Misdiagnosis resulting in PTS. Should I pay bill??

[StarcatcherWilliam]

I don't want to go into too much detail here. Vet messed up from the beginning, conducted a lameness assessment without a shoe, totally misdiagnosed the horse, gave treatment which ultimately made the condition worse. Over a period of 6 weeks I had twenty vet and farrier visits. It wasn't until I pushed for an MRI that the horse was correctly diagnosed by another vet and had to be pts as the condition was so severe and advanced. I am totally heartbroken. The horse was insured but my vet has used up all the insurance money on treatment that she didn't need, leaving nothing for the MRI etc. Should I pay my vet even though he got it so wrong?? I intend to speak to my insurance company tomorrow, but wanted to see what your opinions were first, just out of interest.

 

[ihatework]

I don't want to go into too much detail here. Vet messed up from the beginning, conducted a lameness assessment without a shoe, totally misdiagnosed the horse, gave treatment which ultimately made the condition worse. Over a period of 6 weeks I had twenty vet and farrier visits. It wasn't until I pushed for an MRI that the horse was correctly diagnosed by another vet and had to be pts as the condition was so severe and advanced. I am totally heartbroken. The horse was insured but my vet has used up all the insurance money on treatment that she didn't need, leaving nothing for the MRI etc. Should I pay my vet even though he got it so wrong?? I intend to speak to my insurance company tomorrow, but wanted to see what your opinions were first, just out of interest.

I'm sorry you lost your horse

It's impossibly to comment accurately without knowing how the horse presented, what the various treatments were over time and how the horse responded to those. Unfortunately veterinary science isn't exact, sometimes it does take time to pinpoint the right diagnosis and treatments do add up. That said there are plenty of very big errors made by vets so I'm not dismissing your concerns.

Unfortunately none of us on a forum can give you any real advice on the info you have written.

If you are concerned with your vets treatment then speak to them about it. Also speak to your insurers. Good luck

 

[throughtheforest]

I'm sorry to hear about your horse and my god I would be furious... I would be seriously weighing up whether you could sue the veterinary practice as well! Although I understand most people may choose not to take this route, it sounds as though you have good grounds to do. Obviously you will need to consult a solicitor dealing with equine law, as it would need to be proven that the vet in question was negligent and her actions and treatment in fact, caused the death of your horse.

 

[StarcatcherWilliam]

Thanks guys. I am furious and totally and utterly devastated. What upsets me most is that the horse suffered for so long - that is what I am struggling to come to terms with. My vet made out that I was over reacting and that the whole thing was something minor even though the poor horse deteriorated from day to day.

 

[LadyRascasse]

Can I ask, if the horse was MRI 6 weeks ago he would have been able to have been successfully treated? Or is it a case of the horse was suffering longer than necessary? Just the two would make a big difference to the way you could handle this.

 

[Exploding Chestnuts]

It is very difficult.
Even if you are "in the right" it will be difficult to get another vet to stand up in court and give evidence "against" the original vet practice.
If you contact the other [MRI] vet practice, you might see how they are viewing the situation.
I think you are entitled to ask your insurance for legal advice, and for them to with hold any further payment at this time..
Vets are insured against this sort of thing, I think the only thing I would do at this time is to ask them to appoint a senior practice representative to deal with this. Not the vet who you had dealings with.
Any written correspondence should be very simply / carefully worded.
Problem is you are not familiar with the procedures and options. I can understand how awful this is for you, but one thing you have to clarify is what you want to happen. Personally I would not expect to be out of pocket and would be furious if the insurance company paid them at this stage.
I understand how you feel about suffering to horse and stress to you, but I don't know how this is viewed in a legal sense, I think it is something to enquire about.

 

[StarcatcherWilliam]

Can I ask, if the horse was MRI 6 weeks ago he would have been able to have been successfully treated? Or is it a case of the horse was suffering longer than necessary? Just the two would make a big difference to the way you could handle this.

The chances are that it may not have been possible to save her even with an MRI but a decision to pts might have been made sooner rather than later. I did request an MRI very early on Nd my vet just rolled his eyes at me.

It is very difficult.
Even if you are "in the right" it will be difficult to get another vet to stand up in court and give evidence "against" the original vet practice.
If you contact the other [MRI] vet practice, you might see how they are viewing the situation.
I think you are entitled to ask your insurance for legal advice, and for them to with hold any further payment at this time..
Vets are insured against this sort of thing, I think the only thing I would do at this time is to ask them to appoint a senior practice representative to deal with this. Not the vet who you had dealings with.
Any written correspondence should be very simply / carefully worded.
Problem is you are not familiar with the procedures and options. I can understand how awful this is for you, but one thing you have to clarify is what you want to happen. Personally I would not expect to be out of pocket and would be furious if the insurance company paid them at this stage.
I understand how you feel about suffering to horse and stress to you, but I don't know how this is viewed in a legal sense, I think it is something to enquire about.

The vet I was dealing with is the senior vet. And he is very difficult to deal with. He is arrogant and not very good at communicating as he thinks he knows it all.

At one point I even asked one of the other vets if it was "x" (which is what it was) and he told me no!! I keep going over the if onlys all the time and it's tearing me apart.

Will speak to insurance first thing. Thanks for your responses. xx

 

[JillA]

In your shoes I would also speak to the RCVS, to see whether they have a complaints and/or compensation system, and whether they can conduct an investigation so that what sounds like professional arrogance can't do the same to others. http://www.rcvs.org.uk/complaints/

 

[cptrayes]

We can't judge without knowing what 'x' is. We don't need to know what he thought it was, but we do need to know what he missed. Vets are human. We all make mistakes. At the moment we are all in the dark about whether his was excusable, or not.

 

[Kelpie]

Yes, unfortunately no-one can advise you without the full story.

For example, not to MRI straight away is common - indeed, insurance companies often won't pay for it before other routes have been tried.

To have a case against your vets you need to show negligence on their part. The test for this is not whether, with the benefit of hindsight, they got it wrong - instead you need to look at whether their actions were basically industry practice for the presenting symptoms.

I am very sorry you lost your horse and if your vets were negligent then go ahead and sue them - but think very hard and take advice on the legal definition of negligence first or else you will not only spend money, effort and time for no reason, you will quite possibly have a large impact on the vets that they don't deserve either.

 

[ILuvCowparsely]

I don't want to go into too much detail here. Vet messed up from the beginning, conducted a lameness assessment without a shoe, totally misdiagnosed the horse, gave treatment which ultimately made the condition worse. Over a period of 6 weeks I had twenty vet and farrier visits. It wasn't until I pushed for an MRI that the horse was correctly diagnosed by another vet and had to be pts as the condition was so severe and advanced. I am totally heartbroken. The horse was insured but my vet has used up all the insurance money on treatment that she didn't need, leaving nothing for the MRI etc. Should I pay my vet even though he got it so wrong?? I intend to speak to my insurance company tomorrow, but wanted to see what your opinions were first, just out of interest.

So sorry to hear this sad news, without knowing all the details and exchange conversations. Its hard to advise what to do, going on what you said. I would contact the BHS or legal Horse solicitor and gather all the dates for your vet visits, all bills you have paid for medication etc as you will need all of this if you pursue it. This will provide evidence of what they were treating the horse for. Vets are not above the law, they are their to advice and treat and if they are unsure they have to refer you to a specialist which they clearly did not.


My plan would be


As above.


Contact BHS legal advise
contact equine solisitor
gather all vet bills
or bills for medication
all the dates from this situation, ,when horse first went lame, first date vet came, and all the subsequent visits.
what was done and what dates, what was given and what dates.

The legal person will need all this info. It won't be easy to prove neglectfulness. The BHS are best to help you but gather all the evidence and facts you have so they have the full picture and story.


one of my liveries had been treating her horse for over 1 year for a illness, the horse never improved many vet bills - pill's £90 every 3 weeks on pills. Only to find out at the end after a second opinion than nothing was working due to the medication given was not for the problem he had and wasted money. though treated for it
He was pTS





After this what ever the outcome, I would change vets- a fresh start, with a new horse.

 

[Booboos]

Sorry to hear about your horse.

It does sound like you did not get on with your vet and perhaps the lesson from this is to change vets and find someone whose character and approach fits in with you better.

As for suing it's a very difficult business. To succeed you'd have to show negligence as part of the initial diagnosis, the vet needs to have missed something that most other competent vets will not have missed. An MRI is quite an advanced diagnostic tool, it's unlikely a vet would recommend it for a lameness that has been going on for a few weeks and has not been treated with anything else. You also need to show that had the correct diagnosis taken place at the beginning this would have made a difference to the outcome. If the outcome would have been PTS but 6 weeks earlier you do not have a case.

The BHS legal helpline or a first free consultation with an equine vet should be able to give you more details.

 

[Exploding Chestnuts]

In your shoes I would also speak to the RCVS, to see whether they have a complaints and/or compensation system, and whether they can conduct an investigation so that what sounds like professional arrogance can't do the same to others. http://www.rcvs.org.uk/complaints/

I phoned up the RCVS about a local vet, they took record of my complaint, but is is the vets own little society, and even when a vet [ http://www.horseandhound.co.uk/news/banned-vet-james-main-restored-to-the-register/ ] has been taken to court, they get re-instated.
There was no further action on my part as I would have had to get another report, and my main focus was on getting the horse fed, watered, and out of the situation.

 

[StarcatcherWilliam]

The horse actually had laminitis. Initially diagnosed as navicular, I was told that her navicular bone had ten flask shaped channels in it. The whole thing started badly as the vet conducted a lameness assessment without a shoe on the bad foot. She then had corrective shoeing and tildren. She got a lot worse the next day. Eventually she got lymphangitis and unfortunately her fate was sealed when she was given steroids for that. She was so acutely lame by then that the vet thought it was an abscess causing necrosis of the hoof. I was told to poultice. I was unhappy as she was obviously also uncomfortable on her hinds but was told it was just because her fronts were sore and she was holding herself awkwardly. I had to travel the poor horse 140 miles for the MRI and this should never have been done in her condition. MRI vet said her navicular bone was very healthy. My poor lovely horse, I will never forgive myself.

 

[YasandCrystal]

I have only ever refused to pay a bill once when a vet blatantly lied and advised me he had carried out a PM and gave me the cause of my horse's colic. He hadn't carried out a PM - I knew that 100% and it was really upsetting to think that a vet could just blatantly lie to an owner.

In your shoes I would put my feelings in writing and request in light of the diagnosis and the fact that you had suggested the possible and eventual correct diagnosis to be dismissed as grounds for a substantial reduction in the bill. You can but ask and I would suggest that it is worth it.

Very sorry to read Op - I lost my beloved mare to laminitis nearly 2 years ago now. My mare seemed to be making a slow recovery only for there to be necrosis of her sole and the too high risk of pedal bone penetration. Very bad that the vet did not suspect that from the pulses?

 

[StarcatcherWilliam]

I phoned up the RCVS about a local vet, they took record of my complaint, but is is the vets own little society, and even when a vet [ http://www.horseandhound.co.uk/news/banned-vet-james-main-restored-to-the-register/ ] has been taken to court, they get re-instated.
There was no further action on my part as I would have had to get another report, and my main focus was on getting the horse fed, watered, and out of the situation.

Yes I have just done some investigation into making a complaint to RCVS and this is what it says on the website:

Our jurisdiction is limited in law to cases of:

Serious professional misconduct
Criminal convictions that affect an individual’s fitness to practise
Fraudulent registration

It seems that misdiagnosis or a missed diagnosis is no grounds for complaint. Without knowing what caused the laminitis we will never know if she could have been saved or not. I just wish that she hadn't suffered for so long and I feel awful that everything I was doing to try to help her was wrong. I have already made the decision to not use that vet again, but the other local practice misdiagnosed my friend's horse in a very similar case to what happened with mine. I realise that it is not an exact science, but he should have taken me more seriously and had my horse's best interests at heart from the start, which I don't think he did.

 

[StarcatcherWilliam]

Very sorry to read Op - I lost my beloved mare to laminitis nearly 2 years ago now. My mare seemed to be making a slow recovery only for there to be necrosis of her sole and the too high risk of pedal bone penetration. Very bad that the vet did not suspect that from the pulses?

She did not have digital pulses - hence why the diagnosis was missed I suppose. I can't find any other reference to a horse not having digital pulses with laminitis on the internet, it seems to be very unusual. By the time she had the MRI the pedal bone had rotated and was only mm from penetrating the sole. To be told that your horse has to be put down on grounds of welfare is very hard to bear. It's all such a shock at the end of a very traumatic few weeks. My life feels so empty without her.

 

[cptrayes]

An MRI is not needed to diagnose pedal bone rotation. Did he not x Ray???

It's the. MRI bill that iws be querying, not the rest, especially if the horse had no pulses.

I am so sorry you lost your mare, and in such bad circumstances.

 

[ILuvCowparsely]

The horse actually had laminitis. Initially diagnosed as navicular, I was told that her navicular bone had ten flask shaped channels in it. The whole thing started badly as the vet conducted a lameness assessment without a shoe on the bad foot. She then had corrective shoeing and tildren. She got a lot worse the next day. Eventually she got lymphangitis and unfortunately her fate was sealed when she was given steroids for that. She was so acutely lame by then that the vet thought it was an abscess causing necrosis of the hoof. I was told to poultice. I was unhappy as she was obviously also uncomfortable on her hinds but was told it was just because her fronts were sore and she was holding herself awkwardly. I had to travel the poor horse 140 miles for the MRI and this should never have been done in her condition. MRI vet said her navicular bone was very healthy. My poor lovely horse, I will never forgive myself.

So sorry I lost my mare of a lifetime last year to Laminitis - still so raw have to pm you as cannot put this in open forum

like yasandcrystal we (yas and i )grew a close friendship through the yard times through our mares illness.

 

[ester]

do you have a copy of the original xray? ie can it be confirmed that there was no rotation at that point and therefore laminitis wouldn't be suspected on a horse with no pulses?

 

[Booboos]

You are feeling very guilty which is normal, you have lost a horse in really horrible circumstances.

However, from what you say I am not sure what could have been done differently. If the lameness did not present as laminitis how was the vet supposed to know this was what it was? I know you mentioned laminitis to the vet but if it did not have the symptoms of laminitis why did you expect the vet to treat for this? It also sounds like a very severe case of laminitis and with the lymphangitis on top it's not immediately clear that the horse would have had a good prognosis even with an early diagnosis.

I am very sorry for you and your horse but sometimes awful things happen and it's not anyone's fault.

 

[StarcatcherWilliam]

An MRI is not needed to diagnose pedal bone rotation. Did he not x Ray???

It's the. MRI bill that iws be querying, not the rest, especially if the horse had no pulses.

I am so sorry you lost your mare, and in such bad circumstances.

After the MRI they also took X-rays which showed the pedal bone rotation. She had been X-rayed 6 days previously by my vet to look for "gas bubbles" but this apparently did not show any rotation - although I haven't seen the X-ray. Or maybe they didn't even look as they were so focused on it being an abscess?!

So sorry I lost my mare of a lifetime last year to Laminitis - still so raw have to pm you as cannot put this in open forum

like yasandcrystal we (yas and i )grew a close friendship through the yard times through our mares illness.

I'm so sorry to hear about your horse and also about Yasandcrystal's horse too. It is totally heartbreaking. Yes, she was my horse of a lifetime too. She was only 7 and not the easiest of horses. She was a very big, black, opinionated but very sweet, warmblood. She was too good for me really and very clever and always a step ahead of me! But I had perserved and we had a fantastic year together last year, hopefully one day I will be able to look back on the happy times we had together without it twisting the knife.

I don't think I'll get any where with the vet, but I do intend to speak to him for an explanation into why he did things the way he did and why he missed things. Thanks everyone for your kind comments. I would do anything to have her back, I miss her so much, I was so lucky and privileged to have had three and a half years with such a special horse. xx

 

[ester]

Sadly I think that if there was no rotation in the initial xray then there wasn't really any signs to indicate laminitis at that time to indicate vet was at fault. - Although a conversation/highlight how you feel about it to them would probably not be a bad thing. I'm very sorry for your lose.

 

[cptrayes]

After the MRI they also took X-rays which showed the pedal bone rotation. She had been X-rayed 6 days previously by my vet to look for "gas bubbles" but this apparently did not show any rotation - although I haven't seen the X-ray. Or maybe they didn't even look as they were so focused on it being an abscess?!




Yes, she was my horse of a lifetime too. She was only 7 and not the easiest of horses. She was a very big, black, opinionated but very sweet, warmblood. She was too good for me really and very clever and always a step ahead of me! But I had perserved and we had a fantastic year together last year, hopefully one day I will be able to look back on the happy times we had together without it twisting the knife.

I don't think I'll get any where with the vet, but I do intend to speak to him for an explanation into why he did things the way he did and why he missed things. Thanks everyone for your kind comments. I would do anything to have her back, I miss her so much, I was so lucky and privileged to have had three and a half years with such a special horse. xx

I would check the original x rays to make sure they took side on ones, then make sure that the rotation was not missed on the side on ones. You have cause for complaint If it was missed, because it is easy to spot. Or if side on were not taken, because they should have been.

Next, I think you have cause for complaint that simple x rays were not taken before an extremely expensive mri was done, unless the ones six days previous were absolutely perfect.

 

[StarcatcherWilliam]

You are feeling very guilty which is normal, you have lost a horse in really horrible circumstances.

However, from what you say I am not sure what could have been done differently. If the lameness did not present as laminitis how was the vet supposed to know this was what it was? I know you mentioned laminitis to the vet but if it did not have the symptoms of laminitis why did you expect the vet to treat for this? It also sounds like a very severe case of laminitis and with the lymphangitis on top it's not immediately clear that the horse would have had a good prognosis even with an early diagnosis.

I am very sorry for you and your horse but sometimes awful things happen and it's not anyone's fault.

Agreed. The 2nd opinion vet said it was "extremely unlucky". Having done some reseach in the last few days, I have found out that there are some very high profile cases of dressage horses getting laminitis and not being saved (Annastasia/Poetin) and get some comfort in the fact that if these horses with all the expertise and money at their disposal couldn't be saved then unfortunately it is just one of those things that happens and it is unlikely that anything could have been done to save my horse. Even if she had been diagnosed earlier, there is a chance that I might have decided to try to rehabilitate her with the same outcome. Impossible to say and it's easy to know the best thing to do in hindsight.

 

[Birker2020]

I intend to speak to my insurance company tomorrow, but wanted to see what your opinions were first, just out of interest.

I am very sorry to hear of the sad loss of your horse.

The same thing happened to me in 2004 when my horse was misdiagnosed as having EHV despite a vet from the same practice coming out to an emergency call from myself when my horse had had an accident in the field and gone over backwards ending up unable to raise his head higher than chest height. The vet attending the emergency visit said my horse was presenting as having wobblers syndrome. However, after talking to the yard owner in a private conversation (the two were good friends and used to go out for dinner with their partners) retracted his diagnosis and said the horse had just hurt his neck. It later transpired that the YO had lost her temper with my horse, jabbed at his mouth with the chifney and he had gone over backwards onto his neck.

Initially the horse recovered from his 'neck problem' but the following weeks and months the horse got worse and felt uncoordinated and strange. One day taking him for a hack the horse was unable to walk in a straight line, and his back end started swaying, so much so I had to dismount and lead him home. Again the emergency vet was called out and diagnosed possible EHV. All the horses on the yard were swabbed and the swabs sent to the laboratory for testing at a cost of £20 per horse. THe whole thing was a nightmare. The horse had three more ataxic episodes over a period of two or three months and I was repeatedly told the horse had EHV. I remembered the first vets diagnosis of wobblers, started researching this condition, realised this is what the horse had and demanded he was referred to a hospital for treatment. My vets wouldn't refer as they felt the horse was highly contagious and would pass on the EHV to other horses, and wanted to contain the spread of it to where the horse was based. I even had the vet clap her hands in front of me exicitedly and say "I hope it is EHV as I can write it for my thesis". I could have happily slapped her one. Because of her blo*dy thesis my horse was misdiagnosed and no doubt suffered mentally and physically as a result.

Eventually, eventually the vet decided that my horse (although a shredder of the virus as 33% of horses are) did not have EHV and he travelled to Liverpool Philip Hulme Hospital where he was diagnosed with Wobblers Syndrome. Within two hours of arriving at the hospital I was saying farewell to my lovely horse, and he was PTS. There was nothing that could be done. He was 10 years old.

I was livid and wrote to my vet. The two big partners stuck together and protected their vet saying she had done what she thought was right and that EHV and wobblers are very simnilar.

In my opinion it is a bit like saying bubonic plague and the common cold are similar. I didn't want compensation, I just wanted an apology. I stopped using the vets after this incident.

Previously in 2008 they had put my horse to sleep with a broken leg and ended up shooting it twice and made a right b*lls up of it.

 

[2horsesnomoney]

as a few people have said mistakes do happen and without D. Pulses laminitis would not be not be first on the list of differentials. to be able to "sue" or make a complaint about this practice/ vet you would need to prove they were negligent ie. lateral x-ray showing pedal bone rotation but if no rotation was present just a few days before i dont think there is much you can do. I would ask to see the x-rays taken originally and if they refuse to give them to you speak to the mri practice i would think they have a copy. Just to clarify if rotation was present or not. Did the vet do nerve blocks or anything ? i find it a bit odd to confuse navicular and laminitis as the pain is a oppoiste ends of the foot giving differant foot flight and landing position.
either way i am sorry for your loss,

 

[TheMule]

Without seeing the evidence, it sounds entirely possible that the laminitis came on later on, having started with something else. Steroids can and do trigger bad laminitis

 

[Goldenstar]

Surely there's a middle way .
If this happened to me I would go to my vets and say I am not happy xy and z happened and I do not wish to pay all this bill as I feel the service you gave was sub standard .
I am willing to pay x of the bill .
Then see what they do .
Then if they choose to take you to court to get the money the boots on the other foot and they are the ones suing the heartbroken owner of a horse they failed to treat properly .

 

[StarcatcherWilliam]

I am very sorry to hear of the sad loss of your horse.

The same thing happened to me in 2004 when my horse was misdiagnosed as having EHV despite a vet from the same practice coming out to an emergency call from myself when my horse had had an accident in the field and gone over backwards ending up unable to raise his head higher than chest height. The vet attending the emergency visit said my horse was presenting as having wobblers syndrome. However, after talking to the yard owner in a private conversation (the two were good friends and used to go out for dinner with their partners) retracted his diagnosis and said the horse had just hurt his neck. It later transpired that the YO had lost her temper with my horse, jabbed at his mouth with the chifney and he had gone over backwards onto his neck.

Initially the horse recovered from his 'neck problem' but the following weeks and months the horse got worse and felt uncoordinated and strange. One day taking him for a hack the horse was unable to walk in a straight line, and his back end started swaying, so much so I had to dismount and lead him home. Again the emergency vet was called out and diagnosed possible EHV. All the horses on the yard were swabbed and the swabs sent to the laboratory for testing at a cost of £20 per horse. THe whole thing was a nightmare. The horse had three more ataxic episodes over a period of two or three months and I was repeatedly told the horse had EHV. I remembered the first vets diagnosis of wobblers, started researching this condition, realised this is what the horse had and demanded he was referred to a hospital for treatment. My vets wouldn't refer as they felt the horse was highly contagious and would pass on the EHV to other horses, and wanted to contain the spread of it to where the horse was based. I even had the vet clap her hands in front of me exicitedly and say "I hope it is EHV as I can write it for my thesis". I could have happily slapped her one. Because of her blo*dy thesis my horse was misdiagnosed and no doubt suffered mentally and physically as a result.

Eventually, eventually the vet decided that my horse (although a shredder of the virus as 33% of horses are) did not have EHV and he travelled to Liverpool Philip Hulme Hospital where he was diagnosed with Wobblers Syndrome. Within two hours of arriving at the hospital I was saying farewell to my lovely horse, and he was PTS. There was nothing that could be done. He was 10 years old.

I was livid and wrote to my vet. The two big partners stuck together and protected their vet saying she had done what she thought was right and that EHV and wobblers are very simnilar.

In my opinion it is a bit like saying bubonic plague and the common cold are similar. I didn't want compensation, I just wanted an apology. I stopped using the vets after this incident.

Previously in 2008 they had put my horse to sleep with a broken leg and ended up shooting it twice and made a right b*lls up of it.

Gosh how totally awful. I am so sorry for you and your horse(s). What an insensitive comment by the vet re the thesis. I did have something similar from my farrier, asking if he could take pictures of the special shoe he had made because it had been such "good fun" making it. Turns out his shoe was totally crap and his trimming (or lack of) was appalling, but that is a whole different can of worms which I won't be opening. If I ever feel ready to have another horse and at the moment I don't think I will, I will certainly be changing my vet and farrier. That is one big thing I have learnt from this sorry mess. My ex-farrier is one of the highest qualified farriers in the country and he can't trim a horse's feet properly. My inexperience coupled with the fact that I trusted him purely because of his qualifications resulted in bad feet which undoubtedly contributed to the horse's unfortunate condition.