Dear Audrey,
My 12-year-old Thoroughbred won’t lie down to sleep. He will lie down to roll, but it looks painful…even when he’s not stiff, rolling looks like this. I was always focused on his front legs since he has an old, healed dead kid fracture, but it really seems like his hind end won’t bend. What can I do to help him lie down more comfortably?
Thank you so much!
Kandace

Hello Kandace from Denver!

Unfortunately, IF your horse is not able to lie down to sleep comfortably, he is sleep deprived. The question I have for you is: Does he lie down at night/day to sleep for any period of time, or is he falling/collapsing and unable to lie down? Sleep-deprived collapsing horses are another topic that I will address in a later blog, but I am unsure if this fits the information that you gave me on your horse. You would need cameras on your horse to see if he is actually lying down to sleep or if he is collapsing and not sleeping. Many people do not recognize that their horses are collapsing, not sleeping, and do not sleep because they still have shavings on them, as many are falling and unable to stay down due to the pain present when they are down. The first indication of a horse that is sleep deprived and collapsing is front fetlock or knee abrasions on the front limbs. Please look at him and let me know. The absolutely horrific and inconceivable fact is that there are fetlock boots being manufactured as a solution to this problem! I am going to use some very improper grammar here…. The VETERINARY PROFESSION should’ve, would’ve, could’ve solved this problem in the first place; it would not have happened at such a high number to warrant multiple manufacturers to manufacture a temporary solution that does not solve this problem!

The most important point I need to make is this:
JUST BECAUSE A HORSE CAN ROLL DOES NOT MEAN THEY CAN LAY DOWN TO SLEEP!

The next thing I have to tell you about your horse…this is NOT A QUICK FIX! Remember this, as I am going to go into more details now.

Unfortunately, I see many horses, very young to middle-aged horses, not comfortable or able to lie down to sleep or roll in their stalls or outside. Many owners, like yourself, express these exact concerns to their veterinarians. The unfortunate point is many veterinarians will avoid or pass this information off as “its ok and just the way the horse is” or simply do not know how to help you or your horse, as most horses with these problems/concerns are seen in elderly horses. Your horse is only 12 years old and does not fit into the elderly category. So what do we/you do? I always start by asking questions to solve an unknown solution to a problem.

The questions everyone needs to ask to understand this problem is:
1. Does the horse have difficulty flexing/folding the front limbs? Yes/No
2. Does the horse have difficulty flexing/folding the hind limbs? Yes/No
3. Or is it both, a front and hind limb flexion/folding problem? Yes/No

I would say by watching the video with your horse the answer to the questions asked is #3, BOTH front and hind limbs. The hind limbs are worse than the front however both are affected with inability to flex/fold to enable the your horse to lie down or to roll.

If the front limbs are having a hard time flexing/folding to enable a horse to lie down, then there are several problem areas I would look at:
1. Lower cervical region and all structures.
2. Wither/scapular region and all structures.
3 Thoracic/saddle region and all structures.
4. Ribcage/sternal region and all structures.
5. Carpus/knee pathology

One to five above are all the regions affected, along with all the structures involved in each region, which do not allow a horse to flex/fold its front limbs. This region I call CCSG: Cervicothoracic-Costosternal-Scapular Girdle. I hate to say it, but it is the most difficult and complex region of any horse to treat and deal with, but with the right veterinarian, they may be able to help pinpoint which of the 4 regions or regions and 1 distal limb structure to focus on and treat. Most of the problems I see with horses unable to flex/fold their front limbs is caused by equipment. Plain and simple, equipment! Fixing the equipment will help solve this problem in acute cases but not chronic cases where extensive treatment is involved, and that will depend on a proper diagnosis of region(s) involved.

If the hind limbs are having a hard time flexing/folding to enable a horse to lie down, here are the problem areas I would look at:
1. Lumbosacral region
2. Coxofemoral region
3. Stifles

Again, 2 regions, 1 distal limb structure, though all can be affected. I would vote for #1, as this region needs to flex extensively for a horse to lie down and also to be comfortable to stay lying down. The hard part will be to find a veterinarian that is qualified and skilled enough to understand how to treat these regions because just the lumbosacral will not fix this problem (NOT SI)! May help temporarily by giving some pain relief but will not solve the problem, which is more complex in understanding and above this readership or your pay grade.

Going to rant for just a second….THIS is where the big gap in knowledge is present in the veterinary profession, and it is not their fault, because NO ONE teaches OR understands the biomechanics of how a horse works! If veterinarians knew, then you would not have to Dear Audrey me because veterinarians would already look at this short video and say… EASY PEASY, as I did and know exactly what was wrong and how to treat your horse! It is plain and so simple to me with your horse….but that DOES NOT help you with your horse since we are 1000 miles away from each other! THIS IS THE EXTREME FRUSTRATION THAT YOU FEEL, I FEEL, AND ALL OF YOU FEEL, WITH YOUR HORSES! UURRGGHHH! I feel it, trust me, and this is how you all can help to help more horses, simply spread the word with this blog. I will be teaching biomechanics to veterinarians and trainers this year! Watch my website, this blog and social media. It is the only way we can PREVENT another horse like your own from having these clinical signs! Ok, sorry about the rant but I am just as frustrated as you are about finding veterinarians that have the understanding and knowledge to deal with and treat successfully horse like yours! It is not a simple conversation on the phone and
WALA, they can treat and get your horse comfortable to lie down. How I wish this was true!

Remember what I said earlier about your horse…this is NOT A QUICK FIX! That remains true still 800 some-odd words later. One treatment, one whatever, will not fix this problem and costs money. It is complex and multifactorial…meaning many, many factors causing and affecting regions that have created these clinical signs and inability to get down and stay lying down comfortably. One simple thing you can do right now is to consult with your personal veterinarian about pain management and muscle tension management that can be helped with prescription medicines. This will help with the pain present and muscle tension present to allow him to lie down more comfortably and hopefully sleep for some time lying down if he is not. This is a chronic problem, so it will take sometimes several weeks to months of medication to see changes. Remember, no quick fix. Small baby steps are what you are looking for, not miracles.

PEMF, MAGNA Wave, physiotherapists, massage therapy, and acupuncture will all help a lot with muscle tension/pain. You can try chiropractic options, but please ensure that the person is qualified and certified because you need to be careful with what is going on with your horse, as it could get worse. All of these modalities will help along with light exercise at walk-trot only.

Hope this helps some. I know it does not solve your problem but gives you regions to look at to help your veterinarian if they are open to learning. If your veterinarian would like to speak to me please have him/her call me. I can explain things to them in more detail to help. They have to call me….I WILL NOT CALL THEM…because THEY have to want to learn! My philosophy is that I will only feed the hungry.

Thanks for reaching out, and please let me know if you put/have cameras on him if he is actually lying down to sleep.

Kind regards and big hug to you and your horse,

Audrey