Inflammation is good. It informs the horse’s brain that there’s a problem, prevents overuse of an injured area that could make the damage even worse, and also mediates the important process of cleaning up and removing damaged tissues.
However, there is a down side. Those inflammatory reactions of heat and swelling can easily become excessive, causing unnecessary damage to healthy tissue in the area and even becoming self-perpetuating. For this reason, it’s important to get on top of inflammation rapidly and aggressively. Luckily, you have a number of treatment options.
While we all know that cold-water hosing helps control inflammation, for really tough cases we don’t think you can beat using actual ice or freezing-cold water.
Advice on how long to ice an area varies from no longer than 20 minutes at a time to continuously. Studies on recovery from injuries and surgical procedures show far less pain, more rapid return of function and shorter healing times when continuous icing is used for the first 24 to 72 hours. We’d stick closer to the continuous approach.
The ease of use and effectiveness of the MacKinnon Ice Horse machine (www.mackinnonicehorse.com 800-786-6633) make it an outstanding choice for applying cold. The pads provide compression while the unit circulates iced water through them at a constant temperature. However, it’s also around $550 to $600.
For most barns, a cooling wrap might be the way to go. These wraps contain relatively lightweight, flat, nonbulky ice inserts divided up into small cells. They tend to mold well to most any area and have Velcro closures to keep them in place. They’ll cool anywhere from 20 minutes to an hour or longer, depending upon the brand. (Note: We have a field trial of cooling wraps underway. Stay tuned for our recommendations.)
It’s tougher to do than apply cooling wraps, but you can also do a good job of icing by using finely crushed ice inside self-sealing plastic sandwich bags, held in place with polo wraps or even a sock (see sidebar). When using ice, secure it just tight enough to put light pressure on the leg and check the wrap for slippage that might occur as the ice melts.
If you can’t ice continuously, wrap the leg with a cotton soaked in witch hazel or, better yet, Equilite’s Sore No-More (www.equilite.com 800-942-5483) that has been chilled in the freezer first. Be sure to apply your polo or flannel outer wrap with even and snug pressure, but not too tightly. A chilled poultice is another good choice for continual cold therapy on a leg.
After the first few days, when heat and swelling are controlled, go with Sore No-More applications several times a day, with or without a standing wrap, or try the combination of Sore No-More and a magnetic wrap.
These techniques work well for foot problems and as overnight therapy for horses with acute inflammation, beginning after the initial 24 hours of icing and one overnight cold poultice treatment. The swelling stays down and joints are cool with this combination, horses maintaining the improvements from the day before in terms of lameness as well.
If we played a word-association game and asked for the first thing that comes to your mind when we said “inflammation,” many of you would probably come back with “bute.”
Phenylbutazone is an inexpensive, time-honored and undeniably effective anti-inflammatory drug in the NSAID (non-steroidal anti-inflammatory drug) class, which also includes flunixin, ketoprofen, ibuprofen and aspirin. NSAIDs get the job done, but there is a price to pay in side effects, such as gastric ulcers. While we wouldn’t hesitate to use bute initially with an acute injury, we prefer carrying on the therapy with alternatives, such as devil’s claw (see bute alternatives June 2001).
In fact, discuss with your vet the use of any herbal or NSAID for use in combating your horse’s inflammation. Too much is not better, and you can easily get overaggressive.
If you’re into high-tech, the clear choice for horses with acute heat and swelling is the AlphaSonic (www.infrasoundtherapy.com 877-244-6942; basic unit around $900). This technology is especially useful for horses with muscle injuries in the large muscle groups, or acute back strains, where you can’t easily ice or wrap.
After the first three days or so, when heat and swelling are controlled, we also like ice in combination with pulsed electromagnetic field therapy from Respond systems (800-722-1228 www.respondsystems.com), either the blanket and boots combination or the stand-alone boots/wraps with battery pack.
If you’re willing to put out the time and effort, even raging acute inflammation can be rapidly brought under control. Successful therapy of any injury depends on an accurate diagnosis, careful monitoring during the healing program and a strong treatment and rehab schedule. The treatments we list in our box on this page are aimed at the first 24 to 72 hours following an injury, with the goal being to control inflammation.
As always, your veterinarian has the final word. Always use stall rest for a horse with an acute injury, at least until a firm diagnosis can be made and details of treatment decided by your veterinarian.