Equine Veterinary Client Survey

Giving advice on welfare

In order to evaluate how horse owners experienced the availability of equine veterinary services during the challenges of the pandemic in 2020-2021 and what they are experiencing in 2022, a survey was prepared. The 21-question survey link was distributed by email invitations to subscribers of Horse&RiderPractical Horseman, EQUUS and The Horse. The survey was open from May 24 until June 13, 2022, and 1,720 horse owners responded.

All the magazines’ readers share a deep interest in horses. However, there are differences in how they participate in the industry. Horse&Rider readers are strictly Western riders, including pleasure, ranch horses and competition. Subscribers to Practical Horseman are entirely English riders, focusing primarily on dressage, hunter/jumper and eventing. EQUUS magazine appeals to a broad audience fairly evenly split between English and Western riding. About half of them compete. Most of them are very involved in the equestrian lifestyle and have a keen interest in horsekeeping. Readers of The Horse, which is focused on horse health, describe themselves as hands-on horse owners. That audience also includes veterinarians. Of the total 1,720 respondents, the majority were readers of The Horse (57.8%). The rest were equally divided between Horse&Rider (14.2%), Practical Horseman (13.3%) and EQUUS (14.7%).

Where Were the Respondents in the Veterinary Survey?

In order to utilize demographic information about the respondents in analyzing the results, questions included the number of horses they owned and the zip code zone of those answering the veterinary survey. In addition, questions were asked about the type and size of the veterinary practices used by respondents.

Results indicated good participation across all regions. Zip code zone 9 (which includes California, the #2 state for horse population according to the American Horse Council’s 2017 study), had the highest number of respondents. Zip code zone 6 had the lowest number of participants. (See Figure 1.)

Practice Stats

The veterinary survey respondents’ veterinarians worked at practices with fairly similar practice size to the 2016 AVMA AAEP Equine Economic Survey participants. Furthermore, 50.3% of horse owners utilize practices with two or fewer full-time equivalent (FTE) veterinarians. (This is the same size as 52.8% of practices in the AVMA AAEP survey.) Solo veterinarians made up 30.2% of the practices used by horse owner respondents. Twenty percent reported using a two-doctor practice. Meanwhile 28.3% used a firm with three to four full-time equivalent (FTE) DVMs, the most prevalent size. An additional 11.3% utilized a five- to six-doctor practice, and 10.1% reported that their veterinarian came from a practice with more than six doctors.

When analyzed by zip code zone, differences were seen. Those in zip code zone 0 were least likely to use a solo practitioner (24.1%). Respondents in zip code zone 8 were most likely (37.4%). Those in zip code zone 3 were most likely to use a large practice with more than six doctors (14.5%). Respondents in zip code zone 6 were least likely (5.4%).

In rural areas, like much of zip code zone 6 and 8, larger practices might be less common due to lower population density. In contrast, areas with high concentrations of horses—such as the horse show destinations and racing centers of Florida—support multiple large practices. Most surprising was that zip code zone 4, which encompasses Kentucky and its mega-sized equine practices in the Lexington area, had only 9.3% of respondents who reported using a practice with more than six veterinarians. (See Figure 2.)

Types of Practice

Horse owners also reported on the kind of practice at which their horses’ veterinarians worked. A majority reported that they utilized an exclusively equine practice (52.7%). However, there was some variation depending on the geographic location of the respondent. Only 45.3% in zip code zone 7 use this type of practice.

Utilization of mixed practices had an average of 27.6% nationally. However, there was a spread of 18.5% in zip code zone 9 to 42.5% in zip code zone 6. These differences are likely due to the prevalence of mixed practices in rural areas with low population densities where there are not sufficient numbers of horses to support many exclusively equine practices. Respondents from central U.S. agricultural states in zip code zone 6 had the smallest number of horse owners using large animal practices, which was unexpected.

Those in the densely populated states of zip code zone 1 were most likely to use large animal practices (23.6%). One possible explanation is that because the Northeast has limited agriculture, predominantly equine practices often take care of residents’ small numbers of farm animals and pet pigs, goats and sheep. (See Figure 3.)

Number of Horses Owned

Nationally, those owning just one horse was about 25%. However, this varied by location, with 17.5% having just one in zip code zone 7, and 34.3% in zip code zone 0 reporting the same. The most common number of horses was two to three, with 42.1% of respondents. Four to five (16.6%) and more than five (16.2%) were tied.

Zip code zones 6 & 7 had the highest number of veterinary survey respondents with more than five horses. These regions include Texas (the state with the highest equine population) and the rural Midwest, where horse-keeping is relatively inexpensive. (See Figure 4.)

More or Fewer Horses

When asked whether they had the same number, more or fewer horses in 2022 than in 2020-2021, three-quarters (76.1%) of veterinary survey respondents answered that they had the same number. Nationally, only 5.9% had more.

Those from zip code zone 2 reported the most acquisitions of horses (8.4%). Respondents from zip code zone 1 reported the least (3.4%).

Across the country, 18.0% reported owning fewer horses, led by zip code zones 7 (23.6%) and 8 (22.3%). Those reporting the least number of horses lived in zip code zone 3 (15.1%). (See Figure 5.)

These figures are in contrast to those reported by the Zoetis American Horse Publications survey of 2021, in which 11% of respondents reported owning more horses in 2021 than 2020, 14% reported fewer horses, and 75% reported the same number. Although many people purchased horses during the pandemic, quality animals were in short supply, leading to rising prices. Perhaps those who reported fewer horses in 2022 had actually sold horses to owners new to the horse world, not yet plugged in to the horse publications, and therefore underrepresented in the current survey.

Vet Care Concerns

Horse owners were asked about their experiences and concerns with equine veterinary care during the pandemic in 2020-2021 and in the first half of 2022. A question for each of these periods asked, “What was your level of concern for availability of veterinary care for your horse or horses?”

Nationally, 30.5% of veterinary survey respondents reported having a high or moderate degree of concern in 2020-2021, and 24.7% had a minor degree of concern. However, different regions of the country not surprisingly had higher or lower concern. This is most likely due to the presence or absence of robust numbers of equine veterinarians. For instance, in zip code zone 9, 17.5% of respondents had a high level of concern in 2020-2021. This fell to 11.9% in 2022. In contrast, 6.4% of zip code zone 6 respondents expressed a high level of concern in 2020-2021. This remained at 6.3% in 2022. (See Figures 6 & 7.)

Perhaps most surprising, considering the marked difficulty that equine practices are experiencing hiring and keeping equine associates, is that so few clients are worried about availability of care for their horses or actually experiencing difficulty in obtaining care. Unfortunately, this might indicate that those still working in equine practice are increasing the number of patients they see. Thus, they are experiencing higher workloads, which may accelerate stress and departure from the field.

It seems imperative that horse owners realize that a crisis in the workforce of equine veterinarians might soon affect them.

A survey of veterinarians’ experiences in 2020-2021, published in EquiManagement, indicated that not only are equine veterinarians working more hours, seeing more emergencies and adding more new clients, they are also exhausted and increasingly approaching burnout.

Horse Owner Comments

Comments made by some respondents in the horse owner survey revealed a sense of entitlement for veterinary medical services and a lack of understanding of the industry.

Said one, “We have had difficulty finding a veterinarian that does emergency calls. Our vet no longer offers this service. Guess she’s making too much money to care about emergencies. We are in a very rural area.”

Another opined, “I’m very concerned about the availability of standard pain medicines and antibiotics. Vets are
very restrictive, limiting the amount prescribed and demanding to inspect the animal again—all at the cost to the consumer.”

One of the worst comments was “Equine vets are absolutely DEPLORABLE here. You cannot be seen unless you purchase a ‘wellness’ package paid in FULL. That is $2K per horse. And does not cover anything but the vets’ sometimes availability. You still incur trip fees, vaccines, drugs and whatever other services. That is $12,000.00 before I can get ANYONE to come out. I have well-cared-for retired show horses, and I couldn’t even get someone out to euthanize my old gelding. So, I had to do it myself. I can’t get simple drugs like dex for heaves without paying $12K immediately. I will have to euthanize another horse because of this. This is completely UNACCEPTABLE. And this is not just from one practice either. It’s several. The old vets are retiring, and these new ones are in it for the money only.”

More Horse Owner Comments in Veterinary Survey

Other horse owners stated:

  • “I am concerned that there is a shortage of vets. Prices are outrageous since there is no competition, so horse owners are held hostage.”
  • “Equine veterinarians have mercenary attitudes and practices with incredible price increases … talking down to knowledgeable and well-schooled horse owners with a total lack of respect for their prior experience and expertise, and the dismissal of owners’ rights to vaccinate their own animals.”

Perhaps these people have forgotten that horses are a luxury item, not a basic necessity of life. Business owners can set whatever policies and prices they wish, and consumers can choose whether or not to purchase.

A bright spot was the number of positive comments that showed some understanding and gratitude for their horses’ doctors. Comments included, “My vets are prompt, very capable and compassionate” and “I am extremely fortunate to have a caring and responsive vet team.”

One respondent from zip code zone 5 commented, “We are burning out our area vets. Housing costs for new vets are also driving them away from our community.”

Another said, “I respect my equine vet so much. I would highly recommend her because she is very competent, kind and intelligent.”

A reply with no concerns said, “We have no trouble with availability. Our vets are amazing and thorough.”

Availability Concerns in Veterinary Survey

A horse owner who clearly has been paying attention said, “I am concerned by the lack of equine vets and the stress that overload puts on the current veterinary professionals. This is in addition to the cost and debt load a veterinarian has to juggle coming out of vet school and trying to start a practice.”

The worry about availability is palpable in comments such as: “I live in a rural area with one horse vet with no help. He is seriously overextended and getting older, with no new vets going into equine practice!” and “Emergency care is nil to none in my area. My horse colicked twice in April and no mobile vet was able to come. I called the equine emergency number, and four hours later they called back when I was already en route to my usual veterinary office an hour away. Thankfully, he didn’t go down in the trailer. There are no ambulatory veterinary services for an emergency.”

A thoughtful owner stated, “I think the veterinarian and vet support staff shortage is very concerning, especially with the extremely low amount of newly graduated vets that want to practice equine medicine or are leaving the profession or going into small animal practice. I think horse owners need to be aware of the situation and how hard it is on our current vets, along with the increasing suicide rates in the profession. And I think horse owners need to take ownership of their behavior that drives good vets out of the profession and look to improve their relationship with their current vets.”

Veterinary Survey Reveals Clients Need to Change Their Stance

Some comments supported the perspective that clients need to change their stance toward their veterinarians. Multiple respondents complained that new veterinarians were unskilled compared to their older retiring practitioners. For instance, one said, “It seems that many vets are retiring now, and the newer generation is less well-equipped to handle unusual diagnoses and/or perform treatments in a farm setting. My previous vet of 20 years was able to diagnose and treat an amazing array of situations on-site. The newer vets I have tried want to immediately admit an animal to a clinic or hospital, rather than follow through to complete the necessary course of treatment.”

Perhaps clients are unaccustomed to being offered a higher standard of care, and do not feel they are offered a range of treatment options. Or maybe they feel judged if they are offered options and do not feel they can afford the best care. Not being offered options, but instead simply having their veterinarian assume they only want what can be done on the farm, might make these clients more comfortable. However, best practices to give the best care as well as avoid malpractice claims are to offer the optimal treatment as well as a menu of other choices.

Another respondent stated, “There are too many young, inexperienced vets these days.” Still another horse owner said, “My issues with veterinary care are with the attitude of younger vets. They wish to perform more tests, adding expense, and are available fewer hours—some not at all for emergencies.”

It seems that veterinarians might need to develop additional communication skills to help clients understand the changes in veterinary medicine that have occurred in the last few decades.

Could Owners Get Care?

A series of questions then queried the amount of difficulty horse owners had in receiving routine care, elective surgical care, urgent care and emergency care during each of these time frames.

Of those respondents who scheduled routine care in 2020-2021, 5.2% experienced major difficulty. This included 9.3% of those in zip code zone 9. In 2022, only 4.3% of respondents who scheduled routine care had major difficulty. Zip code zone 9 dropped to 6.9%.

Elective surgical care was only sought by 239 of the 1,720 respondents in 2020-2021. Among the respondents, 23.4% had a little or a lot of difficulty being scheduled. In the first six months of 2022, just 129 of the 1,720 respondents scheduled this type of care. However, 27.9% reported difficulty.

Urgent and Emergency Care

Another question concerned urgent care needed for minor injuries or sickness, such as lameness or excessive coughing. In 2020-2021, 813 of respondents needed this care, and 25.9% reported a little or a lot of difficulty being scheduled. In the first half of 2022, 616 scheduled urgent care, with 25.9% again indicating some level of difficulty.

Emergency care was also subject to difficulty in scheduling care. Nationally, 27.2% of the respondents needing emergency care for their horses reported difficulty in 2020-2021. Among respondents, 11.4% experienced a lot of difficulty, and 15.8% reported a little difficulty. Zip code zones 8, 9 and 3 reported the highest percentages of a lot of difficulty. Zip code zone 6 reported the least. (See Figure 8.)

Respondents expressed concern about this development. One said, “There are now weekends where there is not a single vet available for an emergency visit (outside of going to the hospital). More distant (45-60 minutes’ drive away) vets won’t even return phone calls.”

Another shared, “Emergency coverage in my area for horse care is horrible. Fortunately, I have a trailer and can haul to a clinic 1.5 hours away. My routine vet is great but often not available and is 1 hour away. Weekend emergency calls go unanswered by vets! They are now taking the stance you must be their clients for them to come for an emergency.”

In the first half of 2022, 19.1% of the 298 respondents whose horses needed emergency care reported a little difficulty in obtaining care. Furthermore, 14.8% reported a lot of difficulty. This is a sharp jump from the figures reported in the previous two years. (See Figure 9.)

Lack of Coverage Likely to Increase

As fewer equine doctors remain in practice, this lack of coverage is likely to increase in many areas.

For veterinarians to provide care most efficiently, horse owners will increasingly need to haul into local clinics or referral centers. Many practices have higher emergency fees for non-clients. Some do not provide emergency services at all to those who are not regular clients.

With fewer veterinarians in the equine field, the pressures of emergency care increase, which can then push more doctors into companion animal positions where emergency services are not required. This causes an ever-worsening cycle.

Clients need to be educated about the current realities in the industry. Having a relationship with a veterinarian, utilizing routine health maintenance services, and being ready and able to transport their horses during an emergency are all ways that clients can assure emergency service access for their horses. This need in the industry also offers opportunities for equine practitioners that enjoy emergency work to consider opening emergency-only practices in areas with adequate horse numbers to support this service. Smaller practices might subscribe to an equine emergency service to reduce on-call responsibilities for their veterinarians and thus increase their retention in the field.

Telemedicine Use

Telemedicine has been adopted widely in human medicine, and overall, patients are very pleased with the convenience of the service. However, in equine veterinary medicine, utilization of this new trend has been lower.

Very few practices offered telemedicine in the years studied (12.1% in 2020- 2021, and 9.8% in 2022), according to the respondents, but quite a few wanted it offered. (See Figure 9.)

The largest proportion of horse owners reported being unsure whether telemedicine was offered. This might signal an opportunity for practices to educate clients about a lower-cost, efficient service for minor concerns, rechecks or other issues.

One respondent said, “I hate the idea of useless telemedicine appointments. If you don’t want to put your hands on a patient, you shouldn’t be a doctor/veterinarian. Period.” Perhaps this owner would be more grateful for this option if there were no equine veterinarians available in his/her county.

Take-Home Message of Veterinary Survey

The results of this veterinary survey of horse owners illustrate the changes that many equine practices are currently living. Fewer equine veterinarians during a time when horse numbers are stable or rising slightly means more horses to care for per veterinarian. Rural areas are feeling the pinch more than suburban areas due to longer distances and lower horse population density.

Equine doctors are feeling the stress of being unable to serve all their patients’ needs while still maintaining a healthy amount of time away from work. The horse owners who do not have an understanding of and appreciation for the challenges of equine veterinarians make the profession less appealing to new entrants. Those clients who understand the pressures in the current equine veterinary industry are patient, thoughtful and appreciative of their horses’ doctors.

Increasing the awareness of all stakeholders in the equine industry about the current issues in the veterinary industry is a necessary part of ensuring that all horses can receive the care they need now and into the future.

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