Equine rehabilitation

Question 1

what are the client consideration when thinking about rehabilitation of equine musculoskeletal injuries?

Answer 1

• prognosis for athletic function
• prognosis for pasture soundness
• cost
• duration of box rest
• time out of work
• amount of nursing required

Question 2

what equine musculoskeletal injuries have a poor prognosis for recovery?

Answer 2

• compound, open fractures with significant contamination or soft tissue damage
• complete fractures involving the femur, humerus and tibia
• complete laceration SDFT, DDFT and SL
• complete laceration of SDFT, DDFT and distal sesamoidean ligaments

Question 3

what long term analgesia can be used for equine musculoskeletal injuries?
what are the side effects?

Answer 3

NSAID - Phenylbutazone
* Licensed for long term use, but warn client about possible complications
* Side effects include: right dorsal colitis, gastric ulceration, renal disease, blood dyscrasias
* Safety threshold is low - work doses out correctly
* Horses cannot compete on medication for most regulatory organisations
* Young horses esp susceptible to ulceration – do not use in foals < 6 weeks,

Question 4

what long term analgesia can be used as an alternative to phenylbutazone in equine muscularskeletal injures?

Answer 4

• Alternatives to phenylbutazone:
  
  • Oral flunixin, oral suxibuzone, oral meloxicam
• Other analgesics:
  
  • Oral paracetamol (not licensed)
• Intra-synovial corticosteroids – triamcinolone, methylprednisolone
  
  • Can be very effective for relatively long periods of time post injection, think carefully about loading and use of joints after medication
• PsGAGs – intra-articular or IM administration – some anti-inflammatory action as well as effect on joint biology

Question 5

what are the alternative analgesia that can be used for equine muscularskeletal disease?

Answer 5

• Shock wave therapy – proximal suspensory, navicular and some other conditions, ? Effect
• iRAP (Interleukin Receptor Antagonist Protein) – some anti-inflammatory effects
• Arthramid – polyacrimide hydrogel - adheres to synovial lining and reduces inflammation
• Weight loss
• mobilisation and controled exercise

Question 6

what drug is used for equine back pain?

Answer 6

Sarapin

Question 7

what techniques are used for behavouir management of horses on box rest?

Answer 7

• mirrors
• enrichment - games, clicker training
• pheromonatherapy
• hand walking (care regarding excitement)
• drugs? - ACP (a seditive, not an anxiolytic)
• change diet to high fat, low starch

Question 8

what are the concequences of box rest?

Answer 8

implications: Effects ont he rest of the horse, not just injured area: decreased weightbearing leads to asymmetry in loading, decreasedflexibility, weakness and backpain

Consider structures affected and implications regarding healing times:
Bone – requires loading for a strength (Wolfs Law)
Tendon ligament – requires loading for future elasticity
Muscle – resolving oedema and restoring function minimising scarring
Therefore exercise might be part of the healing regime - physiotherapist (specific exersices used to target certain deficits

Question 9

when should horse be turned out again after injury and box rest?

Answer 9

• Can be the most likely time to reinjure.
• Consider temperament and small paddock options, use sedation,consider tissue effects of high speed and sudden braking whenturned out.
• Ideallydo not start turn out or ridden workbefore ground work to strengthen wholehorse has been completed if behaviour allows. (use a bridel for more control)
• Duty of care to those handling horse
• For the horse to carry a person, the back must be strong to prevent future problems.