Aging Equines: Understanding the Experience of Caring for a Geriatric Horse with a Chronic Condition

"How long is life worth living for the horse?" A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses

BACKGROUND

Quality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations.

METHODS

Seven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses.

RESULTS

Findings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders' contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences.

CONCLUSIONS

Differences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse's QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process.

The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses

Intra-articular corticosteroids are a popular treatment choice for joint-associated pain and inflammation in horses despite recent work on the metabolic effects of these drugs. The goal of this project was to compare metabolic effects between intra-articular (IA) triamcinolone acetonide (TA) and an autologous protein solution (APS). Five mixed-breed geldings (4-9 years) were utilized for this project. Three identical and consecutive 28-day treatment blocks were used, with metacarpophalangeal IA treatments consisting of equal volumes of saline, a commercially available APS, or 9 mg of TA. Regular plasma and serum samples were collected for ACTH, cortisol, glucose, insulin, and thyroid hormone analysis, in addition to thyrotropin-releasing hormone (TRH) and oral sugar tests (OSTs). Significant treatment effects of IA TA were present at 48 h post-injection in both the TRH and the OST. There was also significant suppression by IA TA of baseline ACTH and cortisol between 2 h and 96 h post-treatment, hyperglycemia between 12 h and 48 h, and hyperinsulinemia at 32 h post-treatment. There were no treatment effects with respect to any measured thyroid hormones, nor were there any significant treatment effects of APS noted. Results suggest at least 2 days and up to 7 days should elapse between a single 9 mg IA TA treatment and OST and/or TRH testing. This study found that TA exhibits significant effects on ACTH, cortisol, glucose, and insulin, while the APS does not.

Owner-reported health and disease in U.S. senior horses

BACKGROUND

Information on health care and health status of U.S. senior horses (≥15 years of age) is currently sparse.

OBJECTIVES

(A) Provide an overview of owner-reported (1) medical conditions, (2) management/treatment practices for equine metabolic syndrome and pituitary pars intermedia dysfunction (PPID), (3) frequencies of routine health care practices and (4) supplement and pharmaceutical use in U.S. senior horses (≥15 years of age). (B) Evaluate potential risk factors for certain medical conditions and for low routine health care.

STUDY DESIGN

Online survey.

METHODS

Descriptive and inferential analysis (binomial logistic regression and ANOVA) of 2717 questionnaires from owners of U.S. senior horses.

RESULTS

The most common owner-reported veterinary-diagnosed medical conditions were osteoarthritis (30%), dental disorders (15%), lameness (14%), PPID (12%) and ocular disorders (6%). Advancing age was found to be a risk factor for PPID (odds ratio [OR] [95% confidence interval, CI] = 1.14 [1.10-1.18]), dental (OR [95% CI] = 1.18 [1.15-1.22]) and ocular (OR [95% CI] = 1.05 [1.01-1.10]) disorders. Only 36% of horses were free of owner-reported veterinary-diagnosed medical conditions at the time of the survey. During the year prior to the survey, most routine healthcare practices (i.e., veterinary health care, dental care and anthelmintic treatment) were typically undertaken one to two times per year, while farrier visits occurred mostly every 5-6 weeks. Retired senior horses had a higher risk of no health care visits (OR [95% CI] = 2.1 [1.38-3.06]), no dental care (OR [95% CI] = 2.0 [1.31-3.00]) and low farrier attendance (i.e., ≤4 times/year) (OR [95% CI] = 2.4 [1.57-3.63]) compared with senior horses used for pleasure riding. The most frequently administered drug was firocoxib (18%) and joint supplements were the most provided supplements (41%).

MAIN LIMITATIONS

Potential recall, response and sampling bias. Risk factor analyses do not establish causal relationships.

CONCLUSIONS

Medical conditions are highly prevalent in U.S. senior horses. Retired senior horses have an increased risk of low routine health care.

Retirement risk factors, exercise management and muscle mass in US senior horses

BACKGROUND

Information on the management and health of US senior horses (≥15 years of age) is currently limited.

OBJECTIVES

Provide information on (1) primary use of US senior horses, (2) reasons and risk factors for horse retirement, (3) exercise management, (4) prevalence of low muscle mass and (5) risk factors for, and owner-perceived consequences of, low muscle mass.

STUDY DESIGN

Online survey.

METHODS

Survey responses from 2717 owners of U.S.-resident senior horses (≥15 years of age) were analysed descriptively and inferentially, using ordered and binomial logistic regression, ANOVA and the Kruskal-Wallis test.

RESULTS

The most frequently reported primary uses were pleasure riding/driving (38.5%) and full retirement (39.8%). Most horses (61.5%) were retired between 15 and 24 years of age, with health problems being the main reason. Age, female sex, Thoroughbred breed and various medical conditions were identified as risk factors for retirement. In working horses (i.e., those not retired or semi-retired), exercise intensity was negatively associated with age. The owner-reported prevalence of low muscle mass in all horses was 17.2% (95%CI = 15.7-18.7). In those affected by low muscle mass, the ability to work and welfare-related aspects were commonly perceived to be impaired. Increasing age, sex (gelding), pituitary pars intermedia dysfunction, osteoarthritis, laminitis and primary use (retired and semi-retired vs. use for competition) were identified as risk factors for owner-reported low muscle mass.

MAIN LIMITATIONS

Potential response, recall and sampling bias. Causal relationships cannot be established.

CONCLUSIONS

Although structured exercise into old age may provide health benefits (as seen in elderly people), a large proportion of horses were fully retired in the current study. Senior horses were mainly retired for health problems and characterising these problems may aid in extending their work/active life. Low muscle mass was perceived to affect horses' welfare and ability to work, and identification of prevention and treatment strategies is therefore warranted.

Immunosenescence and inflammaging in the aged horse

The equine population in the United States and worldwide now includes a higher percentage of geriatric horses than ever previously recorded, and as methods to treat and manage elderly equids are developed and refined, this aging population will likely continue to expand. A better understanding of how horses age and the effect of age on immunity and disease susceptibility is needed to enable targeted preventative healthcare strategies for aged horses. This review article outlines the current state of knowledge regarding the effect of aging on immunity, vaccine responsiveness, and disease risk in the horse, highlighting similarities and differences to what is observed in aged humans. Horses show similar but milder age-related alterations in immune function to those reported in people. Decreases in lymphocyte proliferation and antibody production and diminished response to vaccination have all been documented in elderly horses, however, increased risk of infectious disease is not commonly reported. Aged horses also show evidence of a proinflammatory state (inflammaging) yet appear less susceptible to the chronic diseases of people for which inflammation is a risk factor. Information is currently lacking as to why the horse does not experience the same risk of age-related disease (e.g., cancer, heart disease, neurodegeneration) as people, although a lack of negative lifestyle habits, differences in diet, exercise, genetics and physiology may all contribute to improved health outcomes in the older horse.