Ask The Vet: Rehabilitation From Injury

Courtesy of AAEP

Question: I have an older gelding (18-years-old) that has been stumbling occasionally for no obvious reason. The stumbles are severe enough he goes on his knees. Could this be a side effect of him being ” nerved ” before I got him ? Is there any way to determine if he had this procedure done? Is there any rehab suggestions you could offer?

Answer: Yikes, this is a dangerous situation for you. Stumbling is a very common complaint for horses that have navicular issues, which is why they are subsequently ‘nerved’ to prevent the horse from feeling pain in the heel region of the foot. The effects of this ‘nerving’ surgery can last anywhere from 1½ to 10 years, but most commonly the effects of surgery last an average of 4 years because the nerves regrow in the area. When the nerves return, there can be some return of symptoms as you are observing in your gelding. Your veterinarian can help you determine if your horse was nerved previously (usually there are small scars) and if the nerves have regrown in the area (your veterinarian can test for sensation in the heel region). Additionally, your veterinarian can block the heel region with a drug similar to novicaine and see if that relieves the lameness or the stumbling and can help you determine further options for your gelding. Unfortunately, there are no rehabilitation options for this situation.

Question: My appendix mare is just coming out of 6 months stall rest after a stifle injury. We are hand walking her, but were told to ride her instead. Why would this be more beneficial? She of course, gets excited and jumps around, so we are a little afraid to ride her yet. Also how will we know when it is okay to move her into a trot.

Answer: Generally, rehabilitation from injury depends on the type and severity of injury that the horse sustains. In your case, at this point your veterinarian feels it is appropriate to start riding under saddle at a walk. The benefits to this are several – first, the horse receives slightly more stress from the weight of the rider and therefore gains more muscle to support herself, but not so much to strain the injury.

Secondly, the owner is allowed to feel like they are progressing by getting back astride the horse and usually can control those ‘excited tendencies’ of the couped up horse a little better (although not always). If you feel concerned for your safety while riding, you can ask your veterinarian about some quieting products such as quiessence, quietec, etc., which are feed supplements or a mild tranquilizer such as acepromazine which you can give 30 to 45 minutes prior to riding. It is always scary to get back in the saddle after your horse has had an injury, but at some point, it becomes a necessity to work forward in the rehabilitation process.

As far as the introduction of trot goes, that should be determined by your veterinarian. It usually depends on the extend of the injury as well as monitoring for any changes in the stifle such as joint effusion, lameness, changes on x-rays or ultrasound, etc. If you have any concerns when you increase your work load (under your veterinarian’s advice), you should stop the work and contact your veterinarian as you may have progressed too quickly and need some more time at a lower rehabilitation level.