Sometimes you know it's time: When an older horse in less-than-ideal health suffers a serious bout of colic, euthanasia might be the best option. Other circumstances tell you it's not time: When an otherwise healthy horse develops a potentially life-threatening condition, treatment might be the better choice.

But what about when it's not so clear-cut--when continued medical treatment and careful management are options, but the animal's quality of life could go downhill very quickly. Do you stay the course? Do you opt for euthanasia?

My horse's "girlfriend," Maddie, a 13-year-old Thoroughbred/Paint mare owned by my good friend Emily, had earned the nickname "Mad Cow" because of her sometimes cantankerous temperament. From a distance Maddie looked like a picture of health: well-conformed with a sturdy build, solid bone structure, and good muscle tone. If you took a closer look, though, Maddie had significant health problems.

Maddie

From a distance Maddie was a picture of health, but she suffered from incurable conditions.

First, there was recurrent airway obstruction, or heaves. Certain environmental triggers, such as dust mites, would set off a reaction of labored breathing and coughing. She often required clenbuterol, even in open, airy stables. Maddie was also allergic to alfalfa as well as to many other plants. Fortunately, the lush Kentucky pastures she grazed and a specialized feeding program were enough to keep her in good body condition.

But the health issues didn't stop there. Maddie had developed a rare form of photoactivated vasculitis. Essentially, she was allergic to the sun: If she spent too much time in the sun, she developed painful lesions all over her body. Her condition was incurable, but my friend could manage it with pentoxifylline and flysheets or by stabling during the sunniest times of day.

Emily did a masterful job keeping Maddie comfortable, happy, and as healthy as possible. She showed unwavering dedication, venturing to the barn daily to ensure Maddie consumed her medications and to treat any skin lesions. It was beautiful to see an owner so dedicated to an animal, but the time and expense to keep the horse comfortable became draining.

Emily began considering the options: continue managing Maddie's complicated medical problems or euthanasia. As Maddie's heaves worsened, even after adding more advanced treatments to the regimen, the answer became clearer.

Our veterinarian came out to discuss Emily's options. After reviewing Maddie's medical records closely, he concluded that her concurrent medical problems made her one in a million. Never in his career had he seen a horse with Maddie's combination of problems (and he's not likely to again, he says). With the different treatments the mare would need to continue living comfortably, the stress and expenses would keep adding up.

More importantly, Emily had to balance each decision with the mare's quality of life without falling into the anthropomorphism trap: attributing human emotions to animals. Emily realized that horses don't plan for the future, and, therefore, she needed to filter the trade-offs of any type of treatment or management through the lens of a sentient animal who lives only in the present. Euthanasia was looking like the right course of action.

The veterinarian requested the opportunity to discuss the case with his colleagues to ensure he wasn't missing something that might present another solution. Emily agreed. Shortly thereafter, he phoned to let her know the rest of the practice had concurred: Continued management would be increasingly difficult, time-consuming, and expensive. He and Emily scheduled Maddie's euthanasia for a few days later.

Emily took the time she had to say goodbye and to finish coming to terms with her decision. On the day before the last vet visit, she said, "You know, Maddie doesn't know what's coming. Right now she's as happy as can be." And she was right.

She didn't want to be there when the vet came, so Emily's husband and I went to see Maddie off. As it were, the day dawned to Maddie's favored weather conditions: cool and cloudy. Snowflakes fell as the vet pulled in. We all said our last goodbyes, and before long, Maddie lay down quietly and went to sleep.

It took my friend a few months of consideration to reach her conclusion, but she has never doubted she made the right decision. It was a hard choice, but in the end, she knew it was time.

Originally published in the August 2012 issue of The Horse: Your Guide To Equine Health Care.


Erica Larson is the news editor for The Horse: Your Guide To Equine Health Care. She also authors the "Old Horses: Better With Age" blog on TheHorse.com.