Post Operative Recovery Programs

The first racing preparation after surgery is referred to as a ‘RECOVERY PREP’.  With the completion of this RP and a further 6 weeks paddock rest the horse is referred to as RECOVERED or NORMAL!



WHY do we need a RECOVERY PREP?


Because horses with throat/breathing problems are often


1) born with  (i) anatomical anomalies ( not strictly abnormalities rather

                         variations of  normal!)

                      (ii) a genetic tendency towards suffering asthmatic or

                         inflammatory & infectious ‘ lung problems’.  These lung

                         or lower airways conditions can then increase the

                         pressure on the throat ( upper airways) causing it to   

                         dysfunction.


2) as weanling / yearling’s - suffer protracted lower airways infections ( colds/ viruses) and may incur downgrading of connective tissue elements in the throat leading to increases in upper airways collapse ( breathing problems).


But then the DIAGNOSIS or AWARENESS of these dysfunction's is often not made until these horses are put under gallop or race pressure some years later. Indeed horses with throat problems have often been know to win or perform very well in  ‘easier’ races and thus the dysfunction's do not become obvious till later in their careers. The attitude that if they are winning then there is not a problem is quite common.

Also horses with these problems often race well with ‘fresh lungs’  i.e. first few starts in a campaign before ‘going off’ or only race well when ‘freshened’ (again fresh lungs). OR only race well  when lungs are being constantly treated!


All this then means that there is often a considerable GAP between the onset of the problem and its eventual diagnosis. In fact we not uncommonly see 6-7 year olds that retrospectively have probably had these dysfunction's since being first ridden and yet with both training and pulmonary ( lung) management have pleased their connections by winning a good number of races. As to whether they would have raced any better if the underlying problem was treated earlier is a question for those with ‘crystal ball’ capabilities. Personally I would prefer to treat the primary problem initially rather than be continually treating the symptoms over the horses racing life.


Once we understand these facts we then realise that .......


(A) The bigger the gap between the onset of the dysfunction and the eventual diagnosis and treatment and ........

(B) the more pressure ( both training & racing ) that the horse has to cope with during this period or GAP .......

the more the post operative PROGNOSIS for successful racing DECREASES!


Why?


Well a useful analogy might be the requirement for adequate lighting in a factory. If the factory lights are dimmed during work hours both the quality and quantity of the work is likely to suffer. In addition the number of machine and staff ‘accidents’ or ‘trauma’ will increase. The longer the lights remain dimmed the more one could expect to have long term damage to machines and staff.

Now even when the lighting is rectified it is likely to take considerable time to restore production to normal. i.e. by treating the injured and repairing machinery. If however either persons or machines are not repairable or at least not to prior standards then production levels will be permanently affected!

N.B. If work ceases during this event then production will be affected but at least damage to machines and staff are averted.


Similarly horses that have airways dysfunctions are often still subject to training and racing stresses which often leads to damage of two main types.

1) Psychological trauma - in general the more often these dysfunction's occur, the more pain and or discomfort the horse feels and the more resentful they become. Nervous , fired up, not wanting to go on the track or into barriers, overworking / pulling , over racing or ‘not trying’( can’t or won’t run even time). are not uncommon psychological consequences!

2) The lungs are being undersupplied and try to compensate by ‘sucking harder’  which means more dangerous negative or suction pressures are being applied to the fragile air sacs and vasculature in the small or terminal airways. An increase in the incidence or severity of inflammation and or bleeding is an obvious consequence.

In addition direct contamination of the lungs with oral contents ( food, saliva & bacteria from the mouth) due to mouth breathing is another consequence of incorrect breathing. Over a period of time this will affect both lung integrity and function.


Obviously the longer training and racing continues whilst these horses are under powered the less likely it is that full racing performance can be achieved following corrective surgeries. And as importantly any return to form will not happen the instant upper airways ( throat) are repaired but will more parallel repair processes and improved function in the lungs. People who talk about getting horses back onto the track quickly should be aware that most horses that come to surgery also have concurrent inflammation, bleeding and sometimes infections of their lungs. If returned quickly ............ ‘good air to bad lungs’ may feel better from the horses point of view but the owner / trainer is less likely to be overjoyed as race form will often be no different or at least not for some time. ( new carburettor on a dicky motor?)


So. prior to contemplating surgery one should


(i) Have an assessment of ability.

(ii) Consider length of time dysfunction has been present and thence general condition of lungs. Has the horse bled from the nostrils, tracheal sample results ( T- Wash, BAL) etc.

(iii) Be prepared to put the horse through a recovery program which is time consuming and therefore comes at a cost.


Also the length and extent of recovery and degree of attention required for an individual horse will be proportional to the amount of pressure and thence trauma that it has already incurred!


POST OP RECOVERY PROGRAM


General Principles.


Type of work - Post operatively it is best to ‘forget that you knew the horse’ ... start again’. Horses that ran well ‘fresh’ preoperatively will most probably ‘blow up’ if trained the same way post operatively! Plenty of long work canter pace work with appropriate gallops is the norm post op. Look at it this way. You hopefully now have a horse that  gets its ‘proper air supply’ ..... so use it! Otherwise why did you have the surgery done?



Type of riding - A horse will normally adopt a head/neck/body frame which creates the best airway. Let it do this. By working it on its own, putting hands on the whither and letting it work on a long rein, and take a comfortable lean on your hands ( just on, to just off the bit... fly fishing ! ).

If preoperatively they had become pullers then once fit enough let them do a little too much early and they will eventually come back to you. The truth is that they need that rein pressure to help support their throat ... if you don’t let them have it then they will eventually come back under you.. looking for your hands .. then you can give them support! Imagine you have a 10 kg fish on a 2 kg line. Heavy sand is a great place to do this as the sand assists by helping to get them off the bit.

Conversely if preoperatively the horse had stopped trying then post op a set of blinkers and a ‘strong rider’ may help challenge them... when appropriately fit!


Type of gear - As one does with a new horse start ‘Plain’. If a puller or mouth breather then a loose nose band or elastic nose band or crossover is your main training aid. Tongue ties ( for those that fiddle with the bit or get their tongues back) are reserved for trials & races.


Post Op noises - Firstly a ‘reality check’! The absence of noises post operatively has never been a reliable guide to future success! Many horses will still make noises particularly early in work when ‘fresh’ and lacking fitness. A better guide to whether progress is being made is in their behaviour and attitude to their work. “definitely more relaxed and not jacking up when going onto the track are ‘good signs’!

Remember these animals are elite athletes not opera singers!


Lung medication / ‘ lung cleaning’. - First prep ( recovery prep) only!

Akin to a horse coming back from a tendon or ligament injury one expects that when race pressure is reapplied it is quite common to get a little swelling or inflammation at the injury site. Similarly lungs that have been traumatised because of a pre-existing airways problems during prior training and or racing will often become inflamed at  this pressure stage! When this happens the horses breathing will become uncomfortable (asthma like) and it will usually stop ‘trying’ ( self preservation). When this happens a period of 7-10 days of walk only or half acre paddock rest plus treatment with clenbuterol twice daily plus an antibiotic if appropriate can be used to settle the inflammation down. We refer to this loosely as a ‘LUNG CLEAN’.

Treatment is not recommended whilst the horse is working. Dressing a wound and then using a light sandpaper on it makes little sense! Air rushing over inflamed airways is the ‘sand paper’!


Post Operative Recovery Program.


Example 1


Surgery - followed by 6-8 weeks in the paddock. 


12 - 14 weeks training including plenty of  long pace work. Water work ( rushing) or good sand / bush work are very useful once fit enough. If at the track a standard 2 laps of pace work after warm up is the norm.

1000M Trial ( some trainers prefer to trial twice)

then 2 weeks to Race 1 - Most importantly a ‘Don’t push Don;’t Pull ‘ ride .

A horse being ‘strangled’ or conversely pushed along when ‘off the bit ‘ are big NO NO’s !

then 2 weeks to Race 2 ... then 2 weeks to race 3.


Then 6 weeks in the paddock ( can treat with clenbuterol for first 7 days only).


The horse is now referred to as RECOVERED or NORMAL !

so return to normal training with breaks when appropriate.


Example 2


Surgery - followed by 6-8 weeks in the paddock. 


12 - 14 weeks training including plenty of  long pace work. Water work ( rushing) or good sand / bush work are very useful once fit enough. If at the track a standard 2 laps of pace work after warm up is the norm.

1000M Trial ( some trainers prefer to trial twice)

then 2 weeks to Race 1 - Most importantly a ‘Don’t push Don;’t Pull ‘ ride .

A horse being ‘strangled’ or conversely pushed along when ‘off the bit ‘ are big NO NO’s !!


then LUNG CLEAN ( 10 days with appropriate treatment)

and then resume training with 3 - 4 more races.


Then 6 weeks in the paddock ( can treat with clenbuterol for first 7 days only).


The horse is now referred to as RECOVERED or NORMAL !

so return to normal training with breaks when appropriate.



NB :-  VERY IMPORTANT IF THE HORSE RUNS A BAD RACE ( Doesn’t try or Stops)  during this first prep , don’t give it another race without a LUNG CLEAN first or you risk ‘BLEEDING them !!



There are other variations depending on the horses

          (i) individual surgery

          (ii) individual racing program

          (iii) individual state of health prior to surgery.