What is involved in a horse’s recovery after the cross-country phase *H&H Plus*

As soon as he is safely over the cross-country finish line, the three-day event horse is met by grooms, support crew and vets. Their aim is to manage and monitor his recovery, maximising his chances of passing the vet inspection the following morning and performing at his best in the showjumping phase. As the rider dismounts, the grooms untack and check the horse over. Cooling is especially important in hot, humid weather. Heat produced by the muscles during cross-country will raise the horse’s body temperature unless it is dissipated. Core temperature usually rises within five to 10 minutes of finishing. Heat is lost via the blood vessels in the skin, so applying large volumes of cooled water over the entire horse is the most efficient cooling method. A horse’s temperature, which is usually between 37˚C and 38˚C, can reach more than 40˚C at the end of cross-country. If it rises above 41˚C, he may be at risk of overheating, or hyperthermia, signs of which include staggering, kicking out and a groggy, uncoordinated appearance. [subscriber-content]The competition vets observe the horse finishing, checking him for injury and monitoring his temperature, heart rate and rhythm, and respiratory rate. While galloping around the course, a horse’s heart rate may have reached 180–220 beats per minute (bpm). This falls to around 100–140bpm after the finish, and with normal recovery will decrease gradually to 80–90bpm. The time this takes depends upon the horse’s level of fitness. It may not drop further until he is in a quiet environment; heart rate returns to resting levels only when the horse is truly resting. Any arrhythmias (abnormalities in rhythm), are noted and monitored. Respiratory rate will partly reflect body temperature and also the amount of lactate build-up, or “oxygen debt”, in a horse’s system. This should reduce gradually. At a major event, a team vet or the rider’s private vet will be on hand to observe the general appearance of the horse as he pulls up, noting if he looks hot or exhausted and whether he is moving normally or shows any lameness or stiffness. They will identify any obvious wounds or blood and check that his shoes are in place. A more detailed inspection takes place as the horse is walking, to check for small wounds, over-reaches and stifle scrapes, or swellings on the legs once boots are removed. The vet will watch for any evidence of lameness, or the muscle condition exertional rhabdomyolysis (known as azoturia, or tying up), as adrenalin wears off. Any wounds are initially cleaned and covered so that they can be properly examined and treated back at the stables. If a shoe has been lost and the horse has to walk back over stony areas, the foot is bandaged. Ice may be used (over cloth, or tubigrip) to start cooling the tendons and ligaments of the lower limbs. Assessing injury Back at the stables, work begins to help the horse recover fully for the following day. The groom or rider will check him thoroughly for any new swellings, heat, cuts, scrapes or tack rubs, and check his mouth for split skin. It is important to know what each horse’s legs look and feel like normally, so that any changes can be easily identified. Ice is again applied to the lower legs, covering the tendons and fetlock joints – ice boots or whirlpool hydrotherapy boots are useful for cooling. Any knocks or scraped stifles will also be iced. A horse who has lost a shoe or has sensitive feet will benefit from standing in iced water. Ice is applied for 20 minutes and is then removed so that blood flow can return, before the process is repeated. Any significant swellings or cuts are examined by a vet, especially those near joints or tendon sheaths where penetration of a synovial (fluid-filled) structure is a risk. Clear information, using ultrasonography or radiography (X-rays) where necessary, will assist with treatment decisions and help determine whether the horse should continue in the competition. During recovery, the horse will be trotted up in-hand to assess for any developing stiffness or lameness. Feet should be well shod and in good condition prior to the competition. Common foot problems after cross-country include corns, bruising, quarter cracks and abscesses. A farrier can advise on appropriate management. Feeling the strain Over-reach wounds vary in depth, severity and the involvement of underlying structures. Bruising or a cut to the coronary band may be painful. A more serious injury may involve the tendon sheath and deeper structures – a tread from a stud near the coronary band may even penetrate the coffin joint. An over-reach should be cleaned thoroughly. Standing the foot in iced water can reduce inflammation and pain. A farrier may construct a shoe to take the loading off the affected area, such as a bar shoe with a flattened or “seated out” section. Stifle scrapes occasionally involve bone damage, such as a patella or tibial crest fracture, or injury to the ligaments or menisci of the stifle. Even with a patella fracture, lameness may not be obvious until later in the day. Radiography is necessary to identify fractures and ultrasound to assess soft tissue. Tendon strain injuries may be subtle, with mild lameness, or result in marked lameness or a swollen or thickened tendon. Knocks that do not penetrate the skin may still bruise tendon fibres and cause subsequent tendon injury, so need careful assessment. The suspensory ligaments and branches are prone to injury in the cross-country phase, coming under strain when the horse gallops, lands and turns. Suspensory ligament branch injuries may appear as swelling on one side of the fetlock, above the sesamoid bone. Ground conditions also have an effect: firm ground may result in jarred fetlocks and feet, while loose or deep footing, such as sandy tracks or mud, can cause tired, tight or sore muscles. Hamstrings and triceps are prone to soreness on loose surfaces. A sore back and muscles will benefit from physiotherapy and massage, along with walking in-hand and the use of therapeutic rugs and other permitted equipment. An equine physiotherapist can treat a horse throughout the competition and assist his recovery after cross-country. Before the final morning trot-up, a horse’s legs are usually iced and he is walked – and in some cases ridden – to help loosen him up. A practice trot-up is important, to spot any problems. A horse should be withdrawn where an injury is significant and competing would make it worse. With good management, hopefully he is sound and ready to go. Liquid assets Allowing the horse to eat, drink, relax and graze will allow vital replenishment of energy and lost fluids. Water intake should be carefully monitored throughout the competition. While hydration is important for optimal performance, remember that fluids themselves will not make a horse into a better showjumper. Recovery is mainly down long-term training and the correct preparation, along with the rider’s ability to give the horse a good ride both across country and in the showjumping phase. If dehydration is significant after the cross-country, or the horse has “tied up” or is colicky, intravenous fluids might be given. Such treatments will require authorisation by the FEI veterinary delegate, however, and their decision as to what is necessary or allowed may vary according to the event and the conditions. About the author: Liz Brown MRCVS focuses on the performance horse in eventing, racing and dressage She is an FEI vet for eventing and attended both the London and Rio Olympic games in her capacity as current team vet for the British eventing team. Ref Horse & Hound; 30 April 2020 [/subscriber-content]