Abstract

Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB).This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis in GB.Self-selected horse/pony owners submitted regular management and health data over 29 months and reported dates and reasons for euthanasia during this period. The overall incidence of euthanasia was estimated and associated factors were identified using multivariable Cox regression modelling, adjusted for age, with variables retained in the final model if P ≤ 0.05.Data were available for 1070 horses/ponies contributing 1093 horse-years at risk (HYAR), with 80 owner-reported euthanasias. The incidence of euthanasia was 7.3 euthanasias per 100 HYAR (95 % confidence interval [CI] 5.9, 9.1). The most frequently reported health reasons contributing to euthanasia were laminitis-related consequences (25.0 % ; CI 16.8, 35.5 %), colic (21.3 % ; CI 13.7, 31.4 %), non-laminitic lameness (20.0 % ; CI 12.7, 30.1 %) and age-related deterioration, including owner-perceived compromised quality of life (20.0 % ; CI 12.7, 30.1 %). Health-related factors associated with significantly higher rates of euthanasia were colic (hazard ratio [HR] 26.4; CI 12.5, 55.8), pituitary pars intermedia dysfunction (HR 3.0; CI 1.7, 5.4) and lameness due to navicular syndrome (HR 5.9; CI 1.8, 20.0), soft tissue injury (HR 6.5; CI 2.7, 15.6) or laminitis (HR 2.7; CI 1.3, 5.7). Further factors included being pure bred (HR 1.7; CI 1.0, 2.8), female (HR 1.7; CI 1.0, 2.9), having poor owner-perceived hoof quality (HR 2.4; CI 1.1, 5.2), being entirely stabled (HR 5.0; HR 2.1, 12.0), being on loan or under temporary care of the study participant (HR 2.3; CI 1.2, 4.4) and participating in affiliated or professional competitions (HR 5.9; CI 2.4, 14.8). Euthanasia rates were significantly higher in the first two study years compared to the third (P < 0.001). Animals whose owners used the study’s custom-designed weight tracker tool had significantly lower rates of euthanasia (HR 0.6; CI 0.3, 0.95).This study has identified a number of, arguably preventable, health-related factors associated with higher rates of euthanasia. Data on owners’ decision-making process regarding euthanasia, including emotive and financial impacts, were not recorded but are important contributors to euthanasia that require better understanding.

Highlights

  • Self-selectedhorse/ponyownerssubmittedregularmanagementandhealthdataover29 months and reported dates and reasons for euthanasia during this period

  • Study population and study period The study population included horses and ponies enrolled in a web-based prospective cohort studyofequinelaminitisinGBbetweenAugust2014andDecember2016.Thenatureofthe cohortwasdynamic,inthatanimalswereenrolledintoandcouldleavethestudyatanypoint duringthe29monthstudyperiod,althougheffortsweremadetoretainanimalsforaslongas possible.Descriptionofrecruitmentandretentionmethodsareavailableelsewhere(Pollardet al.,2019b,2019a).Inbrief,self-selectedhorse/ponyownersorcarersfromEngland,Scotland and WaleswereactivelyrecruitedbetweenAugust2014andJuly2016,irrespectiveof whether ornottheiranimalhadahistoryoflaminitis.Ownersweremadeawareofthestudy nationally via traditional and social media, veterinary practices, other equine health care practitioners,equinecharities,breedorganisations,ownerinformationevenings,face-to-face conversationsatequestrianeventsandword-of-mouthfromexistingparticipants.Regular

  • Removalofhighlyinfluentialobservationsandindividualshadnoconsiderableeffecton modelparameterestimates,thusallobservationsandindividualswereretainedinthefinal model.Allvariablesretainedsignificancefollowingadjustmentofstandarderrorstoaccount forowner-levelclustering,thereforenoadjustmentsweremade.Kaplan-Meierestimatesof survival probability, stratified by health conditions significantly associated with euthanasia, areshowninFigure1

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Summary

Introduction

Self-selectedhorse/ponyownerssubmittedregularmanagementandhealthdataover months and reported dates and reasons for euthanasia during this period. The overall incidenceofeuthanasiawasestimatedandassociatedfactorswereidentifiedusing multivariable Cox regression modelling, adjusted for age, with variables retained in the final modelifP≤0.05. Euthanasia is available to the veterinary surgeon when assisted death is believed to be in the bestinterestsoftheanimal’swelfarerelativetootherpossibleoptions(Yeates,2010).Infact, delaying euthanasia when it is considered necessary has considerable ethical and welfare implications(Rollin,2011).Euthanasiaisacomplexandemotivetopic,withanimalowners usingmultiplefactorstoshapetheirdecision-makingprocess(Marchitelli,2019).Ownersof aged horses and ponies ranked veterinary advice, health conditions with a poor prognosis or JournalPre-proof thosecausingprolongedpain/stressandtheanimal’santicipatedqualityoflife(QoL)asthe mostimportantfactorsinfluencingtheirdecisiontoeuthanase(McGowanetal.,2012). Whileitisnotinthe animals’interesttoreduceratesofappropriateeuthanasia,understandingtheepidemiologyof euthanasia can help prioritise research into life-threatening conditions that are potentially preventable. JournalPre-proof InGreatBritain(GB),94%ofgeriatric(≥15years)equinemortalitieswereattributedto euthanasia rather than unassisted natural death (Ireland et al, 2011b) suggesting that improvedknowledgeoftheincidenceandfactorsassociatedwitheuthanasiacanhelpfocus futurequalitativeandquantitativehealth-andwelfare-relatedresearch.Followingacohortof horsesandponiestodeterminewhichonesdevelopedequinelaminitis,asystemicdisease resultinginlameness,presentedanopportunitytoexploretheepidemiologyofeuthanasia withinthisageunrestrictedpopulation(Pollardetal.,2019b).Theobjectivesofthis prospectivecohortstudyweretoi)describeowner-reportedreasonscontributingto euthanasia,ii)estimatetheoverallrateofeuthanasiaandiii)identifyfactorsassociatedwith euthanasiainhorses/poniesenrolledinaweb-basedepidemiologicalstudyoflaminitisinGB

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