Equine euthanasia: supporting owners in decision-making

Following a review of the equine health and welfare strategy in 2012¹, the UK’s Equine Sector Council for Health and Welfare rated a delay in euthanasia as the second highest issue in the welfare risks category, after the breeding of low value equines.

Horses in Our Hands², a University of Bristol study supported by World Horse Welfare and the Bristol Equine Welfare Project, concurred, identifying delayed death as one of four priority challenges to equine welfare.

Sometimes, equines suffering from conditions associated with old age, major behavioural issues, irresolvable injuries or other problems are left untreated and not euthanised when it is the most appropriate course of action. This delay – whether wilful, through ignorance or because an owner/carer is unable to face making the decision – presents welfare concerns. Additionally, if euthanasia is pertinent and not carried out, these equines are sometimes abandoned or put out on loan, either as companions or for another purpose for which they are unsuitable. This often results in welfare organisations becoming aware of these equines and then stepping in to take responsibility for them.

In 2014, Advancing Equine Scientific Excellence (AESE) launched a collaborative study to provide an in-depth awareness of attitudes to equine euthanasia and end-of-life decisions. The Equine End of Life (EEoL) project was sponsored by The Donkey Sanctuary and World Horse Welfare, with support from the British Equestrian Federation and Alltech.

The EEoL research project gathered data through depth interviews (DI) and an online survey (OS). A total of 462 DIs were completed, while the OS received 2,002 responses. Results were grouped into those with experience of equine end of life and euthanasia, and equine owners/carers without experience and analysed by data source (DI or OS).

Background to last equine lost

Those with experience of an equine that had died were asked a series of questions about the last equine they lost, including the type of end of life and age when it died. For the type of end of life, respondents indicated elective euthanasia was the most common (52% DI; 59% OS), followed by emergency euthanasia (31% DI; 35% OS) and sudden death (17% DI; 6% OS).

Care should be taken when viewing this data as the respondents self-classified – for example, someone may consider an equine euthanised due to acute colic was elective, whereas it would be more appropriately categorised as emergency euthanasia.

Respondents were asked how old the equine was when it died. In the DI most equines were lost between the ages of 11 to 15 years (19% DI; 16% OS) and 16 to 20 years (19% DI; 18% OS), while in the OS most equines were lost at the slightly older age of between 21 to 25 years (18% DI; 21% OS).

Both sets of data contained more than 10% of equines that died between the ages of 7 to 10 years (14% DI; 11% OS), with a smaller proportion being lost before they had reached the age of 7 years (9% DI; 9% OS).

Planning

All respondents who had lost an equine, regardless of the method of death, were asked if they had a plan in place for the euthanasia and/or the disposal of their equine’s body. Around a third had no plan in place (42% DI; 31% OS); conversely, approximately half had a plan in place for both the euthanasia and disposal of the body (44% DI; 52% OS). A small proportion of respondents in each category had a plan in place for euthanasia of the equine, but not disposal of the body (10% DI; 14% OS), and a smaller proportion had a plan in place for disposal of the body, but not euthanasia (3% DI; 3% OS).

Those who responded positively to having a plan in place for the euthanasia and/or disposal of the equine’s body were asked who knew about the plan. “Family” was the most commonly given response (65% DI; 65% OS), with “my vet” (48% DI; 40% OS), “friends” (33% DI; 35% OS), “other people who looked after the equine” (27% DI; 25% OS) and “livery yard owner” (16% DI; 16% OS) also cited.

Respondents who had not experienced equine end of life were also asked if they had a plan in place, with data showing a split response. Around a third had no plan in place whatsoever (37% DI; 26% OS), while some had thought about what they might do should the situation arise, but had no plan (28% DI; 50% OS). Around a quarter had a plan in place for both euthanasia of their equine and disposal of the body (26% DI; 19% OS), while a small group had a plan for either euthanasia of the equine or body disposal (9% DI; 5% OS).

Those who had no experience were then asked how they would feel if their vet or livery yard manager asked them to complete an end-of-life plan for their equine. A large proportion of respondents selected “I think it is a good idea” (71% DI; 61% OS). Around half of respondents selected “I would feel comfortable completing it” (54% DI; 46% OS), while a much smaller group selected “I would feel uncomfortable completing it” (14% DI; 20% OS).

Sourcing information online

Respondents were asked to specify the top three websites they would trust to provide them with information about equine euthanasia. The question was asked without any prompt and respondents were not given a pre-populated list to choose from.

For those with experience of equine euthanasia the top three websites were: The British Horse Society (58% DI; 70% OS), Horse and Hound (44% ID; 32% OS), and World Horse Welfare (32% DI; 35% OS). The Donkey Sanctuary (10%t DI; 3% OS) and Blue Cross (9% DI; 7% OS) were mentioned by a small proportion of respondents.

Veterinary websites were specified – mainly by participants suggesting they would view online the website of the practice they use (50% DI; 39% OS). Additionally, some respondents mentioned BEVA, the RCVS or another website linked to veterinary practice, and these were grouped into the same category. A small proportion of respondents suggested they might use social media, an internet forum, a search engine or Wikipedia (12% DI; 7% OS).

Respondents with no experience of equine loss ranked the same three websites top of their list, although in a slightly different order: The British Horse Society (59% DI; 80% OS), World Horse Welfare (35% DI; 38% OS), and Horse and Hound (28% ID; 21% OS). Blue Cross was more popular with this group of respondents (24% DI; 22% OS), while The Donkey Sanctuary was mentioned at a similar rate as for the experienced owners (7% DI; 5% OS).

Veterinary practice websites were specified slightly more frequently in this group (56% DI; 40% OS). As with the other group, a small proportion suggested they would use social media, an internet forum, a search engine or Wikipedia (16% DI; 8% OS).

While the proportion of those using social media and internet forums is relatively small, it is unclear from these data how many of those using Horse and Hound are accessing the website’s forum for information, and how many view website articles.

What can vets do to help?

The three aforementioned areas give some pointers as to the steps that can be taken to help equine owners be prepared for the worst case scenario of losing a horse.

Sam Chubbock, head of UK Support for World Horse Welfare, was interested both data sources showed the same trend with sudden death being the least common occurrence. She explained: “We take a significant number of calls from people who think they don’t need to plan their equine’s euthanasia as they hope the animal will die naturally in the field or stable. However, this data indicates, in reality, only a small proportion died suddenly, suggesting it would be beneficial for all owners to consider the options well in advance.”

The age of the equine at time of death further emphasises Ms Chubbock’s point in relation to owner preparedness, as 20% or more of equines in each data set were lost before they reached 11 years of age. Some owners might feel they do not need to think about equine end of life as they have a young animal, although this data indicates youth is no guarantee it will not occur.

Karen Rickards, principal vet at The Donkey Sanctuary, added: “Owners need to be educated to ensure they have sufficient information to prevent delays in euthanasia. As a profession, we as vets need to make sure we are providing owners with good advice on quality of life assessment and euthanasia options to support them through the process of making this difficult decision” (Figure 1).

In terms of planning for equine end of life and euthanasia, the data indicated opportunities exist for both vets and livery yard managers to speak to owners about creating a plan for this eventuality. An area that would undoubtedly benefit from careful handling by both veterinary practices and livery yards, it could be included as a part of a new client/equine registration, or featured as an additional item to be added to the information held through timely communications to existing clients, such as a monthly newsletter. This may also help increase the proportion of owners with a plan, but who have not made their vet or livery yard owner aware of it.

The data gave clear guidance as to where owners are likely to look for equine euthanasia information. Respondents in both groups were more likely to visit The British Horse Society’s website, which contains information about equine euthanasia and its Friends at the End scheme³, than that of their own veterinary practice. The World Horse Welfare website contains information about planning for the end of life of an equine⁴, while The Donkey Sanctuary website hosts a leaflet entitled “Dealing with death”⁵. Blue Cross’ website also contains generic information on pet loss through its Pet Bereavement Support Service⁶.

The preference for owners to visit the website of a welfare organisation over their veterinary practice for equine end-of-life and euthanasia information may be due to their prior knowledge of what is available. This is an area on which veterinary practices could build – possibly by signposting clients to material readily available, as well as providing their own information.

It should be noted OS participants were self-selecting, while DI respondents were chosen to meet pre-defined criteria. All respondents were open to discussing equine end of life and euthanasia. Other equine owners/carers may not be as willing to consider the subject as this sample. However, losing an equine, in any circumstance, is a traumatic experience for many. The results from this study indicate owners should be prepared from the first moment of equine ownership and age is not an indicator of likelihood of occurrence. The veterinary profession, welfare organisations and livery yard owners, as well as others involved in equine health and welfare, have an important role to play in supporting owners to be prepared (Figure 2).

Acknowledgements

AESE acknowledges the many people who participated in this study, including the 28 students from 13 institutions who gathered the data. The institutions involved were: Askham Bryan College, Canterbury Christ Church University with the University of Sussex, Duchy College, Hadlow College, Harper Adams University, Hartpury College, Myerscough College, Plumpton College, Reaseheath College, Royal Agricultural University, Sparsholt College, University of Plymouth and Writtle College.