How PTS decisions are made

[Heartbrokenrider]

I am trying to get my head around the world of older horses or those with medical problems.
I have returned to riding relatively recently (part loan an horse at a livery yard) and am feeling incredibly sad that my favourite horse there is going to be PTS next week.
He is 16, has suspected ulcers (but no scoping has been done) and has fallen over a couple of times recently, once with a rider on him. I have heard the phrase ‘wobblers’ about him.

He is still his usual bright self, very affectionate, although he has lost weight over winter.

Is this just what happens? Or is it possible for this kind of horse to recover, or retire in a field somewhere?

I know I’m probably being naive, but am interested in what experienced horse owners generally do.

I think it depends on circumstances. If an owner is able to care for that horse and has the funds, knowledge and appropriate facilities then retirement will likely be fine. If the owner couldn’t afford it or for whatever reason was unable, it is far more responsible to put that horse to sleep than pass it on, to an uncertain fate likely being passed round bin end dealers l, hurting novice riders and having a miserable time of things.

IMO I buy a horse with a commitment to have it until it needs PTS. That means accepting that the latter years will mean living as a field ornament.
However it is also better to PTS a day early than a day late especially if it is falling over etc.
My current horse is 21 with PPID which although medicated causes a raft of low level issues. He is also ulcer and colic prone.
The key is managing all of these. He is semi retired and I will be guided by him as to when he will be fully retired.
For ulcer you need to scope a horse and treat according to type and severity of ulcers. In this day and age there is no excuse for any horse to suffer with ulcers which are very painful.

What proportion of horses manage to live until old age eg 25 years or more?

I wish I could pay for some investigations and treatment and ‘save’ him but he isn’t my horse, and perhaps this kind of situation is more common than I thought?

He still has a great appetite.

People mention it being kinder if they are in pain (I 109% agree of course) but how easy is it to tell if a horse is actually in pain? This particular horse acts just the same as he used to as far as I can tell- Or is it something that makes us humans feel better about PTS so we convince ourselves they are suffering.

Ulcers are treatable. Falling over, especially under saddle, may not be - even with unlimited money for diagnosis and resources for treatment. If "wobblers" - cervical vertebral stenotic myelopathy - is suggested, that's a major spinal issue and it may be kinder to PTS.

It is never an easy decision, but if there's a spinal issue which is progressing then it is far kinder to have a humane end than arrive one day to find the horse has collapsed in a field and is in distress & pain, or died in that kind of state.

@Heartbrokenrider there are key indicators for pain throughout certain body language etc. The vets will have discussed this in detail with the owner and they wouldn't suggest PTS lightly.
The welfare of the horse has to come first and that means putting their comfort ahead of our needs/emotions
Many horses live to 25+ however the number of 25 year olds who are ridden is much lower.

Thank you for your explanations- I can see the logic behind the decision and that is the responsible thing to do. Tbh I’m surprised at how upset I feel. He is such a lovely little horse and it’s heartbreaking hearing him nicker a greeting knowing what is coming 😢

@Heartbrokenrider actually ulcers are themselves an indicator of pain so most likely that these have been caused by whatever else is going on

Thank you, I didn’t know that.

I think it does depend on the owner . We keep all of ours to the end and I’ve had 4 pts over the years the youngest being a 16 yo Shetland the oldest being a 27 yr old ex racehorse . All 4 had fairly long retirements and were pts when their health issues deemed it necessary . The thoroughbred had upwards of 20k of vets fees after she retired through a mix of illness and injury . We currently still have a 31 yo retired Dartmoor x who looks about 15 and is likely to outlive us all the way it’s going .

This is when a good relationship with your vet is important - I've sadly had to have several PTS, and a couple way before their time and it's always an incredibly hard decision to make. You have to put your feelings on one side and consider only what is best for the horse.

I think in many cases we are too slow to consider PTS although I understand why sometimes. However it breaks my heart when I see ads for very old companions - those are because the owner either refuses to pay for something they can't use or would rather just pass the issue on. It's feels like playing god deciding when something is going to die, and it's truly horrible, I hate it, but since the welfare of the animal is up to you, you have to take responsibility. Look after your horse for as long as it is healthy and happy, don't discard it just because it's "too old" or it can't be ridden.

Too many owners keep horses going too long for their own selfish reasons. Heard it so many times, just one more summer, see how he/she fares this winter etc meanwhile said horse is hobbling lame, can’t hold condition, looks dead behind the eyes etc.
As owners you take on a horse knowing you will one day have to make the call and it’s always better to be day early than a day late.

It's actually very hard to tell if a horse is sick or in pain - there are some tell tale behavioural signs but a lot of horses mask pain very very effectively. The thing is we tend to romantisise the 'natural' way or how things would be in the wild but the sad reality is that older, sicker or injured horses will often simply be left behind by the herd to die or worse if resources are scarce will actively be bullied and prevented from eating until they get too weak to fight back - harsh but that's what keeps the herd as a whole safe and the breed continuing as survival of the fittest. So horses are very inclined to behave as close as possible to normal even if they're actually hurting.

The other things is people can talk quite blithely about diagnostics and rehab etc being able to cure virtually anything, and of course vet medicine has come on leaps and bounds but you shouldn't underestimate how difficult it can be to get to the bottom of what's wrong with a horse - MRI or CT scans for instance which are a crucial diagnostic tool are much harder in a large animal that won't stay still without sedation. Particularly true of neurological conditions which are really hard to properly diagnose in horses - if only they could talk it would be so much easier. And some horses really don't cope well mentally and physically with box rest, which is often required for treatment. Even the option of retiring a horse that can no longer be ridden to the field is not always as easy a solution as it sounds, I've retired two now and one adapted super easily, the other was frankly miserable, anxious, out of routine, bored, pacing the gate line constantly wanting to be brought back in 😢 . Remember living in a small field although closer to a natural life is still not 'natural' for them and it may not be what they're used to either.

I'm sorry to hear about the horse on your yard, it does sound sad but there's probably a lot of factors that have gone into the decision, wobblers is incurable if it is that (or even if it's not, randomly falling over is very likely a sign of something badly wrong, healthy horses just don't do that). I've been on the horse hospital advanced diagnostics and rehab merry go round before and I'm not sure I'd put another horse of mine through it again, especially not an elderly one, the back and forth to the hospital, the being repeatedly sedated for tests, the sheer terror they seem to feel when coming round from anaesthetics, the constant blood tests and jabs, the miserable box rest periods, only to not be guaranteed a good outcome either for the horse or the owner... PTS can honestly be the very best outcome for the horse hard as that is.

I think age and quality of life is one of those things that can be incredibly random.

I look after a 28 year old horse who is in incredible shape for his age. He's not been ridden in about six (?) years now as he is a bit arthritic but he's not on supplements or any medication and he lives out year round with access to a stable and shelter.

He still canters over to greet me and loves a good roll in the dirt and mud. If I didn't know he was 28 I'd never guess it - I've ridden much younger horses who struggle much more.

He's one of those hardy souls who's never colicked or had issues with laminitis etc either. He's ISH cross.

The oldest I knew was a fell pony who made 39 years of age. The owner found her dead in the field one morning with all her herd mates around her.

Horses that fall down are a danger to themselves and to the people around them - and there's always the risk they'll go down and not be able to get back up.

I'm really sorry 💔

In terms of actual large horses, not that many live to 25+. Lots of smaller ponies will make that age, but IME a horse that has got to its mid 20s has done well and been lucky.

A few years back, someone did a survey on horse and hound, and around 17-19 was a prime age for larger horses to be put down- those who survived this period seemed to go on into their 20s. This is all highly unscientific, but the point is that it's not actually unusual for issues to start to show up in horses in their late teens.

"Wobblers" is a colloquial term that is used about a range of neurological issues. If the neurological issues are bad enough, then vets can find signs of them through physical examination. Horses with bad neurological issues can deteriorate very quickly and there is no real treatment. They can experience sudden incredible pain. The alternative to PTS now is that he could fall and be unable to rise and potentially hurt someone in the process. With an animal as large as a horse, you also have a duty to consider the safety of those who have to handle them.

The ulcers themselves are potentially a symptom of pain or distress. If it's hindgut ulcers that are suspected, they aren't visible on a scope anyway. If the horse has already fallen over multiple times, the vet may feel it is not safe to sedate the horse and so may not be able to scope.

I get that this is distressing for you, and I'm sorry, but even if you had the money (and, being blunt, you don't, so it's very easy to say "if I had x, I would do y" without considering the actual reality), you don't sound experienced enough to care for a horse with a potentially very serious medical condition.

Personally, I think we owe it to horses to give them a good end of life. Unfortunately, that doesn't always look like years of retirement in a lush field.

I really hope you haven't communicated any of this to the horse's owner who is probably dealing with all sorts of emotions. The owner is also not obliged to disclose the whole medical history to you, especially at such a difficult time.

I didn’t mention any of this to the owner, or ask for more details about the medical situation, only offered a hug. I agree I’m definitely not experienced enough to have taken on such a horse, but just wanted to understand more about the PTS decision which I couldn’t ask in real life, so posted here. It may well be a decision I have to take one day and appreciate how difficult that would be.

I'm glad you've been supportive of the owner in real life.

I understand it's upsetting for you, but this really isn't a decision that any owner makes lightly.

When an animal as large as a horse is falling, it's an incredibly difficult and dangerous situation.