“All I can do is continue to do my best, following the best evidence-based practice within the limitations of life” - Veterinary Practice
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InFocus

“All I can do is continue to do my best, following the best evidence-based practice within the limitations of life”

As in any profession, working in stud medicine comes with its own highs and lows, but even when things go wrong you can find your way to a perfect outcome

Another year, another crop of foals. After all the planning and research of stallion choices and the significant effort (financial and emotional) of getting your mare in foal, and then the 11-month wait… spring is around the corner and with it, anticipation becomes reality.

As a stud vet, I love every element of my job, except one. I am always happy to help and advise owners as to which aspects of stallion choice might be relevant to them, to help achieve the best result. Equally, there is the challenge of getting the mare pregnant, with all of its associated highs and lows. And, finally, the management and protection of the embryo, then foetus, until birth. Surprisingly, it’s this latter period, which is very low key and shouldn’t be onerous in any way, that is the least pleasurable for me. Any deviation from the norm – excessive abdominal distension, early mammary development, vaginal discharge, etc – all feed into my personal self-doubt. Did I miss a twin, perhaps? Obviously, the pathological processes leading to these findings are varied, and in the main unrelated to twin foetuses, but this is one of the elements of equine veterinary science where the outcome is binary and there is nowhere to hide. I am, however, paid to examine the mare and guarantee that this outcome never occurs.

Obviously, the pathological processes leading to these findings are varied, and in the main unrelated to twin foetuses, but this is one of the elements of equine veterinary science where the outcome is binary

In an imperfect world, guaranteeing this perfect outcome can indeed be stressful. However, having chaired the BEVA artificial insemination (AI) discussion forum for several years, it is clear that the standard of veterinary ability in the UK is exceptional. Our stud vets are knowledgeable and empathetic – a winning combination – and our dedication to our clients goes way beyond the remuneration. We truly ride the emotional waves with our clients and provide a level of service and support that we should be hugely proud of. Obviously, we all go the extra mile with every facet of veterinary medicine, but this is my world and it’s an opportunity to praise my tribe. We are, however, facing changing times, and this aspect of equine veterinary medicine will have to change more than most.

Studs are used to having their own veterinary surgeon who is dedicated to their every need, day and night, for the entire season. But with current trends it is likely that this will not be the case in the future. The desire for a better work–life balance and an increasingly part-time workforce will make this style of provision almost impossible. As always, communication, teamwork and the empowerment of others will be the key to our success. Our challenge is often to convince our clients that others can do what we can do and often even better. Giving them confidence in our colleagues gives us freedom from the grind. Obviously, this comes with investment, and, for me, this is one of time and communication. Taking the time to ensure that others are equally well placed to achieve the same outcomes and using technology to ensure fluid communication are essential. Our reproduction team now have “on-site” white boards at every stud, “on-person” WhatsApp groups and a central practice management system to aid the seamless transfer of information to ensure the best outcomes are achieved. This ensures we all have access to the right information, and the right support, at the right time. However, as previously stated, in an imperfect world we still have our problems.

As always, communication, teamwork and the empowerment of others will be the key to our success. Our challenge is often to convince our clients that others can do what we can do and often even better. Giving them confidence in our colleagues gives us freedom from the grind

Every season has its own new challenges. Recently, I was presented with an interesting case: an 18-year-old mare on a commercial stud well known to me. The manager called in the early hours as the mare was presenting with foetal malposture; she could palpate the foal’s head in the vestibule, but neither leg was palpable. Caesarean section was not viable economically. I asked her to keep the mare on her feet and drove to the stud with the manager on speaker phone so I could maintain control of the situation en route. While driving we established our priorities: the foal versus the mare and her future breeding potential. We concluded that while the cost of a caesarean was prohibitive, the foal was the priority due to the age of the mare. A second vet was also called for timely assistance.

On arrival, I sedated the mare and confirmed the findings and the presence of a live foal. The mare was exhausted from being kept on her feet until I arrived and her contractions were reduced. Her pelvic inlet was generous in size and, as such, I attempted correction. I located one metacarpus and repositioned it, then the other. Pathological carpal flexure was at the forefront of my mind but thankfully this was not the case. A few minutes later the foal, “Sterling”, was delivered without complication. The second vet was informed immediately so that they could turn around and go home, and, following appropriate assessment and treatments, I drove home feeling elated.

An hour later, however, I was called back! Sterling had moderate flexure tendon contracture of both front legs. Both of the foal’s legs could extend beyond the vertical (I had checked before leaving) but their preferred position was caudal to the vertical, making standing impossible. I administered oxytetracycline and considered limb support options. Having first-hand experience of limb support induced pressure sores, I reluctantly bandaged and splinted his legs allowing him to be largely self-sufficient. My approach would have differed at the hospital, but manpower was limited and I knew this foal had to contribute to its own success. After three days of medication and splinting, his tendon flexure reduced and he could stand unaided, albeit with some dermal oozing indicative of forthcoming pressure sores. Again, these areas were treated but they did indeed slough and heal with depigmented hair: a reminder every time I visit the stud of my nearly, but not quite, perfect outcome!

VIDEO (1) Sterling with bandaged and splinted front legs to treat the moderate flexure tendon contracture

Horse breeding in the UK always results in mixed opinion, which ranges from the top studs producing some of the best horses in the world, to the equine charities struggling to rehome unwanted horses. In my humble opinion, my duty of care is to inform my clients of the implications of their choices and support them in the provision of the best welfare possible for their horses. And, before this article is published, another mare will throw me a late-term curveball and my self-doubt will kick in again. All I can do is continue to do my best, following the best evidence-based practice within the limitations of life, hoping that, yet again, it’s an ascending placentitis rather than a set of twins. After all, common things are common, right?!

Huw Griffiths

BEVA President, 2021–2022

Huw Griffiths, BSc, BVSc, Cert AVP (Stud Medicine), MRCVS, graduated from the University of Liverpool in 2000 and has a keen interest in equine stud medicine. He is a clinical director and ambulatory vet at Liphook Equine Hospital, and president of the British Equine Veterinary Association (BEVA) for 2021–2022.


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