Cost of an ageing population

A phrase often thrown around, especially in politics, is we are “suffering” from a phenomenon known as an “ageing population” and all the things that come with it.

It has been cited as a contributor to the “demise” of the NHS, and to justify tax increases and spending cuts. It was reported more than two-fifths of NHS spending goes on patients aged older than 65.

But this increase in lifespan is not just having an effect on the human population; it’s possible the ageing equine population generates a similar proportion of equine veterinary revenue. Vets are seeing more horses older than 20, 25 or even 30 years; it is thought almost 30% of the equine population is older than 15 years.

My mother-in-law has a small yard and three of the five horses are “geriatric”. These geriatric horses are often looked after better than ourselves, with multitudes of supplements, rugs and anything else suggested to promote health and lifespan.

Experience counts

Horses are being used for longer in high-level competition thanks to lifestyle and veterinary interventions. A 13-year-old horse, Vics Canvas, finished third in this year’s Grand National and a 16-year-old horse, La Biosthetique-Sam FBW, won this year’s Badminton Horse Trials.

As a vet, I take pride in the fact horses can be maintained to compete at this level for so long. It’s the equivalent of a middle-aged man being at the top of his sport; the most obvious comparison is Sir Steve Redgrave, who astounded the world by winning his fifth rowing gold medal at the Sydney Olympics in 2000, aged 38.

The increasing lifespan of equines in the UK is a good thing, but has a similar effect on owners’ pockets as the ageing human population does on the NHS budget.

We are a nation of animal lovers, so, often, we don’t think twice about forking out for anything recommended by our vet or advertised in a magazine, but the cost of an elderly horse can be extreme.

Even if a horse does not need any medical intervention, the cost of maintaining a horse for those additional years racks up costs into the thousands. Of course, owners never resent this additional cost, but, often, these elderly horses are companions or light hacks and a shadow of their former selves in terms of function. In fact, in the past, a horse’s lifespan was often dictated by the duration of its athletic ability; now, people desire aged horses as companions, children’s ponies or quiet hacks.

Supplementary need

Some horses, however, will need additional drugs or supplements. One major drug elderly horses are on long-term is NSAIDs. One study showed more than 50% of “aged horses” were lame in trot, highlighting the proportion of horses that may require some medical intervention. These, typically, cost £1.50 per sachet, meaning a cost of up to £1,000 a year.

This is not a small amount of money and I am sure most vets would agree when I say I am amazed at the love of owners who don’t think twice about whether to pay this for their beloved animal.

Another drug familiar to equine vets and owners alike is pergolide, which is used to treat pituitary pars intermedia dysfunction (Cushing’s disease), a frequently occurring disease affecting aged horses. One study (Ireland et al, 2012) found more than 20% of horses older than 15 years had changes associated with pituitary dysfunction.

Until 2010, no licensed form of this drug existed for horses; vets were allowed to dispense the human tablets or write a prescription. Owners often used to get the medication via a prescription to reduce the cost from about £1 per tablet to about 50p per tablet. However, pergolide is now licensed for use in horses. This has removed the loophole for reducing the cost of the tablets, so the price per tablet at online pharmacies is £1.

Most average-sized horses (450kg) are on 1mg per day as a maintenance dose, costing owners more than £350 per year. I am amazed it took so long for a licensed product to become available.

We also need to remember most treatments these elderly horses receive are lifelong, so the cost to owners skyrockets.

Healthy teeth

As an odd vet who loves rasping teeth, I get a lot of satisfaction from helping elderly horses eat. My first horse had a tooth missing and it was a constant irritation, resulting in quidding, overgrown opposing molars and the inevitable – and slightly comedic – hamster cheek appearance.

Although older horses have slower erupting growing teeth due to a reduction in the reserve crown, this does not mean their mouths don’t need regular attention. Ireland et al (2012) showed more than 95% of horses older than 15 years had dental abnormalities.

Sharp edges are less of an issue, but periodontal disease and diseased teeth are more likely. Therefore, regular check-ups from a vet or equine dental technician are required and some extra thought may be needed in picking feeds.

Although geriatric horses show signs of their advancing years with, for example, sway backs, grey hairs and thicker coats, most horses don’t act their age. In fact, most owners choose to say their final farewells when their beloved horse no longer shows the same joie de vivre as when they suddenly buck and race around the field.

Treating elderly patients is more common, and I believe vet students and CPD courses should spend more time focusing on areas of equine gerontology and geriatric medicine, a relatively recent focus for equine research.

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