EquiSearch's Ask the Vet: Equine Dementia

In this edition of EquiSearch.com's Ask the Vet, Dr. Joyce Harman explains how to provide hospice care for senior horses who display signs of dementia or confusion.
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In this edition of EquiSearch.com's Ask the Vet, Dr. Joyce Harman explains how to provide hospice care for senior horses who display signs of dementia or confusion.

Question:Over the past few years we have managed to gather up several elderly (over about 25) rescue horses. Every year during their complete physical exam I ask my veterinarian about the possibility of my "old people" being senile or acquiring some form of equine dementia. There doesn't seem to be a firm answer regarding this. A boarder's horse recently died of renal failure. The horse was 30 years old and at times, I wasn't sure he "knew" where he was; often his sleep state was filled with nickers, and it seemed he'd "run" in his sleep, and while awake he seemed to wander aimlessly. As he declined both physically and mentally he seemed to slip into these behaviors more regularly. Is there information and/or studies that seem to point that horses acquire some form of dementia as a result of old age? Also the aged pony we used as a companion seemed to slip into a depression now and again (caretakers' syndrome?) so we'd give her a few days off, and she'd brighten up. Any empirical data on that as well? Thank you for any information you can give to help those of us caring for a geriatric horse or community.

Answer: Since many of us are keeping our horses in good shape well into their older years, this is a very relevant question. There is no specific research that I have seen on dementia in horses, however, it is recognized in humans and dogs. So there is reason to think it can happen with horses. I work with many older horses, and it is a common to see them exhibit signs of confusion or uncertainty. They do not always seem present, even when their familiar people or horse companions are right there with them.

In the past, and still in many people's views we should "put the animal out of its misery" if he/she seems to be failing. However, with more attention being paid to hospice care in the human world and the desire to let our companion horses live out their entire life, the idea of hospice care for horses is very valid. With that aging population come brain and body functions that are not that of a younger animal. This is OK. We do not run out and put our grandmother down just because some of her body parts are beginning to fail--we find ways to help her, both medically and physically. Obviously there are more limits with horses than with people or small animals. We cannot give them a walker or a wheelchair, nor can we pick them up and carry them outside to enjoy a day in the sun or to relieve themselves. Horses whose ability to stand and walk are gone will have to be helped into the next phase of life (or put down depending on how you look at it).

As long as the horse looks forward to each day, looks for each meal and lets us know he wants to keep going, we should honor that if at all possible. If he is a bit confused about the day, or forgets where his food tub is for a little while, or sleeps longer and harder than in the past, it is OK. She may spend more time actually lying down, and if she can get up on her own, it is OK. I know quite a few horses who would get a bit stuck or lay down in the wrong place (facing uphill for example) and would be helped up with a tractor and a few neighbors. These horses were very peaceful and accepting of the help. Once up they would stay up on their feet for many more months. Some were wiser than others and never got in a sticky place again, while others would require help a couple times a month. If the facilities exist for this to happen without injury to the horse or humans, it is OK.

As with hospice care in humans, the horse's needs are important. Company is almost always required in the form of a kind pasture companion, preferably one the horse knows already. As you indicated in your letter, this can be stressful for the companion so it is important to pay attention to that horse's needs also and give her a break at times. Sometimes the companion will not leave the older one alone. Occasionally the companion will work hard to not let the old one lay down too much, or when the time is near, will even chase the old one to keep him from lying down and leaving.

Older horses may need blankets, even if as a younger animal they did not like them. Even with lots of fur, some horses get cold quite easily especially in the last years of a long life. If they are a bit confused they may not come in out of the cold wet rain, or they may stand under their favorite tree, which does not have any leaves on it in the winter. So you may have to pay more attention to their basic needs. The same goes of the hot summer, which can be even more stressful than a cold winter. Be sure they have shade and shelter. In nature the horses would not live to this age. Something would have eaten them long before dementia set in.

There are number of things one can do to help the older horse. Pain relief is very important. Much more research is being done on pain control in all species of animals. Sometimes fairly high doses of drugs are needed, which could prove to be toxic. However, when you weigh good, pain-free (or pain relief) quality of life with the possibility of shortening life a few days or weeks due to some side effects of a drug, the drug may well win out.

Several natural treatments can be used to help both the older horse and her companion. From any health food store you can obtain some remedies called Bach Flowers. Books have been written that describe which remedy to select for different emotional states. These books are sold for animals as well. Read through the book and pick anywhere from one to three or four remedies that seem to fit your horses. Then mix 10 drops of each remedy into a dropper bottle (from a pharmacy), fill the bottle with water and put a squirt or two into the water bucket or directly in the horse's mouth. These remedies can help with stress, depression, anxiety and worry.

For help with pain or discomfort, a treat of some acupuncture can have amazing uplifting effects for many of the old ones. I have seen them kicking their heels up after a treatment, where before they walked around slowly. Gentle chiropractic or osteopathic treatments can also be very beneficial. A veterinarian trained in homeopathy or Chinese herbal medicine can help with formulas and remedies to keep life a bit more spunky. Many western herbs provide nice, gentle support, and some companies make specific formulas for older horses. One herbal book written just for the older horse is A Veteran Horse Herbal by Hilary Self. You can get some of this information from my website.

The most important thing in dealing with the old ones is to be sure to spend quality time with them. Take them for a walk around the farm or down the trail, even if they are not rideable. Groom them, let the kids play with them or give them whatever joys they had when they were younger.

When the time comes, you will know that they are ready for help ending their life on this planet. It is not something anyone can put into words. You just walk out to the barn in the morning and know it. And also know that your horse lived his or her life to its fullest and down to the last minute. It is a hard but peaceful time. Enjoy every moment until then.

Dr. Joyce Harman is a veterinarian and respected saddle-fitting expert certified in veterinary acupuncture and veterinary chiropractic; she is also trained in homeopathy and herbal medicine. Her Harmany Equine Clinic is in northern Virginia. Visit her online shop.

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