Vetnews | Desember 2024 8 « BACK TO CONTENTS The possibility of veterinary surgeons losing objectivity around normal function, health and welfare was also mentioned in the context of lameness assessment: ‘I often wonder whether our eye is so skewed by looking at chronically lame racehorses all the time that the balance of judgement on what is acceptable has lost its way somewhat, probably in the most part due to pressure from trainers’. Upper airway surgeries or ‘wind ops’ were mentioned by 11 respondents. Lack of evidence or scientific basis for treatments was mentioned by nine respondents: ‘treatments done not always with clinical indication and no real scientific basis’. Administering treatments without appropriate prior diagnostic investigations was mentioned by seven respondents. Often this was clarified as a lack of diagnostic investigation of lame horses prior to treatment. 3.4 | Most challenging situation When asked to describe the circumstances of the most challenging type of situation, more than half of the 81 (84%) respondents identified situations similar to their answer to the preceding question (which was What [if any] are the ethical challenges facing veterinary surgeons who provide equine sports medicine services?). These included pressure for the horse to compete, pressure from the client, health conditions affecting horse welfare, provision of medications too close to competition and excessive or inappropriate intraarticular medications. Responses included: being asked to medicate/administer a drug and not put it on the clinical record as the rider/owner knows it isn’t allowed that close to competition, dealing with lame horses that are required by the owner/rider/ trainer to compete come what may. Other themes mentioned were euthanasia and the challenges of veterinary provision at the racetrack: Conflict management on race day when a horse is considered unsuitable to race, contrary to the view of the trainer. Pressure to allow horses to race that are ‘poor movers’, which in my opinion is a euphemism for a lame horse that we allow to cloud our judgement. Treading the line of acceptability of discomfort for the horse is hard. I sometimes wrestle with communicating clearly and effectively to trainers that just because an animal is performing well doesn’t mean it isn’t in pain sufficient to compromise its welfare over a period of time, rapid decision making about the withdrawal of horses in pressurised situations such as the starting stalls can also be a challenge, attending racecourse casualties under the full view of the onlooking public and television/press. When asked how commonly their most challenging situation arose, the most frequently chosen response (53.5%) was a few times a year, with a further 29.1% of respondents choosing ‘monthly’ or ‘weekly or more’. 3.5 | Pressures and conflicts of interest The questions that were designed to identify factors which may lead to pressures or conflicts of interest when providing equine sports medicine veterinary services were answered by 94–96 (97%–99%) respondents (Figure 2). Financial constraints and differences of opinion with the owner/trainer were most commonly encountered. Respondents had the opportunity to identify other areas of conflict of interest/pressure. There were 44 responses. Many provided examples of a similar conflict to those above, that is, pressure from an owner to perform a treatment or sign a declaration, pressure from a senior veterinary surgeon to perform a treatment, lack of finance for appropriate diagnostics etc. Other conflicts identified included competition between veterinary practices and lack of time. Interestingly, there were several responses to the theme of ‘pressure for good outcome’, ‘reputational pressure’, and ‘fear of failing to get a correct diagnosis’. Other areas identified were pressure around the trot-up [veterinary inspection for lameness], and pressures / conflicts around prepurchase. Other conflicts were performing procedures on horses that were then used for breeding, conflicts around rehabilitation such as boxrest, and that choice of medication may be based on withdrawal times rather than choosing the most appropriate drug. Other concerns included ‘offering services for commercial reasons in the absence of scientific evidence’. 3.6 | Medications and treatments Specific questions were asked about medication control and prohibited substances. When asked ‘Are there any medications or other substances that are not prohibited which you think should be?’ the majority (n = 32) of the 43 respondents chose ‘no’. Specific responses included: sarapin (n = 2), tiludronic acid (n = 1), pentosan polysulfate sodium (n = 1), bisphosphonates (n = 1), blisters (n = 1), omeprazole (n = 1), over the counter calmers (n = 1) and any prescription medicine apart from antimicrobials (n = 1). There were two more general comments which discussed any substance being used for competitive advantage: Anything administered to a horse that is given to improve performance should be prohibited, why are there ‘therapies’ allowed to be administered to horses at competitions, if they are being done it’s to improve performance so they should all be banned, to not do so is not in keeping with promoting horse welfare. When asked ‘Are there any medications or other substances that are currently prohibited which you think should not be?’ there were 50 respondents. ‘No’ was selected by 17, and varying medications were listed by others: omeprazole n = 10, pergolide n = 11, altrenogest n = 2, frusemide n = 2, methotrexate n = 1, procaine penicillin n = 1, non-steroidal anti-inflammatory drugs n = 1, multivitamins n = 1, canagliflozin n = 1, intra-articular anabolic steroids n = 1 and naturally occurring nutraceuticals (n = 1). When asked whether there were any permitted veterinary treatments or procedures that respondents consider ethically unacceptable, there were 41 (42%) responses. ‘Wind ops’ was mentioned 14 times, with soft palate cautery in particular mentioned 9 times. Tendon firing was mentioned 13 times. ‘Firing’ without clarification of the structure involved was mentioned a further six times, blistering six times and neurectomy or neurectomy/fasciotomy seven times. Shockwave, joint injections, kissing spine surgery, treatments with lack of evidence of efficacy, acupuncture, laser and chiropractic were also mentioned at least once. When asked whether there were permitted veterinary treatments or procedures that respondents thought were used excessively within equine sports medicine, such that they may not be in the horse’s Leading Article
RkJQdWJsaXNoZXIy OTc5MDU=