Safe & Successful Comebacks

After your horse has been sidelined due to injury or illness, you need to be careful when you return him to work. Here’s how to keep him healthy and happy after four common causes of lay-ups.
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After your horse has been sidelined due to injury or illness, you need to be careful when you return him to work. Here’s how to keep him healthy and happy after four common causes of lay-ups.

Bringing your horse back from serious injury or illness involves a delicate balance: If you take things too fast, you risk causing reinjury or relapse, but go too slowly and you’ll needlessly delay a return to regular activities that will benefit you both. Finding the best compromise between caution and progress requires an understanding of what to expect and how to proceed.

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Underlying all of your decisions are the physical limitations posed by your horse’s condition. “Of course, you always want a veterinarian to clear you before starting work again, no matter why your horse was off,” says Barney Fleming, DVM, a veterinarian from Custer, South Dakota. “Your veterinarian will also be your best source of guidelines and things to watch out for. But, ultimately, you’ll be the one making the decisions each day.” 

Every situation is different, but the issues that arise when returning a horse to work are generally predictable. To help you make the best decisions possible, we’ve outlined the basic challenges presented when returning a horse to work after four common problems---musculoskeletal injury, respiratory disease, colic and neurological impairment.

Unfortunately, there’s no template for conditioning a horse after serious illness or injury. But if you keep common pitfalls and important considerations in mind, you’ll be able to help your horse make a smooth and uneventful return to his regular exercise routine.

Musculoskeletal injuries

When bringing a horse back from a bone, tendon or ligament injury, err on the side of caution. “The worst thing you can do is rush and stress a healing area,” says Gail Conway, DVM, from Comanche, Texas. “You can easily reinjure the site---especially tendons---and put yourself right back to square one.”

Fleming urges owners to view a return to work as part of the healing process, not a sign that it is over. “The healing process goes on longer than the rest period,” he explains. “You want to start the rehab period with the intent of loosening the horse up rather than returning him to his normal use. You might say that you are stimulating the healing process in the first few weeks; getting the horse back into motion is part of the healing process.” 

Start with hand-walking, particularly if the horse has been on stall rest. “Your veterinarian will probably give you the go-ahead to start hand-walking the horse well before it’s time to ride him again,” says Conway. “Not only does that keep him from feeling cooped up, but it’s the basis of reconditioning.” It’s important, however, to limit your walks to areas with good footing and good fencing---so the horse can’t run off if he gets loose.

Be prepared to do a lot of walking---both on the ground and once you’re back into the saddle. This gait will lay the foundation for your horse’s conditioning. “Plan on just hand-walking for the first week or two,” says Conway. “And when it’s time to get on him, plan on walking some more.” 

Fleming also offers a caution: After weeks of walking, you might feel ready to seek some more interesting scenery, but resist the urge to leave your riding arena. He warns that the terrain surprises found in fields and on trails can strain a healing musculoskeletal structure. “You don’t want to be hitting any holes, divots or ditches in the beginning. You want a nice, soft surface with nothing to trip over or fall into,” he says. 

What’s more, arena footing will provide the cushion and consistency that nature generally doesn’t. “You don’t want anything muddy or deep,” says Conway. “But it can’t be extremely hard either. A well-groomed arena is a good place to start.” 

As your horse continues to regain his strength, avoid longeing, free longeing, riding in small circles and other activities that may cause a strain. “You need to reasonably eliminate the need for tight turns, which can stress healing tissue in a limb,” says Fleming. “If you’ve only got a 25- or 50-foot round pen, you aren’t going to do the horse much good by working him in it, and you might even aggravate things. A better number that suits me is at least 100 feet.” However you begin working your horse again, take it slowly and build gradually.

Plan on keeping your early rides fairly short. “If you’ve been hand-walking or ponying before you ride, you don’t have to be super-restrictive,” says Fleming. “A 10-minute ride isn’t going to give him much more exercise than he gets walking around the stall. A half-hour is a reasonable place to start.” After at least a week of walking under saddle, add short trots---never more than a minute or two---to your sessions. Then gradually lengthen your trotting stints and total ride time over the course of several weeks. “Slow, slow, slow. That’s the key. Don’t get impatient,” says Fleming. 

Eventually, as your horse regains his fitness, you can head back out on the trails, but stick to familiar places and go with calm companions. Remember that hills can stress limbs, so avoid big ones for several weeks and consider dismounting and walking up or down inclines until you are certain your horse can handle them.

At every phase of your horse’s recovery, stay alert for signs of trouble. “The second you feel anything that’s irregular, it’s time to quit,” says Conway. “Call a halt to the session at that point, dismount and head back to the barn. Don’t try to ‘ride him through’ anything.” Back at the barn, he says, “feel his legs, look for signs of swelling and compare it to the opposite leg. If there is more heat in the leg that was injured, it’s time to back off and regroup.” 

Even if your horse seems fine, Conway recommends cold hosing or icing the injury site for about 10 to 20 minutes after every ride. “That will help reduce inflammation, and if you’re using a spray nozzle on the hose, that will give it a bit of a massage to increase circulation and promote healing.”

Finally, have your veterinarian make regular visits to monitor the healing of the injury at all stages of rehabilitation. “If you had an ultrasound done of the original lesion---say, a tendon tear---it’s extremely helpful to have subsequent ultrasounds done to see how things are progressing,” says Conway. 

If you have no major setbacks, you can expect to have your horse back to his old routine in anywhere from three to six months, depending on how long he was laid up. “Part of the process is rehabilitating the injury site, but the other part is recovering the horse’s overall fitness level,” says Conway. “Two or three months down the road, the injured leg is not going be any more at risk than the rest of them, but you still need to take things slow because the entire horse needs to be reconditioned.” 

Respiratory Illness
A respiratory illness such as influenza can sideline a horse with a fever and cough for a good two weeks, but the road back to his regular routine is much shorter than you might expect. “If you or I sat on the couch for two weeks with the flu, we’d have to start all over fitness-wise. But that doesn’t happen with horses,” says Conway. Horses, unlike people, can retain their physical fitness for months, even during times of illness. 

So bringing a horse back from a respiratory illness means you will need to focus primarily on his lungs; the rest of his body should be able to pick up where he left off.

There’s more good news. “Equine lungs are very resilient. They are designed to clean up whatever is sucked down into them, and the normal action of breathing in and out helps do that,” says Fleming. “So what you want to do is get on them and get them moving to ‘blow’ the lungs out and get mucus moving. It will be helpful.”

So once your horse’s fever has been gone for several days and he’s been given the go-ahead from your veterinarian to start work, saddle up and get moving. “He’s going to cough a few times when you begin riding,” warns Conway. “Don’t panic. That’s normal and even helpful. I once had a horse come back from a minor respiratory infection who would cough at the beginning of every ride, three or four times, for maybe six months or eight months. There was nothing wrong with him.”

Fleming says that clients will occasionally call and inquire about medicine to quell a post-respiratory-infection cough, but he typically advises against it. “That cough is helpful,” he says. “It’s the body’s way of moving something, maybe dust or bacteria or extra mucus, up and out of the lungs. You don’t want to stop that process.”

Conway suggests sticking to a walk and trot for a few days, just to ensure that your horse has indeed fully recovered. “Keep an eye on his attitude and appetite and take his temperature if you’re unsure of how he feels. Coughing at the start of a ride is normal, but if he’s coughing throughout it or while he’s standing in his field or stall, that’s not good.” 

Conway also recommends monitoring your horse’s respiratory rate: “Watch him at rest; you should see less than 10 breaths in 20 seconds. More than that and he might not be ready for the level of work you’re at.” If there’s any indication your horse might be relapsing, call your veterinarian.

Should all go well, however, it’s possible to have your horse back to the level of work he was pre-illness in about two weeks. “Horses typically don’t experience the same generalized weakness and loss of condition we do after a respiratory illness,” say Fleming. “They are pretty much good to go once the fever is gone. It’s pretty remarkable.”

Colic
The time frame for getting a horse back to work after colic depends on what type he had. A simple case that was managed on the farm with medication may have little or no impact on how you resume work. A colic that required surgery, however, requires a little more consideration.

“The thing about [medical] colics to remember is that they can go away as fast as they arise,” says Fleming. “In a simple case, like a gas colic, once the horse’s digestive tract empties, 12 to 24 hours later, he’s fully recovered. There are no lingering effects at all. And you can’t cause a horse to colic again by working him too soon.” In mild cases of medical colic, the horse can be ridden as soon as the next day.

“Exercise can actually help a horse recover from colic,” says Fleming. “One way we treat an active colic is to have the person load up the horse and drive him halfway to the clinic, then get out and check on him. Many times, that much movement helps things along, and they turn around and go home.” The same applies after colic is resolved: Movement stimulates the gastrointestinal tract, keeping things in working order. Getting a horse back on an exercise program as soon as he feels better is one way to keep him feeling that way.

You’ll want to be sensible, however, about the conditions under which you work him. “After a bout a colic, it’s possible that the horse is dehydrated,” says Conway. “So you’ll want to make sure he has plenty of water, particularly in hotter parts of the country. You can also wet down his hay to get more water into him. If it’s very hot and he’s likely to be sweating, you may want to talk to your veterinarian about using electrolytes as well. These are all just precautions against dehydration, which is a concern with any horse but may be heightened after a bout of colic.”

A horse who has had colic surgery will, understandably, take longer to recover. “The typical rule of thumb after surgery is four to six weeks of rest and relaxation to allow the incision to heal,” says Fleming. “After that time, the skin is going to be as strong as it ever was, and you’ll be able to pick up where you left off with your riding.” 

Conway agrees. “Any incision troubles, like infection or wound dehiscence0, are likely to come up in the week or two immediately following surgery. You aren’t going to have any troubles a month or six weeks out. And your horse won’t have lost any condition in that time,” he says. “Start slow because that’s always sensible after a layoff, but don’t feel like you have to wait months to get back to where you were. Come back one or two notches lower in intensity and take it from there. You aren’t going to make him colic again simply through exercise. Get him out and moving; it’s only going to help.”

Neurological Condition
Not everyone agrees that it’s advisable to ride a horse after he has recovered from a neurologic condition. West Nile encephalitis, equine protozoal myeloencephalitis (EPM) and other conditions that cause neurologic impairment often result in permanent deficiencies in muscle strength and/or coordination.

“The difficulty is that some horses are so badly compromised that they can never be safely ridden again, while others are only slightly affected and can return to their previous level of work with little trouble,” says Conway. “There are no universal guidelines. They are all individual judgment calls that you will have to make as an owner and a rider.”

The decision-making process starts with a full neurological workup by your veterinarian, who can give you an idea of the horse’s status in that moment but may be unable to predict how much more he will improve, if at all. “I’ve seen some horses come back from West Nile with hardly any signs they had it,” says Conway. “And I know a few that are going to wobble forever because of it. There’s no real way to tell at the outset which way they will go.” 

Movement may encourage any healing that will take place early on in the recovery process. “Once a horse has passed through the acute phase of a neurological condition, I think movement is helpful,” says Fleming. “If he can safely walk across the yard, put him on a lead and get him moving in hand. That may help ‘rewire’ those neurological pathways in the early phases of recovery.”

When---or whether---to begin riding a horse after a neurological disease is a difficult decision you have to make with your own safety as the priority. Ask your veterinarian for his assessment and spend some time watching the horse move at liberty, in a round pen or an arena. “Watch him carefully, to see that he’s moving squarely and balanced and he knows where his feet are,” advises Conway. “Make sure he doesn’t stumble when he turns in either direction. Then decide if you’d feel safe on him.”

Fleming recommends asking two questions: Is this horse safe for me to get on? Would I let someone else get on him? “If you see any stumbling or knuckling or toe-dragging when the horse is at liberty, I think the answer is no,” he says. “It’s only going to be worse when the weight of a person is added. We like to think they will improve over time. Some might improve a bit, but many of them won’t. After a while, what you see is as good as you’re going to get.” 

Conway says that a neurologically impaired horse may be rideable, but not at the level he was at before. “He may be sound enough if you stay at a walk over good ground,” he says. “But you might not get any more than that, recovery wise. I’d go a long time and think very hard before I asked a horse coming back from a neurological condition for any type of speed work. I’ve had a few horses fall with me and it’s very hard to get out of their way."

Getting back on your horse after he has been ill or injured is a big step back to normal and a great milestone. But to avoid setbacks and relapses, you need to be mindful of the specific challenges that come with recovery from certain types of illnesses. Once you’ve taken those into account, your return to your regularly scheduled riding activities should be smooth and easy.