Box rest is a common veterinary prescription for equine injuries but creates significant welfare challenges, and management strategies can substantially mitigate the behavioral and psychological costs of confinement.
Box rest welfare management requires recognizing that confinement causes real behavioral and psychological harm that must be actively mitigated rather than accepted as unavoidable. Horses on box rest benefit from stable companions where possible, haynet provision throughout the day to maintain continuous feeding and occupation, hand walking allowances as permitted by the clinical condition, and environmental enrichment through toys and varied feeds. Veterinary management of box rest welfare should be integrated into the treatment plan rather than being an afterthought. Where confinement is required, the welfare cost should be weighed against treatment benefit in case-by-case decision-making.