View Full Version : Bute & box rest!!!!!!!
4th July 2011, 03:35 PM
Little rant coming on now.
Not aiming this at anyone with lame horsies as I know there are a few about at the moment.
I hate vets with a passion, always have done BUT what I hate even more is that when a horse is lame, vet ALWAYS prescribes Bute and Box Rest.......
Now, in severe cases, yes I agree there are times when the horse needs to be confined and buted up but it seems to be common practise that whenever a horse is even slightly un level on one leg/foot, the horse must immediately be boxed up tight and dosed up to the eyeballs on bute.
In my mind, bute is only going to mask the problem. Unless proper serious lamness where the horse is not weight bearing and obviously in discomfort yes, bute is needed. But if it's something like a minor sprain injury why is the horse pumped full of chemicals to just mask the problem.
Also box rest - confined and restricted movement is going to increase chances of swelling and also build up stiffness. Is extra swelling/fluid and stiffness going to do the horse any good, well no IMO.
If the horse is moving, swelling will be kept down and the movement will help to keep everything working as it should. Long periods of box rest isn't any good for the horses tendons. Picture the scene, horse kept in for say 6weeks. Horse then goes out (no matter how small an area) and has a hoo haaa, putting strain on the tendon and risking injury to said tendon.
Even whilst horse is confined and on bute, horse is going to feel perfectly fine due to bute masking the problem so a "well" horse on box rest is more likely to injure themselves in the stable, be difficult to handle for the owners and it's not very good for their mental wellbeing is it. Saying that though, lets just get some sedalin from the vet and keep the horse half asleep fopr 6weeks :rolleyes:
Rant over, for now.
4th July 2011, 03:51 PM
I'm of that way of thinking too but bute is an anti-inflammatory so in much the same way as I had to rest my injured foot and take Ibuprofen and Paracetamol to give it time to heal then bute and box rest gives that opportunity to the horse. I have kept Stan out 24/7 and not ridden him for 2 weeks but he hasn't improved. I guess B&B is the next step in the investigation.
4th July 2011, 03:55 PM
Jane I'm not questioning Stans treatment at all. Individual horse and all and I don't know the in's and out's anyway.
What I am getting at is the fact that from what I see in every case of lamness, the bute and box rest is always advised willy nilly.
My Kiwi isn't totally sound, never will be due to his arthritis. I bet if I had a vet out B&B would be insisted whereas it would be the WORST thing for kiwi. It seems that no matter what is causing the lameness, B&B is always the "treatment", that's what I am ranting about.
4th July 2011, 06:37 PM
I think the idea of B&B is probably so they don't aggravate any possible injury.
It made my boy worse!!!!
4th July 2011, 06:44 PM
That's what I am trying to get at. In some cases B&B is going to make matters worse whereas in other cases it is the best thing. Vets seem to dish out B&B to every case with what seems like no regard as to whether it is A) necessary or B) needed
My Crazy Clan
4th July 2011, 07:37 PM
Sisco was told to be on stricked box rest and 4 bute, although I agreed with the bute because you could see he was clearly in pain! and like jane said it is an anti-Flam.
But when it was time to come out he would hoon about and cause him self to go lame again, which they said more box rest, in the end sisco and I were getting p***ed so I turned him out completely with bute, within a few months he was back out with the boys in the big field, best thing I ever done!
4th July 2011, 08:14 PM
Our vets are more likely to recommend bute , hosing and day or half day turnout on a flat field for non specific lameness. Or if the horse is a bit nutty in the field then in-hand exercise and hosing - so not all vets are the same.
However they know us very well and know the horses are monitored in the field. Some vets I think just want to cover themselves in case the horse injures itself further and if they have recommended turnout then they could be seen as liable.
Rhea, whenever we have had to box rest our vet has recommended in-hand and ridden work for at least 4 weeks before turnout (depending on the problem and the length of box rest) to avoid exactly what you are describing.
4th July 2011, 08:57 PM
ive never been advised to do bute and box rest, and its not what we would routinely do on any yard ive worked on, unelss its for an abcess of something, we would genrealy give bute bring in daily for a check and turf it out in the field
4th July 2011, 09:59 PM
When Milo was lame last year because of infected mud fever, his legs were really swollen, so it was bute, but under no circumstances was he to be rested - because it was infection they wanted him moving to get rid of the swelling. In fact the vet was out in the field with my friend chasing him around to get him shifting a bit. The vet commented that box rest can often have the opposite effect to desired, because they are standing around, the medication isn't circulating quickly through their system, and they would get better quicker when still being allowed to move around as the circulation is better.
4th July 2011, 10:18 PM
I think we're lucky with our vets. They are a solely equine practice and Bute and Box rest has never been prescribed for our horses other than for injuries where bute and box rest is needed. i.e. Prince's most recent injury, slicing open his leg, getting it too dirty to stitch, having to have it bandaged and poulticed and his movement needing to be limited so as not to put too much pressure on the wound, hence the box rest and the bute was administered more to relieve swelling as he never appeared to be in pain, he was also on a lot of antibiotics. He was in for two weeks but he quite likes box rest. Good thing seeing as he has 6 - 8 weeks box rest coming up, he's in for surgery next week.
Certainly our old practice, a general veterinary practice, where they more specialised in hampsters and other small creatures best cared for with a shovel over the head IMO (please don't take offense) administer box rest and bute for a week without fail before they'd undertake any form of diagnosis. As such they missed my horse having pulled his deep digital flexor tendon off the bone leaving bony chips floating in and around the tendon sheath. It took them over a month to diagnose the problem, fobbing us off for the 2nd week getting us to try field rest and bute. Poor Harley was soooo lame. In the end we demanded they scan and actually attempt to diagnose. Thankfully he was referred to a large veterinary practice and they were able to remove all the chips and a year on he was sound and able to do dressage, but he'd never jump again.
Sorry got on my soap box a bit there.
4th July 2011, 10:21 PM
I couldn't agree more, my cousins mare has laminitis at the moment and our barefoot lady said try and move her to relieve the pressure and swelling in her legs and get the blood going, so we have ben walking her around our school for ten mins twice a day, (with millie munchers cavalos on), now the vet has said under no circumstances is she to be allowed out and he has upt her bute to 3 sachets a day (she is 23 has cushings and is only 12.2) i am no vet but my heart tells me this is wrong, and goes against everything i know about the human body, blood will always go to the lowest point and stay there, thats why when you see runners stop at traffic they always keep moving as the sudden decrease in movement causes blood pooling and can make them faint as oxegen levels fall, I know the advice is to keep them in when they have laminitis but why did our barefoot lady say keep her on the move? now i know we are different in make up to horses, but we are skin and bone, tissue and tendons alike, am i barking up the wrong tree or just barking mad to disagree with a vet?
4th July 2011, 10:50 PM
You "hate vets with a passion, always have done",
Right, I'll bear that in mind. Also maybe you should bear that in mind if something ever comes up with one of your horses that your vet, and only your vet, can treat, like for example, a horse that my vet had to go out to every 2 hours for two days to drain the air out of it's chest after it staked itself on a post and rail fence. I'd dearly like to see the physio/back-man/chiropractor/NH therapist/bowen therapist/animal communicator deal with that one.
Yes, I agree with you that some vets will advise bute and box rest before anything else but I'd hazzard a guess that if you did a survey of all of the cases that this was prescribed for, it did do more good than harm. Vets cannot accurately scan a tendon until the inflammation has gone down. Bute is an anti-inflammatory. The vet does not know that your horse isn't going to do himself more damage out in the field and unfortunately we can't explain to Mr. horsey that he will hurt himself more if he has a bit of a trot around the field, or spooks at something and gives his injury another jerk.
Just imagine for a second, your vet comes up to see your horse who has "strained something" and is now acutely lame. What exactly would you prefer your vet to do? Tell you "ah sure he'll be fine, just throw him out into the field. We won't give him bute to alleviate his suffering, because, perish the thought, we wouldn't want to Mask his pain!" You do as he says. Some deer jump into your horse's field during the night, he gets a fright and is on three legs the following morning. Are you going to just shrug your shoulders and say "oh well, at least my vet didn't tell me to put him on box rest, otherwise his legs might be a bit filled up today and that would be a real tragedy." I'd guess that most owners would be straight on the phone to (a) another vet to tell them that the first guy was an idiot (b) their solicitor and (c) the vet in question to tell him that he is an absolute idiot and that they have got a second opinion to say that he was negligent and that he will be hearing from their solicitor.
Come on! We go to college for 5-6 years. Believe it or not, we have a fair idea of how your horse works, how disease works and we know how to predict your horse's reaction to disease and injury! If you don't want your vets advise and if you don't value her advise then DON'T CALL the vet in the first place! Deal with it on your own.
And as for the argument that the horse is going to get wound-up in the stable and then go crazy when you do put him out, well, common sense would surely suggest that you don't just chuck him loose in a paddock after 3 months in a stable then! Any vet that I've ever been with that has prescribed bute and box rest has always been sure to also suggest hand walking and hand grazing every day so that this doesn't happen. As for the horses that are truely going to go insane in the stable, the owner has been told to put them in the smallest possible paddock.
Sherman: the reason behind putting a laminitic on box rest is to minimise the mechanical strain on the laminae. If the laminae are breaking down and the pony is walking around, he is effectively helping this breakdown to happen. I would be very skeptical of a practitioner who tells someone to keep a laminitic moving just to keep the blood moving, unless the disease has been stabilised and the pony is sound. It doesn't make sense while the pony is still at the lame stage. I don't see how that is Not going to exacerbate the degeneration of the laminae and will more than likely lead to pedal bone rotation and sinker.
4th July 2011, 11:10 PM
You "hate vets with a passion, always have done",
Right, I'll bear that in mind. Also maybe you should bear that in mind if something ever comes up with one of your horses that your vet, and only your vet, can treat, like for example, a horse that my vet had to go out to every 2 hours for two ............... a laminitic on box rest is to minimise the mechanical strain on the laminae. If the laminae are breaking down and the pony is walking around, he is effectively helping this breakdown to happen. I would be very skeptical of a practitioner who tells someone to keep a laminitic moving just to keep the blood moving, unless the disease has been stabilised and the pony is sound. It doesn't make sense while the pony is still at the lame stage. I don't see how that is Not going to exacerbate the degeneration of the laminae and will more than likely lead to pedal bone rotation and sinker.
Point well made. (sorry cut some out as it was a very long quote, made a lot of sense.)
4th July 2011, 11:14 PM
As I have said a couple of times now, I am not talking about specific individual cases here, it's just in general. Maybe it's the area I am in, I don't know but IME any lame horse gets shoved in a stable and dosed up to the eyeballs on bute. This is REGARDLESS of what is causing the lameness in the first place. IME many a vets I have come across do very poor examinations of lame horses, they just dish out the B&B there and then with no more thought.
Obviously my experience of vets isn't good, which is why I detest them so much and no, I don't call the vet until every other option has been looked at and only as a final resort. I wouldn't not call the vet IF required, however it does have to be a serious problem before I will even consider getting a vet involved.
4th July 2011, 11:37 PM
Ok so your vet is good enough to save your horses life if they get a very bad colic or if they get an injury that is too bad for anyone else to deal with but they are completely incompetent at dealing with minor lameness. Is that the gist of it?
I know you're not talking about individual vets and clearly you've had some truly awful experiences with vets in order to feel that strongly about the entire profession but you can't put up a post like that and expect someone like me, who has devoted the rest of her life, at a cost in the region of 100k in order to be a vet, to not be more than a little bit upset at this notion that vets are the lowest of the low and that everyone else's opinion should be favoured above the vet's opinion.
I have to log off now, because I will be up at 6am to go with my vet to scan a mare before she goes to stud, then mark and microchip 15 unhandled 2 year olds and then take some x-rays. I really don't know why we're bothering with any of it really, I'm sure the alternative practitioners would do a much better job of it all.
4th July 2011, 11:50 PM
I'd dearly like to see the ..... NH therapist/bowen therapist/animal communicator deal with that one.
Nothing to add, that just made me laugh :lol:
I've never had an issue with any of my vets. The times Saffy has been prescribed bute and box rest it has worked and she's recovered quickly. She's never had any major problems though so I haven't got much place to comment.
5th July 2011, 07:04 AM
I see the pros and cons with this.
When Becky went lame we got given bute but vet just said to continue turnout.
If horse is hopping lame then yes box rest is needed, its like yourself if you really twist your ankle and go to A&E they will say rest as much as possible but still keep moving. This will be box rest and a wolk out n hand for your horse. Well thats how I see it.
Sparkey I think you make a very good point.
5th July 2011, 09:26 AM
I'm sorry you seem to have had a rough time with your vets.
I can only really say good things about mine. They always come out and see what degree of lameness they are and tried to find what could have caused it and then sort out the best road to go down with them.
The longest I have had a horse on box rest was jasper 2 summers ago when he sliced his leg down to the bone. He had to be in for 3 months because they couldn't stitch it for various reasons and wasn't allowed to move much at all so it could heal properly.
When he was allowed out again it was in a 12 x 12 pen and then increased slightly every day with walking out in hand so he was getting out a bit but cntrolled.
This I would have thought would have been common sense for any horse that has been on box rest for more than a week?
Last week Flynn had a day on box rest of my own decision, he was stood in the field not looking right so I bought him in his feet were hot and his pulse was up, knowing his past he had a day in the stable and then as out overnight in the school as normal, next morning he was completely fine all back to normal and his grazing wad restricted even more.
If I had left him out all day he would have been far worse by tthe end of the day.
He wasn't lame as such in fact wasn't lame at all, I trotted him up to check and was fine, he was just not quote right.
5th July 2011, 03:34 PM
Ive built up a good relationship with my vet and will use her for everything with Bertie now, except obviously if it's an emergency. I trust her totally and do whatever she tells me to do with Bertie. If she advises box rest, that's what he gets, she hasnt done anything wrong so far and Im not about to decide whether she knows what she's doing. The bute and boxrest thing is usually an initial thing to do I think, like if you were limping round the doctor would probably say rest and paracetamol rather than exercise and an x-ray. Do you see what I mean? I think it's just the first stage of figuring out lameness that vets do.
Having said that, when Bert first went slightly lame last year she said to keep riding and dont box rest at all, vet's see things we dont (obviously lol) and my vet was almost 100% on Bertie having a joint problem, and didnt want him box rested in the run up to the appointment at the vet unit.
Hope all that ramble makes sense :lol:
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