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When Digging For A Diagnosis Becomes Harmful

Equine and pediatric medicine has many parallels, notes Dr. David Ramey in an article for Horse Network, including a propensity for overdiagnosis.

Ramey draws multiple similarities between the two, including that both horses and children are reliant upon adults to make medical decisions for them. Additionally, neither small children nor horses can talk, so diagnoses must be made on observation and testing.

Ramey says that a horse may have an issue where a diagnosis is warranted, but determining an exact diagnosis can be difficult—and in some cases harmful–to the horse. An ultrasound can be a helpful tool to use if a horse is colicking and a diagnosis on whether surgery is needed is imperative. However, sometimes a precise diagnosis isn't needed. If a horse is older and sore, using every diagnostic tool to determine where it is unsound may not change the treatment or the outcome—it simply adds to the owner's expense. In Ramey's words, “'Overdiagnosis' describes a situation when an abnormality is found, but detection of that abnormality doesn't actually benefit the patient.”

Though vets have multiple diagnostic tools at their disposal, their use doesn't always behoove the horse or the owner. Using every tool available to find a diagnosis might physically harm the horse: It's imperative that the owner and vet agree that the benefit outweighs the possible risk of the test or procedure.

Psychologically, naming the issue may change the perception of what a horse can do. Some owners then become focuses on “fixing” the problem, adding in supplements and other treatments that the horse may not need. Finally, the financial strain on owners who choose to offer treatments to horses that may not garner long-term improvement can be immense.

Ramey offers some thoughts on why veterinarians may seek to over diagnose the equines in their care:

Industry influence
Defensiveness
Incentives

Owners may attempt to seek out concrete diagnoses for their own peace of mind; uncertainty is not well tolerated by most people.

The benefit—to both horse and owner–of performing a test or procedure should be discussed before an owner agrees to pay for it. Many equine conditions improve on their own, so immediately throwing every test and procedure at the horse may result in the same diagnosis as waiting and not doing additional tests.

Dr. Richard Bowman: Guardian Of Minnesota Racehorses

Prior to the intervention of Dr. Richard Bowman, the bulk of racehorses retiring from Minnesota racetracks were sent to slaughterhouses in Mexico or Canada, reports the Star Tribune.

A vet with the Minnesota Racing Commission, Bowman was first asked to help find a retiring racehorse a home in the late 1990s. Now, he gets asked for help several times each week. When he learned of how many horses needed assistance in finding homes when they could no longer race, he opened his 4,000-acre cattle ranch in North Dakota to Thoroughbred and Quarter Horses that are too injured, old, lame or slow to continue their careers as racehorses at Canterbury Park in Shakopee, MN.

At the ranch, which is nine hours from Canterbury Park, he focuses on rehabilitating and adopting out as many horses as he can (nearly 600 so far). The horses that are too unsound remain in his care at the ranch indefinitely—there are 35 such horses on the ranch currently. Now a 501(c)3 charity called Bowman Second Chance Thoroughbred Adoption, the program is famous for welcoming every horse in any condition, taking in the horses many others will not.

Each horse that enters Bowman's program is assessed for personality, temperament and ability. Once rehabilitated, the horses that are adoptable are paired with an adopter. Bowman's horses have been adopted out all over the United States; they do everything from hunters, jumpers, eventing, cattle work, polo ponies, dressage and other disciplines.

Bowman is one of three Minnesota Racing Commission veterinarians, along with Dr. Christy Klatt and Dr. Lynn Hovda. The trio are tasked with ensuring the horses racing at the state's tracks are sound and healthy to race; they also assist with rehoming nearly 60 racehorses each year.

Some of the horses are adopted directly from the track; those in need of temporary shelter go to Hovda's farm. Most of the horses head West to the Bowman ranch, where they settle into a less-pampered lifestyle before they are prepared for adoption. In addition to horses retiring from racing finding homes, the veterinarians team with Canterbury Park officials to pull two to three horses with ties to the state's tracks from kill pens each year. They are able to prevent these horses from being shipped to slaughterhouses outside the U.S.

Learn more about Bowman Second Chance Thoroughbred Adoption here.

Ongoing Research On Horse-Human Interactions Bode Well For Equine Welfare

The interactions between horses and humans were discussed during a three-day, virtual conference hosted by the International Society for Equitation Science (ISES). Dr. Katrina Merkies recounted research on understanding human impact on the physiological and behavioral states of horses. She believes that evidence-based research will continually improve equine welfare, reports Equine Guelph.

During her presentation, Merkies referenced a survey that asked people to characterize their bond with their horse. Respondents reported that their horse approaches them, vocally greets them and touches them. They also stated that their horses may turn to them when frightened.

Another study noted that while survey participants may be able to discern a scenario where there is a physical threat to a horse, they might not be able to accurately answer questions regarding when a horse is bored or frustrated. This lack of understanding is of concern as the “five freedoms of animal welfare” recommends that animals not just survive, but thrive in the care they are receiving—their social and emotional needs must also be met in addition to their needs for food, water and shelter.

Merkies also reported that:

Horses blink less when they're acutely stressed
People who possess insecure attachment styles do not overly stress therapy horses
Horses can aptly distinguish between human facial expressions
Horses are more likely to approach an attentive person than an inattentive person
Horses react to the tone of voice used with them
Incorrect use of negative reinforcement increases stress in horses
Horses that live out most of the time become desensitized to novel stimuli more rapidly

Merkies finished her presentation reiterating that humans in charge of horses must be in tune with equine needs and allow horses to express themselves. She believes that education will assist horse owners and handlers in their ability to recognize positive welfare as well as welfare warning signs.

Morris Animal Foundation Awards Nearly $1 Million In Grants For New Studies Benefiting Equine Health

Morris Animal Foundation, a leader in advancing animal health, has awarded nearly $1 million in large animal health research grants, supporting 14 projects. The studies will help veterinary scientists improve the well-being of horses through improved prevention and treatment of numerous health challenges, including eye cancer, heart arrhythmias and risks for injury from air transport.

“We were very impressed with the quality of proposals received this year and we believe they have the potential to drive significant improvements in the well-being of our equine companions,” said Dr. Janet Patterson-Kane, Morris Animal Foundation Chief Scientific Officer. “We are very proud to support these enterprising researchers in their endeavors.”

Through this year's grants, the Foundation is supporting teams at 13 universities and institutions, including the University of Minnesota, Colorado State University and the University of Calgary. The Foundation's Large Animal Scientific Advisory Board reviewed all submitted grant applications and selected, based on scientific merit and impact, the studies with the greatest potential to save lives, preserve health and advance veterinary care. Large animal studies funded for 2020 include:

Working Toward a Genetic Test for Heart Arrhythmias
Researchers will investigate if genetic variants can help identify horses at high risk of developing potentially fatal cardiac arrhythmias. If successful, the team will use this information to develop genetic tests, as well as other screening protocols, for early identification of at-risk horses for the condition.

Developing Health and Well-Being Guidelines for Air-Transported Horses
Researchers will determine how horses can be managed when transported by air to optimize their welfare, identifying factors that increase or decrease the risk of health and behavioral problems. Findings will be used to inform guidelines to improve the health and welfare for horses traveling by plane.

Understanding Changes in Gut Microbiome and Health
Researchers will study gut microbiome variation as it relates to the health and wellness of a well-studied group of feral horses living on Sable Island, Canada. Data generated will provide a large baseline platform to spur further research and discoveries about associations between gut bacteria and health in horses.

Evaluating a Novel Treatment for Eye Cancer
Researchers will investigate the efficacy of a novel treatment for ocular surface squamous neoplasia, a type of eye cancer in horses. Findings will help advance our understanding and treatment of this cancer.

Morris Animal Foundation is one of the largest nonprofit organizations worldwide that funds health studies benefiting cats, dogs, horses, llamas alpacas and wildlife. The Foundation currently is funding 150 studies encompassing a broad spectrum of species and diseases.

Learn more here.

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