The Horse

SEP 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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32 TheHorse.com THE HORSE September 2018 concern about viability of their practice if they get injured is often in the backs of their minds. "The thing is, while you're not serving your clients, somebody else is," she says, noting that she's found some veterinar- ians going back to work two weeks after a head injury or directly after an extended hospital stay. But while there is "tremendous, back- biting competition" in some horse-centric areas of the country, Grice says that's not typically the case elsewhere. Rather, most surrounding vets "just come on in and take care of their injured colleague's cli- ents and do their own calls and take good care of them and then hand them back. There is still a lot of collegiality in many places. The more veterinarians compet- ing for a shrinking pool (of horse-owning clients), the worse that collegiality seems to be, but I guess it's human nature." Compassion Fatigue & Moral Stress Veterinarians must also manage stress that comes with making sad and/or dif- ficult decisions on a regular basis. Many refer to this as compassion fatigue. "I think all veterinarians have those times when they just happen to run into a week where they've just had some really, really hard cases," says Grice. "I think about a week that I had one year when we had a particularly awful strain of Potomac (horse fever), and … you would do every single thing you knew how to do, and you had to euthanize them anyway. In one single week I (lost) one of my own horses and two client horses. "I don't know if that's compassion fatigue or it's simply just way too sad when you do everything you know and it doesn't work," she says. "Or you get a string of broken legs. It can't help but get to you when you're a witness to such sadness and the breaking of the human- animal bond, which can be very, very strong with horses." However, "I don't sense that veterinar- ians get tired of being compassionate," she says. "Especially equine veterinar- ians, because they're wired that they love horses and the people that love horses. So, they do this hard, dangerous job because they love it." Brandt agrees. Although compassion fa- tigue has been a common conversation in the industry (in fact, it was the 2015 AAEP Convention keynote subject: TheHorse. com/37070), when she talks to veterinar- ians, "it can be more about the moral and ethical stress that they have, where they may be asked to do something by a client that is difficult based on the other options available." Whether it's to administer a drug that might be in violation of competition rules or perform a procedure such as tail blocking—which can cause injection site infections, among other complications— such requests put veterinarians in stress- ful situations. Then there are the cases where the choice is between treatment and euthanasia. "So, if the decision has to be made by the client because of finances, which we understand," says Brandt, "for a veterinarian who has to face that day in and day out, having to make decisions about medical care based on the client's finances can be difficult. More and more clients are facing financial stress, so that transfers to the veterinarian." A Shifting Industry, Demographic Grice says that in the 1990s and early 2000s, which she calls the go-go years, equine veterinary practices were growing quickly, and it was a matter of whether veterinarians could get all the work done every day. Today, she says, fewer people own horses, and they tend to be a wealth- ier demographic overall. Veterinarians must determine how to provide a lot of value to a limited number of clients, to provide the best possible care for their horses … without always being on call. One approach she says vet practices are taking is building loyalty to the practice rather than individual veterinarians with- in it. "Those are the practices that can have a four-day week," she says, "because no matter which doctor comes out— and (the client) may prefer a particular doctor—they know that they will receive very good care and … the ideas, the type of care, the treatment will be similar." She gives the example of Carol Sabo, DVM, founder and manager of Haymar- ket Veterinary Service in Virginia. "She has a number of young women work- ing for her," says Grice. "She set up her PAULA DA SILVA Busy veterinarians don't often make time for themselves to exercise or enjoy an unrushed healthy meal. Intensive Care AAEP Respondent Physical and Mental Health Condition by Gender* 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% % OF RESPONDENTS PHYSICAL HEALTH MENTAL HEALTH Male (n=403) Female (n=567) Male (n=403) Female (n=566) ■ Excellent 32.9% 35.8% 50.4% 24.7% ■ Good 55.9% 54.1% 39.7% 51.9% ■ Fair 10.1% 9.7% 9.2% 18.7% ■ Poor 1.0% 0.0% 0.7% 4.1% ■ Very Poor 0.0% 0.4% 0.0% 0.5% SOURCE: 2016 AVMA/AAEP SURVEY *note that younger veterinarians on average are female

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