Any discernible swelling or puffiness on any of your horse's joints warrants a veterinarian call; prompt and proper treatment can prevent or minimize more severe and potentially permanent damage. While waiting for your veterinarian, though, a good rule of thumb is to apply cold therapy immediately following the injury. You can use ice, cold water or a cooling poultice. Depending on the source and severity of the swelling, as well as your veterinarian's advice, additional treatments range from applying cotton standing wraps to surgery.
Contact your veterinarian if your horse displays any sign of discomfort, even if there is not yet swelling and he appears sound, to prevent a progression toward [irreversible arthritis](http://equusmagazine.com/article/coping-with-arthritis-in-horses-8356).
Ice and Hydrotherapy
Since you can't ask your horse to hold an ice pack to his leg, you need to find a way to apply cold treatment to reduce swelling and alleviate pain. One way is to apply pliable ice packs with a cotton wrap; you can also purchase ice wraps and blankets from equine supply stores. Lower leg and foot joints can be treated by placing your horse's feet in buckets of ice water.
Hydrotherapy sounds more complex than it is -- although some of the therapies can be elaborate. Any application of cold water is hydrotherapy, whether it's directing a stream directly on the inflamed joint via a simple garden hose, or with a specially designed equine cold saltwater spa.
While cold hydrotherapy is typically beneficial at the earliest sign of joint trauma, your horse may benefit from ongoing hydrotherapy treatment. Your veterinarian will guide you toward the proper length and type of hydrotherapy treatment.
Poultices and Liniments
Cooling poultices allow you to extend your cold and hydrotherapy efforts to leg and foot joints. Moisten butcher's paper or a torn brown paper bag and wrap around the poultice application, keeping it in place with a cotton standing wrap. This can be left on for several hours or overnight.
Liniments are typically applied once the initial swelling has been treated, or when your vet advises their use, as many generate warmth. They can also alleviate swelling and pain in older injuries or in arthritic joints. You can apply cotton standing wraps over most liniments for additional warmth; read the label carefully or follow your veterinarian's advice.
Many horse owners and veterinarians routinely use dimethyl sulfoxide, or DMSO, for joint swelling, particularly in sweat wraps. This powerful agent helps other therapeutic substances penetrate cell membranes. While it can do wonders for your horse, the wrong application can be harmful so always consult your veterinarian before using DMSO.
Make sure the area being applied is free of any **chemicals**, such as fly spray before applying DMSO, to prevent unwanted substances from entering your horse's bloodstream.
Non-steroidal Anti-inflammatory Drugs
Your vet may prescribe a non-steroidal anti-inflammatory drug such as phenylbutazone -- bute -- for several days following the injury to reduce pain and inflammation. A long course of bute can upset your horse's gastrointestinal system, but there are oral, injectable and even topical alternatives that can be used in long-term pain management if your horse's condition is chronic, such as with arthritis.
DMSO is classified as a NSAID.
Many joint injuries will require some type of long-term therapy; all horses are subject to degenerative joint disease, or osteoarthritis, and any injury that causes acute swelling will eventually lead to some degree of dysfunction in that joint. The more serious the initial injury, the more likely your horse will experience an earlier onset of arthritis -- which is why early treatment is so important. In addition to treating the primary cause of the swelling -- for example, surgically removing a fractured bone chip -- you have several options that may delay the negative effects of arthritis, including:
- oral or injectable joint supplements;
- interleukin-1 receptor antagonist protein (IRAP), which uses your horse's own re-injected blood to block a protein that can accelerate joint damage;
- extracorporeal shockwave therapy;
- or surgical bone fusion.
Your vet can help you weigh the pros and cons of each therapy or a combination of two or more, depending on the age and use of your horse, his prognosis for future performance and your ability to bear the cost of treatment.