Coping with Nursing Sick Horses - When Is Enough Enough?

Sick horses may suffer a number of welfare compromises. These include physiological and pathological states such as injuries, dehydration, malnutrition and inflammatory and stress responses, and inabilities to perform motivated behaviours. These may correspond to various unpleasant mental states, which can be described as the ‘illness’ of disease, most notably malaise and pain, but also including boredom, fatigue and frustration.

The use of curative or palliative treatment protocols can improve horses’ QOL to certain levels. The same treatments may also be life-saving, by curing underlying diseases. In other cases, euthanasia or a high-risk treatment may end the animal’s life. But such treatments come with a risk of iatrogenic welfare harms. Surgical interventions may cause pain and hospitalisation may cause stress and frustrate motivated behaviours.

This paper firstly considers how improvements in quality-of- life can be maximised, and iatrogenic harms minimised, through the use of pain assessment tools, quality-of-life assessment methodologies and welfare-based care plans. For example, established quality-of-life assessment methods can be useful in many ways, including screening for issues that have not been noticed by an owner; monitoring chronic and progressive cases; assessing palliative treatment; monitoring geriatric cases; assessing iatrogenic side effects; assessing novel surgeries or treatment regimes; providing useful prognostic indicators; determining treatment priorities and in clinical governance and trials. These can be adapted and used in equine practice, although practitioners must decide other questions, such as who is best placed to monitor quality-of-life. [...]