Vetnuus | December 2024 9 best interest, the two clinical areas with the most answers were joint injections (n = 27), and upper airway surgery (n = 18). Other responses were shockwave therapy (n = 5), denervation (n = 4), IV fluids (n = 2), kissing spine (n = 4), stem cells (n = 1) and ‘loads’ (n = 1). 3.7 | Sensitive information It was anticipated that veterinary surgeons may at times be aware of highly sensitive information and a series of questions was asked to explore this further (Figure 3). Of the n = 94 (97%) respondents, 35% reported frequently encountering ‘owners/trainers administering a medication without veterinary advice’ and a further 48% encountered this occasionally. At least 50% of respondents also reported encountering ‘a horse continuing in training against veterinary advice’, ‘a horse being given a controlled medication too close to a competition’ or ‘a horse competing with a known underlying disease process or injury that you perceived to be either likely to be significantly worsened by competing and/or a significant detriment to welfare’ either frequently or occasionally. Respondents were aware of one or more occasions where a horse underwent a procedure not permitted by a sporting governing body (n = 54%), and a horse being given a banned substance (n = 51%). Twenty-four percent of respondents were aware of one or more occasions where a horse underwent a veterinary procedure not permitted by the RCVS, and 36% were aware of prohibited activities performed by an owner/trainer. The majority of respondents had not reported these situations to any governing body, reasons included: ‘insufficient evidence’, ‘risk of losing employment’, ‘risk of losing client’, ‘it’s too common to attempt to deal with single-handedly’, ‘not permitted under client confidentiality’. Six respondents said that they had reported the situation to a governing body. 3.8 | Regulatory organisations A series of questions were asked that aimed to identify whether respondents perceived any differences in whether the duties and obligations of veterinary surgeons were well defined by the regulatory body, comparing the during competition/race period with the between competition/race period (Table 1). There was no significant difference in opinions when considering the RCVS, but for the sporting governing bodies (BHA and FEI) there were significant differences in opinions with a shift towards less agreement that duties/obligations are well defined in the between competition period (Figure 4). 3.9 | Reputational risk and priority areas Many of the responses and themes in the final set of open-ended questions were similar. ‘Which equine sports medicine ethical challenge (if any) do you think is the highest priority for the industry to address?’, received 70 (72%) responses. There was a strong focus on the high prevalence of lameness, and other diseases (e.g., gastric ulceration), and how to minimise injuries and fatalities. Training methods and the high training and competition loads were also discussed: Balancing the stresses and strains of training placed on the equine athlete with their welfare - what is acceptable for us to ask of them? Human athletes report being in almost inevitable discomfort during training and competition at the highest levels and require significantly more medical intervention (particularly from an orthopaedic perspective) than lay members of the public. Is it acceptable that we ask the same of a horse? How do we balance that with the general public’s perception of the use of horses in sport and the maintenance of our social licence? Other themes focused on a lack of pain/lameness recognition and provision of treatments without clinical indication or appropriate diagnostics or which lack evidence of efficacy. Other responses mentioned treatments being administered that were not under veterinary guidance and client administration of medications. Excessive or inappropriate use of ‘wind ops’, joint injections, medications, neurectomy, obesity, and hypersensitisation were all mentioned. The importance of prioritising welfare was discussed, along with high wastage [horses retired from racing/competition] and quality of life in retirement. Two questions focused on the reputational risk of certain practices. First, respondents were asked to list any elements of equine sports medicine that they believed posed a reputational risk to equestrian sport (i.e., elements that may cause significant public concern). In total, there were 63 (65%) responses, some of which were not veterinary-specific (e.g., racing, polo, endurance, whip use). The responses relevant to sports medicine, again focused on treatments without clear indication, treatments without prior diagnostics, intra-articular medications, wind ops, firing, neurectomies, IV fluids, injury rates, wastage, disease rates (e.g., gastric ulceration/lameness), fatalities at the racetrack, euthanasia, medication control (lack of) and doping. The only comment that had not previously been raised elsewhere in the response was ‘the lack of veterinary supervision at some sports, e.g., polo’. Second, respondents were asked to list any elements of equine sports medicine that they believed posed a reputational risk to the veterinary profession. There were 49 (51%) responses, with many similarities to the previous question. The responses included intraarticular medications, firing, ‘wind ops’, neurectomies, kissing spine surgery, treatments with little evidence of efficacy, medication usage including banned substances, antibiotic usage, excessive treatments and ‘maintenance’ therapies. There were 59 (61%) responses listing areas respondents felt would be the highest priority for further research aimed at improving the welfare of competition horses/racehorses. There was a focus on particular diseases, procedures and treatment efficacy which included airway surgeries, intra-articular disease, tendon injuries, catastrophic injuries, exercise-induced pulmonary haemorrhage, suspensory ligament desmitis and overriding dorsal spinous processes. There was also a strong focus on improvement of injury reporting during training, risk modelling for injury and pre-race screening. Husbandry practices, welfare assessment, assessment of equine emotional distress, training and track surfaces research and the reporting and tracing of medications and procedures were all mentioned. Finally, how to improve veterinary ethics in the UK was raised. Leading Article Equine veterinary surgeons’ (n = 95) self-reported responsibility to various stakeholders when practising in equine sports medicine.
RkJQdWJsaXNoZXIy OTc5MDU=