A VETERINARIAN’S VIEWPOINT
Here are four important questions to ask before you agree to pay for something for your horse---whether a procedure, product or service.
Bottom-line horse care: Here are four important questions to ask before you agree to pay for something for your horse---whether a procedure, product or service.
Most people consider two main things when deciding whether to become the owner of an animal. First is how complicated and expensive caring for it will be. Second is how much emotional return you get on your investment. Let me explain.
Dog care can be very complicated and somewhat expensive. Dogs require at least daily feeding, you have to get them looked after when you go on vacation, you have to clean up the yard from time to time, you have to take them for walks (which, of course, is good for both of you) and so forth. For their part, dogs are pretty much always happy to see you, they sit by your side, they lick your face, they want to go on walks with you, and if called upon they will put up with wearing all sorts of outfits, costumes and sweaters. Dogs are a highmaintenance/high-reward sort of an animal. Most people love them.
Some people keep snakes. Snakes don’t develop attachments to people. They slither around in your hand when you pick them up, and they are actually a pretty cool conversation starter for those folks who don’t have ophiophobia. But overall, a snake is a very low emotional reward sort of creature. On the other hand, snakes only have to be fed periodically, and there’s very little to pick up after. Snakes are low reward, but low maintenance, too.
Horses, I think, kind of fit in the middle. They’re certainly more complicated to take care of than are snakes. But they don’t require as much attention as do dogs. For example, you can leave them in the field with grass and water for a few months and
they’ll do just fine.
They’ll nicker when they see you: one of the most heartwarming sounds in the animal kingdom. They won’t curl up in your lap---which is a good thing, insofar as prevention of serious injuries to you goes---but they will let you brush them and dress them up and, of course, ride them. In general, I think of horses as a sort of mediumreward/medium-maintenance animal (there are plenty of individual exceptions, of course).
Given that horse care does require some effort, and horses can’t sit with you on the couch and watch television, I think that the last thing that horses need is a bunch of folks telling you how complicated and difficult it is to take care of them.
But this notion is taking root in the horse world. In fact, the message is being delivered from just about every direction. Frankly, after caring for horses for more than 30 years, and watching the commercialization of all things equine, as well as expansion of choices available for the treatment of many conditions, I worry that all of this noise is making the horse world a very loud, difficult, expensive and unnecessarily complicated place to be. In fact, it’s worse than that; it risks separating horses from owners by making ownership a financially and emotionally demanding proposition.
Horses survive---and thrive--without two things that are often imposed on horse owners: precision and cost. Precision and cost are the bane of people owning just about anything, because precision usually means difficult, and cost means, well, it’ll be expensive.
For example, one might be able to achieve a precise diagnosis with detailed images from a horse’s puffy ankle, but a little patience and some rest might achieve the same result at a fraction of the cost. I worry that a misguided emphasis on precision and cost is causing some people who might be inclined to own horses to just not bother, and that it’s causing some people who are in the horse world to leave.
So what can you do to counteract these pressures? Well, before you pay for something for your horse, before you let somebody do anything to him, before you buy some product or service, ask the following four important questions. QUESTION 1: “Why is this necessary?”
This seems obvious, but even in this modern era, when there’s access to so much information, many people seem to take a lot on faith. You’re calling someone to help you with your horse because you believe that the person is thoughtful and well-informed. You’re buying some product or service because you want to help your horse. I get that. But you really do want to know why a particular treatment or test is recommended for your horse. You don’t want to look like a bobblehead doll---simply nodding mindlessly---when it comes to discussing your horse’s health.
The question “why” is not at all difficult for someone who is really interested in helping your horse. In fact, “why” questions are easily addressed---and usually welcomed---if a person has taken the time to think over the situation. If someone isn’t willing to address the “why” question, can’t answer it to your satisfaction, or gives you some answer that comes from out of left field (“Well, we need to support his energy” or “his rib is out of place” to name only a couple of a whole bunch I’ve heard), there’s reason to be suspicious.
BOTTOM LINE: “Why” questions can help protect against over-diagnosis and over-treatment. QUESTION 2: “What else?”
In just about every instance, you have options. The horse who has a bit of swelling over his tendon may not have any swelling or any problem in a week; if it’s a serious injury, the swelling or problem will still be there in a week. One alternative to ultrasound and injections---surely, the cheaper
The question “why”
is not at all difficult for someone who is interested in helping your horse.
one---might be to just wait a week.
The “What else?” question is simply a reminder that, when it comes to treating most conditions, there are many ways to go. You want the best thing for your horse, but of course, that begs the question of what “best” means. And here’s your answer. “Best” means:
• the treatment or procedure that’s most likely to help.
• the treatment or procedure that’s least likely to hurt.
• the treatment or procedure that’s the most economical (assuming that you care about such things).
Ideally, your question, “What else?” will prod some extra thinking. It also conveys your interest in knowing all of the options, so that you can compare price, amount of time involved and likely outcomes. The only option that really matters is the best one for you and your horse.
BOTTOM LINE: When it comes to tests or treatments, there are usually a number of ways to go, all of which may get you where you want to go (healthy horse). Make sure you learn about all of them before you pick one of them.
QUESTION 3: “What if I don’t?”
Keep in mind that, in many situations, if you decline a test or treatment, the world is unlikely to come to an end, and your horse may get better anyway.
Take, for example, a horse with a tendon injury. What if you don’t do an ultrasound exam? Will the treatment be any different? Will it make a difference in outcome? (Note: Ask these same questions before you agree to an MRI to investigate your horse’s lameness.) If you need to get your horse back to riding soundness as soon as possible, perhaps close monitoring will be important. But how about if you’re happy just to give him a year off? Maybe that will do just as well, and for a lot less expense and effort.
On the other hand, if your horse needs colic surgery, and you decide against it, his life is going to end. Not a good result, for sure, but this is information you need to have. Most important, if you know the likely outcome, and you can’t afford the solution, at least you’ll be able to keep him from suffering, which is very important.
BOTTOM LINE: “What if I don’t” questions help you make better decisions, because they help you understand the potential outcomes without treatment. They may help save you money, too.
QUESTION 4: “Then what?”
This question is all about knowing what you and your horse might be in for if you do select a treatment.
Say you have a horse with osteoarthritis and you’re thinking about treating him with one of the many types of injections available. You’d want to know
when you’d have to treat him again. You’d want to get some idea of how likely it is that he might respond. You might want to know how quickly he’d respond, or how long he’d be expected to be better, if he got better. You’d want to know if the treatment would change the outcome of the disease, too.
Likewise, when considering an expensive procedure, you might want to consider its relevance and importance for an old horse who might do just as well with an inexpensive one.
BOTTOM LINE: Always try to get some idea of what you’re in for, with or without treatment.
These questions come from my many years of practice as an equine veterinarian. Although I keep an open mind and consider various possibilities when I examine a horse, it’s not uncommon for him to turn out to have what I suspect from the start---and for me to have a pretty good idea from the beginning of what he needs to have done. That’s fine---in fact it might be one of the benefits of my long experience ---but it doesn’t mean that I don’t want the owner to ask questions and, perhaps, challenge my assumptions.
I urge horse owners to participate in the diagnostic and therapeutic process. Don’t just accept what you’re told---ask these four questions and more each time you get a recommendation for a procedure, treatment or product for your horse. Not only will you be a more informed consumer, but you’ll be better able to ensure that you’re doing the right thing for your horse and yourself. About the author: David Ramey, DVM, is a graduate of the Colorado State University School of Veterinary Medicine. Since 1984, his clinical practice in Southern California has specialized in the care and treatment of sport and pleasure horses (RameyEquine. com). In addition to being a fulltime practitioner, Dr. Ramey is also an active advocate for the application of science and evidence to veterinary medicine. He is an internationally recognized researcher, lecturer, blogger (DoctorRamey.com) and author, having written 13 books, 5 book chapters, and over 100 papers and letters published in professional journals and proceedings.