To Treat and Spell or to Spell and Treat?

  When an owner has many thousands of dollars and a large chunk of hope invested in a competition or racing horse he or she is open to suggestions for what used to be called ‘Heroic Medicine’.  When the Vet and the Trainer also have their hopes and reputations invested in the same animal, the tendency is almost always to Treat first and if that fails to Spell the animal. 

  The logic behind this approach is;

  “Well we did our best but now we need to let nature take its course!".

  There is no doubt that to Treat and Spell is the most expensive approach.  It is also clear that in many cases, it is not the most logical approach.  If we believe that nature has a chance to heal when interventionist medicine has failed, surely the most logical approach in many cases is to let nature have a go at it first. 

  Our bodies and those of our horses were designed to heal themselves, not like our motor cars, which were not.  Nature has provided all living creatures with healing mechanisms to help us recover from accident along with instincts and an immune system to help us deal with illness.  The fact is, we often do more damage than good, in our impatient efforts to intervene and treat as a first response.

  The Accident:

  In a natural environment there is absolutely no question that the best approach for all but a tiny number of accidents is first aid, followed by rest and a managed treatment and recovery program. 

To take an example by way of illustration of a horse, which went through a fence and inflicted a large open wound on the leg, partially sawed through a ligament and also presented lame with inflammation and pain in the hoof.

  Orthodox veterinary practice may call for topical and intravenous antibiotics (to protect against infection), maybe probing to help clean the wound, sedation and stitching to attempt to close the wound and Bute for the pain and inflammation.  Management advice may include stabling (to prevent the horse inflicting further damage) for some weeks followed by some more weeks in a small yard (while the wound heals) and ongoing Bute to manage the pain and inflammation while the hoof heals.

Analysing this approach from a holistic point of view comes up with some very serious shortcomings indeed;

a.      There was nothing done at all to treat for shock.  Indeed, further severe shocks were inflicted in the form of sedation which savagely depletes adrenal reserves, injections which administer severe shocks to the immune system by having unnatural substances show up without warning in the blood.  Added to these will also be probing, stitching, X-Rays, and various manipulations, possibly also travel while injured and a stay in hospital, all involved in ascertaining the extent of the injury.

b.      Pain is nature’s restraint and it is pain, which allows the horse to know what level of movement is appropriate to all stages of healing.  By using powerful painkillers, we allow the animal to bear weight when it is not appropriate to do so and to allow a range of movement, which can further stress healing tissue.  In order to reduce the problem of further damage (or often just to stop from tearing the stitches), we restrict the animal to its stable and force it to stand almost motionless during the first critical stages of healing.  Bute also has the potential to severely damage the digestive system after a relatively short exposure, thereby possibly compromising the nutrient intake needed for healing.

c.      Confinement restricts the animal’s movement and restricts them to a single surface texture underfoot while keeping them away from natural fresh feed substances and herbs and weeds which their instincts would have them seek out, to aid the healing process.  Confinement also allows neglected and injured ligaments to scar and to shorten maybe compromising their elasticity and function forever.

d.      Stitching forces the surface layers of a wound to heal together (possibly out of alignment) but more importantly, before the wound has had the opportunity to seal and heal from the inside out while at the same time naturally expelling foreign bodies or infective material.

e.      Antibiotics kill bacteria good and bad thoughout the whole system leaving debris for the blood to deal with and promoting the emergence of resistant organisms while damaging gut flora which further compromises the digestive systems ability to obtain nutrients so essential for healing.

I am really not saying that all the tools of orthodox veterinary medicine are bad or dangerous.  What I am saying is that just because we have the tools, the medicines and the surgical techniques does not mean that we should automatically use the whole range at our disposal as a first response to accident.  Every single situation should be evaluated from a whole health point of view, and decisions made with this constantly in mind. 

Contrast for a moment the above scenario against the typical advice I would give in such a situation;

a.      Immediately treat for shock by giving Rescue Remedy orally.

b.      Gently examine the wound and flush it with water and apply an antiseptic/styptic combination of the herbs Calendula and Yarrow to which has been added further Rescue Remedy.   The styptic will seal blood vessels and encourage healing from the inside of the wound outward and the antiseptic will prevent infection.  If the positioning and the nature of the wound allow the edges to be held together with tape or light bandages, do this.  If this is not the case, don’t worry about closing the wound, just attempt to organise a way in which it can be protected from further dirt or debris.

c.      Bring the horse to comfortable protected surroundings and provide plenty of bedding and warmth as required for comfort.  Continue to treat with Rescue Remedy and small repeated drenches of herbal teas made from dried Rosehips and fresh Hawthorne leaves, if available, for central nervous system and adrenal shock.

d.      For initial severe pain only, consider Bute for one or two doses.  Rather, if debilitating pain persists, use herbal anti-inflammatories containing herbs such as White Willow bark which will reduce but not mask pain allowing the horse to correctly judge what degree of movement is safe at the early stages of the healing process.

e.      As soon as the horse’s appetite returns, feed healing herbs suitable for supporting healing of ligament injury and circulation to the area and to the hoof.  Continue to change dressings and to bathe the wound periodically using simple antiseptic treatments like Calendula or Hydrogen Peroxide.  Arnica may be used to promote the reduction of soft tissue and of bone bruising but should not be used until bleeding has stopped and not too close to the open wound. Topical herbal preparations should be applied regularly to the hoof to reduce inflammation and to promote circulation to the limb generally and healing within the hoof itself.

f.        As soon as the wound has sealed it should be left uncovered regularly and preparations containing the herbs Comfrey and Linseed should be applied daily to support healing and to minimise scarring.  These can either be in the form of poultices using the fresh leaf or root crushed into linseed oil and held in place with bandages or the same ingredients mixed into an ointment base for those areas not amenable to strapping.

g.      Allow the horse free access to an exercise yard and pasture, obviously managing distractions like other horses in the same enclosed area, but not locking it completely away from its companions.

h.      Treat any signs of infection with natural antibiotic substances like Garlic or Colloidal Silver along with alterative herbs to assist the immune system and the blood to deal with such problems.  In fact, in the injury described in our example, and treated as recommended, septicemia is extremely unlikely and could only occur if very obvious early signs were ignored.

i.         Reduce very quickly all dependence on pain management herbal or otherwise and allow free access to pasture and hopefully to herbs.  Freedom to exercise will speed the healing process and progressively allow the flexing and testing of the healing ligaments ensuring their return to full health, strength and elasticity.  Walking and exercise will also allow the natural pumping action of the pedal bone to bring circulation to the hoof and to carry fluids away via the same mechanism.  Confinement can subvert this very important function, at best compromising the rate of healing, and at worst leading to permanent damage within the hoof.

j.         In the case of a competition horse, a structured work program should be recommenced as soon as healing has progressed to the point that normal walking and running around has returned without lameness.  While healing process are still active it is important to structure work to further focus healing on those areas needing extra strength and fitness for the sport in question.  Herbal support is to be continued throughout this buildup in work. The herbal treatments should continue all the way up to 100% effort in training and continued for the first three months of competition to ensure the ligaments are fully fit and fully recovered all the way up to the full demands of the sport.

In the above example over a period of 6 months using my preparations of Trauma Drops, Antiseptic Styptic, Tendon and Bone Healing Mix, Hoof Oil and possibly Anti-Inflammatory Healer the total cost of treatment would be well under $1000. 

At the end of that 6 months I would expect the horse in this example to be in full work, totally recovered and, with the followup during the first three months of competition, I would also expect no signs or weakness and only minimal scarring.

Where was the Vet during all of this you may ask?

a.      If the injury involves arterial bleeding the Vet is called immediately after attempts to stem the blood flow are in place.

b.      In all other cases a Vet, experienced in this sort of injury (you don’t want a bright young thing with a book and no experience), should be called as soon as you have the animal treated for shock and settled comfortably.  The task of the Vet is to evaluate, with minimal further stress to the animal, the pain levels involved and the extent of the injury in general terms.  If Bute were called for the Vet should be the one to administer this drug.

c.      A followup visit after two or three days to re-evaluate the extent of the injury and to decide if in fact further intervention or surgery was absolutely necessary.  If you have any doubts about the advice given, seek a second opinion before proceeding.  During this visit also it should become clear if the horse’s natural immunity is coping with any infection and if not, the appropriate treatment should discussed, maybe with input from your Herbalist.

d.      After 3 weeks or so, a further visit preferably from a Vet, Trainer or other experienced professional in your particular sport, to advise of specific flexing, exercise and training appropriate at this early stage of recovery and to lay out a program for the coming weeks. 

e.      A final visit after 3 months to access if the animal is ready to commence full preparation leading to competition fitness within the next 3 month period.

Total cost of professional consultations maybe around $600.

--Robert McDowell , Herbalist.

November 1999.