by Heather Smith-Thomas

Horsemen for decades have used cold therapy as a treatment for injuriesÑto reduce swelling, heat and painÑusing ice boots, cold water hosing, standing in buckets of ice, etc. Modern technology has taken this a step farther with a technique combining cold water and salt. A cold saltwater spa for horses was developed in 1998 in Australia by professor Evan Hunt (University of Sydney). As a veterinarian, he had been doing research on the effects of cold saltwater on equine injuries. He and a gentleman from England, Ean Branston, teamed up in 2000 after Branston imported one of Dr. Hunt's machines to open an equine therapy center. The Australian version of the machine was very rudimentary, put together with available materials. Being a perfectionist, Branston improved it by using fiberglass, rounding the edges, recessing all the handles, putting cutouts in the doorways so the horses wouldn't catch their hips going in and out, and basically making it safer for horses. He incorporated about 20 safety features.

Ean Branston and Allen Gutowski (a horseman in New Jersey) became acquainted through an associate and made an agreement in 2005 to bring the product to the United States. The first equine spa in this country was sold to a man in Texas in early 2006. Now there are more than 150 machines in various countries, and 15 in North AmericaÑ5 of which are in Texas. Gutowski runs the ECB Equine Spa headquarters in New Jersey, distributing these machines.

"Everyone who has a spa has created a business with it. One person in California, for instance, is creating his rehabilitation facility with just our machine alone. Roy Ferro, in Texas, is running an entire rehabilitation business with this machine,'says Gutowski. Ferro, located at Southland Ranch, near Pilot Point, Texas was one of the first people in the U.S. to get one, and works with several veterinarians in that area who send horses to him for treatment. Ferro was a trainer for 45 years, then started working with equine rehabilitation, and calls his business the Cold-Salt Equine Hydrotherapy Center.

"I originally bought my machine to work on my own horses. One of my best mares was injured in a reining futurity and I wanted to get her healed. Then one of my vets saw the machine, and things went on from there,'says Ferro. He now treats many horses besides his own.

"I treat a lot of racehorses. Quarter Horses that run at Delta Downs in Louisiana and come up here to Lone Star Park in Dallas, come to me to have a treatment in the morning and then run in the afternoon. They use the spa at Delta Downs (which was one of the first in the U.S.) so they already knew about the machine. I treated 2 racehorses that recently broke world records, one for 300 yards. I've also done a lot of world champion western pleasure horses, reining horses, barrel races, hunt seat horses, etc. Bottom line is, it works,'says Ferro.

Some of the major rehab centers around the country and in Canada are using it as part of a multi-faceted approach to helping horses heal, recover from injuries or regain fitness, along with use of swimming pools, underwater treadmills, exercise machines, etc. The difference between this and the aqua-tread or Aquapacer is that they are used for helping keep a horse in shape or for getting a horse back into shape while recoveringÑto help with range of motion and regaining fitness. The spa, by contrast, aids healing and prevent injuries.

"Since I'm working closely with several veterinarians, it gives us a way to monitor healing,'says Ferro. "If a horse comes in with a suspensory problem, I may work on it for a week-and-a-half and then it goes back to the vet for an ultrasound, then comes back here. We get a good chance to really see what this machine is fixing, and how long it takes. This gives us a way to check on healing progress,'explains Ferro.

"One of our spas is located at Woodbine racetrack and it's the first one in the Thoroughbred industry, in North America,'says Gutowski. "In England, most of them are being used for Thoroughbreds, but in North America there's only one, so far. There is another one being used on Standardbreds at Mohawk racetrack. Another machine is at Delta Downs (which has mostly Quarter Horse races) in Louisiana,'he says. Lisa and Kenny Osborne installed the one at Delta Downs in December 2006. The track provided them with barn space, and many of the trainers use it.

The Sanctuary Equine Rehabilitation and Sports Therapy Center in Ocala, Florida, recently installed one and is already using it daily for treating a variety of equine injuries. Brenda McDuffee, who manages this center, for owners Tom and Amy Grabe, Tim and Ann Admonius, and Ron Scott is very enthusiastic about this therapy and says they are presently using it on a mare with chronic navicular problems to relieve inflammation and pain and it has helped to reduce the need for drug therapy.

It also helps tighten the legs and keep them stronger and less vulnerable to injury when the horse is working hard. "We have already developed that type of clientele, as well as treating various injuries, and wounds--since the saltwater acts as a poultice and draws any edema and infection out of a wound,'says McDuffee.

"Since cold saltwater can help prevent as well as treat injuries, and decrease any swelling or stiffness in the legs immediately before and after training exertion or competitive events, it can reduce the need for drug therapy (such as anti-inflammatories) in many instances. This is a big plus for horses that compete in sports where use of drugs is prohibited. Cold saltwater therapy can help treat injured tendons, ligaments, shins, early stages of laminitis, hooves, open wounds, cuts and bruises.'says Gutowski

HOW IT WORKS

"When professor Hunt began his research on cooling the legs with saltwater, he began to see a Ômiracle' effect on every injury on which he used it. This immediately takes the heat and inflammation out of a leg. A horse might go into the treatment with a leg twice it's normal size, and come out normal size. Of course it starts to swell up again several hours later, but if you treat heat and inflammation on a regular basis and keep taking the heat out, this is where the miracle takes place,'says Gutowski.

After the horse enters the unit, the water is added to reach a level above the knees and hocks. "We can treat anything from that level on down,'says Ferro. "We also have a hose unit that allows us to do hips, stifles or backs, or body wounds. Any place there's a wound you can't wrap and is hard to heal, such as on the neck or shoulder, this can help,'he says.

"People used to take their kids to the ocean and let the saltwater heal them. When I was a child, my father used to have me stand a horse in the river, if it had swelled legs, to reduce the heat and pain. People would also stand a horse in ice. But this spa works much better. I've used this machine to heal a lot of pressure sores on horses that founderedÑwhen they got sores on their stifles and hocks from lying down too much,'says Ferro.

Lisa Osborne, at Delta Downs, says that saltwater is helpful for speeding healing of athletic injuries. "Jockey Pat Day used to take his horses to the beach. When he was younger and they first started riding at Bay Meadows, trainers would ride the racehorses to the beach and stand them in the seawater,'she says.

When Ferro was looking into getting one of these machines and talking with people in England, he found that many of the racehorse facilities in the UK have them. "One gentleman said it was the next best invention since the halter. I hesitated for a moment and asked if he'd been drinking! He said no, and that if I ever got one of these machines I would understand. Now I do understand what he meant, because it does so many things,'says Ferro.

The spa is installed on a pad of concrete and doesn't take much space (65 inches high, 91 inches wide, 100 inches long). It has ramps to provide easy entry and exit for the horse, unless it is installed below floor level. It has a non-slip bottom, for good footing. It requires a water supply and a power source. It is a self-contained unit with a holding tank for 520 gallons of 35 degree Fahrenheit (2 degrees Celsius) saltwater.

The water is continually circulated through a cooling unit that keeps it at that temperature. "This is cold enough, according to the veterinarians I work with, that it almost closes the capillaries in a horse's legs and nearly halts the circulation,'says Ferro. "It pulls out heat and toxins and totally numbs any pain. After you take a horse out and feel his legs, they feel like they are frozen,'he says.

Water purity is maintained using a double filtering system and chlorine, and can be reused thousands of times. Due to the cold temperature and addition of chlorine and salt to the water, any micro-organisms are hindered; the risk for transfer of any infection from one horse to the next is eliminated.

"The filter is easy to clean; I can change it in less than a minute,'says Lisa Osborne, at Delta Downs. "Even though the machine has a filtering system, we also make sure the horse is clean before he goes in. We rinse his feet off and put a manure bag on him, to collect any manure before it drops into the water. We keep the water as clean as possible,'she says.

“We rinse his feet off and put a manure bag on him, to collect any manure before it drops into the water. We keep the water as clean as possible”

"In that 520 gallons of water is 250 pounds of salt (150 pounds of Epsom salts and 100 pounds of sea-salt),'says Gutowski. "The salty water acts as a poultice for wounds, drawing heat and infection out of the tissues. Salt pulls the heat out of anything near it; an example is adding salt to the icewater around a tub of cream when making ice cream. If you add salt to a plain bucket of water, the temperature of the water will drop.'

The salt concentration and composition have a positive effect on body tissue response, to pull out any heat and infection. Ordinary seawater contains varying amounts of sodium chloride and magnesium chloride, but the cold saltwater spa allows for introduction of higher levels of salt, increasing the potential healing effect. The research done by Dr. Hunt pinpointed the amount that would have the greatest osmotic influence (pulling out heat and infection through osmosis). The depth of the water also increases physical pressure on the leg tissues and this is why the water level is often brought above the knees and hocksÑas deep as possible without reaching the horse's abdomen.

Gutowski says, "When we first put a horse in the spa, we put in just a little bit of water to get the horse used to it, before filling it on up. It takes about 3 minutes to fill to the level you want it, and another 3 minutes to drain it after the 10 minute treatment; the water fills and drains quickly. It's very safe. Even if the horse is nervous and kicks, the spa is very durable and he can't hurt it,'he says. The fiberglass models use the same material used for building yachts. The horse does not have to be sedated to use the spa, and for horses that compete in sports where use of drugs is prohibited this is a plus.

The machine solves the challenges of treating injuries in difficult locations. Osborne says that when a horse gets sore in the front legs and then puts too much weight on the hind legs, or has an injury on the hind legs, it's always been hard to treat those. "You can put a horse's front legs in ice buckets, but most horses won't tolerate this on the hind legs. The machine does all four legs, and hocks are a huge issue,'she says. You can't stand a horse in anything else deep enough to treat hocks.

"Total time involved, getting the horse ready, putting him into the machine, filling, treating, and draining, leading him out and rinsing his legs off, takes about 20 minutes,'says Gutowski. "The 10 minute treatment does as much good as you can do; you don't get any further benefit. A lot of people think that if they put a horse in ice for 2 or 3 hours it will be beneficial, but it may actually be harmful. After that length of time they might create nerve damage,'he says.

One of the most common questions people have regarding the spa is "what's the difference between ice and cold water in the spa?'Gutowski explains that the temperature of ice in water is in the mid 40's. "When you have ice in water and a horse just standing still in it, the horse's body temperature comes into play, like standing in a pool; the body heats up the water around it,'he says.

"In our machine, we introduce aeration into the water as well. It's constantly circulating, and also going through the chilling system that keeps it at 35 degrees. So there is no way for the horse to escape the cold, and it's basically about 10 to 15 degrees colder than plain ice and water, which gets warmer when the horse is standing in it.'

Some people ask what this cold temperature does to the horse's body temperature. "In a 10 minute treatment, in 35 degree saltwater, no change takes place in the horse's body temperature,'says Gutowski. The horse's legs and feet have a different type of circulation than that of human legs. A horse can stand in snow at sub-zero temperatures and never suffer from hypothermia nor freeze his feet, whereas a human cannot. The temperature of the foot does not affect the horse's body temperature. Cold water over the body, however, would tend to lower the body temperature, and this is why the level of the water in the spa is only brought above the knees and hocks and is not allowed to touch the belly for an extended period of time. For injuries and open wounds on the body, however, a connective hose can be used to spot treat certain areas with the cold water.

The horse stands in this spa for only 10 minutes, in continually cold water. After that length of time at 35 degrees, the horse's leg is basically as cold as you can possibly get it. "The leg usually stays cold for up to 3 to 4 hours. When the horse leaves the 35 degree salted water, that's when the miracle starts to happen. There's suddenly a massive rush of blood and circulation back into the cold legs, even into areas where normally there wouldn't be that much,'says Gutowski.

Ferro says that when the horse comes out, for the next 1 to 4 hours (depending on how cold the outside temperature is) the legs warm up again. "The body is telling the horse's brain that something's wrong down there and everything is too cold. So the circulatory system starts pumping maximum amounts of blood to that area to try to get the legs back up to temperature, and this increase in blood flow speeds the healing process,'he says.

"There is no healing without good circulation. The more blood flow, the faster the tissues can heal,'explains Ferro. This is similar to applying cold packs and heat alternately to an injury, to try to reduce inflammation yet still increase circulation, but the cold saltwater treatment does it even better.

Lisa Osborne points out that this rush of circulation back to the feet and legs can often help pinpoint an elusive problem. "One horse we treated was sore but the owner couldn't find the injury, then after the circulation started coming back into his legs she found that his ankles were hottest. This gave her a clue about where the problem was,'says Osborne.

"Due to increase in circulation following a treatment, the researchers who created the machine started to see one good thing after another, and so they began to put in horses with serious injuries, to see what would happen,'says Gutowski.

"For instance, a grade 3 superficial flexor tendon injury could take 10 or 12 months to heal, with conventional therapy, and might never be perfectly strong again if it ends up with much scar tissue. When the fibers come back together, they are often misaligned. When you use the cold therapy in the spa on a grade 3 tendon injury to take the heat out, longitudinal fiber alignment is amazing in just one month. With proper treatment, an injury like this can heal in as little as two months,'he says.

Ferro points out that spa treatment for a badly pulled suspensory can heal it in half the traditional recovery time. "The standard method of treating these has been stall rest. That's wonderful for alleviating stress on the injury, but it doesn't help the circulation. You prolong the healing process with rest, because you've reduced circulation to the legs. The vets want you to start hand walking the horse as soon as possible, in any horse that's been stall rested, just to get some circulation going,'says Ferro. "The Epsom salts and sea-salt also pull out any kind of infection in the tissues. A bruise, wound, or scratches are soon gone,'he says.

"Hoof growth is also astounding,'says Gutowski. "Some people are using this for laminitic horses and in the early stages these can be very quickly turned around,'he says. He recommends working closely with your veterinarian during the course of any treatment, since every horse and every injury is a little different.

Frequency of treatment for any particular horse will depend on the type of injury, it's severity, and how recently it occurred. Horses are all different in how long it takes to heal. In most cases, however, the spa speeds the healing process; it's just a matter of what degree. "The best thing about this machine is that no matter what the problem is, you can't hurt the horse,'says Ferro. "It's just cold saltwater. So it will help to some degree.'

Once a day treatments (or even twice a day in some serious conditions) are usually required for a few days, and then decreased over time, usually treating every other day for a while longer. Depth of the water can also be altered, depending on the severity and position of the injury. The more severe injuries require higher water levels just to increase the pressure against the injury. A five minute treatment is sufficient for preventative therapy, on a horse with no specific injury.

PREVENTATIVE THERAPY

Some horsemen use this treatment to take out heat and inflammation a few hours before a race or some other performance event, like a western pleasure class to ready the horse for the event, so the legs will be in peak form. Many people are using the spa right after an event to take out heat and relieve the stress and strain. "The people using this as a preventative therapy are finding that the horses are not suffering injury,'says Gutowski.

The legs are not as vulnerable to problems. It optimizes the structural integrity of the legs. As stated by Gutowski, "We can't make a bad horse great, but what we do allows a great horse to be great, to be able to perform at his best potential.'It helps keep horses in top shape for peak performance.

Lisa Osborne says that people with racing Quarter Horses like to put their horses in the spa to keep them sound and prevent athletic injuries. "They put horses in it after their workouts. You don't want those young horses to get sore. If they get a little sore, they associate the pain with the work and may not be as eager to perform,'she says.

She and her husband also treat a lot of barrel horses and any other equine athletes that develop strain and stress. "We have clients who took their 24 year-old Shetland pony to the Little Britches Rodeo finals. They use him just for goat roping, but he runs so well after a treatment in this machine; it makes him feel like he's 18 again,'she says.

Heath Taylor, one of the leading Quarter Horse trainers, uses their machine every day. "One of his colts, G T Warlock, is treated regularly. Heath says the only time this colt is happy is when he comes out of this machine! The horses not only feel good, but when they go back to their barn after a treatment, they often lie down and go to sleep. They are very relaxed,'says Osborne.

Ferro says that a couple treatments in the spa can take all the heat out of an overworked joint and the horse feels like he's been rested for 3 months, since his legs feel great. "Let's say you are preparing him for a reining futurity and working him hard. After the event, he's sore and tired. You'd have to rest him two or three months to get him ready for the derbies, since it takes that long for him to recover from the strain and be in peak form again. But with 2 or 3 treatments in the spa and a week of rest (after the horse's mind is settled down again after the competitive event) the horse feels as good as if he's been rested for three months,'says Ferro.

Gutowski says that since this treatment has been so successful for performance horses in England, his company is now making human spas. "The Welsh rugby team uses our spas before and after every match and every workout. We've also sold some of our human versions to a soccer team in England, the Aston Villa. They are putting these in their training centers, as well,'he says.

RESEARCH

"There are several healing properties with this treatment that we are still learning about,'says Gutowski. "The salt acts like a poultice, and the transition from the cold back to hot increases circulation. But there is also something that happens in 35 degree water that doesn't happen at 50 degrees or 80 degrees.'

When the jets are turned on to circulate the water as it's filling, this aerates the water, which increases the amount of dissolved oxygen. "At 35 degrees, the oxygen content in the water triples. It goes from 4 parts per million to 12 parts per million. If we introduce air into 50 degree water or warmer, no change in oxygen content takes place. At 35 degrees, and the tripling of oxygen content in the water, as soon as we turn on that air, the horse's heart rate drops to as low as 22 beats per minute. The theory is that some of the oxygen is being absorbed right through the skin. We're still a ways off from proving this, but we are hoping to do some studies on this,'says Gutowski.

"We are trying to align with the New Bolton Center for some studies. At present Dr. Chris Pollitt is there, and he's done a lot of research on laminitis. Much of his work is based on cryotherapy (use of cold, or freezing). There is a grant currently available through the Grayson Jockey Club Research Foundation that was set up in the name of Barbaro, and there will be $100,000 going toward laminitis research.'says Gutowski.

For more information, check the website: www.equinespa.com