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Horse Culture and Vet Care, Where Do I Stand?

Horse Care
#1

My horse just reinjured his suspensory, and I immediately reached out to my vet yesterday morning. I got no call and no message about how to proceed until yesterday evening (message) saying I will get a call this morning (no instructions). I put the horse immediately on box rest, iced his leg, and gave him 2 grams of bute while conscious that I have just spent $$$$ treating hind gut ulcers - just got him off the meds two weeks ago, and bute is going to start the stripping of the GI mucosa, but the horse is obviously in pain. I had leftover Misoprostal and Gastrogard, so I administered 1/4 dose of each in hopes of protecting the GI, but I am not a vet, so hopefully this is OK.

So, my question is is it too much to ask that I get a vet to instruct me on what to do when I have an injured horse the day I contact that person? Even if the vet canā€™t necessarily come out right away?

The second question is that do I keep falling through the cracks because the six figure show horses prevalent in my area somehow gobble up the resources? Why was my horse suffering from ulcers when I brought this up in May and July (sitting on the fence), and it was finally diagnosed in November? Why was my horses suspensory diagnosed as ā€œall in his headā€ when he legitimately had an injury, that is now chronic, and this last for three years? I have so much cognitive dissonance about how I could live in an area with so many elite horses, and yet I donā€™t appear to be alone in vet shopping to resolve issues that go unresolved for long periods of time. I just donā€™t understand. Are the vets overwhelmed? Not paying attention? Any ideas?

Bridle Lameness, Diagnosis of Exclusion
#2

I suspect this is a problem in your area correctly cited as a shortage of vets. The only solution I see is attempting to establish a better relationship with one of the vets ā€“ make an appointment for a ā€œconsultationā€ maybe even at the vetā€™s office. Briefly explain your concerns, calmly, and ask what is the best way to go forward. Expect to pay for the visit. The only other solution is to change vets --ask other horse owners in your area and economic level who responds to their needs. Where I live there are an abundance of vets in all price ranges. I use a cow doc (specialist in dairy cows, but does horses) for everything horse related as heā€™s been my vet for 30 years --but, I have no compunction about going to the mega-vet (with the horse MRI in his office) for something the cow-doc struggles with --most recently an intermittent lameness. Mega-vet had same diagnosis as cow-doc, but was more specific in treatment options. FYI cow-doc has never failed to call me back within the hour --for any thing at any time --while I wouldnā€™t say cow-doc and I are friends, thereā€™s a mutal respect.

5 Likes
#3

Hi Foxglove, thanks for your input. Under no circumstances are you allowed to have two vets - a farm vet and a specialist. Never. Furthermore, as with the referred vet who scoped the horse, the referred vet is not allowed to do anything the referring vet can do, else it is consider stepping on oneā€™s toes. Scoping vet did an incomplete job (no ultrasound, no rectal exam, no blood work) and gave the horse a bloody nose to boot. Anyway, a shortage of vets is almost certainly one part of the problem, but the care is still somehow incomplete. There really is no discriminator regarding oneā€™s economic level and choice of vet. The prices are demand driven, and they are high, really high. People who have found they can not afford the care, pay anyway and go without, or they donā€™t call the vet. Scope alone with two samples sent to the lab was $1,165. Again, no check of the colon, or blood work; nothing else but a look at the stomach and two samples sent to the lab. There is this incompleteness to the care that is costing me years of riding time with my horse, and it is beginning to get to me. I will take your words to heart and try to develop a better understanding with my current vet. I just wish I understood why the system is so incredibly inefficient. How do people on the FEI circuit deal with this?

#4

I donā€™t know you so maybe I am reading tone into your posts that is not there in real life, but you sound like nothing that happens is right enough in your opinion. Could this tone be something the vet hears/feels too so that is on the list of reasons why you are not a primary client?

My response to your first post was to call and schedule an appointment for a same day emergency exam, donā€™t expect them to treat over the phone when they canā€™t see what the problem is. You are setting them up for failure if you expect treatment plans with no insight from an exam.

Then I read the second post. Did you ask the referring vet to do the things you are angry that they did not do? I assume you had an opinion about them then, so why not bring it up while they are there?
A bloody nose is not a rare thing from something getting shoved up a horseā€™s nose. It does not mean the vet is a bad vet.

If your vet is so horrible to deal with as you describe here (so many rules, so many poor diagnosis) why not find another vet?

6 Likes
#5

I totally agree my reply did sound snarky. I also agree that they need to see the horse to develop a complete treatment plan. The thing is you canā€™t leave a horse in pain for a known issue or a history of a known issue. It is upsetting.

1 Like
#6

Did you try to schedule an appointment?

A same day (in my world paid as an emergency) appointment would not have left the horse in pain. Calling and asking for ā€˜how do I treat thisā€™ is leaving the horse in pain.

There was recently a thread discussing the pros and cons of using the more expensive big vet practice versus using a single vet practice that might be more personal. Your post is part of the reason I use the big vet practice. There is always a vet on call. If my horse has a problem I can call and get same day service.
Now, I have no idea what would happen if I was calling asking for free care instructions. I donā€™t do that so I donā€™t know if the response would be immediate.

4 Likes
#7

Iā€™m curious where you are. Iā€™ve had similar experience to your first post. The solution is to use a different vet. They are multitude here, though, and plenty of options to choose from. Doesnā€™t make it any less frustrating to wait a long time for answers that donā€™t come.

But youā€™re NOT ALLOWED to use another vet? That alone would have me running for the hills. Different vets are good at different things, and itā€™s not a slight to use multiple people/practices. Is this the only clinic available to you?

10 Likes
#8

The first thing I asked for was a lameness exam. I waited all day to hear back. I am thinking a big vet practice too. I am not asking for free vet care instructions. I am charged for every call, every visit, and mileage to drop off meds. I am totally willing to pay for time, no problems there. I like my vet, and from what I can tell, my vets all like doing business with me. This isnā€™t a personal thing. It isnā€™t a seldom thing. When a vet tells me he is the 3rd, 4th, or 5th person called in on a case, you kind of have to wonder why that is. Some cases are hard, very hard. I get that and have given ample latitude for the art as well as the science.

3 Likes
#9

So you are hearing about the awful other vets in part from your vet?

And youā€™ll be fired as a client if you use another vet that may be better with your situation? But your vet isnā€™t really solving any problems either ( do you know what was ordered for the scope? Did you get thatscope scheduled or your vet?)

I think the problem is your vetā€™s attitudeā€¦

1 Like
#10

Hi Simkie, About five years ago, I had a really nasty experience with a vet who failed to read a flat spot on the radiograph findings. I contacted a surgeon as the horse was not able to walk, and when I called her to update her, she threatened to fire me from her practice. She said she wanted first chance. I was horrified. She has no surgical experience or a surgeon within three hours of us. Even then, I still may have gladly given her another chance, but she was so darn condescending the first time around and insisted the joint in question was fine. It was not fine, surgery cleaned up the joint, and then he was fine.

My second experience, is surgeon does not want to do shots. He wanted emergency vet or another vet to do routine work. Reached out to well-respected vet and let her know that surgeon has just done a lameness eval including blocking, as she was coming out to do shots. Very quick and abupt visit and then she handed me back to the surgeon saying I was in good hands. But wait . . . surgeon doesnā€™t want to do shots or routine vet work. Itā€™s a conundrum.

1 Like
#11

From your first post it sounds like you acted to treat the pain - assuming you left that info in your message? - & if your message was just a request for a lameness exam it does not sound (to me) emergent.
Large animal vets are becoming scarce in my area.
When my vet of 20+ years retired his equine practice, I was fortunate to watch a friendā€™s (owns a boarding barn) vet treat horses at her barn & she is now my vet.

When my mini had a laminitic episode in May, I called her, told her I had given banamine & asked what else she recommended doing. She was scheduled for Spring vax in 2wks.
I followed her advice until that visit: changed his feed, kept up the banamine, restricted access to any grazing. But it was hard watching him gimp around for the 2wks.
She is very quick to respond to calls or texts & is the sole practictioner.

I have to ask who does not ā€œAllowā€ you to call another vet?
Both vets had no problem referring issues to the nearby (1h haul) vet college if their treatments were not resolving the issue.
In all my time with my old vet I was never charged for a phone consult, nor does new vet do this.
Could you pick up meds to avoid the mileage charge?

Hope your horse recovers from the reinjury.
I have BTDT with some pretty bad & not-so-bad issues in my own horses.
Very frustrating.

2 Likes
#12

Hi LilRanger, Yes, you are in danger of being fired or most likely being moved to the bottom of the priority list. So, I am very careful about the politics of vet care in my area.

1 Like
#13

It sounds like the vet culture is the problem if all the vets in the area behave like this. Which seems odd if there is a shortage of services, there should be a surfeit of clients. Perhaps they believe that they can afford to be arrogant about clients. My guess is this is a tit for tat between vets and was started by a prominent vet practice years ago.

What an awful situation, I feel for you!

#14

Thank you 2DogsFarm. I wish I had something more like what you are describing. Yes, I can see where requesting a lameness exam might not sound like an emergency, although I did say I was pretty sure he had just reinjured his suspensory and was in pain. Woke up to giant bites chewed out of the 6ā€™x6ā€™ post in the corner of his stall. Very alarming. Put him on the lunge line, and yes, he is limping all over again. I guess I know that chances of getting someone out the same day is slim to none. I think I should have been more specific and asked exactly what to do, or as has been suggested, go to a bigger practice, where there is back-up available if needed.

#15

I do similar. I always use the bigger, higher tech, and thus more expensive vet practice. I use them for everything. Diagnostics, annual shots, dental, and emergency. They always have a vet from their practice on call. If I have an emergency they will be there ASAP. If I call in with random questions but am not trying to schedule an appointment then yes I wouldnā€™t be surprised to wait 24-48 hrs for a call back. Presumably if my questions were related to an emergency issue Iā€™d be calling to schedule an emergency farm call.

In my area, some horse owners try to save a few dollars by using the cheaper sheep vet to do their annual stuff (vaccines, teeth floating etc). I have heard complaints from those sorts that emergency farm calls are not as reliably available to them from the big practice. I have heard complaints from same that big practice vets are not willing to give them free phone consults. Iā€™m not sure if something similar maybe happening to OP or not, but itā€™s something to be aware of.

2 Likes
#16

Yes, I think it is the vet culture. There is so much business here, and the demand just keeps growing. A vet really can afford to lose clients, and I am thinking that unless they are high end clients, it doesnā€™t bother them a whole lot. When I finally put myself out there on this forum, I know I will hear lots of different perspectives. What strikes me is to listen to what I am saying when I post and what that tells me about the situation. This shouldnā€™t be like this, but yet it just is Given the feedback, I can see where I need to adjust for the mobile practice and be much more specific in what I want and when, even if I think that should be evident. I also should be very clear, that instead of letting a failing treatment plan continue without any adjustment, I will seek outside help. Maybe that means trailering to the University Large Animal hospital, maybe that means a second set of eyes. Thank you everyone.

1 Like
#17

Actually, I probably picked one of the most expensive mobile vets in the area, if not one of the most expensive vets out there. I really like this vet. Maybe I was just upset that this horse has been left in pain for months and years, and he happened to be last on the scene. I needed to convey my sense of urgency. I can see that now. Also, I need to really start tasking the professionals to be more present and make sure they absorb what I am saying. I think it is true, I have a certain expectation. I expect a lot of myself and maybe I expect too much from what the area offers. However, I am fair, and I am flexible. I have learned a lot today.

1 Like
#18

Also, remember that to most people a suspensory is not urgent. Most vets donā€™t want to ultrasound a fresh injury for 2-3 days because the swelling can make the image harder to read. And many horse people know how to stabilize a probable soft tissue injury - wrap and stall rest.

I have a great relationship with my vet, and would expect a text back within a few hours. If she can, she will always fit me in same day or next day. If I need an emergency call though, I have to let them know that I want the vet on call to come now. That is one of the benefits of working with a larger practice - an ongoing relationship with a single skilled vet, but also access to the rest of the team when needed, 24/7 on-call support, and a hospital that will take my horse on a moments notice. Theyā€™re very expensive, but I feel like I get what I pay for.

Iā€™m super curious what area you are in - I can only think of one or two where Iā€™ve heard such crazy stories about people being territorial about clients.

4 Likes
#19

As I said in my post, Iā€™m not sure if you were in a similar position. Now youā€™ve clarified that youā€™re not in the situation I see in my local area that often yields vet complaints.

I can understand why you would be frustrated / upset / disappointed that your horse went without a proper diagnosis / treatment for so long. Iā€™d be upset too. Is this latest issue with the lack of return phone call kind of like the straw that broke the camelā€™s back?

It can be difficult sometimes to advocate for a different treatment plan than what the vet recommends. But I think it just has to be done sometimes.

My personal example. My vet practice also treats small animals. When my dog was a puppy she got quite ill. Vet discovered she had contracted canine influenza even though she was on the recommended vaccination routine. Vaccine manufacturer comped her initial care. For a solid YEAR after this my dog suffered with ā€œfevers of unidentified originā€. We tested for everything, most things twice. Eventually I gathered up the guts to ask for Lyme treatment even though dog tested negative (twice). One round of doxycycline and voila no fevers. There is some weird balance between trusting the vet and questioning the vet.

2 Likes
#20

Hi Joiedevie99, and a follow-up to everybody,

I just got off of the phone with the vet. I think you are right Joiedevie, I think a suspensory is urgent, but a lot of people donā€™t. I needed to know that! He said just what you said that we need to wait a few days before doing an ultrasound because you canā€™t see the where the tissue begins and ends with the swelling. He totally addressed protecting the now healed GI (really trying to be a better communicator - see post of 20 minutes ago!). I was very specific about what exact meds, how much, how long, steps going forward, steps to avoid this reinjury situation happening again. Told him I totally expected to pay for all of his time and be billed, just so that is out there and confirmed. He didnā€™t seem too concerned, but I just wanted to cover the base. So, the question is having back-up in case of emergency. I will discuss this with him when he comes out. I want to know what constitutes an emergency, vitals are pretty obvious, and maybe I need to learn more about lameness. When they canā€™t walk itā€™s an emergency? I am not going to bring up the scoping vet, nor do I plan to use her again.

This forum is really amazing. I was so upset, and although I feel down about a whole new suspensory rehab when I was so looking forward to more work, I feel I can do a sanity check here. Sometimes, one just needs a sanity check!

12 Likes

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