Baffled; vets, physios and insurance?? Long, help please would be fab

[dressagelove]

So I want the physio to come look at my horse, posted about this a while ago, but I am very confused.

I dont like / trust vets, never have. I am as confident enough in my own experience (without having been to vet school!) that I think my horse needs the physio without there being anything else majorly underlying. I have spoken to my vet, and he made it clear that they will not sign a referral form for the physio unless they have seen the horse first. Fine.

However, I spoke with my vet at the weekend, he works for this practice, not the big cheese, but works for the head guy; he has seen my horse the most. He said he is quite happy for my horse to see the physio, go for it, but they cannot 'sign' this insurance form.
I asked him what they would do if I had him out before the physio, and as usual with vets, the answer was not a lot! They could only have a look at him, and then be unable to diagnose anything without further xrays, tests etc etc. So I would pay out for call out, travel and inspection for them to go ' well we can run test x, y, z, but otherwise he needs to see the physio...' I am not insured for vets fees and would like to cut out this middle man...

Told my physio this this morning, and she says, oh thats fine then, I can just put that onto the form that he has given verbal permission...

To me this seems strange, if it came down to it, it is just one persons word against the others... There is so much red tape and insurance these days, I am unsure if this is okay, normal protocol etc. The physio is a very reputable one, pm if you want the name, so I think I can trust them. Wanted to know if anyone knows the reasons for this, and if it sounds legit ?
Thanks

 

[LouS]

I don't understand, if you're not insured for vets fees then what's the problem? Or am I misunderstanding?

My physio calls my vet for verbal permission and I've never had any problems.

 

[BigRed]

What I don't really understand about your post, is that you say you are not insured for vet fees, which I would assume means, you are not insured for physio fees either.

In which case I assume the paperwork you are talking about, is your physio needing to know that a vet has referred your horse for treatment, for the physio's own insurance liability ?

Your physio is being a bit naughty accepting a verbal communication, but at the end of the day, I don't see your horse is likely to suffer any damage from doing things this way.

 

[BorgRae]

Hiya,

You don't need the vets permission to call your physio out. My lad had an issue in December that I knew was a physio related issue that the vets may/may not be able to fix, but the physio definitely would (pulled his peck muscles!). It cost me £300 in physio bills, so not worth claiming on Insurance anyway, and he's all fixed now without having to see the vet.

If you're not insured for vets fee's and so therefore aren’t going to claim, just get the physio out (I use a fantastic physio in the NW who will work along side the vets if needs be). If the physio then thinks you need scans, x-rays etc, then get the vet involved.

What documents do you need signing??

 

[dressagelove]

See this is whats so confusing! It seems there are different rules for every vet / physio practice.
I understand Im not covered for physio, Im paying for that myself, but didnt want to spend an extra £80 on getting the vet out first when it is not really required.

The physio wanted a referral form signing so the vets insurance then covers them if anything goes wrong... but I don't see how a verbal permission would allow them to use vets insurance anyway. Having said that, it was the vet that told me that...
Plus my vet seemed to be trying to put me off having the physio, saying they dont like how some of them work, which seems a bizarre thing to say... Its so difficult knowing who to trust and who is telling you the truth!

 

[dressagelove]

bump

 

[Equetouch]

Hi,

I'm an Equine Sports Massage Therapist & the Veterinary Act states that only the owner or vet can administer or treat the horse. It does allow for complimentary therapists like me, physio, chiro etc. to treat as long as the vet has given approval. This can be verbal & most of my clients ring their vets to obtain this over the phone. I record on my own documentation that this has been done & ensure the client signs my paperwork when I see them confirming this. The law is not specific on this, hence a variety of methods adopted.

That said you state that you are not covered for vets fees & are paying physio fees aswell as not covered for that, so there is nothing further needed. If not resolved by physio treatments though, then I suggest you do get the vets out. Hope it all works out for you.

 

[Avonbrook]

The physio wanted a referral form signing so the vets insurance then covers them if anything goes wrong...

If you have understood this correctly, go elsewhere.

I am a chiropractor (human and animal) and I carry my own comprehensive insurance. As does every reputable chiro, osteo, physio, Bowen, Massage therapist...

I work much the same way as Equetouch as regards referrals and (having obtained consent) talk to the practice myself if I find myself wondering if the client has actually contacted them - or if I consider that the case is not appropriate to me.

 

[alsiola]

It is a legal requirement for physios etc. to obtain veterinary consent prior to treatment. This is both to protect horses from potentially damaging treatments being applied in inappropriate situations, and to protect them from a delay in reaching a correct diagnosis. For example, I would need both hands to count how many times I have seen horses because physiotherapy was not working for a back problem, that actually had laminitis. A 6 week delay in the treatment of this, and other, conditions can be critical.

Unfortunately, as much as you may like it to be true, your years of experience are not a replacement for a vet. While they can play a role in horses' recoveries, physiotherapists are not a replacement either. Without a doubt, THE most effective treatment for muscular problems is rest and anti-inflammatories. Without a vet you cannot do even this most simple of treatments.

Ultimately you are asking your vet to certify that it is safe for your horse to receive physiotherapy. If they have not examined your horse there is no way they can do this.

 

[foxy1]

It is a legal requirement for physios etc. to obtain veterinary consent prior to treatment. This is both to protect horses from potentially damaging treatments being applied in inappropriate situations, and to protect them from a delay in reaching a correct diagnosis. For example, I would need both hands to count how many times I have seen horses because physiotherapy was not working for a back problem, that actually had laminitis. A 6 week delay in the treatment of this, and other, conditions can be critical.

Unfortunately, as much as you may like it to be true, your years of experience are not a replacement for a vet. While they can play a role in horses' recoveries, physiotherapists are not a replacement either. Without a doubt, THE most effective treatment for muscular problems is rest and anti-inflammatories. Without a vet you cannot do even this most simple of treatments.

Ultimately you are asking your vet to certify that it is safe for your horse to receive physiotherapy. If they have not examined your horse there is no way they can do this.

Exactly. Most back problems are caused by low grade hind limb lameness IME

 

[SusieT]

you are asking your vet to false certify. That is not fair . It puts them in a very difficult situation if your physio causes more harm and you decide to sue them. Kknow it all horse owners who believe 'fluffy' is just misunderstood/needs a good slap/is just trying it on are the problem with the horse world.

 

[rhino]

You don't need the vets permission to call your physio out.

This is incorrect. Legally you do need permission (Veterinary Surgery Exemption Order 1962)

http://www.legislation.gov.uk/uksi/1962/2557/pdfs/uksi_19622557_en.pdf
Exemption 4 (a) IIRC

 

[dressagelove]

you are asking your vet to false certify. That is not fair . It puts them in a very difficult situation if your physio causes more harm and you decide to sue them. Kknow it all horse owners who believe 'fluffy' is just misunderstood/needs a good slap/is just trying it on are the problem with the horse world.

Not sure what you are on about... I never said he is misunderstood, in need of a slap or is trying it on. I am sure he is in pain.

The comments on bad backs being caused by hind limb is interesting and helpful, thank you, I will bear that in mind... I hope I can get to the bottom of what it wrong with him... was suggested by many to get the physio out and it was my first thought too hence why I have done so, plus the fact that I have many bad experiences with vets and do not trust them! Which is in my experience hence shaping my approach to this problem!

 

[Foxhunter49]

Get the physio, keep quiet and who will know?

 

[dressagelove]

Get the physio, keep quiet and who will know?

Lol, exactly, not like everyone is part of this claim culture. I most certainly am not!

 

[glenruby]

For what it's worth I wouldn't be trusting your physio either based on what you have said in this post. She does not have verbal agreement at all. And trying to do The physio under vets insurance without orpper consent will surely void the insurance - which begs the question is tour physio fully covered? As for your vets comment - it may be that the qualifications your physio holds are not well regarded by your vet? Just a thought?
And yes you are essentially looking for a vet to falsely certify that your horse is in need of physio treatment. How about getting the vet out to check for lameness ( you seemed to say there is none). It is definitely worth finding out if there really is an underlying lameness before embarking on physio ( which may be more beneficial AFTER the problem has been diagnosed).

 

[MeganLindsx]

It is unlikely for you to be covered for physio fees if you aren't for vets fees but if you are they will only pay out when a vet has signed and agreed that your horse needs/ will benefit from physio. The physio should also keep in contact with your vets regarding treatment.

Insureance companies will be reluctant to pay out if you don't have a vet referral.

Also agree that back problems or problems that seem like back problems do normally stem from hind limb lameness as i have spent a lot of money on physios in the past just to be told that it wasn't her back at all.

 

[mightymammoth]

Lol, exactly, not like everyone is part of this claim culture. I most certainly am not!

just being nosey but whats wrong with your neddie? I'm having the physio to see my boy (the physio said she can only come if the vet has verbally agreed this) Luckily the vet had been out that week to do his teeth and had seen him trotted up etc when I mentioned my concerns over his on and off lameness

 

[dressagelove]

just being nosey but whats wrong with your neddie? I'm having the physio to see my boy (the physio said she can only come if the vet has verbally agreed this) Luckily the vet had been out that week to do his teeth and had seen him trotted up etc when I mentioned my concerns over his on and off lameness

He is very stiff, doesnt bend well, doesn't track up well, goes disunited in canter. He tends to 'hold' himself when ridden, and is generally shortened stride and just feels very uncomfortable. He is like that when ridden, and when lunged loose he does move a lot better, although still not perfect, hence making me feel it is a physio related issue

He also tends to 'run' from the riders weight, the leg, the contact... He is not grumpy to tack up however which is the odd thing. He is generally an extremely good tempered boy which I think makes it slightly harder to spot his discomfort

FWIW I've just been reading H&H guide to hind limb lameness and he doesn't have any of the symptoms highlighted in there...not to say thats not what is is, but for the time being not going to go down that road.

 

[Foxhunter49]

I am older than most on here (I think) I have my chiro come and treat the horses and will tell the vet I did so. I have never ever thought of asking his permission. Never has he said I was wrong in doing so!
Then again, I have the greatest respect for my vet and he has for me. More than once he has called me to ask my opinion on something and more than once he has sent horses here when my chiro is visiting.

 

[SusieT]

He sounds like he needs a vet work up-has the vet even seen your horse for a proper examination??

 

[Pearlsasinger]

He is very stiff, doesnt bend well, doesn't track up well, goes disunited in canter. He tends to 'hold' himself when ridden, and is generally shortened stride and just feels very uncomfortable. He is like that when ridden, and when lunged loose he does move a lot better, although still not perfect, hence making me feel it is a physio related issue

He also tends to 'run' from the riders weight, the leg, the contact... He is not grumpy to tack up however which is the odd thing. He is generally an extremely good tempered boy which I think makes it slightly harder to spot his discomfort

FWIW I've just been reading H&H guide to hind limb lameness and he doesn't have any of the symptoms highlighted in there...not to say thats not what is is, but for the time being not going to go down that road.

TBH that sounds like a saddle fitting issue or a rider/position problem. Have you considered getting a saddle fitter out? You certainly don't need a vet's permission for that!

 

[dressagelove]

TBH that sounds like a saddle fitting issue or a rider/position problem. Have you considered getting a saddle fitter out? You certainly don't need a vet's permission for that!

Its been suggested yeah and it was in my to do list! but I thought I should get the pain sorted first...? To be honest though, I've not ridden him now for over a week because of this, and have been doing a bit of lunging with no saddle, just a roller, and he still doesn't track up, and goes disunited in canter, doesn't bend and fights the contact....

I used to event him to BE100 quite happily so he hasn't always had this problem, so also unlikely it is my riding...
But eventually if I get this problem sorted yeah I will get the saddle looked at too thanks

 

[SusieT]

disuniting and not bending/accepting contact, shortened hind limb strides-all sounds like hndlimb lameness.

 

[FestiveBoomBoom]

Its been suggested yeah and it was in my to do list! but I thought I should get the pain sorted first...? To be honest though, I've not ridden him now for over a week because of this, and have been doing a bit of lunging with no saddle, just a roller, and he still doesn't track up, and goes disunited in canter, doesn't bend and fights the contact....


But eventually if I get this problem sorted yeah I will get the saddle looked at too thanks

I'm a physio, I have to say that if you called me describing the above symptoms I would be advising you to see your vet first for a diagnosis on what could be dorsal/lateral sacroiliac ligament injury, possible pelvic fracture, stifle, hock, suspensory ligament injury etc, who knows! Only they can diagnose that. But as someone else said, soft tissue spasm, weakness, pain etc is likely going to be secondary to something else and not the primary problem. So your physio could come out and treat your horse but they won't be treating the root cause and so his symptoms will remain. Once you have a diagnosis from the vet then that can be treated and any secondary soft tissue pain/injury can be treated by the physio

Also, just to add I only work with veterinary consent. That's me phoning and speaking to the referring vet to gain consent and I also have my own insurance

 

[Goldenstar]

I hate to say it but it sounds like he needs a work up from a vet, not a physio .

 

[dressagelove]

I'm a physio, I have to say that if you called me describing the above symptoms I would be advising you to see your vet first for a diagnosis on what could be dorsal/lateral sacroiliac ligament injury, possible pelvic fracture, stifle, hock, suspensory ligament injury etc, who knows! Only they can diagnose that. But as someone else said, soft tissue spasm, weakness, pain etc is likely going to be secondary to something else and not the primary problem. So your physio could come out and treat your horse but they won't be treating the root cause and so his symptoms will remain.

Thanks. How would they diagnose these though? Will they need to run any tests in particular / xrays etc?

 

[dressagelove]

Yeah.... okay thanks for all the advice, maybe the vet is the best call then... was hoping to avoid it! but hey ho

 

[FestiveBoomBoom]

Thanks. How would they diagnose these though? Will they need to run any tests in particular / xrays etc?

No probs, they will do a full lameness work up, look at him moving in a straight line in walk and trot on a hard surface, small circles then possibly lunge on a hard surface then in the school, flexion tests and then depending on what they find they might suggest nerve blocking, xrays, scans etc to get a definitive diagnosis

 

[dressagelove]

No probs, they will do a full lameness work up, look at him moving in a straight line in walk and trot on a hard surface, small circles then possibly lunge on a hard surface then in the school, flexion tests and then depending on what they find they might suggest nerve blocking, xrays, scans etc to get a definitive diagnosis

Okay thanks, that doesnt sound too bad... will ring physios and vets in the morning. Thanks everyone for help, Ill keep you posted if interested really stressing me out this. Smashed a glass earlier and I burst into tears! lol