June 2007
VET FORUM
Treatment advances: high expectations, cost
By Michele Roush, DVM
Most of us have, at some time in our lives, heard from what might be known as our "inner voice.Ó It is usually quite soft-spoken, and tends to tell us things we'd rather not hear. Sometimes, it can even cause us to develop an underlying sense of unease. As such, it is easily ignored. You might think that the inner voice is the last tool an endurance veterinarian would reach for, but I can tell you that the rider's inner voice is one of the most important tools we have in our pockets to assess a horse's condition. Riders ignoring theirs do so at their own -- and at their horses' -- peril.
The importance of the inner voice can be thought of in terms of four aspects:
1. Time spent with the horse
I tried to work out, in percentages, the difference between the time a rider spends with a horse and the time an endurance vet does. The task proved too overwhelming for me, when not only training time, but also hours spent feeding, grooming, fitting tack, and even just watching the horse at rest and at play was taken into consideration.
For instance, a rider who trains three times a week may spend 10 hours a week with the horse. Training eight weeks for a 50-mile ride equates to 80 hours, or 4800 minutes. This is probably a low estimate, but will serve for our purpose of comparison.
At a 50-mile ride, a vet may perform four exams on a horse (pre-ride, two during the ride, and post-ride) and each exam may take three to five minutes. At a maximum, then, the vet spends 20 minutes with the horse. That is roughly 0.4% of the time that the rider has spent with the horse, just for the eight weeks leading up to that ride.
Which person, then, do you think knows the horse better, and has the better chance for accurate assessment of a subtle or developing problem? Some of you may argue that because of extensive post-secondary education and experience, the vet should be better qualified to assess the horse. This is very true on many levels, but it brings us to our second consideration: the nature of being a prey animal, and:
2. The ability to hide weakness
Horses are evolutionarily geared towards flight from danger, and have a remarkable ability to keep going, at least for the short term, in the face of physical stress and metabolic imbalance.
Think of the tired horse who, scenting home, picks up and wants to run in. Think of the horse developing a classic tie-up episode who wants to keep up with the group by cantering. Think of the exhausted horse who feels "fineÓ on the trail, but then won't eat in the vet check. All of these examples have an element of disguise that the horse uses to override a weakness, whether it be fatigue or metabolic imbalance.
What has all of this to do with assessment of "fit to continueÓ within a vet check? The answer is that many times, horses are examined by the vets immediately after coming in to the check from the trail, rather than after a rest period. The timing of this can aid the disguise of a tired or metabolically unstable horse by allowing some of the parameters (with the exception, for the most part, of gut sounds) to appear to be a better quality than they might after a rest period.
The vet, then, sees falsely good-looking parameters, and does not have the opportunity to truly assess the horse. In other words, a horse using all its reserves to maintain the ability of flight (read: go down the trail), may come in to a vet check, recover heart rate, get As and Bs on hydration factors, and then "let downÓ with a period of rest, and score Cs on an exam done 30 minutes later.
If there is no call for a recheck, or exit, examination, these worsening signs can easily be missed by the ride veterinarian.
3. Historical knowledge
Once again, the rider has the advantage over the ride veterinarian in that the rider knows, in most instances, not only the horse's medical history, but also its training history and degree of preparedness for the ride.
An example for this situation is a horse that is coming back from a lameness or injury. A few inconsistent off steps taken at a vet check late in a ride might not ring too many alarm bells for the veterinarian looking at the horse. However, if the rider knows that the off steps correspond with the site of previous injury, and if the rider listens to his or her inner voice by telling the veterinarian this, a more educated decision may be made for the horse.
4. Individual variation
Remember that the ride veterinarian looks at every horse in the ride, whether it be Remington the Icelandic, Robin Hood the Mustang, or Bezatal the Arabian. What may be normal for one could be indication of compromise in another. While veterinarians are very good at discerning these individualities, and in recognizing their degree of importance, it is up to the rider to know signs of what may be trouble for his or her own horse, and to communicate those concerns.
To get back to the "inner voice,Ó then, if you sum up all of this, it is clear that while ride veterinarians can and do perform excellent and irreplaceable assessments of a horse's fit to continue status, the rider can hold a very important card in the play of that assessment.
If you, the rider, get that niggling sense in the back of your mind that something is just not right, do not ignore it. Listen to it. Sometimes, it may be your own nerves jangling, but other times, it may be the voice of caution that all is not well with your horse.
It is not enough to read your vet card after the exam, and think that because your horse scored mostly As and Bs, everything must be okay. The vet may know best, but may be operating without all the information. It is up to you, the rider, to help -- and to not be fooled -- by listening to and voicing aloud any concerns of your inner voice.
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