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WORKING TOGETHER FOR BEST OUTCOMES

BY DR MAXINE BRAIN

As an equine vet, I feel it is important for owners to promote a good relationship between their vet and all other healthcare professionals who provide a service to your horse.

I have worked with and conversed with many individuals in the equine world, and never once have I found anyone who has been 100% right, 100% of the time. In times gone by, it was not uncommon for vets to bang heads with other health providers involved in the care of the same horse, such as farriers, physiotherapists or dentists.

In my experience, it wasn’t necessarily just the vet that instigated the disagreement regarding how an owner should proceed with their horse, as farriers would dispute hoof care and physios would differ on management programs and the fallout was a confused owner and an unhappy horse. Thus, in the best interest of the horse, it is important that everyone is open-minded, communicative and works together as a team.

As an owner, you should take a proactive role and encourage a good relationship between all healthcare providers, and not be responsible for, or propagate, any bad blood between them. For example, if the horse is lame and the vet believes the lameness comes from the foot, don’t say to the farrier: “The vet said it is footsore, so it must be your fault.” Similarly, the vet should refrain from making those sorts of comments, and if he or she inadvertently does, then don’t be so quick to pass on the negative comments, but rather exercise some tact in the interest of better relationships.

The benefit of a harmonious relationship is evident in a case I saw recently where I was able to work as a team with the farrier and the outcome was great for everyone. The patient was a three-year-old thoroughbred gelding that was 2/5 lame in his left front leg, and I was able to localise the lameness to the foot. The farrier was consulted and he took over the management of the lameness, although I stayed in close contact with the owners to follow the horse’s progress.

The lameness improved under the farrier’s care initially but returned about a week or so later. An abscess or an under-run sole due to an infection was suspected, but with pain around the whole foot, the farrier could not isolate an area on the sole to dig into and relieve the pressure. Despite daily bathing of the foot and hot poultices applied, the horse remained lame with no sign of an abscess tracking out of the foot.

BEST APPROACH

As I had a great relationship with the farrier, we discussed the case and decided the best approach was to work together to find a solution. I was able to X-ray the foot with the farrier present and isolate a small pocket of pus (gas pocket) near the toe of the foot. The farrier was able to cut the tip of a horseshoe nail and fix it to the area of the sole that we both thought approximated the underlying gas pocket. By X-raying again and adjusting our marker, we were able to accurately pinpoint an area and the farrier was able to make a small hole directly over the abscess and allow the pus to escape. The result was a horse that was significantly sounder (and happier) the following day.

This is a very simple case, but it illustrates that a combined effort can often resolve an issue more efficiently. There are numerous examples of cases where communication and co-operation between the veterinarian and the farrier have resulted in far superior outcomes than with either working alone. Laminitis sufferers, thin-soled horses and horses with pedal bone fractures have all benefited from a dual input approach.

Chiropractors, physiotherapists, and veterinarians have probably had a more volatile relationship than that of the veterinarian/farrier. This is potentially due to the lack of regulation in the “muscle person” industry and the ability of some lay people to branch into this field with little or no training. There are, however, several very well-credentialled physiotherapists and equine chiropractors that I have a good working relationship with, and even if I don’t agree with everything they find or techniques they may utilise, I am still happy to show them respect and listen to their assessment, without forming a negative opinion before I have contemplated the validity of their findings.

To the contrary, I have often discussed their findings with them and utilised their input to help gauge an overall assessment of the musculoskeletal system. There have been incidences where I have been unable to improve a horse’s gait, but the owners have reported immediate improvement following treatment by the physiotherapist or chiropractor. I generally find that the well-credential physiotherapists or chiropractors are comfortable discussing their cases with the vet and can offer good advice on managing movement, balance, and rehabilitation exercises for all types of injuries. This advice can then be used to help incorporate exercise protocols around veterinary timelines such as ultrasound or X-ray assessments.

These are some of the reasons why I believe it is essential to promote and encourage a good working relationship between all the individuals involved in the care and welfare of your horse, because not only will your horse be better off, so will you. EQ

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