Thinking inside the box

It is an unfortunate fact that recovery from injury or surgery can require box rest, and the management challenges it brings. Kieran O'Brien MRCVS explains how best to approach such challenges

- Kieran O'Brien

RECOVERY from surgery or a significant injury or illness often involves a period of box rest or confinement in a stable-sized pen. This may be for as little as 24 hours following a routine joint injection, or six months or more in the case of a fracture.

Uncontrolled movement greatly impairs tissue healing. By restricting movement, box rest reduces the strain on wound edges, allowing healing to occur. Excessive movement disrupts tendon and ligament healing, making reinjury more likely when the horse returns to work.

The types of box rest are:

Simple confinement to a loosebox (or pen) - this is the most common form.

● Confinement to a loosebox and tethering in the box - this stops the horse lying down and now is used only very rarely, for example for pelvic fractures.

● Confinement to a small yard or very small paddock. This allows limited movement by walking only and is useful in the rehabilitation stage.

● Box rest followed by in-hand walking this allows controlled mobilisation and loading of healing tissues, in turn allowing gradual strengthening.

Horses are highly social animals accustomed to being able to move freely, and unhappy horses can become ill due to confinement. However, most resign themselves to box rest quickly, if well managed.

MANAGING BOX REST

Feeding

●Reduce hard feed to a minimum. The best option is low-calorie chaff with a handful of nuts or coarse mix added. Feed chaff generously - the act of feeding seems to provide some psychological comfort for the horse. Half a bucket of chaff two or three times a day is ideal. However, check with your vet if a specific diet or supplement is appropriate.

● Ensure constant access to hay or haylage. Natural foraging behaviour can be mimicked by giving different forages in different areas of the box haylage in one; hay in another.