Pain Management, Part I
Someone in the comments asked about managing pain in older horses or horses with long term issues. That is a really tough question to answer simply because each individual horse owner has a different philosophy in regards to this subject.
I will say for myself and my own horse, if the need ever arose I would not be opposed to daily bute or daily equioxx/previcox. Of course long term daily use of NSAIDS can potentially have side effects down the road, but for me personally I am all about quality of life and not quantity of life. If some daily pain relief provides a reasonable quality of life I’m all for it. Of course not every horse owner subscribes to this theory. Some would rather euthanize a horse than use daily pain meds. I don’t think this is wrong either, it just isn’t my personal choice.
I think the best thing anyone can do for pain and health management of a horse is to give them as natural a lifestyle as possible. In reality nothing we do with horses is natural. We feed them grain, we feed them hay, they are trimmed and/or shod by the farrier, they are fenced into pastures instead of roaming thousands and thousands of acres, we vaccinate them, we provide them with barns and run-in sheds and we blanket them. Let’s face it, horses in their natural state have none of these things.
That said I do strongly believe that maximizing turnout with compatible groups is the number one thing that can be done for pain management. It is amazing how pulling the shoes and letting the horses enjoy group living increases their soundness and mental health. However I think this can be tough to accomplish, especially depending on where you live. In my opinion (I keep putting that disclaimer out there!) a 40 stall boarding barn on 20 or 30 acres isn’t going to be able to accomplish this.
The groups need to be small compared to the acreage they are turnout out on. Having good grazing most of the year is critical to success in our experience. This means the horses don’t feel like they have to share each other’s space to forage. They can graze as close or as far away from each other as they desire. And I will say again the groups need to be compatible. Too often the choice of turnout groups at a boarding barn consist of the mare group and the gelding group. Well, not all mares are going to like each other and be compatible as companions and the same for all geldings.
Using our farm as an example not all horses will enjoy being part of the Big Boys. When they are so moved the big boys like to be rowdy. At times they run hard and they play hard. We have another group that the members pretty much want to eat and nap, period. Their big daily activity consists of a couple of trips to the water trough. The other groups are somewhere in between.
I would say the number one concern that we hear most often is worry over pulling the shoes. We are not opposed to leaving a horse shod if that is the owners desire, and I do not subscribe to the philosophy that barefoot is always best. However we have successfully transitioned every single retiree out of shoes and over time their soundness improves. It goes without saying the we need a truly gifted farrier to accomplish this.
The majority of the retirees here had a vet and farrier saying the horse could not be comfortable without shoes under any circumstances. A lot of the owners really had to take a leap of faith and trust our judgement when we did the barefoot transition. When you are used to listening to one trusted team of advisors saying “must have shoes/special shoes” and then we’re saying “trust us and let us try a different route” that is a huge decision on the owner’s part. This is something we never EVER take lightly. Someone is trusting us to take care of a living, breathing animal and we do not take this lightly. I am not going to ask someone to allow us to transition their horse out of shoes unless I am confident that the outcome will be good.
Just to be clear I am NOT saying that these same horses could go back into regular work and stay barefoot. I AM saying that living the life of a retired horse where they self direct their exercise on comfortable turf footing without shoes has never, not once, had a negative effect on one of the retirees here. It has always improved soundness over time. We often use boots with pads for a period of time (varying lengths of time according to the individual) in order to assure a pain free transition out of shoes but often this is not even necessary.
I think what often happens is we start tweaking the shoeing jobs. Changing this angle or that angle, using a wedge, or bar shoes or trailers. And it works for awhile. Then another tweak is needed and that works for awhile. But eventually it often stops working at some point, and then no matter what you do with the shoeing package you still have a lame horse. Many of the retirees here have chronic or permanent soft tissue damage. It is my personal opinion that the state of the horse’s feet is often to blame for this. Jason and I have a running joke that if vets continue to treat the soft tissue injuries while “tweaking” the shoeing package we will never hurt for business. I know that sounds like a harsh statement but it is simply a truth that we see played out over and over.
An interesting observation is that some of the easiest transitions out of shoes are the ones that you would think would be the hardest. Without fail horses with navicular, pedal osteitis, and ringbone often don’t even need the boots for a period of time after pulling the shoes. The right trim combined with the right lifestyle and the right nutrition is really a magical thing.
Someone asked me once what I would do if I had a horse showing chronic lameness, especially when all rehab options kept failing. I would pull the shoes, make sure the horse had a good, BALANCED trim, feed him a balanced diet, and turn him out for a minimum of a year. Don’t even look at soundness for a year. Even if the horse looks sound at month 9 leave it alone. The horse needs to look SOUND for at least 3-4 months running around in the pasture before you even think of putting it back to work. Too often the horse is put back to work as soon as it looks sound and it doesn’t last. I think a lot of these scenarios could be avoided if the horse was not put back to work until it had looked sound for at least a few months.
With most of the retirees here the hope is not for complete soundness but improved soundness, or maintaining where they were upon arrival. Simply due to the nature or extent of their issues leading to retirement there does come a point when it is time to step off the soundness roller coaster and save your sanity, and not all damage can be undone no matter how you trim, feed or otherwise care for the horse. Anyone who has experienced this realizes that you finally hit the point when when you’ve done all you can realistically do short of a body transplant. I’ve already covered that topic