When I was starting my veterinary practice 14 years ago, I wanted to do something important with my degree. So I contacted a tiny therapeutic riding program in Orange County that had four horses and only a handful of students. I was poor myself, but I thought this was really important, so I said, “I’ll make you guys a deal: You let me take care of your horses, and I’ll do everything for free.”

What I didn’t realize then was the growth that the J.F. Shea Therapeutic Riding Center would experience. It is now the second largest program in the United States, with 30 horses and 600 riders, and it is one of the leading therapy centers in the country. I still care for their horses today.

In the meantime, I grew a sport horse veterinary practice, for which I fly all over the world treating elite-level horses. I manage some of the most famous international show jumpers, but I treat therapy horses no differently.

Amid the many changes, what I’ve really seen transform in these past 14 years is the idea of what a therapy horse does. When many people think about therapy horses, they think about old, lame horses that have been retired from their job because their arthritis is so bad, but that can still be led around in a circle with a rider. In reality, it’s so much more complex than that.

Riders with disabilities range from the severely physically disabled person who has limited mobility all the way up to Special Olympic riders who don’t even appear to have a disability when they ride. The job description for the horses is no longer just walking in circles on a leadline. And the horses that do walk in circles still have very difficult jobs. What I didn’t realize when I first got involved with hippotherapy is that often you have a rider that’s very asymmetrical; they’re not sitting 
centered on the horse and might be leaning off to one side or the other. So the physical -demands on these horses are more than they appear. And because the horses have a repetitive and somewhat monotonous job, mentally they have to be very special animals as well.

Another thing I’ve seen change in the last 14 years is the type of horse we select. We no longer want a horse with a difficult or expensive-to-manage problem because these are working animals. We want a younger, healthier horse that’s going to be able to do more and last longer. And if we have healthy horses, our veterinarians and donors aren’t spending extra time and money trying to maintain pre-existing problems. We also need a horse that is healthy enough to be ridden and schooled by staff and volunteers to maintain its discipline and training. So while it used to be that our horses’ average age was well into the 20s, now their average age is 10 to 11.

What I really want people to know is how our perceptions of these horses have changed: Yes, we do accept horses that have particular underlying medical issues, but we try to pick the same healthy, middle-aged horses you would want to buy for yourself. That old saying, “the most expensive horse is the free one you can’t use,” stands true. The veterinary care is donated but for these horses you still have quite a cost to feed, shoe, and provide other care.

The therapy horses I treat are as valuable to me as any $5 million international level competition horse. What they do for peoples’ lives, health, and well-being is incredible. I even get a little choked up sometimes when I think about what these horses can do. I think they know what they do. I see it in their body language and the way they communicate; they know when they are with someone with special needs.

One last thing I want to say: Get involved in a therapeutic riding program; they’re all over the country. But shop around to make sure you’re with a legitimate, certified program. Today the rider’s medical insurance covers many programs, centers hire licensed physical therapists, and physicians even get involved—it’s become quite sophisticated. Hippotherapy has really evolved to become more than just putting someone with a physical disability on a horse to get their muscles moving. If you’re interested in sharing your horse knowledge with others, this is an amazing way to help make a difference while doing something you love.

Richard Markell, DVM, MRCVS, runs the sport horse practice Ranch and Coast Equine, in Encinitas, Calif., and donates his veterinary services to the J.F. Shea Therapeutic Riding Center, in San Juan Capistrano.

Originally published in the December 2013 issue of The Horse: Your Guide To Equine Health Care.