Full-time stall confinement isn’t good for a horse’s physical or mental welfare. Horses are social animals who, in the wild, move long distances and eat small, frequent meals all day long.
Many domestic horses are stalled due to boarding situations, training, or for weight management. Daily turnout and exercise are essential when this is the case.
Sometimes, long-term stall confinement or stall rest is necessary for a horse to recuperate after a surgery or a significant injury or illness.
By restricting a horse’s movement to a small area, stall rest helps prevent the overloading of weakened, healing structures. This can support faster recovery and limit re-injury risk.
While your horse may need stall rest to get better faster, there are a number of factors to consider so you can keep your horse healthy while their movement is confined.
When do Horses Need Stall Rest?
Stall rest is usually defined as the restriction of your horse’s movement to an area of 12 x 12 feet (4 x 4 metres). Large breed horses may be confined to a larger area, such as 20 x 20 feet (6 x 6 meters).
The period or duration of stall rest will depend on the specific diagnosis and extent of the injury. 
Stall rest isn’t required for many injuries and, in some cases, may slow healing. However, it is commonly used with serious injuries, such as:
- Bone fractures
- Tendon, ligament, or severe muscle injuries
- Acute laminitis
- Post-operative recuperation, such as after colic surgery
- Lacerations or cuts requiring stitches
- Severe burns or infections
- Quarantine if a transmissible illness is suspected
Stall confinement is often needed in these situations to restrict movement and prevent your horse from further injuring itself.
As prey animals, horses have evolved to hide signs of injury or illness. If they have the space to do so, they may run or bear weight on injured limbs, causing further damage.
Risks to Long-Term Confinement
Horses evolved to wander and graze throughout the day. Confining them to a stall is not only boring but can also lead to serious health and behavioural problems.
Stall rest should only be used if absolutely needed under the guidance of a veterinarian. It’s also important to understand that stall rest can be counterproductive for recovery from many types of injuries.
Movement aids in the healing process by promoting blood circulation and the supports the delivery of nutrients and oxygen to damaged tissues.  Stall rest prevents normal movement and may slow healing.
Preventing freedom of movement and a lack of social interaction can also have negative psychological effects on the horse. 
Being aware of problems that stall confinement can cause, owners may be able to prevent them. The following are all challenges associated with long-term stall rest:
One of the most common psychological problems associated with stall confinement is the development of stereotypical behaviours.
Keeping a horse stalled inhibits the expression of natural equine behaviours, which causes stress and frustration. Some horses develop stereotypies, which are compulsive behaviours that may serve as a coping mechanism.
Stereotypical behaviours can be divided into movement-related and oral behaviours. They are repetitive behavioural patterns that serve no functional goal, but that horses may engage in for a large part of the day. Some of these behaviours can even be harmful to the horse. 
Studies show that stereotypies are associated with decreased social contact and insufficient dietary forage. Horses that engage in one type of stereotypic behaviour are more likely to engage in another as well. 
The most common stereotypical behaviours displayed by horses include:
Horses that crib-bite usually grasp an object, such as the water bucket or the top of the stall door, with their incisors, flex their neck, and suck air into their pharynx. Sometimes, horses that crib will even suck air without grasping an object.
Feeding grain or sweet feed is associated with cribbing, as well as lack of exercise. Researchers also believe that cribbing may be associated with abdominal discomfort. 
Once the behaviour has been established, horses will continue to crib even when turned out to pasture. Cribbing can cause damage to the incisors, and other complications include gastric ulcers and epiglottic foramen entrapment. 
Wood chewing is a behaviour that is similar to cribbing in that the horse will perform the behaviour by grasping wood with its incisors. However, unlike cribbing, the horse will chew and swallow pieces of wood it bites off.
Wood chewing is believed to be caused by a lack of roughage in the diet. Stall confinement, high-concentrate diets, and lack of exercise and/or stimulation can increase the chances of developing this behaviour. 
Weaving is a behaviour in which the horse repetitively sways on its forelegs, shifting its weight back and forth by moving the head and neck side to side. Weaving horses may also sway the rest of their body and pick up their front legs.
Horses that stall walk usually walk in circles in their stalls. Stress and anxiety appear to worsen this behaviour. Once turned out into a bigger area such as a pen or pasture, horses may continue to walk in larger circles.
Pawing is when a horse strikes the ground or a stall wall with one hoof. Though any horse may display this stereotypic behaviour at times, pawing can become chronic with repeated episodes throughout the day. Pawing appears to be the result of frustration or anticipation.
Another challenge of stall confinement is increased stress and changes in your horse’s natural feeding behaviour. These changes can lead to gut issues, such as gastric ulcers, especially if horses are stalled without free-choice access to forage.
Horses are unique because their stomach continually secretes acid to digest roughage, even if their stomach is empty.
Infrequent feedings often lead to long periods of time with no roughage to eat. Even when forage is provided free-choice to horses in stalls, they may spend less time eating than horses that aren’t stalled. 
If your horse spends long periods with an empty stomach, gastric acid can eat away at the stomach lining causing ulcers to form.
High-stress levels, diets with excessive grain and use of NSAID medications can also negatively impact the gastrointestinal tract’s protective barrier and increase the risk of hindgut ulcers. 
Research shows that stall confinement is associated with a majority of cases of impaction colic.
Physically, a horse’s digestive system does not function well without movement to promote gut motility (the transit of feed through the gastrointestinal system).
Because of this, horses on stall rest should be fed a minimal amount of grain and have free-choice good-quality hay to ensure adequate fibre intake. Horse also need adequate water consumption and should be hand-walked or allowed limited exercise, if possible. 
Owners should continually monitor their horse’s appetite and manure production. A decrease in manure or dry, hard manure can be a symptom of colic.  If colic is suspected, contact your veterinarian right away as it is a medical emergency.
Weakened Musculoskeletal system
Long-term stall confinement can lead to weakened bones, tendons, and ligaments. Strict stall rest can also result in adhesions of healing tissues, as well as reduced function and range of movement. 
Some veterinarians believe that strict stall confinement may actually be a less favourable choice for tendon and ligament healing.
Instead, graded exercise protocols that encourage healing without overloading the limb may be a better alternative to both stall confinement or pasture turnout. 
Anxiety and Depression
Extended stall rest can also lead to mood disorders, including anxiety and depression in horses, though some tolerate confinement better than others. In rare cases, a horse may need long-term tranquilization during stall rest. 
Some horses in stall confinement may develop drinking disorders. The most common disorder is psychogenic polydipsia, which is excessive drinking of water. 
Isolation from stall confinement can also lead to frustration, unwanted behaviour and resistance to training. This often shows up during handling, training, or trailer loading, leading to injuries in the horse or the handler. 
Aggression or hostility is another negative behaviour that horses in long-term stall confinement may develop. It may be caused by fear, pain, or hormones and may be learned or be the result of dominance behaviour. 
11 Ways to Support Your Horse on Stall Confinement
If your horse must be on stall confinement for any length of time, there are a number of ways you can support them and help to avoid common problems
You will likely need to change your feeding routine and monitor your horse closely for signs of pain and behavioural changes.
Below are the top 11 tips for managing your horse while on long-term stall rest.
1. Dietary Adjustments
Horses on stall rest need to be fed differently than horses at pasture. Your horse won’t need as many calories to maintain their weight while their movement is confined. 
To help prevent ulcers and colic, feed appropriately selected hay on a free-choice basis and reduce the amount of grain or concentrates in your horse’s diet.
If your horse is an easy keeper, use a slow feeder or hay net so your horse’s hay lasts a longer period of time.
Slow feeders are often less labour-intensive than placing hay in a standard feeder or on the ground several times a day. 
For horses that require additional protein sources, adding alfalfa hay will supply high-quality protein. Alfalfa may also help with buffering stomach acid to reduce the risk of ulcers. 
2. Nutritional Support
If your horse is recovering from an injury or illness, it is particularly important to avoid vitamin and mineral deficiencies in their diet. Nutritional deficiencies can impair the healing progress and slow down recovery time.
Feed a concentrated vitamin and mineral supplement to ensure that your horse is getting all the nutrients they need, without the added calories.
Mad Barn’s Omneity is a comprehensive vitamin and mineral supplement with a low-feeding rate that is appropriate for horses on stall rest.
To further prevent ulcers, your veterinarian may recommend feeding Ulcergard or GastroGard (omeprazole) as well. 
You can also feed Mad Barn’s Visceral+, which is a natural supplement recommended by veterinarians to help maintain the stomach and hindgut and support the immune system.
3. Pain Management
Any horse that experiences a serious injury or undergoes a surgical procedure will experience some amount of pain. If your horse isn’t moving much or is lying down more than normal, this could be a sign that they require more pain control. 
Talk to your veterinarian if you have concerns about your horse’s pain level. Firocoxib (Equioxx) is an analgesic (pain-relieving) medication that has fewer negative effects on the digestive system than traditional NSAIDs, such as Phenylbutazone (Bute, PBZ, EPZ). 
4. Adequate Barn Ventilation
An important consideration for any horse on stall rest is barn ventilation and air quality.
Horses exposed to dust from feed, hay, and stall bedding have an increased risk of inflammatory airway disease or equine asthma. Noxious odors and air pollution, such as diesel or gas exhaust, can also cause respiratory issues.
Good barn ventilation is especially critical for horses kept in the barn all day long.  You can improve your barn’s ventilation by opening windows or barn doors and installing vents or mechanical systems in the barn.
It’s also important to minimize dust wherever possible by using low-dust bedding and wetting down hay before feeding. 
Minimize activities that stir up dust, such as sweeping barn aisles, when there are horses in the barn. Remove your horse from the stall, if possible, during cleaning.
Keep stalls clean of manure and old hay, and use ammonia-reducing products to decrease the risk of breathing in this noxious gas produced from urine. 
5. Companion Animals
Horses are herd animals and do not like to be housed alone. Being confined in a stall is even more stressful on your horse if they can’t see, hear or touch other horses.
Because of this, horses on stall rest should have a companion horse stalled next to them or at least be able to see other horses out of a stall window. 
Another option is to provide a companion animal such as a chicken or goat in your horse’s stall or in the stall next door. If a companion horse or goat cannot be provided at all times, studies show that hanging a mirror in the confined horses’ stall may provide a helpful substitute. 
6. Utilizing Outdoor Pens
A better alternative to indoor stalls is to create an outdoor stall or pen that is approximately the same size as an indoor stall. Natural light and fresh air is healthier for horses and may support a quicker recovery. 
7. Boredom Busters
Since horses on stall confinement won’t be able to participate in normal species-appropriate behaviours, you may want to provide them with boredom busters to help pass the time.
Examples of enrichment activities that can prevent boredom include:
- Treats such as chopped apples or carrots frozen in ice
- Puzzle feeders
- Stuffed animals
- Playground balls
- Traffic cones
- Horse toys 
Playing music in the barn can also help to soothe an anxious horse. 
8. Anti-Anxiety Drugs and Supplements
Horses are creatures of habit and can become anxious when there are any changes in their daily routine or housing situation.
While some anxiety is normal, if your horse is experiencing excessive anxiety while on stall rest your veterinarian may recommend anxiolytic (anti-anxiety) drugs. Reserpine is a long-acting tranquilizer commonly used as a sedative to control excitable behaviour in horses.
There are also calming supplements that can support a relaxed demeanor, although research is limited. Products that have been used to reduce anxiety in horses include B vitamins, magnesium, and herbal combinations. 
Talk with your veterinarian if you are concerned about your horse’s well-being during stall rest.
9. Hand Walking
Depending on your horse’s specific situation, your veterinarian may recommend hand walking or hand grazing once or twice daily.
This controlled movement is good for both the horse’s mental and physical health. If your horse misbehaves, have someone else walk or graze a calm horse beside you. 
Most veterinarians recommend increasing hand walking gradually as your horse continues to heal. As they further recover, you may even be able to pony them from a calm horse. 
10. Ground Work and Grooming
Keep your horse on a similar schedule during stall rest. For example, if they are accustomed to daily grooming before riding, continue to groom them at the same time each day.
Ground work can also help prevent boredom. Teaching your horse to ground tie, getting them used to obstacles or walking showmanship can help occupy their time. Ground work can also further strengthen your bond with your horse. 
11. Massage and Stretching
Massage and/or stretching exercises can help to loosen muscles and joints and may possibly speed healing. Check with your veterinarian to make sure these exercises are safe for your horse. 
Transitioning to Turnout and Exercise
When your veterinarian has cleared your horse from stall rest, it’s time to transition back to a normal routine. Keep in mind that your horse will have lost some condition during recovery.
You will also want to increase exercise gradually to minimize the risk of re-injury. If your horse had a tendon, ligament, or bone injury, ask your veterinarian for repeat radiographs or ultrasounds to make sure your horse is ready to ease back into work. 
Start by turning your horse out in a safe paddock or pen to reintroduce green grass and free choice movement. Avoid turn out in round pens, as this might encourage running.
Once your horse is accustomed to moving around in a larger space, implement turnout with one or two calm pasture mates for short periods of time.
Make sure to supervise initial turnout times so your horse doesn’t overdo it by exercising or running too much.
Once your horse is cleared for riding, aim to slowly rebuild muscle tone with a structured exercise program designed by a qualified coach or trainer.
Continue stretching exercises and plan for at least three months of gradual exercise to get your horse back to where they were prior to stall rest. 
Is Your Horse's Diet Missing Anything?
Identify gaps in your horse's nutrition program to optimize their well-being.
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