Decay Of The Profession

It is with a sad heart I write this blog about the professional decay in my profession of equine veterinary medicine. The story told here is true as it was told to me today by a a very kind and generous man I’ll call Jay (not his real name). He is almost 80 years old, lives with his wife on a gorgeous and well maintained farm with 2 old horses. One is 26 years old and the other is 35. He recently lost one to a colic that most likely required surgery.

This is not about the wonderful and talented veterinarians serving many of the horses in cities throughout America and other countries. Most are dedicated men and women working hard to help horses live a good life. Though I disagree with many with their theories and approaches, they still have a fundamental desire to help the horse. But this wasn’t the case for Jay the night of the colic.

There is a disparity being created by a variety of forces that is leaving so many horse owners without options for the care of their horse. The primary force is money followed by an educational system overwhelmed by technology while turning their back on the fundamentals of horse handling and application of the basic veterinary techniques. While not new, the veterinary schools are getting further away from selecting qualified talent with horses but closer to a qualified intelligent person able to learn new technology and theory.

But even worse is the lack of interest of many veterinarians to serve horse owners due to financial business decisions, burnout or both. On this note it is interesting to see the parent veterinary organization commit valuable convention time to the subjects of improving the quality of life and even the growing problem of suicide amount my colleagues. In fact suicide and drug addiction is at an all time high they say though I’m not sure of the numbers.

Old trees with overgrowth and decay.

The Story

The 26 year old horse of Jay’s showed signs of colic. He spent 4 hours calling 3 horse vets trying to find one willing to come to his beautiful but rural farm.

The first vet was the one who in the past had attended to his horses. They even go to the same church. This vet said he would not come to help Jay’s horse because he took his dogs and cats to another small animal only vet. He would only come if Jay agreed to have him perform all the work on all of his animals. I can’t help but to wonder if my work on the horse teeth may have added to the problem. I have had clients call to tell me that they can no longer use me because of this extortion.

The second vet Jay called told him that she no longer enjoyed working with horses. What?!? Why was she ever a horse vet? Was this burnout or was she becoming more afraid? Whatever it was, it wasn’t helping Jay and his horse.

The third vet was a recent graduate I assume. Jay called him a nice young man. After medicating the horse, he spent the next hour attempting to pass a stomach tube. He made two trips to the water trough to use in his tube manipulations, never gave any of the mineral oil in the jug next to his pail and created a very bloody nose which he assured Jay was nothing to worry about.

I asked about the rectal results. Jay said no rectal was done. I asked what the heart rate was. Jay said he was never told.

The horse was left in the pasture that night where he died.

The tree and the fence. Who wins?

Where does the blame lie? What is the problem and is there a solution? The comment section of this blog I’m sure will fill with stories, debates, finger pointing and solutions. I have thought about this for a long time. I have written about it before. However, like all decay, damage is usually permanent and not reversible. This is what saddens me the most that the profession I chose is no longer what it was. It has left me and other older horse vets wondering about the future of our profession. It has left many horse owners living in the rural areas wondering the same. And then there is the other hidden fact that about 90% of the world’s horse, ass and mule population is outside of America with Ethiopia holding the largest population. But in our own back yard, shouldn’t we expect more?

Siegfried Farnam was the owner of the vet practice in the Yorkshire Dales where the famous books of the James Herriot series took place. He gathered James and his brother, also a vet, into the study where he admonished the two for not going to a call. He put it simply with the emotion of insistence and the wave of the finger. “You must attend. You SHALL attend!!” It is the words I have always lived by and maybe it is a place to start.

Responses

    1. 🙁 The good news is that maybe YOU are what your doctor (your boss) needs. Sometimes all they need is someone to show them the reason they chose this profession. Give it a try.

  1. Doc!Unfortunately the mind set is drastically changing. Good old fashion horse sense mixed with true horsemanship seems to be fading.

    Here is an example that relates to the equine dentistry aspect of veterinarian work. I want to practice equine dentistry back home in Ontario,Canada. While discussing my intentions with a track veterinarian about my desire to do so, I was read the riot act. He went up one side of me and down the other with threats of jail, fines and loss of trainer’s license and so on.

    When this person along with a number of other veterinarians were asked to come to the farm to check and do our horses teeth they didn’t have the time of day for us. They don´t want to be bothered with this work (perhaps too tedious and time consuming when the same money or more can be
    made doing less time consuming tasks). However they do not want anyone else doing this.

    Is it not interesting that technology continues to advance and influence our lives, yet a horse is still a horse in search of understanding?

  2. Doc T said: ” an educational system overwhelmed by technology while turning their back on the fundamentals of horse handling and application of the basic veterinary techniques” and I caught my breath. This is a statement of integrity and gives me hope for the future of animal care and animal medicine. Beautifully stated.

    Another problem in current medical care – not the fault of vets – is that owners, trainers, and caretakers often do not properly prepare their animals to cooperate with treatment. This increases the time required, the stress all around, and the danger. I am a professional manager and trainer of exotic animals, so I deal with this extensively. Lack of preparation exposes animals to the necessity of more intrusive, and rougher handling. Training and preparation is essential, as these animals are too big, and too delicate (emotionally) to manhandle. This means that owners, keepers and trainers need to know what procedures their vets commonly use, and they need to train for those.

    In addition, some vets are dopamine addicts at the expense of the animals. We had some very fine vets rotate through the facilities and institutions where I have worked, and we had some outstanding pathologists. However, there was one vet that wanted to make a rodeo out of every interaction with an animal. It was so damaging to the animals, that I came to dread the approach of this sadistic man. He exposed the vets learning under him to greater danger, and they were already worked off their feet. Most of all, I saw that usually, if the animal did not have a desperate need for surgery or antibiotic, they recovered better on their own, than if exposed to this vet. This particular vet was unwilling to work collaboratively with the staff, and showed active irritation when he arrived and the animals were already caught up and often even belted down, curtailing the rodeo session. Fortunately, I think the interning vets saw through the situation and they worked differently. Their gentle approach, respect toward the animals, and willingness to collaborate fostered high care standards for our animals.

    Anyone who works with exotics, knows (or should know), that our animals can die, on the spot, just from fear and stress. Understanding how to respect our animals and colleagues, and how to gently influence behavior to get what we need, is crucial to providing good medical care, and high standards of animal welfare. Preparation and working respectfully and gently with our animals is as important as all the other tools of medicine. I believe that applies to horses as well as to exotics.

    Thank you for speaking out.

    Best wishes,
    Kayce Cover

    1. You’re welcome, and thank you for your thoughts and comment. One of my missions is to bring horsemanship back to the horse owners so they can prepare their horses for the professionals they work with.

      Fear is the bane of horse professionals. When I went through vet school there were no courses on horsemanship and the lack of it back in 1980 was very evident. Couple this with lack of leadership and communication skills of the owners and you have a dangerous cocktail. Owning or working with horses becomes a chore and is no longer fun. Horses become RV’s parked in a garage pulled out to perform and then put away for the next time. So I agree with you on your assessment that the owner is as much of the problem. But it doesn’t excuse the professional from their behavior. All horse professionals must take the lead and show owners that these animals are living, breathing beings and that we all live for the connection we feel with them.

  3. I’m so sorry for the whole situation! I only have great vets! (You’re one of them). But have dealt with some doozies, more in the small animal realm than large.

  4. Dr T. I always read your articles and learn from them. As for the vets here in Delaware, the majority of them are ” pay first or not come” and as I only get paid twice a month, ss and pension, it is hard for me to save enough money for an emergency. Luckily my horses have been good, only one has a problem, very flat feet with heel growing forward which has caused a lot of abcesses that have caused parts of hooves to break off and false parts put on, but after the initial vet check and xrays, the farrier is doing the rest. since it is my daughters horse, she works overtime to pay for his showing and fixing. At least he is not lame now. This may not be right by you, but I give my own shots to my horse because I can’t afford the farm fee the vets charge. As for my dogs, they go to a different vet and they too are expensive. I wish I could add them to my health insurance and us it for them. I have noticed a difference in how the vets work and their reason for not coming to your house. The first vet we ever had did the dogs and horses, he would come to the house and not charge a farm fee nor would he charge an office fee and did great work. He has since died and the person that replaced him is terrible. That is another story.
    So, keep up your good work and your column and I will keep reading them. Love your pictures too. Take care.

  5. Dr T, I have lived and looked after horses in many countries, including the US. Right now I am in New Zealand and have 2 horses, goats, sheep, cows, pigs, cats and dogs. I am extremely lucky that, in the very rural area where I live, I have access to an awesome vet who takes care of my entire menagerie and dropped everything she was doing to come and help my old girl every time she needed her. And if I am tight with money she will always let me pay it off. But I know from experience how rare this can be. Good vets, the ones that do it all day and all night when needed, those vets are gold and should never be taken for granted.

    1. Hello down there! Thanks for taking the time to write. So how do we get what you have to be the normal rather than the rare?

      Please tell your vet that she has a kindred spirit on the opposite side of the globe and thank her for me. Doc T

  6. I cried-my heart goes out that dear man and his family I am so very grateful I have you and Melisa Dr T- thank you both for all you do for my horses- my heart is joyful and at rest because you have never left our appointment without I learn and am confident that you are so extremely thorough and you CARE A LOT!!!!!!!!! – you teach me every time you come to take care of my boys……………..they love you sooooo doooooo I
    God Bless you and Melisa love Sheila Robin and Lord Jimxooxoxoxooxoxoxoxooxoxoxoxoox

    1. Thanks Sheila – As always, we both are grateful for you. Now let’s send your energy into your prayers to help those not as lucky. Blessings to you, X O

  7. Dr. Tucker, you are so right as I see it happening in the field of veterinary medicine with both small and large animals. I also see this happening with doctors who treat people. They hardly look up from their laptop while you’re sitting in the exam room with them. I hope you keep doing what you’re doing and caring for these horses. I remember calling you several times when my horses had issues not related to their teeth. You always advise me and even came here one day to stitch up an injured horse when I couldn’t get another vet. Thank you for all you do. Diane Farina

    1. Thank you Diane – I appreciate your thoughts. When my son was in the hospital for 13 days on death’s doorstep I saw the few who cared and the majority who thought it only a job working on a machine rather than a human.

  8. I live in an extremely rural area as well and have just had to accept that if something terrible happens to my beloved animals that I will have to put them down. My nearest vet is over 3.5 hours away that has more than just the ability to vaccinate my horses. It is sad to hear that this is happening in the veterinary profession but I see it happening as well in the nursing field. We do not have enough older experienced nurses around to teach and mentor the new nurses and find that they end up training themselves. I see mistakes made because of this….. yes they want tech savvy nurses and I think that is a focus as well and lack the basic skills I was taught when I went through school. Sad to see humanity taking a back burner to technology.

    1. Ahh Chriss – my FAVORITE zoo vet! Another perspective on this subject. When our profession has moved past the place of our learning and our experience, what will be left for the horses, asses, mules, zebras, chimps, all primates, all birds, all reptiles, all cats, all dogs, all fish and on and on.

      Truly a blessing – thanks, Dr Chriss

    2. You are correct it isn’t just horse medicine. It is in small animal medicine, farm animal/livestock and human medicine. The skills that once were common place in animal husbandry and human medicine are no longer there. In the past 12 years 4 large animal vets have either retired or passed away. The vets that have replaced them no nothing more than to write a prescription.

  9. How sad. An equal number of equine vets who might attend an ailing horse will not do so for an ailing donkey or mule. A couple of years ago, my donkey became very ill and the equine vets I called for assistance declined to come out stating, “its only a donkey.”

  10. Good morning, Doc. I always read your blog, but have not before felt compelled to respond. I am blessed with good vets for my 6 horses, 3 dogs and 4 cats, but I have certainly encountered my share of vets who were anything but a blessing. Your report of an abortive attempt at tubing triggered a particularly gruesome memory.

    I am now 67 years old, and have worked with horses for 54 of those years. My first vets trained me, and I was their eager acolyte. Then came a period when my vets and I trained each other, observing and discussing symptoms and behaviors and comparing notes over time. Now I am twice the age of some of my vets, and I find that either they yield too readily to my suggestions, or they resist them altogether. That magical synthesis of training, experience and owner understanding of an individual horse is rare.

    Certainly money is a factor. Many vets and other medical professionals graduate with an incredible burden of debt which of necessity governs their decisions. Others face daunting costs to establish their own practices.

    And perhaps fear does enter into it: I have seen young vets invest in handling machinery like mobile stocks which to me seem more of an impediment than a useful tool.

    But horse owners also have changed. I have watched people vet-hop, looking for the latest and greatest of treatment plans. I have watched barns form fan clubs for this vet and hate groups for that one. There is a huge market full of supplements and magnetic pads and special wraps and blankets and magic salts that appears to undermine the authority of the vet who relies on simpler techniques. And of course the internet, a wonderful tool, can also be a disaster for vets, who face owners’ home diagnoses often far off the mark. The consumer has huge power, and often fails to recognize the accompanying responsibility.

    But is this an irreversible decay of the profession? Or just a shakedown cruise?

    I do not know. But I do know that, just as with all important things in life, we all have to step up to steer this ship in the right direction.

    Thank you for asking us to think about it!

    1. Thanks Dale for reading my blogs and taking the time to comment. We are only 3 years different in age and I think our perspective is critical in preserving what has been time tested long before our birth. While change is good in technology, when it comes to living breathing things, change can also destroy.

      I am glad you willing to help steer the ship. Without your help, I believe the shakedown cruise will end badly for horses as well as humanity.

    2. Hey Doc, great article and Dale Rose hit something I too have experienced. Big Pharma is part of this. I hope you are working on something. I try to do my part.
      Keep us posted! Kaye

      1. You bet! But do we have a chance in changing things – or is it too late. I sometimes feel like I’m bailing water at a slower rate than the leak is bringing it in. But with you and all those looking at this, maybe all of our little spoons will get the job done. Thanks Kaye MollyThePony.com

  11. Geoff:
    Sadly, I have to concur. You’ve used an extreme example, but the underlying reality exists across the industry. As you know, we’ve spent over 15 years attempting to educate vets on hindgut issues in horses, that colic is (for the most part) an avoidable issue. We’re banging our heads against a brick wall. Our FBT is a simple, cheap, non-invasive, point-of-care diagnostic aid for a vet, that helps to provide a view into what is otherwise a proverbial Black Box (with no similar tool available). However, vets aren’t taught any of this in vet school, plus I’m no longer sure how many enter the profession simply for the love of the animal and concern for its welfare.

    Is it that vets don’t make enough money from FBT? Does it obviate the opportunity for ‘scoping (in the mind of the vet)? Is it something to do with “I don’t comprehend the problem or issue, so you have a solution to an unseen or misunderstood problem”? We don’t know!
    I have a set of equine veterinary manuals written in the late 1800’s. It’s fascinating: 8 of the 9 volumes deal with keeping the animal healthy while only the last (for the most part) deals with problems requiring veterinary intervention. A remarkable change in just over 100 years.

    One major factor I see is that so much pseudo-science is promulgated, under the umbrella of “education”: it’s about re-inventing the wheel, taking an obtuse view of reality and re-packaging it for the 21st century vet or horse owner who appears to be a complete neophyte. For example, the Red Book actually states that “Girthiness” is a sign of gastric ulceration. Just a moment’s thought would allow any half-way educated equine vet to appreciate the stomach is up in the thorax, quite incapable of being pressurized by a girth, while the girth actually squeezes on the anterior portion of the dorsal colon: so girthiness MUST be a colonic issue. Are vets just uneducated, not thinking, or what?

    How do we change this, for the better? It shouldn’t be that difficult. Facts and an initial comprehension of anatomy & physiology should make this straightforward, so what’s missing?

    I’d love to help.

    John Hall

    1. John – Every year we meet at the AAEP meeting and every year what we see and hear is worse. Yet the profession seems oblivious to it.

      I appreciate your last sentence. I think you responding here is what is needed. You and others responding, telling their stories and stating their thoughts. We need thousands of these here on this post. Then each of us needs to touch just one horse owner willing to listen and have that touch help the horses associated. We might just get lucky and catch a vet or two.

      And don’t you think for a second that I might just be working on one or two other things….