1. Think Ahead

Planning ahead means you can monitor your horse’s health and wellbeing throughout their life. You are then prepared to care for them in the future, and ready for unexpected issues or emergencies. It is helpful to do this from when you first begin caring for them, but you can start at any stage, when you feel ready. To help you make a life plan for your horse, fill in the ‘Your TRUSTED Plan’ document.

What can I do?

• Write down your aims and goals for your horse. What do you want to do with them? How will you care for them now and through their life?
• Build a picture of your horse’s current health and wellbeing. You could do things like assessing quality of life, body condition scoring, creating a list of things your horse enjoys, and writing notes of changes that you see.
• Make and record your plans for dealing with emergencies, including ‘just in case’ for euthanasia. Emergencies can happen to horses of any age. E.g., what would you do if your horse got life-threatening colic, or had a serious accident? If you have insurance, do you know what it covers?
• Discuss your plans with your vet, other professionals, and friends or family involved in your horse’s care. It is important that the people looking after your horse know your wishes and plans in case you can’t be contacted.
• If you’ve nominated someone who can make decisions for you, write down their name, decision-making powers, and maximum cost they can approve. Sign this and give it to your vet practice. Remember to review regularly. 

What can I ask my vet to do?

• Make suggestions of methods and tools for monitoring your horse’s health and wellbeing.
• Help to make, or give feedback on emergency and end of life plans for your horse.
• Review your health monitoring and emergency plans with you, e.g. annually when your horse is vaccinated.

Useful Online Resources:

1, 2, 3, 4, 5, 6, 7, 8, 9, 14, 15

Resources that could be provided by your vet practice:

• Fact sheets for diseases/conditions e.g. colic and survival, caring for geriatrics, obesity & laminitis.
• Webinars/talks for diseases/conditions, planning ahead.

2. Review Your Options

If you’re worried about your horse’s health or wellbeing, the first step is finding out more to help you make the best choice for their care.

What can I do?

• Talk to your vet, equine professionals, and others involved in caring for your horse about treatment options for conditions you are worried about.
• You might want to ask about signs indicating improvement/deterioration, prognosis with different treatment/management options and without treatment, as well as how different options might affect behaviour and welfare, what level of recovery you could expect, costs involved. Writing down questions before you speak to your vet can help you remember key points.
• Think about keeping a diary for your horse, e.g. writing daily or weekly notes on your phone and saving photos and videos. This will help you recognise gradual changes, and find the things that makes your horse happy.
• Think about how you will make difficult decisions. Who would you ask for help and advice? Where will you get information about treatment, care and euthanasia options? Who will you share your wishes and opinions with? Who do you trust to support you?

What can I ask my vet to do?

• Share knowledge and opinions of the issue and treatment options (including costs and practical aspects).
• Listen to and consider your experiences, and things you prefer for your horse.
• Provide or suggest where you can find additional information if you need it.
• Talk to you about who (if anyone) else should be involved in decision-making.
• Have a discussion with you about both of your preferred roles in making treatment or end-of-life decisions.

Useful Online Resources:

1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 15

Resources that could be provided by vet practice:

• Fact sheets for relevant diseases/conditions to the issue/illness.
• Webinars/talks.

3. Understand and Process

Set aside time to process information and your options. Some conditions get worse slowly, and changes can take place over days, weeks, months. So, keep re-assessing your horse and your decisions.

In an emergency, things can change very quickly. If you have made a life plan and an emergency plan, these will help. Remember that plans can and will change, and try to keep them up to date.

What can I do? 

• Help your vet to keep an open dialogue with you, e.g. by being honest if there is anything you’re confused about or don’t understand.
• Read and take time to understand any extra information your vet has provided.
• Consider all the options available and how they could impact your horse and you.
• Consider any new information, changes in your situation, or changes in your horse’s health and behaviour.
• Remember your decisions need to be the best options for your horse, and what you can realistically afford and manage to do.

What can I ask my vet to do?

• Check you have understood information they have provided.
• Consider how different options could be adapted, so they work best for your horse and your specific situation.

Useful Online Resources:

5, 6, 10, 11

Resources that could be provided by vet practice:

• More detailed information on the issue or treatment options, e.g. leaflets and online options, including estimated costs.
• Written summary from vet, including options and costs.

4. Share the Decision

Decisions about your horse’s treatment and wellbeing can be difficult. Your decisions might be around trying or continuing a treatment, providing palliative care, or deciding it is time for euthanasia. It can be helpful to discuss and share these decision with others, e.g. your yard owner, family members, and vet.

What can I do?

• Discuss the roles you want you and your vet to take making treatment decisions. E.g. do you want decisions to be fully shared? Or would you prefer your vet to take the lead, or for you to lead after hearing about the options from your vet?
• Now you have had time to process information, share your opinions and preferences again on the available options.
• Discuss euthanasia with your vet and any others who are involved. When would this become the best option? What would it involve?

What can I ask my vet to do?

• Confirm with you the roles that you, your vet, and any others will play in the decision-making process.
• Listen to your opinions and preferences on the available options, and use this to find the options you will both consider.
• Be honest with you if they think that euthanasia will need to be considered now or in the near future, and explain what would be involved (including body care).

Useful Online Resources:

5, 6, 10, 11

Resources that could be provided by vet practice:

• Detailed information on treatment, prognosis, recovery process for chosen treatment.
• Information on euthanasia methods, body care options, and costs.

5a. Treatment Plan

Once you have decided on your best option, develop a treatment plan with your vet (and any other key people involved). Your chosen treatment may aim to be curative, for management, or palliative. Discuss what needs doing and when, how your horse’s progress will be monitored, and how you can keep checking their quality of life. Remember, you can loop back to any stage of the decision-making guide depending on your personal situation and how things change.

What can I do?

• Develop a treatment plan with your vet and any other key people. Include goals and how to assess response to treatment.
• If you decide palliative care is the best option, talk with your vet about how you keep assessing quality of life. Agree on signs that indicate you need to consider euthanasia soon.

What can I ask my vet to do?

• Develop a treatment plan with you, considering what’s best for your horse and what you can realistically achieve. The plan should be based on input from your vet, you, and any others involved.
• Discuss your expectations for the chosen treatment, and check these are achievable
• Decide with you what both your roles will be in monitoring and assessing quality of life. Provide advice or resources to support you in doing this.
• Agree on signs that indicate you need to consider euthanasia soon. Be honest with you if they believe euthanasia will need to be considered in the near future.

Useful Online Resources:

1, 2, 3, 4

Resources that could be provided by vet practice:

• Information on signs of treatment success and failure, potential side effects and how to manage them.
• Signals of decline in quality of life.

5b. Euthanasia Plan

Euthanasia is part of responsible horse ownership, and used appropriately, will prevent your horse suffering. Most owners will have to make this decision at some point – only 1 in 8 horses in the UK die of natural causes (AESE 2017). Remember, it is ok to stop treatment and choose euthanasia if it’s too expensive, not achieving results, causing your horse stress, or is too much for you to cope with. Once you have made this difficult decision, there are steps you to help this go as smoothly as possible.

What can I do?

• If you made a euthanasia or end-of-life plan beforehand, you should review this and make any changes needed.
• If you haven’t, these are the key things to think about: when, where, and how would you like your horse to be euthanased? What body care options would you like, e.g. communal or individual cremation? Who will be there to help and support you? What keepsakes do you want? How will you manage any other horses, the yard, and informing people? What support and help might you need afterwards?
• Think who you want to share and discuss your plan with, and any questions or extra information you would like.

What can I ask my vet to do?

• Review or develop an end-of-life and/or euthanasia plan with you, taking your views and preferences into consideration.
• Check you understand what will happen before, during, and after euthanasia (including the costs and body care options).
• Listen to your concerns and support you through this process, which you may find difficult and emotional.

Useful Online Resources:

1, 3, 10, 11, 12

Resources that could be provided by vet practice:

• Information about what to expect on the day.
• Confirm costs and practical aspects.
• Recommendations for body care e.g. collection services and options available.

6. Dealing with Difficult Feelings

Losing a horse can affect people in many different ways, and you may be feeling a range of emotions. Grieving is normal. There are resources and services where you can talk through your feelings, or connect with others with similar experiences.

What can I do?

• There are no right or wrong things to do or feel in this stage. If you feel it would help, try talking to other people, or use some of the resources and services listed.
• There are a range of options to memorialise your horse if you wish. E.g., by having keepsakes made from mane or tail, or a horseshoe, by scattering ashes somewhere meaningful, or creating a memory board.
• Remember grieving is normal, and it affects different people in different ways. There isn’t a standard duration or strength of grief.
• Seek help if you are struggling to cope.

What can I ask my vet to do?

• Understand that you are likely to experience a range of difficult emotions. Understand you may feel things like guilt, even if euthanasia was the best decision for your horse’s welfare.
• Signpost you to bereavement resources.
• Discuss memorialisation options with you, or signpost you to sources of information on this.

Useful Online Resources:

10, 12, 13, 16, 17

Resources that could be provided by vet practice:

• Information on memorialisation options or seeking help, if they have these.