I like to think of ice, and thus cold therapy, as nature’s anti-inflammatory. There are many modalities these days for providing cold therapy (cryotherapy) to equine distal limbs with options as low-tech as a feed pan with water and ice cubes or as high-tech as machines that include compression and massage action in addition to controlled sustained cold therapy.
There is increasing evidence of the value of cryotherapy for recovery and rehabilitation of injury in human athletes. Whole-body cryotherapy is not currently an option and not likely to be approachable for equine athletes. But the idea of providing post-exertional cold therapy has been validated and this will likely continue to push available technology toward advanced methods of regional cooling. I generally recommend cold-hosing and cold therapy following exercise rather than prior to exercise. Cold-hosing has the additional benefit of potentially providing some massage action, which can increase lymphatic circulation and has direct benefit in cases of distal limb edema such as cellulitis or lymphangitis.
The biggest downside to hosing the horse is the potential to increase the risk for localized dermatitis secondary to the increased moisture that can be trapped in the hair coat or under bandages applied to a wet limb. This risk exists even with simple bathing and especially when in warmer, more humid climates.
My typical recommendation is to dry the leg well and allow sufficient time for the legs to dry before putting the horse back in a stall and on bedding. Sometimes a fan is helpful, as is baby powder under bandages.
When using ice boots, it’s important to pay attention to the general hygiene of the boots themselves. Since the boots are often constantly getting wet and being re-applied across multiple horses’ legs, you can inadvertently spread bacteria.
When faced with an acute injury and lameness, I recommend cold-hosing or cold therapy as much as possible during the acute phase. This usually means using ice boots or cold-hosing for 15 to 20 minutes, three to four times during the day for five to seven days. I have had really good success using a combination of ice, water and Epsom salts and will sometimes also include a liniment. This combination really keeps the temperature cold and helps it last a bit longer.
When a horse is starting back into work after an injury and time off and there is no longer an acute injury to worry about, I will curtail the cold therapy to after exercise only. I recognize that a pair of ice boots doesn’t get nearly as cold as some of the currently available cold-therapy devices, but they are relatively low budget and easy to use and one can leave them on a horse while doing other barn chores, and that generally means that clients are compliant with the recommendation. A machine may be more beneficial, but only if it actually makes it on the horse. Sometimes low-tech is better than nothing at all.
Christina “Cricket” Russillo, DVM, graduated from the Tufts University School of Veterinary Medicine in 2001. Following graduation, she completed a large animal medicine and surgery internship at Texas A&M and realized her desire was to work on elite sport horses. After 13 years of practice at Fairfield Equine Associates in Newtown, Connecticut, focusing on high-level show-jumping and dressage horses, she joined Virginia Equine Imaging in 2015. Russillo relocates to Florida every winter to support her clients in the Wellington area. She is a member of the International Society for Equine Locomotor Pathology and hopes to attain certification next year. In February 2017, Russillo was appointed the U.S. Dressage Team veterinarian. In addition to her busy schedule focused on sports medicine, she enjoys spending time outdoors with her husband and daughter. She has competed through Third Level and loves to play tennis.
This article first appeared in the February 2018 issue of Dressage Today.