Some Words on Rehab: P1

I have rehabbed a few horses back from injury in my short life (well, technically it's a few rehabs, several on the same horse...Ernie was really good at messing himself up). I'm pretty practical when it comes to rehabbing, and it often means going against what vets tell you. This is a little radical for some people, but time and time again I've found that vets A) don't have enough training to deal with specific issues surrounding injured and recovering horse's care, and B) are great at getting the horse "healed", as in the injured site returns to an un-injured state, but not at all very good at telling you what specifically needs to happen over the course of the rehab to prevent re-injury and correctly train the horse.

Now, I'm not at all saying "Don't listen to your vet"...what I AM saying is do your homework. Read labels. Know your horse and what would and wouldn't work for them. Vets are a FANTASTIC resource, but they are ONLY a resource. They don't and can't fill in for every need you have when caring for your horse. Ultimately, you need to make the decision when it comes to a lot of things.

Thus starts a multi-part series on rehabbing a horse. This comes a great time, as I've been charged with assisting with the rehab of my BO's Trakhener gelding, who got into a horrible trail riding accident a little over a month ago, spent a week under intensive care at Vermont Large Animal Clinic (during which time he tied up severely), and has been on stall rest ever since. She, like many horse owners, was hesitant to go against her vet's advice but had a gut feeling that some of the recommendations weren't all the right choices for her horse.

For this first part, I'm going to touch on a few things immediately following the initial accident where the horse sustained Horrible Injury X. We will assume the vet has already been out, wounds have been sutured, cleaned, stapled, bandaged, etc. X-rays or ultrasounds may have been done. Drugs may or may not have been prescribed. In any event, we will assume that Horrible Injury X requires a period of stall rest followed by a slow re-introduction to work, whatever that work was.

There a several things you can do immediately following the accident to ease your horse into being confined, if that is absolutely necessary (a note on stall rest: I'm not a fan in the least. Horses, given the space, walk tens of miles every day. The movement is necessary to every function in their body. I am ALWAYS a proponent of allowing as MUCH space as possible depending on the injury...)

• Cut the grain. Your horse doesn't need it: he's no longer in work and his dietary needs will change as he recovers. Grain will make him hot, and horses that can't expend excess energy often end up hampering the healing process by stall walking and developing other vices. Instead, feed as much forage as he'll eat, making it available as close to 24/7 as possible. Use nets or bags to continually give him something to chew on. It'll help prevent stomach/intestinal ulcers and boredom. If he gets upset at feeding time, substitute a hay pellet and a mineral/vitamin supplement. He won't know the difference, believe me. 
• Know how severe of an injury you are dealing with. If it's a superficial or mostly-superficial flesh wound that doesn't have any bearing on major internal structures like tendons, ligaments, muscles or bone, chances are your horse will heal just fine with good care and regular attention to the wound. 
• In terms of wounds, less is more. Stay away from creams  the color of highlighters and anything with a name that you can't comfortably pronounce. Basic triple antibiotic ointment is honestly the best thing for wounds: it isn't caustic, it prevents infection and provides moisture in the early healing stages. Keep the area clean and covered until a scab/granulation tissue has formed.
• For injuries to major internal structures with or w/o flesh damage, weigh your options ASAP. Any damage to ligaments or tendons usually are followed with a number of weeks or months of stall rest. This is where vets and I butt heads: joints have very little blood supple and can only be supplied nutrients and rid themselves of waste via movement. Limiting movement slows healing tenfold. Depending on the severity of the injury and the accompanying issues, a very small paddock with shallow, firm footing, limited turnout or hand-walking multiple times a day may be a much better option than stall rest. 
• Always go with the buddy system. If at all possible, keep another horse in close proximity to the injured one.
• Research, Sherlock. Haunt discussion boards, read articles from a number of different sources. Go find an equine medical dictionary/atlas/encyclopedia and read all the technical jargon associated with your horse's injury and then make sure you understand what it means.
• Finally, know your horse. Is he a bit of a worrier, or a calm old guy? Does he love his turnout or does he appear unfazed when he's stuck in for the day due to weather? Is he uppity after a few days of no work, or can he return to the ring/trail without hesitation? His personality and how well you can tailor to it will have a huge impact on how well he heals and how soon.

Up next: the long haul: that in between phase post-injury but pre-return to work.