In today’s equine industry, horse owners are blessed with the advances of medicine and surgery that help keep their horses alive and well into their 20s and 30s. As a veterinarian, it is possible to not only provide excellence in care for these senior patients, but also to maximize this as a business opportunity that benefits the bottom line of your practice.
While some senior horses are retired, there are many that are maintained in regular work, and even are in competition. The older horse’s unique set of health issues is fodder for client education. The relationship of an owner with his or her horse is often a long one, stretching several decades. Once a client understands the physiological differences that beset that horse as the animal ages, it is likely that he or she will want to do whatever is best for that valued equine companion. This is where your role as an educator comes in.
Communication with the owner is key to implementing proper health practices for these aging patients, and the services you provide open the door to increasing your business income.
You have probably set your clinic up with state-of-the-art equipment and diagnostic tools that represent significant financial investments. In addition to your knowledge and expertise, these tools are available to provide the best services to your clients’ horses. They have an important role in servicing the geriatric horse population, as well. So, what kinds of evaluations, procedures and follow-up health checks will you want to discuss with your clients who have senior horses? The following information can act as your guide.
A comprehensive physical exam once or twice a year can pinpoint common problems, such as equine asthma, skin cancers, musculoskeletal problems, ophthalmic issues and dental problems commonly found in aging horses. Wellness exams and veterinary visits provide an opportunity for discussion with the owner about each horse’s diet and supplements, medications, social interactions in the herd, exercise demands, performance output and behavior. Obtaining a thorough history enables a practitioner to make relevant medical decisions.
You can inform horse owners about the greater need to assist native immunity in aging horses by providing excellent vaccination, deworming and preventive health protocols. You might offer an official wellness package that gets you on the farm twice a year to check for changes in each of your patients. New health concerns lend themselves to more regular evaluations, diagnostic procedures and follow-up visits, which give you the benefit of earning additional income from clients who want your services.
A common generator of veterinary income, particularly for aging horses, is dentistry. You might have been taking care of horses’ mouths for years, but now is the time to point out how things might have changed in a senior horse’s mouth and how that impacts feed intake, body condition, energy and health.
Sophisticated dental equipment and practices assist in fixing age-related problems in aged horses. Owners should understand that maintenance of useful grinding teeth helps prevent colon impaction, choke and weight loss.
Owners do not necessarily recognize dental problems in their older horses, and they depend on their veterinarians to bring problems to their attention. A British study identified that 95% of older horses had significant dental problems, but only 10% of owners thought this to be the case before the veterinary exam.
For the older horse, it might be practical to market dental exams as something that should be performed at least twice a year. This gets you on the farm more often and can lead to other income-producing measures that the older horse (or another horse in the herd) might need.
Another commonly evaluated health concern of the older horse is a propensity to develop PPID (pars pituitary intermedia dysfunction, or Cushing’s disease). It is best for the horse to not wait until clinical signs—hypertrichosis, irregular shedding, changing body shape, chronic infections or laminitis—are present before something is done about this condition. Clients generally appreciate a proactive approach when it comes to their horses’ care.
Addressing pituitary changes early on gives the best results while the horse still retains robust health. This calls for a discussion about the pros and cons of testing and the options for treatment in the event the horse has PPID based on clinical and laboratory assessment. Horses as young as five can have PPID.
Stimulation testing with TRH to measure ACTH and insulin is a simple procedure that yields information (and profit). Follow-up testing once or twice a year ensures appropriate dosing of effective treatment medication (pergolide). Both laboratory testing and provision of prescription medication generate income. Keeping tabs on the disease process and treating it are ongoing for the life of the horse.
For horses already in the throes of PPID, your clients will be thrilled with how the horses bounce back to a more vigorous and energetic state when treated. Monitoring and managing PPID is not only a good practice builder, but it also keeps your clients’ horses alive longer, which translates to more income production for the practice over time.
And, because of your role as a healer, you likely achieve personal gratification for the help you tender to the PPID horse. All in all, testing for PPID is a sound strategy for generating healthier horses, personal satisfaction for all involved, and financial gain for your business.
Overfeeding is an unfortunate consequence of horse owners loving their horses too much. Equine metabolic syndrome and insulin resistance are not unique to older horses, but those problems tend to be more prevalent as aging horses exercise less—or with less intensity—yet continue to be overfed.
Client education is a first strategy to help combat the tendency to overfeed and to reduce the risk of laminitis in metabolic horses. Testing for insulin resistance and glucose absorption provide concrete information for appropriate client consultation. These conversations come with a price tag in the form of charges for your expertise and advice.
Parasite control measures are followed for all ages of horses, and they are especially important for the older equid. A horse’s immunity is often compromised by inflamm-aging, PPID, and by the natural course of aging. Again, conversations with your clients can alert them to the practical strategy of performing annual or twice-annual fecal egg counts (FECs), along with periodic fecal egg count reduction (FECR) testing that checks on the efficacy of deworming drugs used on the farm. These tests are simple to perform in-house and serve as good profit generators for the practice.
Veterinarians are commonly asked for advice about nutritional concerns for horses of all age groups, but senior horses tend to have more issues. Some horses have trouble holding body condition; others easily become too fat.
Besides inadequate provision of calories, weight loss can result from dentition problems or discomfort, temporomandibular joint disease, intestinal dysfunction that comes with age, chronic pain, neoplasia or other underlying disease. Obesity usually is a result of poor management and feeding practices; this is an area where client education by veterinarians takes on an important role. Travel to client farms allows you to observe the quality of hay and pasture, and to see exact measurements of feedstuffs and supplements fed. In this way, you are able to make appropriate suggestions tailored for individual horse needs. You can reasonably charge for your time and expertise when consulting with clients on each horse’s diet. While discussing nutrition, you’ll also be able to address dental needs and parasite control measures.
For the hard keeper, it might be relevant to pursue blood testing, a rectal exam, endoscopy for gastric ulcers or neoplasia, and other diagnostic measures that generate income. Some older horses have diarrhea due to intestinal dysfunction, parasite burdens or sand ingestion. Testing for sand, using FECs, ultrasound of the abdomen or running intestinal absorption tests are other diagnostic strategies that yield information as well as profit while also putting some of your expensive practice equipment to work.
Nutritional advice and relevant diagnostic workups not only save your client money on feed bills, but often improve patient health. Control of obesity is essential to maintaining musculoskeletal comfort and stability by minimizing stress on aging joints and preventing development of laminitis. The fat horse benefits from dietary changes and restrictions, slow hay feeders and grazing muzzles. These techniques might not be known to your clients, giving you the opportunity to educate them and have them turn to you as the primary resource for more information about current and future concerns. This helps maintain an active working relationship, which inevitably generates profit.
All equine athletes are at risk of musculoskeletal injury. The aging horse might have incurred an injury early in life, and you are now in the position of maintaining that horse’s comfort with physical therapy and systemic and intra-articular joint therapy. Sometimes newly developed arthritic changes are occurring, and clients want to ensure their horses a good quality of life in their golden years.
Treating musculoskeletal problems is a mainstay of equine practice and a tremendous income generator. Diagnostic imaging helps to pinpoint a diagnosis, once again making use of expensive equipment investments of your practice. Administration of joint injections, intravenous and intramuscular joint therapy medications, and oral joint supplements are income-generating services that enable an aging horse to remain as comfortable as possible so he or she can continue in work or relax in retirement.
Consultation—for pay—with a client’s farrier is another useful service to help keep an older horse sound and/ or comfortable. Regular foot care is important, and veterinary expertise is essential to this care.
It is easy for clients to take for granted that your expertise can be handed out without charge. Yet, your expertise did not come without cost: the expense of a veterinary education, the investment in developing your practice and equipping it with specialized tools, and your time invested in the industry and in honing your skills.
All the knowledge and skills you have gleaned over the years are readily applied to maximize the quality of life for your equine patients. The very specialized knowledge necessary for keeping aging horses robust and healthy has a definite value.
Being compensated for your abilities keeps your practice afloat and contributes to career satisfaction.