Do vets consider a horse's mental health?

Shilasdair said:
Do you think vets consider horses' mental health enough when recommending treatment for physical issues?

So advising 'box rest for 6 months' might help a lameness heal, but might be traumatic/depressing for the horse.

Discuss! :)
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I don't know about horses mental health but I know of a couple of incidents of vets not considering the owners mental health when discussing their horses issues and the need to PTS.
 
My vet is absolutely wonderful. She helped me fashion a small 12'x12' area in the field with electric tape when I had a stressy pony who wouldn't cope with 2 weeks of box rest. She always tells me the textbook, goldstar treatment plan, but then helps me tweak that to something that's achievable for me and tolerable for the pony.

And in my experience vets are very pragmatic about giving owners "permission" not to embark on a long and potentially unsuccessful recovery plan, and just calling it day for the sake of the animal.

I think a lot of vets have slightly different "modes" for treating working horses as opposed to pampered pets though.
 
I tend to ask my vet “what would you do if it was yours?”

I think that, generally, they have to give a clinical opinion to protect themselves. It’s a minefield for them in terms of liability and reputation - especially with blame culture being as it is.

If they recommend PTS and another vet comes in, advises differently and “saves” the horse or if they PTS and someone comes up with something that could have been tried afterwards, there is a huge risk to reputation and even legal risk in some cases.

If they give their clinical opinion to professional standards and then you ask what they would do, personally, in the situation, I think they are often happy to advise more holistically.
 
A good vet will listen to good owner. After a case of colic vet listened to me saying breaking her routine (very stressful mare)would cause more harm and agreed to me turning her out under a watchful eye.
 
No I don't think they do. I also think they don't consider the mental anguish of the owner of having to go through some of these treatment options, which are often not only time consuming, unpleasant for the horse, but expensive too. There is a lot of guilt that comes with not being being able to do everything perfectly as to the vet recommendations.

Sometimes I think the vets think that owners have endless time and finances.

My pony damaged a suspensory last year he did have a prolonged period of box rest which we managed to cope with better than I thought, I livery at a rehab yard so he was able to use their facilities and had plenty of company with other horses on box rest close by and lots of attention during the day whilst I was at work.

However what I have found with the vets is that they always suggest things that are mega expensive and I feel guilty if I decide not to do that expensive option which my vet calls "gold standard". The vet suggest laser for the suspensory injury which would have come to 3k and I decided against it as I could not find any evidence that it would reduce the length of time on box rest. Luckily pony came sound without it. He did however have the ice spa.

I think vets have to tell you what the options are but then you have to decide what you can or cannot do.

I think the box rest thing is a bit of minefield as many vets will probably see horses that are on competition yards that even when sound do not get turnout and horses which are in all winter due to poor grazing so lack of turnout is perhaps not seen as a welfare issue to a vet.
 
Shilasdair said:
Do you think vets consider horses' mental health enough when recommending treatment for physical issues?

So advising 'box rest for 6 months' might help a lameness heal, but might be traumatic/depressing for the horse.

Discuss! :)
Click to expand...

I think the only people who think about mental health is those of us who have been housebound with babies and young children.

ETA: I am of course referring to the sort of mental health issues that can result from being housebound.
 
Yes and no. I think it’s our responsibility to explain to our vets that something isn’t working for our horses, or that they aren’t going to cope with the suggested options. For example, my youngster was in on boxrest for 2 months over winter due to a nasty cut on his fetlock. Luckily I have a cow barn spare that allowed him to move a lot more than in a stable. Initially he was fine (surprisingly for quite a while!) but in the end I explained to my vet that he was getting agitated at being in, and she offered a different solution. Also (although I have savings/credit for vets bills) she was aware and considerate that I didn’t have insurance.
 
I had a vet who wanted box rest for an abscess. I point blank refused as the horse didn't like being stabled. I did try for over 2 days when he had an annular ligament injury though, but honestly it was hell for him and me, even on a tube of sedalin a day he was box walking for England. Certainly not resting it so turned out. The thoroughbred charity he is from are much more pragmatic about box rest. I do think some vets don't take everything into account.
 
I know my vet very well (thanks horses ?) but subsequently he knows my animals, my set up and my capabilities. We have made some tough decisions together but always in the best interest of the horse
 
paddy555 said:
I wouldn't expect them to. I would expect them to tell me all the options from a medical POV and what they will entail, pain they will cause etc etc. I then tell them which bits we can't do eg box rest, and what I want and we then tailor the plan around that. I see it as my responsibility to look at the mental side. The vet doesn't know the horse and cannot really judge based on the short time he is here how a course of action will affect the horse, if there are other horses to bring in to keep it company or anything else. Plus of course every horse is different and the best treatment for one may not be the best for another. Only the owner can know how the horse will react and at what stage to press on or give up.
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I do sort of agree with this, but I would still expect a vet to mention the possible impact on the horse's mental health, especially if dealing with a less experienced owner who may not know any better. My Arab had box rest for a knee injury when she was 11 and I was 14 (we're now 28 and 31!) and I do think the vets didn't give me as much information as they should have done, about various things related to her box rest, caring for her injury and rehabbing her once her box rest was over. Bearing in mind that I was 14 and my parents were not horsey (and never there when the vet came!), I am surprised when I look back that I didn't get more guidance. So yes, in this scenario of course the owner knows the horse best, but I also think perhaps the vet needs to be aware as to whether they are dealing with an experienced or less experienced owner (it is usually obvious!) and make sure they provide advice about how certain treatments might affect a horse's mental health, if necessary.
 
Shilasdair said:
Do you think vets consider horses' mental health enough when recommending treatment for physical issues?

So advising 'box rest for 6 months' might help a lameness heal, but might be traumatic/depressing for the horse.

Discuss! :)
Click to expand...
My vet might not but I do. The only thing I’ve ever done full on box rest for is laminitis, everything else gets either a stable size pen made outside, or turn out in a sand pit which is about two and a half times the size of a stable. I think it’s imperative for both mental and physical health, it’s a compromise I’m willing to risk making for the sake of everything else ?
 
poiuytrewq said:
When my old, retired arthritic horse who’d had every joint medicated ten times over went down with severe laminitis all round I asked the vet to pts. She refused and made me feel awful.
I did the box rest and rehab, against my better judgement as directed and lost him about two years later after several bouts.
I think some vets need to listen more to owners who voice concerns about difficult recoveries. I’ve learnt from it and next time will be more forceful. I strongly believe horses live for the moment.
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That's terrible ??
 
I'm not convinced that all vets even really consider what is possible on the yard where the horse is, which is why I always ask for a specific vet and have rejected one of the local equine practices .
 
Some older/retired vets do. I think the ones qualified in the last 30 years to the present day dont. it seems treat at all costs.
 
Depends on the vet. I know one at the moment trying to encourage an owner to do something differently because mentally it would be better for the pony. I know mine accepts that one of my horses won't box rest and is happy to talk about a plan B and is honest about how that would affect recovery. When the pony needed surgery last year the surgeon explained the recovery times and asked me if I felt she would cope with that length of box rest.

But I've also known vets give some pretty rough advice so it really does depend on their personality and how willing the owner is to engage on behalf of their horse.
 
Shilasdair said:
Do you think vets consider horses' mental health enough when recommending treatment for physical issues?

So advising 'box rest for 6 months' might help a lameness heal, but might be traumatic/depressing for the horse.

Discuss! :)
Click to expand...

I wouldn't have let any of mine stay on box rest for 6 months, they were outdoor horses and unhappy in the stable so I would have turned away and hoped for the best or PTS depending on the injury/illness.
 
My vets do especially regarding box rest but a previous practice did not, and one vet pushed for treatment that was, imo, not appropriate although this was small animal (exploratory op on 19yr old cat anyone?)
 
I think the vet is primarily qualified to advise on treatments for the illness concerned. That doesn’t mean they should be ignorant to the mental / behavioural impact of these but IMO it’s the owner that has ultimate responsibility for assessing that, they are after all the primary care giver. So management of a horse should have joint responsibilities.
 
I think in general vets prescribe what a horse needs physically and if/when an owner thinks this might be an issue adapts the plan to suit but it's up to the owner as the person who knows the horse best. Vets are also aiming for the best case scenario whereas an owner might be happy with just getting the horse comfortable.

M suffered a suspensory injury in March. If we were going for the full recovery, full return to athletic activities option, he'd still be on box rest now and would be thoroughly miserable. He's 25 and been the horse of a lifetime for 20 years so we decided on minimal box rest (4 weeks) to get him to the stage where he can mooch about the field comfortably followed by quiet turnout in a smallish paddock with one other oldie for 2 months before going back into the (very settled, quiet) herd of 6. He's still slightly off in trot (but he only trots when we make him to see how he is, he's never been one to expend energy unnecessarily) and it'll probably take a few more months until he's completely sound but he's now officially retired unless he makes it clear he's miserable doing nothing so it doesn't matter how long it takes him as long as he's improving. Vet would rather he was in but isn't unhappy with this plan considering we don't intend to ride him again.
 
As much of the above, I think they do with owners input but tell you the gold standard for treating the injury/illness first and then rely on the owner to give input on how that would work for them and their horse. In my experience being on livery yards, I see much more physical discomfort from horses with low level lameness being ignored than under mental distress from box rest.

In small animal, box rest for such a period of time wouldn’t be accepted. But horses “put up” with a lot. They seem to accept a situation and become redundant to it. A lot of horses I’ve seen on box rest become very withdrawn and not that bothered about anything else, because they have to accept those four walls have become their new routine and they don’t know when that will change. I think that’s why people feel they cope better than what they do, they just shut down and because they are not screaming or shouting it’s okay.

What’s the alternative though? PTS? Don’t immobilise as much and risk recurrent injury - thus pain and discomfort again? It’s a really difficult one. The good thing is research is showing a lot of injuries benefit from controlled exercise sooner rather than later.

But here is your real problem:

I have a very good, older equine vet who is very fair to you and your horse. He knows the job the horse is intended for, whether that’s a pet or hunter or 4* eventer and advises a treatment plan based on you both, your facilities, your plans for the future, your financial situation. But these vets are dying (well retiring!!) out. Unfortunately we treat vets like sh*t in this country, so we are haemorrhaging young veterinary surgeons from the industry. Less experienced vets don’t have the confidence or experience to stray from gold standard plans. They cover their own clinical back by offering the best options, so should the owner complain (which happens a lot now) they have offered the most well known and tried and tested routes of treatment. Young vet gets increasingly under pressure from owners to make the right decision at the right time and the perfect outcome… it doesn’t happen and time and time again they are left with the fallout… they leave. Our older vets were lucky to gain experience in a time when people trusted their vet more, and had frankly put, more horse sense. The people accepted the ups and downs and the vets learnt what did and didn’t work in their personal experience of cases.

I guess what I’m trying to say is, if you have a less experienced vet, chances are they will be suffering from the above and therefore I would support them make the best decision for the horse by providing information on how you feel the horse would mentally cope with treatment. But also recognise in doing so you may be straying from the exact treatment plan and may not get the tried and tested results.
 
Shilasdair said:
Do you think vets consider horses' mental health enough when recommending treatment for physical issues?

So advising 'box rest for 6 months' might help a lameness heal, but might be traumatic/depressing for the horse.

Discuss! :)
Click to expand...
Yes mine certainly did, granted she ended up on box rest for an awfully long time (broke the wing off her pedal bone and ended up in a cast) but the vet was centred around what was best for her, after the box rest we got her doped up and out in a field for some time to just be a horse again. But even when we weren't supposed to be walking out in hand he said to me we need to do this for her head. And just standing in the yard for a inhand graze and some sun on her back made the world of difference. I haven't found all vets to be like it, but i know i can always call my vet for his advice and i trust it as what is best for my stressy mare!
 
What a great topic to discuss!
I'd like to share my perspective, from a vet student's (who's also a dog, cat and horse owner) point of view. It's not universal to all students and practicing veterinarians, but perhaps may be useful anyway.

We are taught at our vet school to always take an animal's mental health into account when considering possible options of treatment. We would ideally like the animals to be in a good mental state and cooperate with us, as it not only makes our job easier, but often makes the animal's return to health quicker and easier! But making that happen is not easy. After all, it is impossible to explain to an animal that doing something that involves its isolation (e.g. box rest), a certain degree of pain (e.g. cleaning a wound) or discomfort (e.g. brushing teeth, clipping nails, giving medications) may in the long run be beneficial to it. There's a certain balance to it - cause the animal the least discomfort and suffering while treating its disease the best we can. If we cannot treat it and the animal is suffering, we must consider euthanasia.

On top of that, we are also taught to take the owner's mental state, time limitations, financial limitations into account. In order to treat the animal, we must only reach it through the owner; legally there is no other way except in very extreme cases (as in when the animal is seized from the owner by the authorities). You could perhaps say that both the animal and the owner are our patients.

We are medically trained, but we do not know the animals we treat nearly as well as their owners do when it comes to the animal's character, routines, usual behaviours or fears. That's why we need the owners' cooperation. The owners are our connection to our patients by both legal reasons and the animal's trust, and they are also a base on which we can build the animal's treatment - meaning that they are responsible for incorporating the routines we suggest into the animal's life, administering medications, cleaning wounds and changing bandages, as well as observing how the animal's behaviour and mental state progresses during treatment and communicating truthfully with us.

In practice, I've come across both great vets and some bad ones. I've had my horse treated by a wonderful vet who made me understand everything that was happening to it when treating its colic (that vet made me take the final decision to pursue veterinary medicine!). On the other hand, I've cried during a routine teeth check, because the vet kept rudely commenting on how my horse was nasty (he was anxious and wouldn't go into the small space where they had set up their equipment; I have informed the vet in advance that this particular horse is very claustrophobic). I've also come across a vet who wouldn't even come close to my horse when called in due to colic (I believe she was a small animal veterinarian, who just happened to be on emergency duty that night).
 
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