he says. "Horses need to be moving around to ensure proper digestive functions; I try to feed them all the hay that they want. It requires a bit more stall maintenance, but it can usually help to avoid colics and impactions."
Occasionally feeding a laxative type of meal, such as an oily bran mash or another type of laxative, might be recommended to help bowel function.
Conditions of Confinement
While stall rest might be prescribed as a means to recovery, horse owners should be aware of conditions that can become aggravated as a result of being cooped up for a prolonged period of time.
A dusty barn with poor ventilation is not a healthy environment for the convalescing horse. "People tend to like to close everything up. (For horses) I like a lot of air, with everything opened up," says Pelura. He used the illustration of a case where an injured foal must be stalled with his mother. "I usually tell people to get down on the floor of the stall to see what the air quality is like down there, because that is where the baby is going to be. When you are standing up the air is pretty good because you have windows at eye level. When you get down to where the baby is, the ammonia will kill you."
Pelura emphasizes the importance of regularly stripping and cleaning the stall to keep it as clean and dry as possible. If you must clean around the horse, avoid creating clouds of dust when moving bedding.
Horses on stall rest are generally bedded slightly deeper than normal, depending on the bedding that is being used. With wood shavings, Honnas suggests that horses are "bedded deep enough so that they are not going to slip getting up. Bed them so that you improve their comfort level when they are laying down and getting up."
Even the most conditioned horse will get a little stiff when his movement is confined to a 10x10-foot or 12x12-foot area. Simple massage can help to alleviate any discomfort, Pelura suggests.
"You can manipulate the limbs by massaging them up and down," he says. "If the limbs can be bent, bend them--pick the leg up and flex it. You are going to be picking out the feet every day if you can lift the leg, and things like that will help."
In some cases, stalled horses will stock up--a development that isn't usually something to be too concerned about, according to Goldhahn. "I think that stocking up, probably 90% of the time, is not significant; it's a symptom or secondary effect of the stall rest," he says. "Things aren't moving, so the blood doesn't circulate. But as far as it being a health risk to the horse, I think it is rare."
The longer the stall rest lasts, the more muscle tone the horse will lose. Goldhahn warns horse owners to be prepared for this. "It will take them a period of time to get back in shape, and we would do this slowly because of the condition that they were stalled for," he says. "It's not something where you can go back to full-speed work immediately. It's going to be a mutual buildup of increased workload for both the conditioning of the horse and the injury."
Back to Greener Pastures
When the time arrives for the horse to be released from his confinement, horse owners are cautioned to make the transition gradual. Re-injury is to be avoided at all costs, as it will only result in more stall rest.
"I usually have them transition out from the stall to a pen, where the horse can move around a little bit without getting a head of steam. That gets them more accustomed to moving around without being in a full pasture where they run, buck, and kick," says Lloyd Kloppe, DVM, Dipl. ACT, at the Durango Equine Veterinary Clinic in Buckeye, Ariz. "I usually have them work out from a 12x12-foot stall plus a 12x12-foot run, to maybe a 20x40-foot pen, to maybe a 40x40-foot paddock, then out to a pasture."
Granted, not all stables are so well-equipped. When smaller turnout paddocks are unavailable, Pelura offers this advice: "We start by hand walking for a period of time, then maybe a bit of longeing, then turnout in a big field for a restricted period of time," he says. "You would slowly lead them (to the point) where they are out with the rest of the horses."
In some cases, horses will be lightly tranquilized during this transition to ensure that they don't get too carried away.
The physical make-up of the pasture will also dictate how this transition is made. A field of rolling hills is going to be more difficult for a recovering horse to navigate than a flat patch of grass.
Lovingood notes that significant absences from the herd alter social dynamics, requiring owners and stable managers to carefully plan re-introduction. "You never want to turn the horse back out directly into the herd," she says. "I do that slowly, by introducing him to one or two horses at a time, and then more of the herd. The other problem is if you are taking him from a dry hay situation and putting him on grass. You've got to do that very slowly or the horse will founder or colic because of the change in quality and character of the feed."
Ultimately, the stall rest should be a quiet affair. If it isn't or if your horse is showing signs that it won't be, you will need to take some steps to calm things down.
"I have had some horses that get so crazy in the stall that they do better turned out," says Pelura. "If you have a horse that hits the walls and is constantly circling, he will spend more energy in a 10 x 10-foot stall than he would if he were in a small paddock."
"The overall goal is to rest the horse," says Kloppe. "If the horse is going to pace in the stall, then you need to do whatever you can to change that. There will be some horses that will get more rest turned out than left in a stall by themselves; you just have to see what the options are."
Some suggest that the presence of a four-legged "babysitter" will help to alleviate some of the separation anxiety a stalled horse might feel when he is away from the herd. Other horses, donkeys, and goats have successfully served as companions for this purpose. Pelura notes that human interaction is especially important during this time. "Get down there and groom them, talk to them, tell other people to come by and see them," he instructs. "It makes a big difference."
Enabling the horse to properly view his surroundings helps him to feel as if he is a participant in the barn's day-to-day activities, thus keeping him focused on something other than his confinement.
"If horses can hang their heads out the stall and look up and down the barn aisle, they seem so much happier," says Honnas. "It's no different than if you or I were put into solitary confinement without being able to see our environment around us; it would drive us crazy. If we could see a little of what's going on and participate in life a little bit, it provides mental stimulation."
About the Author
Carolyn Heinze (carolynheinze.blogspot.com) is a freelance writer/editor. She currently works from her pied à terre in Paris, France, where she continually dreams of convincing the French Republican Guard to let her have a go-round on one of its magnificent horses. One can dream, can't they?
POLL: Horse Insurance