An online survey conducted as part of the Keeping Britain’s Horses Healthy campaign in 2017 identified 76% of participating horse owners as “wanting to learn more about preventive health care”¹. What a great start. We have an opportunity to engage with thousands of owners who are keen to prevent disease in their horses.
Of course, a proportion of our clients are yet to realise the benefits of preventive health care, and engagement with these horse owners presents a slightly different challenge.
As we are well aware, the horse-owning community accesses health care advice everywhere – from practising paraprofessionals through to internet forums. The more we can consolidate the idea of the vet as the best source of information, the better.
Our training gives us the ability to draw on the expertise and resources available to us to give the best advice.
What constitutes preventive health care?
Most of us would identify with the idea of vaccination for equine influenza and tetanus, routine dental examination and parasite management as standard components of a preventive health care programme. However, scope for a broader, tailor-made approach dependent on our client base exists.
An equally proactive approach to prevention of a wider array of common health issues would doubtlessly be of benefit.
Thanks to efforts within the profession to publicise the need for increased attention to equine obesity, seemingly a trend exists towards receptivity to advice when it comes to nutrition and weight management.
We should be encouraged by this shift, and an increase in owner engagement with vets on other topics can hopefully be paralleled.
Additional areas for provision of preventive health care advice include:
- how to check a horse for signs of disease
- basic foot care
- asthma prevention
- equine gastric ulcer syndrome prevention
- geriatric care
- care of the brood mare and foal for the inexperienced breeder
- management of new horse movement on to yards
- management and isolation of infectious horses on yards
Does anything limit client access to information on preventive health care?
Due to the proactivity of the veterinary profession and increasing attention on the benefits of preventive health care, many clients across UK practices will have already gained helpful input from their vets since the survey in 2017.
However, if we speculate a significant percentage of horse owners would still like to know more, the aforementioned question is particularly relevant.
Is available information lacking? This seems unlikely, when so much useful information is out in the public domain. Could people be uncertain as to which information is reliable? Possibly, highlighting the importance of veterinary involvement. Could some well-meaning clients be simply unaware of the importance of preventive health care? It seems so.
This is the easiest focus point for veterinary intervention. As with any preventive approach, motivation starts with awareness of the implications of the undesirable outcome. An understanding of the diseases at hand is likely to lead to increased owner interest in disease prevention.
Could additional barriers to the implementation of preventive health care be present, such as fears over possible side effects of vaccination or embarrassment about obesity?
Looking for the barriers between us and effective client education may help us better engage with our clients.
The aforementioned points focus on the client side of the scenario, but should we look at any veterinary elements? Is it possible subliminal cultural concerns could be contributing to a lower level of discussion about preventive health care?
In a climate where we often hear of vets suffering unwarranted client accusations of them “just trying to make money”, is it possible we are holding back on recommendations for “non-essential” assessments, diagnostics and treatments due to concerns clients will react negatively or that professional relationships may be compromised?
A total of 64% of owners of non-vaccinated horses described “perceived lack of risk” as the reason for not choosing to vaccinate their animal. This was an interesting contrast to the 13% who described “cost” as the reason.
Perhaps the percentage of clients not engaging with preventive health care due to cost could be less than we think?
Importance of preventive health care: underused opportunities
Thankfully, vaccination is largely a well-established habit within the competitive equine community. However, a remarkable number of UK horses still have a lapsed or uninitiated vaccination status, where improved attention to vaccination would be beneficial.
It’s likely any horse owner who has had the misfortune to have experienced tetanus will be vigilant in the future, but scope still exists to engage in more widespread understanding of the value of prevention.
While conducting initial visits to new horses/clients, could we be making more of the opportunity to discuss preventive health care? How often do we give owners further information about the diseases we are vaccinating against, and why vaccination is important?
Maybe we could take a leaf out of the book of our small animal colleagues, when it comes to raising these conversations: do many owners of dogs conclude their first visit to the vet without a discussion on important issues such as insurance, neutering and worming?
Even when attending cases for non-routine visits, when appropriate, perhaps, we should be using our well-developed communication skills to visit the topic of prophylaxis in unvaccinated animals and other relevant elements of health care. Of course, this adds time to an already busy day, but the benefits for our patients, as well as for our relationships with our clients, could be invaluable.
With more practices now offering equine preventive health care packages, we have a refreshed opportunity to engage with clients about disease prevention.
Health checks included in such plans can provide a receptive opportunity for discussion around all elements of preventive health care.
Pre-paid annual health care packages are likely to encourage compliance with routine vaccination, dental and worming recommendations. Advertising of such packages through the means available to your practice could potentially have a significant impact on uptake of certain elements of preventive health care.
Client awareness of such packages through local business advertising, social media posts and direct-to-client advertising, such as email advertisements, can all help increase uptake of such plans.
In the 21st century, digital communication and education can be both helpful and a hindrance when it comes to the provision of information for horse owners.
As equine clients are often keen for further education, if we use the opportunity to provide this we can ensure its quality, while concurrently engaging with our horse owners.
Optional engagement – such as educational social media posts, client evenings and advertised website articles – can provide clients with an accessible point of call for information.
Although rewarding, preparation of resources for clients can be time consuming, and thankfully some excellent and free resources for client education are already available. The Keeping Britain’s Horses Healthy campaign prepared numerous resources, which can be accessed here.
A practical and accessible source of information to help clients with the assessment and management of obesity was produced by Tamzin Furtado and the University of Liverpool. This guide, funded by The Horse Trust, is freely available.
Methods for increasing client engagement include:
- conversation about broader aspects of preventive health care at both routine and elective visits
- provision of information leaflets to clients
- educational website articles
- educational social media posts
- educational newsletter articles
- client information evenings
- ongoing follow-up and feedback on the progress of any plans initiated
Client attention to preventive health
When new plans or interventions are being initiated, external follow-up and positive feedback may boost the likelihood of continued compliance.
Having a follow-up plan constitute part of subsequent vaccination, health check or other visits can help ensure continued client engagement. This can be verbal, or ideally even written. Examples include use of log sheets for faecal worm egg counts/tape worm ELISAs and anthelmintic treatments, or logs with targets for body condition scores and weight loss.
In particular, when it comes to worming, recommendations have evolved considerably in the past 10 years. Additionally, with limited evidence to base our recommendations on, difference in opinion between colleagues as to the best approach can become an issue.
As a result, clients can often be given varied information, leaving them uncertain which veterinary advice to follow – and them subsequently losing confidence in practice advice.
Within-practice consensus is invaluable when it comes to encouraging clients to persist with recommendations. Creation of practice guidelines on elements of preventive health care applicable to the caseload and clientele could be helpful in increasing compliance.
Additionally, the use of uniform practice paperwork, such as the log sheets already described, can help with across-practice consistency. Involvement in generation of such consensuses also provides an opportunity for clinical discussion within the veterinary team.
With equine health a hot topic in the media, alongside established owner interest in preventive health care, what better a time for us to engage in client education and a wider involvement in disease prevention?