Here’s How

Hot or cold ther­apy for in­juries; how to hold a dres­sage whip prop­erly

Practical Horseman - - Contents -

Q If my horse has an in­jury, how do I know if I should use cold treat­ment (i.e., hos­ing) or heat treat­ment?

ANDY KANEPS, DVM, Di­plo­mate, Amer­i­can Col­lege of Veterinary Sur­geons and Amer­i­can Col­lege of Veterinary Sports Medicine and Re­ha­bil­i­ta­tion

A Ther­mal ther­apy—ap­ply­ing ei­ther hot or cold treat­ments—is one of the most ac­ces­si­ble and time-tested reme­dies for in­juries in horses. Cold ther­apy is gen­er­ally used for re­cent in­juries, within two to seven days of the oc­cur­rence. It is par­tic­u­larly ef­fec­tive dur­ing the first 24 to 48 hours af­ter surgery or in­juries such as sprains or strains of joints or ten­dons, bruises, cel­luli­tis and lym­phan­gi­tis. Cool­ing a horse’s tis­sue tem­per­a­ture be­low about 66 de­grees Fahren­heit re­duces pain, edema (swelling) and bleed­ing and slows down the in­flam­ma­tory re­sponse. It also di­min­ishes the sever­ity of lamini­tis.

Even un­in­jured horses can ben­e­fit from cold ther­apy. Af­ter heavy ex­er­cise ses­sions, such as gal­lops or stren­u­ous jump schools, ice treat­ments re­duce low-grade in­flam­ma­tion, al­le­vi­ate dis­com­fort and pre­vent limb edema. Nearly ev­ery base­ball pitcher un­der­goes a post-game ice bath on the pitch­ing arm for the same rea­sons.

Heat ther­apy—warm­ing tis­sue to be­tween 104 and 113 de­grees Fahren­heit—is more com­monly used for chronic is­sues. In most cases, it should not be ap­plied un­til af­ter the acute in­flam­ma­tion has sub­sided, about seven days af­ter an in­jury or surgery. It, too, de­creases pain while also in­creas­ing lo­cal cir­cu­la­tion, which may ac­cel­er­ate heal­ing. Heat ther­apy is es­pe­cially ben­e­fi­cial for wound heal­ing. Horses ex­pe­ri­enc­ing strained back/topline mus­cles (who are usu­ally hy­per­sen­si­tive to pal­pa­tion of the area) en­joy the re­lief heat pro­vides by re­duc­ing mus­cle spasms. When used in con­junc­tion with care­ful stretch­ing tech­niques, heat can in­crease joint mo­bil­ity and im­prove tis­sue elas­tic­ity, which can be use­ful, for ex­am­ple, to elon­gate foals’ con­tracted ten­dons. Heat ther­apy also helps to soften the skin over an ab­scess to draw out fluid.

There are many dif­fer­ent ways to ap­ply ther­mal ther­apy. The most ef­fec­tive cold-ther­apy modal­i­ties sur­round the limb at the treat­ment site: for ex­am­ple by fully im­mers­ing a horse’s leg in an ice-water-filled bucket or com­mer­cial ice boot or by wrap­ping large, ice-slurry-filled plas­tic bags (such as used 5-liter med­i­cal/ veterinary fluid bags) around the limb. Al­though not as ef­fec­tive as these im­mer­sion tech­niques, tra­di­tional cold hos­ing and cold packs are good for treat­ing ar­eas else­where in the body that are dif­fi­cult to im­merse. You can also freeze water in a pa­per cup, then peel some of the cup away and ap­ply the ice di­rectly to the in­jured area by hand.

Cold ther­apy is very safe; there is no way to harm tis­sue in a horse’s body or legs with ice, so don’t worry about over cool­ing. When cold ther­apy is used im­me­di­ately af­ter surgery, the wound can be pro­tected with a water-im­per­vi­ous bar­rier.

Ex­ces­sive heat, on the other hand, can be harm­ful. Tem­per­a­tures above 113 de­grees can re­sult in pain and tis­sue dam­age. Be­fore ap­ply­ing hot water through a hose, bucket or whirlpool/tur­bu­la­tor boot, test that you can com­fort­ably tol­er­ate the tem­per­a­ture on your hand. If you use a recharge­able hot pack made for hu­mans (the type that starts as a clear gel and re­leases heat when man­u­ally ac­ti­vated), wrap it in a moist towel be­fore ap­ply­ing it to pre­vent skin burns. I don’t rec­om­mend us­ing elec­tric heat­ing pads on horses be­cause the elec­tri­cal cord presents a risk.

It takes about 10 min­utes for any of these cold and hot ther­a­pies to bring the tis­sue to the tar­get tem­per­a­ture, so ap­ply them for 20 to 30 min­utes per ses­sion. Re­peat three to four times daily.

Two ad­di­tional heat ther­a­pies, ther­a­peu­tic ul­tra­sound and leg sweats, should be ad­min­is­tered only by trained horsepeo­ple. Ther­a­peu­tic ul­tra­sound is use­ful for treat­ing soft-tis­sue sprains and strains and to re­duce scar tis­sue from a wound or surgery. It can also be ap­plied in be­tween shock­wave ther­apy ses­sions to treat soft- tis­sue in­juries. Leg sweats—us­ing oint­ment, poul­tice or plas­tic wrap to trap heat against the skin—in­crease lo­cal blood cir­cu­la­tion and re­duce tis­sue fluid, com­monly known as “stock­ing up.” Do not ap­ply a sweat to a re­cent wound or in­fected leg. Ask your vet­eri­nar­ian or an ex­pe­ri­enced horseper­son to show you how to ap­ply ei­ther of these modal­i­ties safely.

One sim­ple heat ther­apy that all horsepeo­ple can ad­min­is­ter eas­ily is a thick fleece blan­ket or ex­er­cise rug. Putting this on a horse’s back be­fore stretch­ing ex­er­cises or rid­ing will help to re­lax tight mus­cles.

Dr. Andy Kaneps is an equine sur­geon and sports- medicine spe­cial­ist. A for­mer veterinary- school pro­fes­sor at Ohio State Uni­ver­sity, Ore­gon State Uni­ver­sity and the Uni­ver­sity of Cal­i­for­nia- Davis, he has also com­pleted ex­ten­sive re­search on patholo­gies and ther­a­pies of horses and other an­i­mals. His pro­lific stud­ies, which in­clude ex­per­i­ments per­formed on the space shut­tle, have been pub­lished ex­ten­sively in mul­ti­ple aca­demic jour­nals. In 2010, Dr. Kaneps co­founded a new veterinary spe­cialty col­lege called the Amer­i­can Col­lege of Veterinary Sports Medicine and Re­ha­bil­i­ta­tion and teamed up with Dr. Steven Adair to de­velop a cur­ricu­lum for a 102- hour cer­ti­fi­ca­tion course in equine ther­apy at the Uni­ver­sity of Ten­nessee Col­lege of Veterinary Medicine. A pop­u­lar speaker at veterinary events around the coun­try, Dr. Kaneps now bases his pri­vate prac­tice, Kaneps Equine Sports Medicine and Surgery, in Bev­erly, Mas­sachusetts.

Wrap­ping ice-filled bags around a horse’s leg is an ef­fec­tive and in­ex­pen­sive coldther­apy method.

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