Trip To The Spa

It's not all mud packs and mineral water, but for horses who need rehabilitative therapy after surgery or an injury, a stint at the spa may be just what's required to speed recovery and get the athlete back to the training or show pen.

by Stephanie Stephens

Your horse's surgery was successful. Or maybe you've just been handed the unwanted diagnosis of your prized competitor's injured tendon or ligament. Now you're facing a period of recovery that is critical to the process of bringing your horse back to 100 percent.

In a perfect world, you'd send your horse off to the equine equivalent of the human Golden Door Spa... where he'd luxuriate in relaxation, restoration and rehabil¬itation. Does such a place really exist?

Absolutely. Several, in fact. These facilities are as in tune with your horse's medical needs as they are with ensuring that he has a pleasant, positive experience while he's recuperating. Most include a standard menu of services along with board. But it's also important to ask each about additional therapy options that cost extra.

STANDING NOT RECOMMENDED

Although the words rehabilitation and aftercare have been used frequently in the world of running Quarter Horses and Thoroughbreds, these processes have been slow to forge their way into the dialogues of western performance horse owners.
"Veterinarians whose practices see a predominance of reiners, cutters and reined cow horses are now starting to think about using our services more," affirms Daniel Vernay at the Selway Equine Therapy Center in Whitesboro, Texas. He treats a majority of soft-tissue injuries to tendons and ligaments, as well as post-chip-removal arthroscopic surgeries.

Vernay can board up to 40 horses, whose usual stay at the "lodge" is between 30 and 45 days. He'll frequently use the Aqua Tred, and underwater treadmill, to help heal the injury. The exercise stretches and flexes the affected area without straining it excessively. "The horse can go through the full range of motion, but without handling his full weight," Vernay points out.

The animal graduates to the power walk, "the edge of trotting," as the horseman describes it; trotting is not recommended. "Trotting in deep water is not comfortable, and splashing can get the horses excited, defeating the purpose of the therapy," Vernay explains. "This has to be a controlled exercise, and with this machine, we control the time, speed and more."

A horse's regimen is usually six days on the program, one day off.
This rehab specialist also incorporates use of the Eurociser walker-horses work between panels instead of hooked to a chain, which enables free exercise. "Then, after a few weeks, when we're comfortable with the healing process, we might work them on a hard surface a bit... walking, then jogging to increase the challenge to the tissue," Vernay explains.

Another high-tech tool found at Selway is the Electro-Acuscope. Electrical stimulation to cells increases their metabolism, according to Vernay, which, in turn, encourages blood flow to the injury location, thus speeding healing.

The whole curriculum is about "helping the body of the horse heal itself; it's a normal process of the body to heal damaged tissue," says Vernay

He counsels that standing in a stall is not the best thing for a recouping equine. Why? He cites the example of "fibers aligning themselves to go any which way - cross linking -creating a lot of scar tissue. When the horse is working, you help the body align the fibers with flexing and stretching, having good blood flow, cleaning the injured spot of waste products that are creating scar tissue, and then helping the body get rid of those."

VETERINAY SUPERVISION

Vernay will also incorporate laser therapy, which uses light to stimulate cells, thereby increasing metabolism. Therapeutic ultrasound might be appropriate as well. "You can go a bit deeper and send heat to the injured spot to promote blood flow, which also has an effect on alignment of fibers in tendons and ligaments," he explains.

If requested, the facility will invite equine chiropractors and massage therapists. He'll frequently recommend therapeutic shoeing "to relieve some of the pressure or tension."

Vernay, a certified veterinary technician with experience at several of the nation's most respected equine practices, works in tandem with the attending veterinarian He'll bring home the ultrasound of the injury, then stay in touch with owner and doctor as the horse progresses.

"The vet is the guy with the know-how to tell us how bad or good we're doing," Vernay says. "So, if there's a lesion in the tendon, for example, I know exactly what happened due to the very objective diagnostic."

He's a big fan of ice after exercise because any inflammation creates waste and byproducts that are very bad for tissues. After 30 days, another ultrasound is recommended, and if all's well, the horse goes home and back to training. If not, it's back to another two to three weeks of rehab.

Dr. Chris Ray of nearby Weatherford, Texas, frequently discharges his equine patients to Vernay's care. "It's been an area in which we've been lacking," says Ray of post-injury or surgical care, "and one in which we have the greatest room for improvement."

As he does his share of chip removal from knees and ankles and treats suspensory problems, he's a big fan of the fitness benefits derived from a program such as Vernay's. After all, when the horse is well, it's back to work.

He finds himself recommending rehab with increasing frequency. "I had no takers at first, but now word of mouth has spread the news. When my job is done, it's going to take time to get the horse back where he started."

Although more research is needed into the best ways to speed recovery, Dr. Ray maintains that "motion in moderation" and "decreasing weight-bearing" does help. "If a horse just stands, the joints stiffen," he says. "Daniel's plan encourages a return to health of the soft tissues, and it means an owner doesn't have to start from square one when the horse comes home."

Vernay, meanwhile, doesn't purport to be a miracle-worker. But he does love to see great results, which occur often. He admits, however, "I don't claim to cure everything."

You're wondering about cost: Expect to pay approximately $1,000-$1,500 a month for your horse to rehab with Vernay. "Two thousand would be a maximum," he calculates.

PAIN STOPS WORK

"The only thing that stops a performance horse from doing his job is pain," says Kirstin Johnson of Kentucky Equine Sports Medicine and Rehabilitation Center (KESMARC) in Versailles, Kentucky. "He doesn't just wake up and say, I don't want to stop and turn today.'"

On a typical day, Johnson is hosting three world champion Quarter Horses in her barn in addition to some of the most prized Thoroughbred racehorses in the country, some of which cost or are insured for millions of dollars.

Johnson isn't shy about touting her comprehensive range of services. "We have created what we believe to be the most complete and innovative sports medicine and rehabilitation center for horses in the world," she attests.

One look at the offerings and it's difficult to challenge her. First, there's the swimming pool, "providing all of the benefits of on track conditioning without stressing the tendons, ligaments and muscles of the legs. It maintains muscle tone and cardiopulmonary capacity. It's excellent therapy for muscle atrophy and neuropathy."

She's also a vocal proponent of using the AquaTred. "Remove those spurs, take the sutures out, and immediately go to the AquaTred," she recommends. "It's also great after colic surgery, with the water supporting the stomach. It keeps horses fresher. Mentally, they think it's fun and enjoy the reward system. It may be the most perfect type of conditioning for the equine athlete. It maintains and enhances conditioning in a relatively stress-free environment, with 20 Jacuzzi jets (five on each leg) and a controlled water temperature."

At her facility, a horse that's had hock surgery might spend a period of 45-60 days rehabbing with the help of not only the underwater treadmill, but the EquiGym walking machine as well.

The latter, says Johnson, "provides the ability to work in both directions, insuring balanced, uniform development of the cardiovascular, respiratory and musculoskeletal system with controlled intensity, duration and fre¬quency of exercise."

KESMARC employs a hyperbaric, or high-pressure, oxygen chamber too. "The oxygen given with increased pressure can correct many serious health problems," Kirstin explains. "The oxygen is no different than natural oxygen, as the increased pressure does not change the composition. It does, however, allow the oxygen to get into the tis¬sues more quickly and in greater amounts."

Horses have access to indoor and outdoor jogging/training tracks, turnout paddocks, a solarium for sun soaking benefits, and, if requested, a range of services including chiropractic and massage.

Without naming names, Johnson cites a reining horse "that won the limited open ten days off our farm. He'd had a stifle strain. This program gives horses like him the option to stay fit without pounding them. The horses have a solid foundation of training already. That's not what they need; lack of pain is what's necessary to allow them to do the job they're trained to do."

Johnson's daily board, including time in the Aquatred and necessary services. Expect to pay $400 for hyperbaric treatments.

ALL IN ONE PLACE

Both Vernay's and Johnson's rehab centers provide the ultimate environment for a horse to go after leaving the veterinarian. At Alamo Pintado Equine Medical Center in the Santa Ynez Valley of California, Doug Herthel, DVM, incorporates hospital and rehab *into one comprehensive facility.

"We see mostly soft-tissue injuries in reiners, cutters and cow horses," confirms Herthel, "and it's the magnitude of the injury that determines the length of rest period and rehabilitation."

Gradations range from stall rest, perhaps with hand walking, to complete immobilization - putting the leg in a cast or splint. "We have no set program for every type of injury, because we want to customize to horse and owner," Herthel says. Of course, hand walking may be impossible with some hotter horses, he admits.

Along with the Aquatred, Herthel vigorously champions the effectiveness of the hyperbaric oxygen chamber in conjunction with stem cell therapy.

"Suspensory injuries are common when a horse works on deep footing without a proper bottom," explains the doctor. "The ground should 'bounce' the foot back; when the footings too deep, the foot keeps sinking down, and the horse can injure the ligament."

He'll first diagnose the lesion with ultrasound, then treat the horse with its own stem cells and bone marrows "to regenerate that ligament." The cost for this treatment is $1,200-$ 1,500. Then the equine is placed in the hyperbaric chamber for two to three treatments at approximately $400 a treatment. And the horse's board and daily care cost $50 a day on top of that.

But the expense is well worth it, says Herthel, who designates the stem cell/chamber combo as "the Cadillac of treatments" for tendon issues.

"We use the chamber routinely not only for treating injuries and traumas, but also for infections of the skin or muscle," he says. "It has the ability to enhance the effect of antibiotics with high-dose oxygen administered in three atmospheres of pressure."

Herthel wants to stop the enzymatic breakdown of the ligament after an acute injury. "Oxygen does that, and it gets rid of edema, or swelling," he points out.
Then the horse undergoes stall rest for one to two weeks and handwalking, if possible, for 30-60 days, 30 minutes a day. The Aquatred may also be used, but "different modalities are employed depending upon the condition of the injury.:
Herthel once used infrared lasers, magnets and more before he began using the stem cell procedure in 1995. But "the bad suspensories were coming back and weren't staying sound," he recalls. Now he sees up to an 85 percent success rate with stem cell administration.

Herthel also calls into play the role of nutrition when rehabbing a horse. Now, if you're thinking "spa menu," it's not that at all, but rather "therapeutically providing the amounts of Omega 3 that horses need for tissue healing. The substance contributes to the health of the tissue and decreases inflammation."
If you don't live in the neighborhood, obviously, you'll need to arrange shipping for your horse to an appropriate facility. But, if the ultimate outcome is important to you, then the extra trouble and expense is probably worth it.

Do-it-yourself works fine in many scenarios, but equine rehab may not always be one of them, especially when the career of a money-winning performer is on the line. Aren't we horse owners lucky that innovation continues to bring us so many beneficial options for our cherished animal partners?

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