not saying a thing.....

Exasperated said:
Thirty plus years ago, actually.
Probably correct, in that the treatment cost his owners the price of a small semi, with never a prayer or thought of recouping that, so it was not strictly necessary that the stallion should survive, but it was absolutely necessary to his survival, as part of the treatment which included industrial quantities of analgesic.
Getting weight off their feet does make a big difference to laminitis pain experienced, hence so many cases lie themselves down.
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But a prey animal having to lie down for extended periods to relieve pain is an additional issue in itself
 
I couldn't do it. I lost a big horse to laminitis (secondary to a horrible abscess). The vet did vaguely mention clogs, which my farrier later said didn't come big enough anyway, but all I could think of was months in a stable or pen and a big horse with the extra forces on her feet. She was already in her 20's and although healthy up until that point, I didn't think the prognosis and suffering was worth it for her.

The horse in the post is suspended for treatment only, and sedated. He wears padded boots the rest of the time but still struggles to walk more than a few steps. Mine was pretty comfortable in the same footwear, so his pain must be worse than that. I think the woman at GTL must have a very hard heart to see that level of suffering every day and not want to end that suffering.
 
This is unfortunately just humans being humans. Putting their own emotions and needs ahead of that of the horse. Wanting their way to be better even if it isn’t, and not giving up even if that harms others.

(Humans do it to each other plenty, and here we are with animals doing it again).

Vets will keep going and going far beyond what is realistically reasonable because for some reason they feel they must. As the owner you have to evaluate quality of life and likelihood of success.
 
AWinter said:
I don’t know how I feel about this stuff really. They do show horses much more comfortable and happy further down the line and I agree that reducing chronic stress by getting horses into an environment where they have access to friends and a feeling of more freedom/needs met etc really helps with recovery. Not going to comment on the trim side of things as I don’t know enough about it.

I appreciate the horse in the post is in an extremely bad way, but I’m trying to think if that was my horse and there was a chance he could go on to have a comfortable, happy life I’d want to give him every chance? I’m just wondering if people think this is cruel because they think this horse will never recover, or they just think there’s a time limit on suffering regardless of whether the horse will be well at the end or not?
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If it is whom I think it is then i am not shocked, just saddened.. again.

I think that they show 'recovered' horses but there have been lots of not recovered horses who are not mentioned.

If it was my horse then I would have to consider lots of things age, health, temperment. and then how much suffering for what outcome and what length of life is left.
 
maya2008 said:
Vets will keep going and going far beyond what is realistically reasonable because for some reason they feel they must. As the owner you have to evaluate quality of life and likelihood of success.
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I do find myself rather offended by this statement. I would be OK with it if you had said 'some vets' or 'a vet I have experienced did'.

As a profession however I don't think you can make an all-encompassing statement like that. I do not think I have ever gone 'beyond what is realistically reasonable'. Nor do I recognise any of my colleagues in that statement. Ethical decisions are always going to be shades of grey, but I would say that in general I have met far more owners determined to keep going than vets. I find that very hard to deal with.
 
Gamebird said:
As a profession however I don't think you can make an all-encompassing statement like that. I do not think I have ever gone 'beyond what is realistically reasonable'. Nor do I recognise any of my colleagues in that statement.
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I have always found my vet to be very much in line with this. I have never had one disagree about making 'that' decision, or want to prolong things unnescessarily.
 
ester said:
I think putting any horse through an extensive and extended rehab for laminitis where it cannot properly weight bare is cruel even if it might recover eventually. There’s some truly awful cases out there historically that have done so but I feel the same about them
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Absolutely!
This "treatment" is disgraceful and immoral in my book. I would report the vet involved to their governing body.
 
Gamebird said:
I do find myself rather offended by this statement. I would be OK with it if you had said 'some vets' or 'a vet I have experienced did'.

As a profession however I don't think you can make an all-encompassing statement like that. I do not think I have ever gone 'beyond what is realistically reasonable'. Nor do I recognise any of my colleagues in that statement. Ethical decisions are always going to be shades of grey, but I would say that in general I have met far more owners determined to keep going than vets. I find that very hard to deal with.
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Well given it doesn’t say ‘all vets’ it would qualify as ‘vets in general in my experience’.

I now ask, ‘In your experience, what has been the outcome of [the treatment you are recommending] in this situation?’ It gets me the answer I need.

The cases that have stuck in my mind the most:
- An older horse, whose owner was given hope after hope and treatment after treatment (I know, she was my friend, I was there) when it was obvious to everyone that the horse was in the process of dying. All any of it did was prolong the process. She got thinner and thinner and sadder and sadder. One morning we found her down, unable to get up. She had to be manhandled out of the stable and onto the yard to be pts (stables inaccessible to machinery).
- A horse with a broken leg, who suffered for weeks while they tried, only to pts in the end.
- A horse I personally knew well whose owner kept saying she didn’t think they would recover, that wasn’t it time? Vet kept telling her, ‘Try this. Give her time.’ After months of pain she finally was hurting so much she became so aggressive that they agreed to pts. The very thing that her owner had wanted to do months before but told she was over reacting.
- Various horses with catastrophic injuries that realistically would never fully heal - treated and owners given hope. Some never came sound, some were only slightly lame so came back into work before deteriorating enough to be pts (not even a field ornament) a few months down the line.
- A horse with every sign of a twisted gut, too old for surgery - Let’s operate. Thankfully that one was shut down and she was pts at home.

And more. So many, many more over decades of horse owning, livery yards, friends. Where the insurance will pay, giving the owner hope and the horse months or weeks of pain only to be pts in the end anyway. Most owners trust their vets and want to keep trying

I love my vets - current ones are pretty pragmatic but will still offer treatment they don’t think will realistically work. They feel they have to try. I get that. They came into this to save animals - my job as the owner is to say when enough is enough. Always better a week too soon than a moment too late. Always.

My little mare is named after the first horse on my nightmare list. I will never forget her, how she held on as long and hard as she could for the person she loved so much; how absolutely awful her end finally was.
 
I erm can’t seem to see the post in question even on Mark’s page so my ability to comment on that is limited.

Re the vet thing obviously I work in the industry so can see it from that side (& tbh there are a LOT of owners that push for absolutely everything including the kitchen sink without necessarily fully understanding what that’s going to mean & entail). I’ve personally through work been involved in more situations where we’re strongly advising euthanasia as an option and the owner isn’t ready than where the owner wants to PTS but vet is pushing not to. (There’s certain situations we may offer a sign over & handover to a charity as an option instead if the main barrier is finances and prognosis with treatment is good but ultimately if that is rejected we’ll go with owners wishes)

That said I have absolutely been in a position where I had one person (not a vet but an extremely good judge of movement & soundness) who’d seen the horse in person (plus A LOT of people on here who hadn’t!) in full agreement with me that this was the end of the road but 3 different vets encouraging me to keep going & try more joint injections etc. Did eventually get one of them to admit that we were at a point where things were only likely to get worse from. (1 of them was even encouraging me to get back on when I was raising concerns that I still didn’t consider the horse sound even if they did and when I’d reported the horse literally falling over on the lunge… even after he nearly came down on top of me because he was struggling to stand on 3 legs for hoofcare I had to be VERY firm about what WAS happening and the extreme resistance I still came up against was why I had the horse shot as I just didn’t want to deal with someone trying to talk me out of it on the day)
 
IME my vets are always very realistic about prognosis and QOL. I have an elderly horse so the conversation comes up often whenever they see him, though he’s doing really well for now we always have the conversation of “he’s doing well now but you need to be prepared for when x and y starts to happen….”, it’s a tough pill for me to swallow but I understand they’re looking at it much more pragmatically as a vet and not an emotionally attached owner and I appreciate that unbiased view to keep my rose tinted glasses in check.
 
I'm Dun said:
It wasnt necessary for him to survive at all. And doing all that was obscene. I find more and more that vets will not call time and prolong suffering massively.
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Vets can recommend but they can't enforce. Which causes them a lot of stress and sadness at times. It's always the owner's call.
 
Landcruiser said:
Vets can recommend but they can't enforce. Which causes them a lot of stress and sadness at times. It's always the owner's call.
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I have to say this thread seems to me to contain several examples where the owner could and should have over-ruled the vet suggestions and pts. If you are paying the bill, the ultimate responsibility is yours and, in the UK, we are very fortunate that we are not dependent on a vet for equine euthanasia.
 
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I think this conversation explains why it's helpful to have the same vet. My vets have many, but I always request the same one. She knows me well and knows I'm quite pragmatic, so no need to give me every possible option at once, because she knows I won't keep them going at any cost. It just makes the whole decision making easier. I have had vets that I felt pressured by, but mine isn't one of them.
 
Just because a vet says "we can do x,y,z" doesn't mean they're recommending it either. They have to offer options. My vet gets stick from people for recommending "too much" (which usually means too expensive) but you have to know the options to make an informed decision. Maybe some people would prefer to be told nothing else will work, even if it isn't actually true so they don't have to actually make a decision, I dunno.
 
You have to remember also that vets are in an incredibly difficult position. When my horse was in Leahurst I outright asked the vet “do you think we should PTS now” and she could only say “I can’t make that decision for you”, I desperately wanted someone to make the decision for me but their hands are tied. They can only give you what they think the prognosis might be if they do x, y and z. And what it might be if they don’t, it is ultimately not their decision whether to euthanise an animal when the legal owner is there. I ‘knew’ my vet felt it was time to stop trying but she couldn’t say that, what she did say was “I think he might die anyway whatever we do” which was enough. I don’t know what the legal implications are but I imagine they have to protect themselves at all costs if they suggested PTS and an owner later was enraged they hadn’t been offered a certain treatment that ‘might’ have helped.
 
KikiDee said:
You have to remember also that vets are in an incredibly difficult position. When my horse was in Leahurst I outright asked the vet “do you think we should PTS now” and she could only say “I can’t make that decision for you”, I desperately wanted someone to make the decision for me but their hands are tied. They can only give you what they think the prognosis might be if they do x, y and z. And what it might be if they don’t, it is ultimately not their decision whether to euthanise an animal when the legal owner is there. I ‘knew’ my vet felt it was time to stop trying but she couldn’t say that, what she did say was “I think he might die anyway whatever we do” which was enough. I don’t know what the legal implications are but I imagine they have to protect themselves at all costs if they suggested PTS and an owner later was enraged they hadn’t been offered a certain treatment that ‘might’ have helped.
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I agree with this, but do they not also have a duty to the horse to tell the owner that the horse is suffering, and that although further treatment is possible, it will prolong the horses' suffering and the outcome is uncertain /poor/ a long time away?
And therefore in their professional opinion, the best thing for the horse is PTS, DESPITE other options being available? I know in rescue cases they do make that call, although perhaps the original 'owner' is not there to complicate things.
 
Gamebird said:
I do find myself rather offended by this statement. I would be OK with it if you had said 'some vets' or 'a vet I have experienced did'.

As a profession however I don't think you can make an all-encompassing statement like that. I do not think I have ever gone 'beyond what is realistically reasonable'. Nor do I recognise any of my colleagues in that statement. Ethical decisions are always going to be shades of grey, but I would say that in general I have met far more owners determined to keep going than vets. I find that very hard to deal with.
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The fact that neither you nor any of your close colleague vets behave like this is reassuring, but does not detract from the fact that plenty of other vets do, nor the fact that as procedural possibilities and possible insurance cover have increased, the frequency of this is also increasing.
I don’t read the initial comment as condemnation of the entire veterinary profession, which would be ludicrous, yet neither can you make an all-encompassing ‘defence’ of it in this respect.
The recent enquiry into veterinary experiences (albeit small animals, yet mixed practices abound) includes evidence from plenty of vets (not all corporate, either) complaining they are pressured to promote and continue treatments not necessarily in the animals’ best interests, let alone their owners’.
It is rare with treatment of genuine agricultural livestock, altho certainly happens to ‘hobby farmers’ whose relationship with their animals is more like pets, and it absolutely, definitely, simply, no doubt about it happens with horse owners. Witnessed it myself, been on the receiving end, and it takes a very confident, experienced person to slap down - which is unlikely the state of mind of your average leisure horse owner, contemplating their beloved animal.
This is not to suggest financial gain is the motivation, altho that may be a big factor in some cases, because some vets genuinely don’t want to disappoint or hurt owners, some really dislike euthanising creatures (altho prevention of suffering is part of the job), some are very interested to see what is possible - multiple reasons.
Yes, cultural attitudes towards animals and death generally have fundamentally changed, and not necessarily for the better. It is bizarre that phrases such as ‘passed on’, ‘crossed a rainbow’, ‘put to sleep’ etc are seen necessary by vets to explain death to owners today, or that vet practices refer to small animals’ owners as their ‘mummies’, their ‘daddies’, or to the actual animals as ‘boys’ or ‘girls’ (which many of them unfortunately do)…..it inspires quite unnecessary ‘guilt’, which I cannot see is helping. I don’t see vets trying such euphemisms with farmers, either.
 
Cragrat said:
I agree with this, but do they not also have a duty to the horse to tell the owner that the horse is suffering, and that although further treatment is possible, it will prolong the horses' suffering and the outcome is uncertain /poor/ a long time away?
And therefore in their professional opinion, the best thing for the horse is PTS, DESPITE other options being available? I know in rescue cases they do make that call, although perhaps the original 'owner' is not there to complicate things.
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I genuinely don't know what the guidelines are on this stuff - perhaps someone in the profession like @Gamebird can shed more light on it. I just know that IME my vets were very hesitant to actually suggest that PTS was the right choice or not, no matter how hard I pushed them for an answer and despite the fact I could tell she very much believed it was the right thing to do. So I imagine they may have some obligation to ensure they are not deemed to have swayed the owners choice in any way and have to stick to a pretty tight script.

I've had the same experience with small animal vets too, with a dog who had lost the use of his back legs, it was me who had to categorically say I wanted him euthanised and not to explore any palliative care. While my vet was in full agreement once I'd actually said that, beforehand that conversation was very much "what can we do to help".

I think end of life must be an extremely difficult situation to navigate for vets and ultimately their role is to give you the facts and let you make the decision yourself. I'm sure there's many cases where they think in their personal opinion it's time to stop pushing treatments and call it a day, but ultimately they are employed to administer the medical care they are asked to provide and swaying into the territory of telling an owner when to end an animals life can be very risky. Of course there is a hard line in an emergency where the horse is catastrophically suffering from an injury or illness where there is no chance of survival and the vets obligation is to step in and immediately end their suffering, but ongoing chronic conditions are much trickier.

The other element of it, sad as it is, is that insurance will rarely pay out for death unless they consider that it was absolutely necessary to end the animals suffering and all treatments had been explored. So if, as an owner, you decide not to prolong a situation with a surgery or long rehabilitation with a sceptical prognosis, and decide to PTS. You could likely find the insurance company will not pay out if you were expecting the value of the horse back. Which again, puts the vet in an extremely difficult position if that were the avenue they had advised you to take.
 
meleeka said:
I think this conversation explains why it's helpful to have the same vet. My vets have many, but I always request the same one. She knows me well and knows I'm quite pragmatic, so no need to give me every possible option at once, because she knows I won't keep them going at any cost. It just makes the whole decision making easier. I have had vets that I felt pressured by, but mine isn't one of them.
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on the other side equally I think it is helpful for the owner to know the vet ie how realistic are they going to be, what are their views.

I have had several horses over the years and you get to know how each vet thinks and their strengths and weaknesses. I remember a 27yo sec D one night we heard through the alarm going crazy, he was throwing himself at the stable walls and falling to the floor. Vey very violent colic. Vet called and as we were waiting I said to OH this may not have a very good outcome. We quickly agreed immediate PTS, it was going to be dangerous enough to get into the stable. Vet arrived and explained our decision. Very unhappy and said I thought I had come to treat colic not PTS. You had but a couple of minutes of assessing the reality of the situation ie 27yo had extremely severe colic for the first time in his life with no reason whatsover and even if it responded to treatment we were all likely to in the same position the next night.
I had the same vet (who was one of the best ever) for another horse where I was very close to PTS (not an emergency) I was persuaded otherwise but he was PTS the following week as he was suffering with no solution possible.


I learnt not to have that vet again out of choice if PTS was a possibility. I spoke to another vet (who knew me) about the colic horse and their instant reply was PTS no question.
It helps if you know the vet, if the vet knows you and also if you have sufficient experience (which is not always easy) and have done your own research to know the questions to ask and how to phrase them. It also helps if you set your own boundaries in advance especially for things like colic. Surgery or not? Is it even possible to send the horse away.

I understand people with insurance may have problems but one of the benefits of uninsured is that it is my decision alone.

it is also helpful to have the same vets even several of them as you know in advance how you are going to deal with them to achieve the outcome you want.

I am banned from the GTL site so no idea of the horse in question. However as I dislike them as much as they dislike me I doubt I would be very happy. Sadly I think with laminitis novice owners just grab any hope someone offers but at the end of the day there may well be only 1 conclusion. When laminitis really takes hold with little clear reason then you get onto the road to nowhere. I'm not sure HM (and others) always realise that.
 
Landcruiser said:
Vets can recommend but they can't enforce. Which causes them a lot of stress and sadness at times. It's always the owner's call.
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I understand that, but Ive had arguments with vets about having an animal PTS, and Ive been pressured to try this, try that etc. Ive been told that even if a pedal bone pentrates the sole we can still do x, y and z, and it will be ok. I think some vets get caught up in what they can do rather than what they should do. I suspect some clients prefer this though.
 
KikiDee said:
I genuinely don't know what the guidelines are on this stuff - perhaps someone in the profession like @Gamebird can shed more light on it. I just know that IME my vets were very hesitant to actually suggest that PTS was the right choice or not, no matter how hard I pushed them for an answer and despite the fact I could tell she very much believed it was the right thing to do. So I imagine they may have some obligation to ensure they are not deemed to have swayed the owners choice in any way and have to stick to a pretty tight script.

I've had the same experience with small animal vets too, with a dog who had lost the use of his back legs, it was me who had to categorically say I wanted him euthanised and not to explore any palliative care. While my vet was in full agreement once I'd actually said that, beforehand that conversation was very much "what can we do to help".

I think end of life must be an extremely difficult situation to navigate for vets and ultimately their role is to give you the facts and let you make the decision yourself. I'm sure there's many cases where they think in their personal opinion it's time to stop pushing treatments and call it a day, but ultimately they are employed to administer the medical care they are asked to provide and swaying into the territory of telling an owner when to end an animals life can be very risky. Of course there is a hard line in an emergency where the horse is catastrophically suffering from an injury or illness where there is no chance of survival and the vets obligation is to step in and immediately end their suffering, but ongoing chronic conditions are much trickier.

The other element of it, sad as it is, is that insurance will rarely pay out for death unless they consider that it was absolutely necessary to end the animals suffering and all treatments had been explored. So if, as an owner, you decide not to prolong a situation with a surgery or long rehabilitation with a sceptical prognosis, and decide to PTS. You could likely find the insurance company will not pay out if you were expecting the value of the horse back. Which again, puts the vet in an extremely difficult position if that were the avenue they had advised you to take.
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It is I'm sure very hard for vets.
I had one situation at vet hospital, after lots of tests/ examination I was told there was a possibility they could operate. The vet said at best they could give a 20% chance of success & warned that if I decided to PTS instead it was unlikely insurance would payout.
I elected to PTS & did end up being fully paid out by my insurance, but I wonder how many would have gone for the op because of insurance considerations?
 
Lamehorses said:
It is I'm sure very hard for vets.
I had one situation at vet hospital, after lots of tests/ examination I was told there was a possibility they could operate. The vet said at best they could give a 20% chance of success & warned that if I decided to PTS instead it was unlikely insurance would payout.
I elected to PTS & did end up being fully paid out by my insurance, but I wonder how many would have gone for the op because of insurance considerations?
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When mine was first admitted to hospital they told me his % chance of survival and told me the treatment would be very expensive and that some people choose to PTS at that stage of diagnosis rather than continuing, then left me to make the decision. I think that’s as fair as they could be tbh. They certainly never pushed me to try the treatment or continue at any stage, if anything I think sadly they felt it was a bit hopeless but gave it their every last shot anyway while keeping me well informed of my escalating bill. (It was a money no object scenario as he was my horse of a lifetime but I appreciate that wouldn’t be the case for everyone and felt they were very pragmatic in warning me how much continuing treatment would cost me).
 
KikiDee said:
When mine was first admitted to hospital they told me his % chance of survival and told me the treatment would be very expensive and that some people choose to PTS at that stage of diagnosis rather than continuing, then left me to make the decision. I think that’s as fair as they could be tbh. They certainly never pushed me to try the treatment or continue at any stage, if anything I think sadly they felt it was a bit hopeless but gave it their every last shot anyway while keeping me well informed of my escalating bill. (It was a money no object scenario as he was my horse of a lifetime but I appreciate that wouldn’t be the case for everyone and felt they were very pragmatic in warning me how much continuing treatment would cost me).
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thats the perfect response in a horrid situation
 
KikiDee said:
I genuinely don't know what the guidelines are on this stuff - perhaps someone in the profession like @Gamebird can shed more light on it. I just know that IME my vets were very hesitant to actually suggest that PTS was the right choice or not, no matter how hard I pushed them for an answer and despite the fact I could tell she very much believed it was the right thing to do. So I imagine they may have some obligation to ensure they are not deemed to have swayed the owners choice in any way and have to stick to a pretty tight script.

I've had the same experience with small animal vets too, with a dog who had lost the use of his back legs, it was me who had to categorically say I wanted him euthanised and not to explore any palliative care. While my vet was in full agreement once I'd actually said that, beforehand that conversation was very much "what can we do to help".

I think end of life must be an extremely difficult situation to navigate for vets and ultimately their role is to give you the facts and let you make the decision yourself. I'm sure there's many cases where they think in their personal opinion it's time to stop pushing treatments and call it a day, but ultimately they are employed to administer the medical care they are asked to provide and swaying into the territory of telling an owner when to end an animals life can be very risky. Of course there is a hard line in an emergency where the horse is catastrophically suffering from an injury or illness where there is no chance of survival and the vets obligation is to step in and immediately end their suffering, but ongoing chronic conditions are much trickier.

The other element of it, sad as it is, is that insurance will rarely pay out for death unless they consider that it was absolutely necessary to end the animals suffering and all treatments had been explored. So if, as an owner, you decide not to prolong a situation with a surgery or long rehabilitation with a sceptical prognosis, and decide to PTS. You could likely find the insurance company will not pay out if you were expecting the value of the horse back. Which again, puts the vet in an extremely difficult position if that were the avenue they had advised you to take.
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I would change my vet!

I have had a vet tell me that she would not advise colic surgery for a large Draft horse. I wouldn't have agreed to it if she had but fortunately the horse pulled through at home with the vet's treatment.

But I don't insure because I don't want to involve a 3rd party in my decision making about my animals.
 
KikiDee said:
I genuinely don't know what the guidelines are on this stuff - perhaps someone in the profession like @Gamebird can shed more light on it. I just know that IME my vets were very hesitant to actually suggest that PTS was the right choice or not, no matter how hard I pushed them for an answer and despite the fact I could tell she very much believed it was the right thing to do. So I imagine they may have some obligation to ensure they are not deemed to have swayed the owners choice in any way and have to stick to a pretty tight script.

I've had the same experience with small animal vets too, with a dog who had lost the use of his back legs, it was me who had to categorically say I wanted him euthanised and not to explore any palliative care. While my vet was in full agreement once I'd actually said that, beforehand that conversation was very much "what can we do to help".

I think end of life must be an extremely difficult situation to navigate for vets and ultimately their role is to give you the facts and let you make the decision yourself. I'm sure there's many cases where they think in their personal opinion it's time to stop pushing treatments and call it a day, but ultimately they are employed to administer the medical care they are asked to provide and swaying into the territory of telling an owner when to end an animals life can be very risky. Of course there is a hard line in an emergency where the horse is catastrophically suffering from an injury or illness where there is no chance of survival and the vets obligation is to step in and immediately end their suffering, but ongoing chronic conditions are much trickier.

The other element of it, sad as it is, is that insurance will rarely pay out for death unless they consider that it was absolutely necessary to end the animals suffering and all treatments had been explored. So if, as an owner, you decide not to prolong a situation with a surgery or long rehabilitation with a sceptical prognosis, and decide to PTS. You could likely find the insurance company will not pay out if you were expecting the value of the horse back. Which again, puts the vet in an extremely difficult position if that were the avenue they had advised you to take.
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If the vet in clinical attendance had advised euthanasia, it would be a brave insurance claims manager told that vet they were wrong. Possibly a compulsory second opinion with exceptionally valuable horses?
The issue is rather that for (whatever) reasons, attending vets are increasingly less likely to advise euthanasia in the first instance; worse, they are too often reluctant to advise this even as situations deteriorate. Clearly this has financial implications, but welfare considerations should be paramount, and vets can certainly override pushy or unrealistic owners when welfare dictates: prevention of suffering - but increasingly rare that they do.
 
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