Your vet has prescribed stall rest. You know it is needed; however, you can only envision the worst: a restless unhappy horse, a destroyed stall, dangerous hand walking, angry looks from the barn manager, and lost sleep. Is the cure worse than the disease? For some horses, it definitely seems that way.

Stall rest is a necessary evil. Horses are not great at self-protection. They aren't even good at self-protection. The tendon may be healing nicely during the summer months when everyone is too hot to do more than mosey to the next patch of grass. But when a nice cool autumn afternoon arrives, off they go; galloping, cart wheeling, bucking and kicking. Unfortunately the tendon isn't ready for more than a gentle walk and you are back to the beginning. Optimum healing requires controlled exercise to minimize re-injury. To get your horse back to work, you are often facing a combination of stall rest and hand walking. The following suggestions may help you both survive.

Natural lighting and fresh air makes us all feel better. Stalls come in many shapes and sizes. In general, stall rest means limited movement or no trotting. It will be important to know the exact limitations required for your horse. If he is wearing a cast, movement is discouraged. For most conditions, walking would be acceptable and the stall rest is designed to keep them at a quieter pace. Consider outdoor stalls or pens the size of stalls. Can you add windows to an indoor stall? Can your horse have a stall near a low traffic door instead of the back corner of the barn? Near the wash stalls or farrier area so there is always something to watch? Keep in mind your horse's needs. Some need more activity while others prefer some down time. If traffic means all the horses pass by on their way outside while leaving your horse behind, that might be more damaging to your horses morale than helpful.

Misery loves company. Visitors are allowed. Can another horse stay inside as well? If need be, the companion horse can be a different one each day. No other horses? How about a pet? Horses can do well with a friend, like chickens and goats to share the stall. People work as pets, too. Can the other people in the barn stop by and say hi as often as possible? Is there a girl scout troop that wants to get their horsemanship badge by practicing grooming your horse? Or a 4-H group that can practice taking vital signs using the “patient”?

Fly feeding frenzy. Bugs like barns. Without a nice breeze or a companion's tail, they can be more bothersome than usual. Add boredom to that and they can quickly drive your patient crazy. Fans, fly sheets and repellants can help minimize the annoyance.

Boredom busters. Many horses learn new skills by entertaining themselves. You might want to pick the skills versus having your horse learn to untie your shoelaces. Think like a zoo; while your horse may not find fish frozen in ice cubes a delicious snacks, is there a way to make him work for his treat? Toys to pick on can be another way to relieve frustrations. Stuffed animals, playground balls and traffic cones can work, along with official horse toys. Music and unbreakable mirrors can also be soothing to some horses.

Better living through chemistry. There are drugs available to help calm anxious horses. Some of the anti-anxiety drugs have the opposite effects in a subpopulation of horses, so check with your veterinarian on all medications. Reserpine is a human drug that is often used for horse sedation; the main side effect is diarrhea, but it isn't common. There are other products that are reported to help (B vitamins, magnesium sulfate, herbal combinations) and may be worth evaluating. Check with your veterinarian first, particularly if your horse is on other medications as they can interact and almost all are dangerous if overdosed.

Stall rest not stall restricted. If your horse doesn't have a fracture or isn't wearing a cast, ask about hand walking. Horses can often be hand walked or hand grazed. If he is acting up or is too dangerous, consider having someone else walk him or walk with a buddy. Have a friend walk a calm horse with you to show him how it is done. If he is doing well, others may be able to take him out additional times. Is there a mom that would be happy to stand with him during a kid's lesson or maybe he can even stand in the middle of the arena with the instructor? As you get further into rehabilitation, you may even be able to pony him or ride him at a walk. Riding your calm, stable older horse while leading your resting horse means all three of you can go on a trail ride.

Watch the diet. Don't forget to adjust the diet based upon the change in activity. Your horse probably doesn't need many calories to maintain his weight while on stall rest. If he needs to gain weight, try to limit carbohydrates. They add energy and will likely increase the restlessness. Try to use fat calories. These allow horses to gain weight more readily and tend to have a calming effect. Furthermore, eating is a good activity. Use lower energy grass hay as the primary staple of the diet and try to ensure he has some in front of him at all times. Hay nets can help make it a little more effort and can slow down the process. Don't forget to use a ration balancer to ensure he is getting the vitamins and minerals he needs for proper healing.

Worth waiting for. Keep him on a schedule as much as possible and keep his routine as close to normal as possible. Did you usually groom him in the crossties prior to a ride? No need to change that part, he can still be groomed there. Regular activities help the time pass faster.

Kill two birds with one stone. Is there ground training you have been wanting to do but haven't had time? How about getting him used to driving reins or other obstacles? Maybe now is the time to teach him to ground tie? These are good challenges for his mind, and will result in a new skill(s).

Ready to limbo? While stall rest can help injured tissues heal, it can stress other tissues. Muscles and joints get stiff, especially in older horses with arthritis. Massage can help keep the joints limber and it feels good. Have your vet show you some stretching exercises to maintain joint range of motion and mobility. You do need to ensure that all exercises are safe concerning your horse's injury. With some regular work, he may be more limber when you finish the recovery than when he started. While you are at it, ask for extra bedding. The extra cushion can really help when standing around all day and make laying down much more comfortable.

Consider a rehabilitation farm. One way to make sure your horse isn't the only one on stall rest is to board at a rehabilitation facility. These barns are used to the restrictions, and there is usually a lot of company inside. Sometimes the new environment helps make the transition easier. Plus, the staff will be better able to withstand the sad looks from the horse and can better follow the veterinarian's instructions.

Still frustrated? Talk to your veterinarian. There may be a middle ground that is safer for your horse than strict stall rest or total turnout. Don't forget to monitor his health. Changes in activity make a horse more prone to colic and stall rest can make them more prone to stomach ulcers. Be sure to monitor his manure, appetite and attitude closely and consider a stomach protectant. Watch the barn ventilation as well; make sure the bedding is cleaned frequently and good airflow exists to minimize the risk of respiratory irritants. Don't forget to take care of yourself; ask a friend to assist you or hire a competent person to give you a break from the caretaker role!

Transitioning out. When the stall rest is over, try to minimize any risk of re-injury on turnout. Your horse has lost some condition, is likely to be overexcited and may need to reassert his role in the herd. Consider not feeding the horses until they are outside, this will give them something else to think about. Turn out with one or two buddies vs. the whole herd or perhaps sedate the horse at first (acepromazine can work well to help mellow out the return the first few days). Turn out during the heat of the day when everyone moves a little slower and supervise turnout. Finally, make sure to start with just a few hours. You can pull the horse back in if it is too exciting and don't turn out into a lush pasture due to the risk of laminitis. Start small; the arena or small paddock may be better than the back 40 acres. Avoid round pens or paddocks with rounded corners as they tend to encourage running in circles which is hard on a healthy body, much less one that is out of shape. Corners tend to make a horse stop.

Rebuild slowly. Don't forget he has lost muscle tone and can't do as much as he used to right away. Keep up your stretching exercises and avoid repetition until he has his strength back. Unless you are working with a specialized rehabilitation program (i.e. aqua-treadmill) or found a way to keep his muscles toned during the layup, plan on at least three months of gradual return to work, longer if he was stall rested for more than three weeks. Rechecking radiographs and ultrasound are often useful to ensure you are moving as fast as possible without causing re-injury. With patience, time and attention to details, you will give your best friend the best chance of coming back as good as new!

This article was written by Erin Malone, DVM, University of Minnesota.

University of Minnesota Equine Center