Reduce the stress of stall rest

With some commonsense adjustments, it’s possible to make stall rest easier on recuperating horses and more likely to achieve the desired results.

“Ah, here it is,” the veterinarian says while pressing an ultrasound wand along your horse’s leg. The dark flecks on the computer screen look trivial, like gnats. But his next words make it clear that they aren’t. “Suspensory ligament’s torn. We’re looking at several months of stall rest. We’ll ultrasound once a month to see how it’s doing.” No owner wants to hear those words.

Stall rest of any significant duration is a gamble. Clearly, rest is critical to recovery from trauma, illness or surgery. But prolonged stall confinement carries risks, too. Restricted horses are prone to colic, poor blood circulation, immune system weakness, rapid weight change, skin disease and respiratory dysfunction. Many become anxious at first, then withdrawn and depressed. As if that’s not enough, muscle, bone and soft tissue lose tone without use: The locus of trauma might need months of rest, but the effects of inactivity extend to an animal’s entire body.

Horse looking through stall bars
If you have a choice of several locations for stall rest confinement, choose one that’s near a tack room, grooming bay or barn door.

Then there’s the balancing act that stall rest represents. Many, if not most, injuries heal best with a combination of rest and moderate exercise—enough to keep the horse moving, but not so much that injuries worsen. “Stalls,” says Jeffrey Warren, DVM, “are for our ease, not the horse’s.”

The key component of stall rest is not rest, it’s control. Injuries are healed by managing the degree and amount of a horse’s movement, not by eliminating it.

Risks persist even as recuperating horses can finally become more active. Reuniting with a herd alters the hierarchy, which often cues some kicking and biting. After extensive stall rest, a horse’s attitude under saddle may need adjustment. He’ll be excited to run and play when loose, potentially re-injuring the original site of damage. The initial problem might be healed, but a horse’s body requires months of conditioning before resuming his previous workload.

All of which means that long-term stall rest is not as simple as it sounds. Maintaining a horse under such artificial conditions is challenging, and the practice itself can be controversial. Even when stall rest is a necessity, disagreements can arise about how to implement it. If you’re lucky, you’ll never have to face the question of how to restrict your horse’s activity to help him heal from an injury or recover from illness. But should the need arise, you’ll be better prepared to make the right decisions for your horse if you understand the factors that make stall rest successful or detrimental.

Every Case is Unique

The best course of care for a recuperating horse depends on the injury, the horse, your veterinarian and your situation. Every actor in this equation has personal strengths and weaknesses, drives and motives. Each has an individual temperament, background and knowledge base that resonates with certain events to form unique responses. Confinement amplifies these responses. When considering stall rest, remember that horses are opinionated participants, not riding machines.

Long-term stall rest is often unavoidable for fractures, severe burns, joint infections or recovery from major surgery. Injuries for which confinement is more controversial center on soft tissue—from chronic strain to full tears in tendons, muscles and ligaments. We have to ask whether an impairment is severe enough to warrant the mental, physical and ethical pitfalls of strict captivity.

Many people imagine that stall rest helps all forms of lameness. In fact, several types of injury do not respond well to confinement. For example, suspensory ligament damage in a hind limb does not improve with stall rest, nor does sacroiliac (SI) trouble. Extended rest is detrimental for certain disorders of the stifle and for horses who tend to tie up. It worsens lameness in horses with arthritis.

Veterinarians differ in their willingness to recommend stall rest and in the length of confinement. A few prefer that the resting horse be left alone; more follow American Association of Equine Practitioners guidelines and ask for mild daily pursuits that keep the animal active. A good veterinarian looks at the owner’s resources and the horse’s temperament—what fits for one team could be disastrous for another. “We ask for stall confinement, but that doesn’t mean an owner can’t also do things to alleviate a horse’s boredom or lack of motion,” Warren explains.

Stall rest is a choice, not a directive, and it can be executed in many ways. Before deciding whether to confine a horse, learn what will be required, then take an inventory of the factors that will ultimately determine whether you achieve the desired outcome.

Does your horse have the temperament and background to handle stall rest calmly? Do you have access to horse-savvy teenagers who want to earn money hand-walking, or to barn friends who will trade services? Can you afford trainers who will manage injuries, or rehab facilities with equine treadmills and water therapy? When you have a good idea of where you stand, discuss the options with your veterinarian. If you question the need for long-term confinement, get a second opinion.

Making stall rest work

When it comes to stall rest, it’s wise to “begin with the end in mind.” In other words, what is the post-recovery goal? Even though confinement with controlled exercise can restore a horse’s health and soundness, she may not be able to return to her previous level of performance. Is she a high-level athlete, expected to compete at major events? Is her injury especially detrimental to performance within her discipline? Jumping requires legs that can handle concussion and enough flexibility to elicit spring; reining and dressage put a lot of strain on the hocks; trail riding mandates strong feet. You are the best judge of what’s required of your horse, so consider her post-recovery prospects and prepare yourself to devise new plans for her future.

In the meantime, remember that equine bodies and minds are not made for sudden change—least of all to abrupt confinement to a small space. Horses dislike exceptions to the norm; Their physiology is not engineered for it, and they don’t always adapt well. Keep the following areas in mind to ease your horse into and through her recuperation period:

• Housing accommodations. Is your horse moving from a lifetime of 24/7 large-acreage pasture to a closed box stall? If so, beware. That’s a lot of sudden change for a prey animal to handle. Many horses who have always lived outdoors are unable to adapt to barn life without gradual steps and daily training. Some never become comfortable in barns.

Depending on a horse’s situation, of course, stall rest can present a less drastic change in a horse’s lifestyle —perhaps he’ll be going from a few hours of daily turnout to none or from a large pasture to a small corral. Try to size the horse to the area, giving a larger horse greater space. If necessary, use temporary steel panels to block part of a paddock that is too large, or to change its shape from a long, narrow run (which encourages the horse to dash back and forth) to a square pen. Many horses will hang out in a strip of fresh air and sunshine just outside the stall door, if one is provided. Be creative in fashioning the best option for your friend.

If you have several locations for confinement, choose one that’s near a tack room, grooming bay or barn door. Such places give your horse greater exposure to activity—people working or chatting, horses walking past, views of the outside. These little windows to the world have a positive mental effect as the months creep by. They also give you more chances to see and hear the confined horse if anything goes wrong.

• Feed changes. During the first days of stall rest, a horse’s greatest risk is colic. In addition to the stress of an injury or illness, an abrupt reduction of exercise or mobility can contribute to digestive upset.

The incidence of colic during stall rest is even greater for certain horses. Nathaniel White, DVM, writes that the risk of colic increases three-fold among horses who have colicked in the past. It’s higher for middle-aged Arabians and Thoroughbreds, and in horses who crib, have worms, were recently transported or skimp on water. Ponies tend to colic easily, as do horses who are overweight.

The main way to reduce colic risk on stall rest is the same as for any other horse—make any feed changes gradually. If confinement requires a change in hay, mix old hay with new for a few days before switching completely. Cut grain or other rich supplements by small amounts every day. Be sure the horse is drinking water and has a salt block.

• Activity. By now you—like your horse—might be grinding your teeth. You aren’t a magician! How are you supposed to keep a horse moving while he’s boxed up like a prisoner? Warren provides another general pointer: “Nothing can happen on a lead that wouldn’t also happen in a stall.” So, you can provide your horse with controlled movement without increasing the risk of damage. Can he jump sideways and twist that sore tendon? Of course. But he can do that in his stall, too. Just be sure your little muttonhead—all hyped up about a brief excursion—doesn’t pull away from you and go charging down the road.

Activity comes in many forms. If the horse can’t be hand-walked yet, let him graze near his stall while you hold the lead. This simple venture provides relief from boredom, fresh air for respiratory health, sunshine for skin condition, nutrients from fresh grass, a gradual change from fresh grass to hay, and attention from you. Plus, it’s easy! If he’s free of infectious disease, approach a pasture fence and let him nuzzle or sniff healthy horse pals for some socialization. Let him track the action in a busy arena. People chuckle, but sometimes even loose horses line up outside the rail like spectators at a slow-motion tennis match, swiveling their heads back and forth, just watching.

• Cleanliness. Confining a horse to a stall has the obvious side effect of concentrating the amount of manure and urine-soaked bedding to be removed. In fact, you might need to go from mucking once a day to doing it twice or more.

And don’t skimp on fresh bedding. In addition to absorbing urine, bedding cushions your horse’s feet and legs, which is especially important if she is restricted due to lameness. To provide enough absorption and cushion, bed the entire stall. Keeping the horse’s space dry and clean saves her feet and lungs—wet bedding increases the risk of thrush, and ammonia harms the horse’s airway. (A horse’s lungs are damaged by two-thirds less ammonia than human noses can detect, so if you smell ammonia in a barn, equine lungs are already in danger.) In addition to cleaning the stall frequently, make sure your barn is well ventilated with doors and windows open to outside air.

• Social needs. Horses are herd animals that evolved to cooperate with each other in monitoring their environment for predators. This means their innate need to socialize is strong. Stall rest reduces social activity in ways that can distress the horse who is supposed to be healing. Suddenly, he is alone in a stall and might not be able to see, hear or smell any of his buddies. Separation anxiety causes shrieking whinnies that can continue for days—if all that racket annoys you, imagine how frightening separation is to your horse. Help him out by opening the top of a Dutch door to see pasture mates, rotating part-time friends in an adjacent pen, hanging a safe mirror on the wall, or at least choosing a stall with an air gap along the top to allow the scents of neighboring horses to enter. A miniature donkey or goat can soothe the isolated horse—they’re inexpensive and don’t eat much.

Temple Grandin, PhD, observes that “people constantly underestimate domestic animals’ need for companionship… Just keeping them healthy and well fed isn’t enough; we need to give them enough social contact with other animals.” Because of their “strong social needs,” she stresses that “you can’t keep a horse locked up alone in a stall.”

A horse adapts to loneliness over time, but that change often comes at a high price. Confined horses eventually give up trying to attract attention. When the surrender occurs, they withdraw. Celine Rochais, PhD, has studied withdrawn horses in detail. They move away from stall doors, retreating to the sides or back of their stalls. Their heads often face the wall, necks flat and extended, weight on the forehand, ears slanted back and unmoving, eyes fixed or dull. This stance differs from the normal waking and sleeping positions seen in unstressed horses.

Withdrawn animals lose interest in unusual noises, ignore light touches to the skin, pay little attention to their environment, yet become abnormally reactive in scary situations. Some even lose interest in treats. Similar effects are observed in restricted monkeys, chicks, rodents, pigs, sheep and dogs. Horses might not feel depression the way humans do, but there’s little doubt they experience it. In fact, equine response to long-term confinement is now used as an animal model for research on human depression.

 • Grooming and therapy. Daily activity and socialization on a lead prevent withdrawal. But attention in the form of grooming or providing healing therapies is important, too. Groom a confined horse daily and you’ll improve her mindset along with her skin health. Watch for conditions that thrive when the immune system has little sunshine or fresh grass: ringworm, rain rot, dermatitis and mites. Clean feet daily as an antidote to thrush. Scratch the spots your best friend can’t reach. Stall rest almost always involves physical therapy —icing, cold-hosing, wrapping, wound cleansing, massage, or maybe stretching for flexibility. Make these therapies a pleasant part of your horse’s routine.

The ethics of confinement

Stall rest can help a horse heal if it is combined with controlled exercise. Good science supports that recommendation. But many veterinarians report that the majority of their clients do not hand-walk daily, even if encouraged to do so. What are the ethical implications of long-term confinement in which horses are largely left to stand alone in their stalls?

Animal behaviorist Temple Grandin argues that long-term restriction of movement is unethical. Cattle and horses need to move; it is part of their physiology, not an option that they—or we—can choose to ignore without negative consequences.

Referring to the Brambell Report— a 1965 document created in England that still guides animal welfare efforts around the world—Grandin points out that ethical husbandry calls for animals to be free from hunger, thirst, discomfort, pain, injury, disease, fear and distress.

In addition, the Brambell Report holds that animals kept on farms and ranches must “have sufficient freedom” to express their normal behavior. A bird, for example, must be kept where it can fly; a chicken must be allowed to peck; a fish must be free to swim.

A horse’s most normal behavior is to move across the ground. Left to their own devices, horses travel an average of five miles a day just grazing. Chasing, playing, bucking and rolling add even more motion to the quota. In Grandin’s opinion, “confinement in a box stall with little opportunity for exercise” leads to a form of animal frustration that is akin to mild rage. Movement is necessary for every horse—for mental, physical and ethical reasons.

At heart, a horse is not an investment or a prize or a piece of sports equipment. He or she is a living being, capable of suffering and enjoyment. The responsible owner provides care in the best interest of the horse, even when that effort requires human expense and inconvenience. As Warren says, “We always have our animals in confinement to one degree or another. [But] the humanity with which we are good stewards is up to each of us.”

It is this kind of responsibility that defines true horsemanship. We teach our horses to treat us with care and respect. We have an obligation to offer the same care and respect to them—whenever they need it. If long-term stall rest is recommended for the veterinary treatment of your equine friend, consider carefully whether it’s in her best interest. If so, make it as active and brief a process as possible.

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