Welfare considerations for management of horses on prolonged periods of box rest

Peeters et al. (2024) describe the presentation, diagnosis and successful management of an unusual fracture, of the femoral greater trochanter, in an 8-year-old Warmblood mare. Internal fixation was not considered feasible due to the high likelihood of implant failure at this location and financial constraints. However, based on successful outcomes with similar proximal limb bony protuberances, conservative management was undertaken with an excellent outcome—the horse returned to its previous level of exercise. The authors should be commended in this case report for considering the welfare implications of horses on prolonged box rest and reflecting on what further steps could have been taken to improve this mare's welfare. This clinical commentary will discuss the welfare implications of confinement in horses before expanding on further options for optimising the management of horses undergoing box rest. The term welfare is often associated with negative connotations, at least in part, this may be due to historical teaching of the subject revolving around the five freedoms (Brambell, 1965). The five freedoms focused on the absence of negatives to ensure animals have a life worth living. As welfare science has evolved, we now strive to provide animals not just with a life worth living but with a good life (Mellor, 2016) and we now recognise that welfare represents how that individual animal feels, that is their mental state, which is dependent on the balance of negative to positive experiences. This balance can be measured using the five domains model, which has evolved over nearly 30 years and now specifically includes intra-species interactions in addition to inter-species ones (Mellor et al., 2020). When considering the welfare of a horse on box rest, we should therefore consider the experience from that individual horse's perspective. To do this, we use the horse's behaviour as a proxy for their mental state, and some behavioural indicators of stress were suggested by the authors. However, previous work has shown poor agreement on the perceived level of stress a horse is experiencing among equine veterinarians (Pearson et al., 2021). Evaluating stress is challenging as individuals across all species employ different coping mechanisms (Budzyńska, 2012; Koolhaas et al., 1999; Vindas et al., 2017). It is easy to recognise the horse that employs a pro-active coping mechanism, it may be doing the wall of death round the box or frequently vocalising. But we should not forget that horses may also utilise a reactive coping mechanism (Budzyńska, 2012). Reactive coping often results in the horse appearing content in the situation, despite mounting a similar physiological stress response to those clearly not coping (Yarnell et al., 2013). Mice kept in a cage environment that meets minimum legal standards spend more time inactive but awake compared with those in an enriched environment, yet visibly they appear content. However, either moving them to enriched cages or providing anti-depressants significantly reduces time spent inactive but awake (Fureix et al., 2022). When you consider the depth and breadth of research demonstrating the negative welfare implications of keeping horses stabled, as reviewed by Krueger et al. (2021), we should always remain mindful that this is inevitably stressful, even in horses that appear outwardly to be coping. As demonstrated by Fureix et al. (2022), providing an enriched environment improves welfare. The term environmental enrichment is appealing and suggests we are creating a positive experience for the animal. But perhaps it would be better described as reduced impoverishment—as at best we are returning them to a life worth living, not a good life (Langford, personal communication, 2023). Engaging owners in the management plan whilst understanding their Capability, Opportunity and Motivation to change their Behaviour (COM-B) regarding their horse's care will increase compliance. Box rest is inevitably stressful for the horse and usually also the owner, yet we often underestimate both. Careful consideration should be given to how we can improve the horse's welfare under these challenging conditions. Involving the owner in decision making, discussing a range of potential options and the feasibility of each option in their individual circumstances maximises the likelihood of success. No funding received. No conflicts of interest have been declared. Not applicable to this clinical commentary.