On Thurs 20th Jan Dr Gillian Tabor and Emma Davis are holding a webinar on – Coping with your horse’s injury: guilt, grief and rehab – find out more about the webinar here.
The webinar will be tackling the psychology of dealing with injury. Emma and Gillian will be discussing feelings and emotions that a rider may experience when their horse becomes injured and during the recovery/rehabilitation process. We’ll look at the horse-human relationship, common reactions to equine injury for owners and riders, and how this may influence your decisions as an owner when it comes to rehab or management choices.
Dr Gillian Tabor has kindly agreed to share with us this blog (see below), a glimpse into the emotional and mental journey into dealing with a horse with an injury.
My injured horse by Dr Gillian Tabor
Part 1
I am a physio who specialises in the treatment and rehabilitation of horses with twenty years of practice. I have worked with hundreds, maybe thousands, of horses and owners who have needed my help to progress back to ‘normal’. I am not writing about these horses, I am now writing about my own.
In May my horse, my baby – the one – the horse of a lifetime, showed up at the field gate with a fat leg. I am not one to panic so I brought him in, had a good feel and decided to see what would happen with it. There was heat and swelling above the fetlock but he wasn’t lame. Over the next few days the swelling went down and I resumed ridden work. The swelling stuck around on the outside of his cannon but didn’t get worse with exercise so we carried on. He still was not lame and was his usual self for a couple of weeks but then got a bit grumpy in the arena. I had kept my eye on the leg and a small wound over the swelling opened up so I called the vet.
Although not being allowed to diagnose because of the Vet Act, I asked the vet to bring their x-ray equipment as I had a nagging and worrying feeling.
Sadly I was right, what initially looked like a little knock when it didn’t get better I suspected a splint fracture. This was clearly visible on x-ray. Immediate box rest and referral to an orthopaedic surgeon led to a plan for surgery to remove the fragments as soon as possible. Not only was there a fracture the edge of the suspensory was also a bit ruffled.
I have been through this before but not with this horse. Looking back, at this stage, my feelings were mainly of guilt because the injury was due to a kick from a new horse in the field. It was my fault because it was my choice to put them in the field together. I have always put my horses in together without any issues but not that day.
The guilt was painful, it makes me choke thinking of it. Have you ever felt this guilt and blamed yourself for something that has happened to your horse? I would be interested to know because it’s not a component of rehab that is within my scope of physio practice when I work with clients, except to be there to listen and discuss with empathy.
Part 2
After surgery and 2 nights at the hospital, an intense period of rehab loomed. I would like to say I was able to take this in my stride but I have a job, a family and other ponies at home and it wasn’t that easy. I had to make some tough and quick decisions. How would I be able to manage a horse on box rest whilst turning out the others as that was their normal routine? How would my horse feel with the others being out and him not going out? Would I have the time to muck him out? What about boredom when I was out all day, would that lead to new behaviours such as cribbing or box walking? Also, I go away for work occasionally and would I be able to ask my family to look after him. Would he be safe in the stable? So, so many questions?
If I kept him home, we would all be compromised, the other ponies, the family and I as well as him. But what were the alternatives? I tried to be as objective and weigh up the cost v benefits. So I came to a decision, I needed a professional yard. Luckily I knew of one and after speaking to Izzie who runs it my mind was made up. My horse went to Devon Equine Hydrotherapy Spa. I drove my horse from the hospital to there and literally took a large in breadth when it came to unloading him.
My precious cargo walked down the ramp, into the yard and straight into the stable where he was to stay for a long while. I took off his headcollar in the stable, he walked around once and then tucked into the hay there for him. The reasons for my decision were based on the yard setup. All the stables allow visibility of the horses in the six-block he was in. I knew there were small paddocks for turnout when we got to that point but I figured that my horse wouldn’t know they were there so no expectations of being allowed out.
I think that makes sense, but how was I to know how my horse felt. It was the right decision in hindsight, Izzie let me know he took a day or two to fully settle and that they kept a friend near him at all times, they also were around all day to check on him and change his dressings and replace his bandages when he ate them!! He initially only walked out of his box for the vet to see him and then straight back in again. He was on full box rest for the first month.
It took a lot of weeks to start to emotionally get over him going to the yard. I felt I was letting him down, surely I was the one to look after him? I was professionally capable after all. What if he was stressed and upset by the change of yards, it would have been my fault. I also felt guilty for sending him away but in a way, it was like I was putting him out of sight. We were to go eventing this summer, I was definitely grieving for the loss of these fun plans.
Trying to decide on the best course of action is tough. How do you know what is right before you know what is right because you have been through it?
Part 3
The box rest went well, except for the occasional eating of therapy equipment, boots and bandages, which he seemed to be managing. He put on weight because it is a real struggle trying to balance keeping them eating and not getting stomach ulcers. I would rather he had ad-lib hay and was able to keep up his foraging behaviour and fibre intake than start any stereotypical behaviour. The change of environment and amount of movement was already a risk factor in the development of behaviours such as cribbing and weaving. However, the benefit of the yard he went to was that there was activity enough to ‘enrich’ his view but not too much to be considered manic and stressful. There was an air of calm there and all the horses seemed relaxed and settled or well managed if not. Where horses can’t have their friends, forage and freedom we have a responsibility to try and meet their needs as maximally as we can.
After one month of complete box rest, I took my horseback to the surgeon at Western Counties Equine Hospital for a re-scan. I am not sure at this point what I was anticipating as the result. My logical professional brain knew what was realistic but I admit I was disappointed when the results were ‘as good as can be expected for this stage of healing’. In my heart I wanted it to be that everything was fixed and we could skip all the next phases of rehab. Unrealistic I know though.
The good news was that he was allowed to start walking, just for 5 minutes twice a day though. This did cement my choice of the yard because they were there and had the driveway and tracks available to walk him. I dreaded the start of walking though. I feared he would not be able to stay calm and that would put the staff at Devon Equine Hydrotherapy spa at risk. I knew they were capable but what if their handling methods differed from my own, and my horse would get confused. He is bred to have a fun foreleg action and has been known to wave his legs in the air. He did stay calm but what if the healing would be damaged by walking. I know all the theories of the healing process, I know that graduated loading is essential to optimise the tissue repair but I also know that too much too soon would be risky.
I think my dilemmas often come from overthinking and the background knowledge I have. But I appreciate knowledge is power so it’s a fine line! Do you think it’s better to know too much or not enough? Have you had to manage a horse that’s starting work after box rest?
What strategies did you use? Safety is paramount, so hats/gloves and bridle and or the use of medication for sedation. There are lots of options and one that is right for your horse.
Part 4
Once we were at 8 weeks post-op, there were no signs of anything wrong happening with two 5 minute in-hand walks a day. If you know me and my research area you’ll know how frustrating I was finding the lack of knowledge about the progress of the healing. I knew it wouldn’t really change anything but if I’d had my own imaging equipment, I’d have been rescanning and x-raying weekly!
As my horse’s behaviour was good and all feet were either on the ground or stepping as required and not launching around it was time to think about more movement. The controlled exercise was required. Fortunately, the decision to have him on rehab livery @devonequinehydrotherapyspa was working out better than I could have hoped for. Because I am away from home for long periods there’s no way I could have been able to build up the exercise gradually, or certainly more than once a day. The irony of needing to work to afford to pay for rehab for my own horse was not lost on me!
When my horse was younger he was taken on lots of hacks in hand. He had previously been very comfortable long-reining so it was decided that was the way forward now. So his programme outside of box rest was increased to include longer duration walking on the long-reins. Once this was going well the next step was to plan his return home. How to transition from the safety of the rehab yard, back to my care, was something that kept me awake at night. I knew I wanted him home but what if I wasn’t able to keep up the good work? The only way I could cope with him home and for him to cope without causing him stress was for him to be able to be turned out.
We had to bite the bullet and give him his freedom. But what if he injured himself in the field? What if the ‘frayed’ suspensory or the bone healing was damaged even more? All these questions and risks need consideration. If I didn’t consider his mental well-being or had the knowledge that graduated increased loading was needed, I would have stuck with the box rest forever! However, frustratingly, I know that bed rest doesn’t help humans and immobility has its own long term consequences.
After the decision was made it actually turned out that turning out was a non-event! The trick it appears is to put them in a small area, with a stable neighbour in the next paddock, and with lots of buckets containing a little bit of food. Such a simple but effective idea. I awaited photos of him out and could have cried when I saw him head down mooching about. Finally a bit of freedom for him.
I’m not sure if decision fatigue by proxy is a thing but by this stage, I was definitely exhausted from lying awake at night worrying. I am not sure which is worse, worrying about children or your horses? Being told that the outcome of all of this is likely to be ok, not 100% of course but probable it’ll be fine, didn’t stop me being really fretting about the future for him.
As I’m writing this I still don’t know if he will be ok. I wish I had a crystal ball. But at this stage, you can’t do anything else but stick to the process and be brave.
Part 5
Everything was under control, so just to risk it all, he needed to come home. A change of ponies at home meant it was time. I had to be away teaching in the middle of the next month and my family usually look after the animals. We decided that it would be too challenging initially for them, so coming home was back on hold. I’m not very patient so this waiting was a trial for me, despite the sound reasoning! However, it gave me time to create four little paddocks within my flattest field. I’m grateful to my husband, his friend and my son as they were fence post donking whilst I was at Hartpury teaching horse behaviour… how ironic!
As soon as I could after that, with nerves and trepidation, I brought him home. On the same day, my daughter’s 13.2 pony went to his new home. A seriously emotional day, I don’t do things by halves! Sadness from saying goodbye to one but the joy of seeing his handsome face (I’m biased!) in his stable was amazing.
Electric fence plugged into the mains and boots on, he went out. The first area was about 10m square and the new 14.2 was next to him. This pony was the one we thought had caused the injury in the first place, however, they had been out together before his diagnosis with no problems. One hour of turnout on the first day, then two and then up to four. A week later the grass was running a bit low and perhaps a bit of boredom or confidence set in. The external electric tape was powered just fine but the strip between the two horses was possibly not working because I looked at the camera (yes I know, I’m lucky to be able to watch them when I’m not there) and the tape between them was down! Immediate panic set in and I expected to find them both trying to kill each other. However, it turns out that they were far more settled and were eating next to each other quite happily. He’d made his own decision to join her – potentially not the best way for it to happen but he’d taken that next step and decision from me.
Hand walking and long reining continued daily and the vet had said that I could ride him. No schooling and mostly walking hacks but nevertheless I was allowed on his back. I have limited time due to family commitments and work so the time and day to ride arrived. Couldn’t be helped that it was a wet, wild and windy September day though. He’d worn his full tack already and I’d checked the saddle fitted but as for getting back on, well I’m definitely not as confident as I used to be.
Body protector on and with a few deep breaths, and a handful of pony nuts in my pocket, I actually got on in the stable. Mine are large with no roof and he’d been backed in there so I thought this was a good option. I wasn’t allowed in the arena and getting on for the first time in the driveway was slightly concerning for me!
I needn’t have worried. He remembered how to approach the mounting block then stood still waiting for his reward. I got on walked a circle and got off, no worries, what a relief. By this time it was torrential rain but it was then or the next weekend so we braved it. I thought we would be nannyed by my daughter on her pony but it turned out she was left behind as we stride off down the driveway!
It was almost as if he was saying, thank goodness, we are finally doing something proper! Ears forward and with his usual upbeat bounce we were off. It was such a great feeling, I was not in a dressage arena or jumping a course but the feeling was just as great. I didn’t even know if he would ever do any more than go out for a walk but it finally felt like there was progress. It was 14 weeks since the operation and nowhere near the end of rehab but it felt like a massive step in the right direction.
I think the short terms goals and mini achievements have been the reason I have been able to manage this whole situation emotionally. I do like a good to-do list so getting it down on paper has really helped me. Does anyone else write down goals and a plan?
Thursday 20th January 2022
Webinar – Coping with your horse’s injury: guilt, grief and rehab by Emma Davies & Dr Gillian Tabor
Join Gillian – find out more here.
