The Geriatric Donkey

Companion donkeys are frequently managed by ‘benign neglect’ - although cared for in the eyes of the owners, they simply live out their lives in paddocks. Because they are not usually in work, problems that may be recognised in the ridden horse or pony may go unobserved in the donkey. For example, weight change, stiffness, or foot and dental disease may all be obvious in horses and ponies at the time of grooming, tacking up and riding.

Age-related issues are frequently neglected in working donkeys around the world, with infirm animals struggling to carry loads. Sensitivity towards local cultural norms and beliefs as well as an awareness of financial, professional and practical constraints are needed when addressing these problems.
 

CLINICAL EXAMINATION

In the experience of The Donkey Sanctuary, many older donkeys that owners wish to relinquish into their care have never undergone a dental examination, are not vaccinated, and have either foot or joint pathology, or both.

Owners may recognise that their geriatric donkey is behaving differently. They may be lying down more, not lying down as much, have reduced activity or have changed in demeanor. For example the once bright and alert donkey is now quieter, wandering aimlessly and not interacting with companions to the same degree. Owners may likely put this down to advancing years rather than disease.

As part of a full examination, the clinician should place particular emphasis on:

• the general demeanour and mobility of the donkey
• body condition score
• assessment of loss of muscle/redistribution of fat
• ease with which joints can be flexed/extended without positive indicators of pain
• vision.

Elderly donkeys may have large crests and pads of retained fat from a previous period of obesity and these may become calcified. These crests and pads can make body condition scoring challenging as they may hide poor fat cover and even muscle wasting.

A test feed is often advisable to ensure that the donkey is prehending, masticating and swallowing effectively.

Feet will still need to be examined, even if arthritis is evident in limb joints, but keeping the foot as close to the ground as possible will minimise the risk of inducing pain and loss of balance in the donkey.

A blood sample for a routine screen should always include an assessment of triglycerides in the donkey where it is presenting as ‘dull’.

COMMON CONDITIONS

Osteoarthritis is common in both axial and appendicular joints.

The ‘stiff donkey’ needs to be carefully assessed for joint pain and the owner should be asked to observe if the donkey is able to lie down and get up with ease. The ability to roll should also be assessed, because this is a natural and important behaviour in donkeys. A donkey which never has straw or shavings (or other substrates) stuck to the coat or rug may not be lying down at all and this may be because they find rising difficult – a fearful situation for a prey species. Carpal and hock lesions may be indicative of difficulty in lying and/or rising.
 

Reluctance on the part of the donkey to allow anyone to lift their feet may be wrongly attributed to resistance behaviour, but may actually be a result of arthritic pain.
 

The arthritic donkey may not have the full range of comfortable neck movement and consideration should be given to adjusting the height of food and water containers to allow for this.

‘Stiffness’ in the donkey usually equates to pain. Analgesics should be prescribed and the response must be closely monitored. Continuing stiffness despite analgesia would warrant euthanasia, because arthritic pain is likely to be unremitting.

Laminitis is common in the older donkey and there may well be a legacy of untreated attacks over decades, resulting in unremitting foot pain but only manifesting as short stridedness, a ‘pottery’ gait, or subtle shifting of weight from limb to limb. Tell-tale laminitic rings may well be present and a dropped and/or thin sole evident.

Some donkeys will not respond reliably to hoof testers; this is seen most commonly in the thick-soled mammoth breeds of donkeys.

Radiographs will confirm the extent of pathology and assist the farrier with any remedial treatment.

The different anatomy of the donkey means that frog supports are contraindicated (unless radiographs indicate otherwise), because unlike in the horse or pony the point of frog is behind the fulcrum of rotation of the pedal bone.

The images illustrate significant laminitic change in a ‘pottery/stiff’ donkey that had never been diagnosed before arrival at The Donkey Sanctuary. This demonstrates concerns raised in this handbook regarding recognition of pain related conditions in this stoic animal.
 

Dental disease, with or without associated sinus disease, occurs frequently in donkeys of all ages but is compounded by time and a lack of regular professional dental care. It is well recognised that dental disease is one of the most severe sources of pain in horses and ponies, and this is no different for the donkey.

Common abnormalities seen in older donkeys relinquished to The Donkey Sanctuary include periodontal disease, diastemata, malocclusions, dental overgrowths resulting in both hard and soft tissue pathology (e.g. penetration of opposing bony structures) and tooth loss.

It is important to make a full patient assessment and a treatment plan in order to prevent any unforeseen consequences from treatment.

Sight impairment may occur as a result of age-related cataracts or repeated attacks of uveitis that have gone undiagnosed or untreated.

The Donkey Sanctuary would not consider transportation of a blind donkey in any circumstances other than an emergency, and would recommend euthanasia in the home to be the best welfare outcome if the owner is no longer able to keep the donkey.

Pituitary pars intermedia dysfunction (PPID), also known as Cushing’s disease may be recognised in the geriatric donkey based upon a change in demeanour, laminitis, slow wound healing, recurrent infections and high faecal worm counts, which are all symptomatic.

The thick coat of the donkey can make weight loss/gain and altered fat deposition less obvious.

Hirsuitism and curliness of the coat are less frequently recognized in the PPID donkey.

High internal and external parasite burdens commonly accompany PPID.

Internal parasite related disease is common in donkeys of all ages, no less so in the geriatric. The donkey may never have been wormed and pasture management may have been lacking. Cyathastominosis may result in typhlocolitis and catastrophic loss of proteins or insidious weight loss.

Liver disease may be diagnosed as a result of a combination of analysis of blood samples, ultrasonography/biopsy and clinical signs that include weight loss, dullness and neurological signs.

Respiratory compromise frequently goes unnoticed in the non-athletic donkey until dypsnoea is obvious at rest.

Tracheal collapse is not uncommon and is a result of age related degeneration of the tracheal rings and cartilage.
 

Pulmonary fibrosis can be seen together with tracheal collapse.

Corticosteroids may provide temporary improvement but, with no effective long-term treatment available, the chronic tachypnoiec/ dyspnoeic donkey should be euthanased.

Mental decline is not uncommon as an age-related condition in donkeys and should be a consideration in any quality of life assessment in the geriatric individual.

Behaviour change, particularly a change in the way companion donkeys interact, may be significant. Lifelong companions may interact less in the face of terminal disease, with the healthier of the two donkeys appearing to abandon its companion.

GERIATRIC MANAGEMENT

Several options are available to ensure that the geriatric donkey has a comfortable life. These will not all be appropriate or even possible for every case. Decisions regarding a suitable management plan should be agreed in discussions with the owner.

• For the older donkey, particularly those with a degree of osteoarthritis, fields should be as flat as possible, because slopes will present a constant challenge and may result in reduced activity.
• Water, feed and shelter should be readily accessible at all times.
• A deep shavings bed is easier to negotiate than straw. Shavings are also recommended for the donkey with dental disease, to reduce the risk of digestive impactions through the inability to process long fibre.
• A stable-safe heat lamp should be advised in temperate/cold climates, and the donkey may require rugging.
• The rugged donkey requires extra vigilance and the owner should be advised to remove the rug daily to check for any lesions.

• Apart from lesions caused by rugging, the owner should be vigilant for any lesions appearing on the carpal and hock joints, which would indicate difficulty in lying or rising.
• Donkeys appear to have an aversion to very cold water, which may result in a reluctance to drink during the cold months. Water with the ‘chill’ taken off it will be more readily acceptable and may reduce the risk of dehydration and digestive impactions. While thermostatically controlled water-supply systems are now available, it is just as easy and less expensive to add hot water to the bucket/trough on at least a twice-daily basis.
• Dental disease will necessitate a specific diet, usually in the form of a short chop forage. There are now high-fibre, low-calorie short chop products available such that ad libitum feeding can be practised, thus satisfying the behavioural need of a trickle feeder. Should dental disease progress such that only ‘gruel’ can safely be fed, then quality of life should be discussed with the owner, bearing in mind that a donkey’s normal behaviour would be to eat for up to 16 hours in a 24 hour period.

• Key to managing the sightimpaired donkey is that the environment remains unchanged. Judicious padding of shelter/stable doorways may be appropriate, and mangers and troughs should be checked to ensure they will not cause injury to the donkey. Some donkeys benefit from being fitted with a padded ‘bumper’ head collar.
   

ASSESSMENT OF QUALITY OF LIFE

If euthanasia is not immediately indicated or accepted by the owner, it is a valuable exercise to monitor changes or progressive decline through repeated examinations and the recording of specified parameters.

The owner can be given a monitoring sheet to record the health and welfare of their donkey. ‘Monitoring your donkey’s quality of life’ has been produced and used by The Donkey Sanctuary.

The owner should be advised to complete a sheet on a weekly basis and to discuss the findings with their vet on a regular basis. The parameters included in the sheet give a good indication of the health and, importantly, the welfare of the donkey, and will enable the owner to see any progress or decline and feed the information that they have observed into the assessment record that their vet or other professionals should keep.

It will allow an informed and objective discussion between the owner and the vet or other professionals about whether the the welfare of the donkey is compromised. The assessment record for the quality of life of the donkey will allow a record to be kept of discussions, owner reports and professional assessments. This will include a defined end point, for example the point at which analgesia is failing to control arthritic pain.

If the quality of life of the individual is poor and treatment options are limited by severity of disease or financial considerations, then euthanasia is likely to be the best outcome for the donkey’s welfare.

Euthanasia should not be considered a failure, but the last good thing that can be done for the donkey.

It is important to consider the companion animal when a decision has been made to euthanase a donkey. Plans must always be made to address the bereavement that the companion is likely to experience.

Findings from the Advancing Equine Scientific Excellence (AESE) End of Life project were that vets provide an important role in supporting owners when making the decision to euthanase their donkey at the most appropriate time. Quality of life assessments are often done on an informal basis between the vet and the owner. However these are rarely logged so cannot be referred back to when monitoring for any decline in chronic conditions.

There can also be a discrepancy between an owner’s perception of quality of life and the reality as shown by the assessment, so this is an important area of education for owners. Where they were asked, owners requested more information on geriatric care and quality of life assessment.