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Home / Equine Research Bank / Animals (Basel) / Experiences of End-of-Life Decision-Making in Equine Veterin...
Animals : an open access journal from MDPI2025; 15(5); 678; doi: 10.3390/ani15050678

Experiences of End-of-Life Decision-Making in Equine Veterinary and Charity Teams.

Abstract: Veterinary and charity teams are frequently involved in equine end-of-life decisions. These can cause ethical dilemmas and emotional burdens and complicate communication with owners. Semi-structured focus groups explored experiences of making decisions about end-of-life care and euthanasia at three UK equine veterinary practices and one charity. There were 26 participants in a mix of roles. Inductive coding was conducted during thematic analysis. Major themes generated were 'Equine Welfare', 'Relationships', 'Decision-Making', and 'Emotional Toll and Coping Strategies'. Communication, finances, and chronic vs. acute cases were key issues featured within multiple themes. The individual horse's welfare was the participants' priority during decision-making. However, there were barriers to coming to a decision about treatment or euthanasia, and conflict caused by these barriers could detrimentally affect participants' mental health. Preferred style of decision-making varied depending on the situation. Examples given included shared decision-making, participants steering the decision, and attempts by participants or owners to shift decisional responsibility onto the other party. Some owners sought additional input into decisions from veterinary nurses and receptionists. Participants found aspects of their roles emotionally challenging. This could be mitigated by supportive relationships and communication with colleagues. Involving veterinary team members in varying roles in end-of-life care planning and euthanasia decision-making with owners contributes a range of skills and expertise and helps to share the burden of responsibility.
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Publication Date: 2025-02-26 PubMed ID: 40075960PubMed Central: PMC11898496DOI: 10.3390/ani15050678Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article investigates the experiences of veterinary and charity teams in making equine end-of-life decisions. The study focuses on the ethical concerns, emotional challenges and communication issues involved in the process.

Research Methodology

  • The research was conducted primarily via semi-structured focus groups. This provided an opportunity for open-ended, qualitative data collection, allowing the researchers a deep insight into the participants experiences and thought processes.
  • It took place across three different UK-based equine veterinary practices and one charity, involving 26 participants in a variety of roles within these organisations.
  • The data collected from these focus groups were then organised and interpreted through a process known as inductive coding during thematic analysis. This process is used to identify common patterns or themes within qualitative data.

Main Themes

  • The research identified four major themes: Equine Welfare, Relationships, Decision-Making, and Emotional Toll and Coping Strategies. Within these main themes, common issues and factors were also identified.
  • In terms of decision-making, the horse’s welfare was always the central concern. However, factors such as communication difficulties, financial issues, as well as deciding between chronic or acute cases were also significant contributors to the decision-making process.
  • The study found that styles of decision-making varied, with shared decision-making, practitioners steering the decision, or shifts in decisional responsibility dependent upon situation and parties involved.

Mental Health Impact and Coping Strategies

  • The research found that the emotional burden of making difficult final decisions could have a detrimental impact on the mental health of the participants.
  • However, it was found that this burden can be mitigated by strong supportive relationships and effective communication within the teams. Input of other members of the veterinary team like nurses and receptionists in end-of-life care planning and euthanasia decision-making could help share the burden of responsibility.
  • The study emphasizes the importance of understanding the emotional toll that comes with these decisions and developing strategies to cope with the high-stress levels associated with such scenarios.

Cite This Article

APA
Cameron A, Geldard M, Mair T, England G, Burford J, Freeman S, Pollock K, Wilson E. (2025). Experiences of End-of-Life Decision-Making in Equine Veterinary and Charity Teams. Animals (Basel), 15(5), 678. https://doi.org/10.3390/ani15050678

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 15
Issue: 5
PII: 678

Researcher Affiliations

Cameron, Amelia
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Geldard, Megan
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Mair, Tim
  • Bell Equine Veterinary Clinic, CVS Group Ltd., Mereworth ME18 5GS, UK.
England, Gary
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Burford, John
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Freeman, Sarah
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Pollock, Kristian
  • Nottingham Centre for the Advancement of Research into Supportive, Palliative and End of Life Care, School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK.
Wilson, Eleanor
  • Nottingham Centre for the Advancement of Research into Supportive, Palliative and End of Life Care, School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK.

Grant Funding

  • G1020 / The Horse Trust

Conflict of Interest Statement

Author Tim Mair is employed by the company Bell Equine Veterinary Clinic, CVS Ltd., and there was no financial gain involved between Tim Mair, Bell Equine Veterinary Clinic, CVS Ltd and the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

This article includes 57 references
  1. Batchelor C.E.M., McKeegan D.E.F.. Survey of the frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice.. Vet. Rec. 2012;170:19.
    doi: 10.1136/vr.100262pubmed: 22084032google scholar: lookup
  2. Rioja-Lang F.C., Connor M., Bacon H., Dwyer C.M.. Determining a welfare prioritization for horses using a delphi method.. Animals 2020;10:647.
    doi: 10.3390/ani10040647pmc: PMC7222753pubmed: 32283607google scholar: lookup
  3. . Code of Professional Conduct for Veterinary Surgeons and Supporting Guidance.. .
  4. . Guide to Euthanasia.. .
  5. Clough H., Roshier M., England G., Burford J., Freeman S.. Qualitative study of the influence of horse-owner relationship during some key events within a horse’s lifetime.. Vet. Rec. 2021;188:e79.
    doi: 10.1002/vetr.79pubmed: 33739494google scholar: lookup
  6. Matte A.R., Khosa D.K., Coe J.B., Meehan M., Niel L.. Exploring pet owners’ experiences and self-reported satisfaction and grief following companion animal euthanasia.. Vet. Rec. 2020;187:e122.
    doi: 10.1136/vr.105734pubmed: 32499277google scholar: lookup
  7. Dow M., Chur-Hansen A., Hamood W., Edwards S.. Impact of dealing with bereaved clients on the psychological wellbeing of veterinarians.. Aust. Vet. J. 2019;97:382–389.
    doi: 10.1111/avj.12842pubmed: 31364771google scholar: lookup
  8. Morris P.. Managing Pet Owners’ Guilt and Grief in Veterinary Euthanasia Encounters.. J. Contemp. Ethnogr. 2012;41:337–365.
    doi: 10.1177/0891241611435099google scholar: lookup
  9. Testoni I., De Vincenzo C., Campigli M., Caregnato Manzatti A., Ronconi L., Uccheddu S.. Validation of the HHHHHMM Scale in the Italian Context: Assessing Pets’ Quality of Life and Qualitatively Exploring Owners’ Grief.. Animals 2023;13:1049.
    doi: 10.3390/ani13061049pmc: PMC10044252pubmed: 36978590google scholar: lookup
  10. Arora A., Clarida K., Steffan M., Zamora D., Londono Forero M., Umair A., Danyliw J.. Final Report: Pet Loss Best Practice Guidelines for Veterinary Teams.. .
  11. Kerrigan L.. Anticipating grief—The role of pre-euthanasia discussions.. Vet. Nurse. 2014;5:236–243.
    doi: 10.12968/vetn.2014.5.5.236google scholar: lookup
  12. Belshaw Z., Robinson N.J., Dean R.S., Brennan M.L.. Owner and veterinary surgeon perspectives on the roles of veterinary nurses and receptionists in relation to small animal preventive healthcare consultations in the United Kingdom.. Vet. Rec. 2018;183:296.
    doi: 10.1136/vr.104773pubmed: 29973384google scholar: lookup
  13. Moore I.C., Coe J.B., Adams C.L., Conlon P.D., Sargeant J.M.. The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics.. J. Am. Vet. Med. Assoc. 2014;245:513–524.
    doi: 10.2460/javma.245.5.513pubmed: 25148093google scholar: lookup
  14. Blue Cross, Bransby Horses, BHS, HorseWorld, Redwings, RSPCA, World Horse Welfare. Britain’s Horse Problem.. .
  15. Hoy-Gerlach J., Ojha M., Arkow P.. Social workers in animal shelters: A strategy toward reducing occupational stress among animal shelter workers.. Front. Vet. Sci. 2021;8:734396.
    doi: 10.3389/fvets.2021.734396pmc: PMC8631323pubmed: 34859083google scholar: lookup
  16. Charles C., Gafni A., Whelan T.. Decision-making in the physician–patient encounter: Revisiting the shared treatment decision-making model.. Soc. Sci. Med. 1999;49:651–661.
    doi: 10.1016/S0277-9536(99)00145-8pubmed: 10452420google scholar: lookup
  17. Charles C., Gafni A., Whelan T.. Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Soc. Sci. Med. 1997;44:681–692.
    doi: 10.1016/S0277-9536(96)00221-3pubmed: 9032835google scholar: lookup
  18. Cornell K.K., Kopcha M.. Client-veterinarian communication: Skills for client centered dialogue and shared decision making.. Vet. Clin. N. Am. Small Anim. Pract. 2007;37:37–47.
    doi: 10.1016/j.cvsm.2006.10.005pubmed: 17162110google scholar: lookup
  19. Tong A., Sainsbury P., Craig J.. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups.. Int. J. Qual. Health Care. 2007;19:349–357.
    doi: 10.1093/intqhc/mzm042pubmed: 17872937google scholar: lookup
  20. Braun V., Clarke V.. Successful Qualitative Research: A Practical Guide for Beginners.. .
  21. Verhoef M.J., Casebeer A.L.. Broadening horizons: Integrating quantitative and qualitative research.. Can. J. Infect. Dis. Med. Microbiol. 1997;8:65–66.
    doi: 10.1155/1997/349145pmc: PMC3327344pubmed: 22514478google scholar: lookup
  22. Ziebland S., McPherson A.. Making sense of qualitative data analysis: An introduction with illustrations from DIPEx (personal experiences of health and illness). Med. Educ. 2006;40:405–414.
    doi: 10.1111/j.1365-2929.2006.02467.xpubmed: 16635119google scholar: lookup
  23. BHS. Friends at the End & Euthanasia.. .
  24. Blue Cross. Pet Loss Support.. .
  25. Burrell K.L., Burford J.H., England G.C.W., Freeman S.L.. UK horse owners and veterinary practitioners’ experiences of decision-making for critical cases of colic.. Equine Vet. J. 2024;56:1216–1228.
    doi: 10.1111/evj.14124pubmed: 38924162google scholar: lookup
  26. Redsell S., Stokes T., Jackson C., Hastings A., Baker R.. Patients’ accounts of the differences in nurses’ and general practitioners’ roles in primary care.. J. Adv. Nurs. 2007;57:172–180.
    doi: 10.1111/j.1365-2648.2006.04085.xpubmed: 17214753google scholar: lookup
  27. De Vincenzo C., Marian I., Piol S., Keisari S., Testoni I.. Self-Help Groups within Nursing Homes: The Experiences of Family Caregivers in Northeastern Italy.. Behav. Sci. 2023;13:485.
    doi: 10.3390/bs13060485pmc: PMC10295437pubmed: 37366737google scholar: lookup
  28. Bateman S.W.. Communication in the veterinary emergency setting.. Vet. Clin. N. Am. Small Anim. Pract. 2007;37:109–121.
    doi: 10.1016/j.cvsm.2006.09.005pubmed: 17162115google scholar: lookup
  29. Lifford K.J., Witt J., Burton M., Collins K., Caldon L., Edwards A., Reed M., Wyld L., Brain K.. Understanding older women’s decision making and coping in the context of breast cancer treatment.. BMC Med. Inform. Decis. Mak. 2015;15:45.
    doi: 10.1186/s12911-015-0167-1pmc: PMC4461993pubmed: 26058557google scholar: lookup
  30. Ireland J.L., Clegg P.D., McGowan C.M., McKane S.A., Pinchbeck G.L.. A cross-sectional study of geriatric horses in the United Kingdom. Part 2: Health care and disease.. Equine Vet. J. 2011;43:37–44.
    doi: 10.1111/j.2042-3306.2010.00142.xpubmed: 21143632google scholar: lookup
  31. Smith R., Pinchbeck G., McGowan C., Ireland J., Perkins E.. Caring for the Older Horse: A Conceptual Model of Owner Decision Making.. Animals 2021;11:1309.
    doi: 10.3390/ani11051309pmc: PMC8147395pubmed: 34063176google scholar: lookup
  32. Furtado T., Perkins E., Pinchbeck G., McGowan C., Watkins F., Christley R.. Hidden in Plain Sight: Uncovering the Obesogenic Environment Surrounding the UK’s Leisure Horses.. Anthrozoös 2021;34:491–506.
    doi: 10.1080/08927936.2021.1914431google scholar: lookup
  33. Ireland J.L., Clegg P.D., McGowan C.M., Platt L., Pinchbeck G.L.. Factors associated with mortality of geriatric horses in the United Kingdom.. Prev. Vet. Med. 2011;101:204–218.
    doi: 10.1016/j.prevetmed.2011.06.002pubmed: 21733586google scholar: lookup
  34. Crossman G.. Equine euthanasia: Supporting owners in decision-making.. Vet. Times. 2018;48:10–11.
  35. Long M., Grimm H., Jenner F., Cavalleri J.-M.V., Springer S.. “How long is life worth living for the horse?” A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses.. BMC Vet. Res. 2024;20:347.
    doi: 10.1186/s12917-024-04211-8pmc: PMC11302025pubmed: 39107791google scholar: lookup
  36. Smith R., Furtado T., Brigden C., Pinchbeck G., Perkins E.. A Qualitative Exploration of UK Leisure Horse Owners’ Perceptions of Equine Wellbeing.. Animals 2022;12:2937.
    doi: 10.3390/ani12212937pmc: PMC9654126pubmed: 36359063google scholar: lookup
  37. Mueller M.K., Sween C., Frank N., Paradis M.R.. Survey of human-horse relationships and veterinary care for geriatric horses.. J. Am. Vet. Med. Assoc. 2018;253:337–345.
    doi: 10.2460/javma.253.3.337pubmed: 30019999google scholar: lookup
  38. Barker I., Freeman S.L.. Assessment of costs and insurance policies for referral treatment of equine colic.. Vet. Rec. 2019;185:508.
    doi: 10.1136/vr.105415pmc: PMC6860416pubmed: 31439823google scholar: lookup
  39. Equine End of Life Service. Euthanasia.. .
  40. AAEP. Euthanasia Guidelines.. .
  41. Lehnus K.S., Fordyce P.S., McMillan M.W.. Ethical dilemmas in clinical practice: A perspective on the results of an electronic survey of veterinary anaesthetists.. Vet. Anaesth. Analg. 2019;46:260–275.
    doi: 10.1016/j.vaa.2018.11.006pubmed: 30952440google scholar: lookup
  42. Matte A.R., Khosa D.K., Coe J.B., Meehan M.P.. Impacts of the process and decision-making around companion animal euthanasia on veterinary wellbeing.. Vet. Rec. 2019;185:480.
    doi: 10.1136/vr.105540pubmed: 31409747google scholar: lookup
  43. Platt B., Hawton K., Simkin S., Mellanby R.J.. Suicidal behaviour and psychosocial problems in veterinary surgeons: A systematic review.. Soc. Psychiatry Psychiatr. Epidemiol. 2012;47:223–240.
    doi: 10.1007/s00127-010-0328-6pubmed: 21181111google scholar: lookup
  44. Connolly C., Norris K., Martin A., Dawkins S., Meehan C.. A taxonomy of occupational and organisational stressors and protectors of mental health reported by veterinary professionals in Australasia.. Aust. Vet. J. 2022;100:367–376.
    doi: 10.1111/avj.13167pmc: PMC9544948pubmed: 35560212google scholar: lookup
  45. Wallace J.E.. Burnout, coping and suicidal ideation: An application and extension of the job demand-control-support model.. J. Workplace Behav. Health. 2017;32:99–118.
    doi: 10.1080/15555240.2017.1329628google scholar: lookup
  46. Bartram D.J., Baldwin D.S.. Veterinary surgeons and suicide: A structured review of possible influences on increased risk.. Vet. Rec. 2010;166:388–397.
    doi: 10.1136/vr.b4794pubmed: 20348468google scholar: lookup
  47. Moré J.M., Lang-Brown S., Romo R.D., Lee S.J., Sudore R., Smith A.K.. “Planting the Seed”: Perceived Benefits of and Strategies for Discussing Long-Term Prognosis with Older Adults.. J. Am. Geriatr. Soc. 2018;66:2367–2371.
    doi: 10.1111/jgs.15524pmc: PMC6365284pubmed: 30347432google scholar: lookup
  48. Ito Y., Ishikawa H., Suzuki A., Kato M.. The relationship between evaluation of shared decision-making by pet owners and veterinarians and satisfaction with veterinary consultations.. BMC Vet. Res. 2022;18:296.
    doi: 10.1186/s12917-022-03401-6pmc: PMC9344613pubmed: 35918681google scholar: lookup
  49. Küeper A.M., Merle R.. Partners in Sickness and in Health? Relationship-Centered Veterinary Care and Self-Educated Pet Owners in Germany: A Structural Equation Model.. Front. Vet. Sci. 2021;7:605631.
    doi: 10.3389/fvets.2020.605631pmc: PMC7873293pubmed: 33585596google scholar: lookup
  50. Yamamoto S., Arao H., Masutani E., Aoki M., Kishino M., Morita T., Shima Y., Kizawa Y., Tsuneto S., Aoyama M.. Decision Making Regarding the Place of End-of-Life Cancer Care: The Burden on Bereaved Families and Related Factors.. J. Pain Symptom Manage. 2017;53:862–870.
    doi: 10.1016/j.jpainsymman.2016.12.348pubmed: 28189769google scholar: lookup
  51. Chung G.S., Lawrence R.E., Curlin F.A., Arora V., Meltzer D.O.. Predictors of hospitalised patients’ preferences for physician-directed medical decision-making.. J. Med. Ethics. 2012;38:77–82.
    doi: 10.1136/jme.2010.040618pmc: PMC10234429pubmed: 21697296google scholar: lookup
  52. Salmon P., Hall G.M.. Patient Empowerment or the Emperor’s New Clothes.. J. R. Soc. Med. 2004;97:53–56.
    doi: 10.1177/014107680409700202pmc: PMC1079288pubmed: 14749397google scholar: lookup
  53. Janke N., Coe J.B., Bernardo T.M., Dewey C.E., Stone E.A.. Pet owners’ and veterinarians’ perceptions of information exchange and clinical decision-making in companion animal practice.. PLoS ONE 2021;16:e0245632.
    doi: 10.1371/journal.pone.0245632pmc: PMC7850489pubmed: 33524061google scholar: lookup
  54. Cameron A., Pollock K., Wilson E., Burford J., England G., Freeman S.. Scoping review of end-of-life decision-making models used in dogs, cats and equids.. Vet. Rec. 2022;191:e1730.
    doi: 10.1002/vetr.1730pubmed: 35703328google scholar: lookup
  55. Christiansen S.B., Kristensen A.T., Lassen J., Sandøe P.. Veterinarians’ role in clients’ decision-making regarding seriously ill companion animal patients.. Acta Vet. Scand. 2016;58:30.
    doi: 10.1186/s13028-016-0211-xpmc: PMC4879734pubmed: 27221809google scholar: lookup
  56. Lane H., Weil J., Jelinek G.A., Boughey M., Marck C.H., Weiland T.J., Haydon A., Philip J.. Ideal care and the realities of practice: Interdisciplinary relationships in the management of advanced cancer patients in Australian emergency departments.. Support. Care Cancer. 2014;22:1029–1035.
    doi: 10.1007/s00520-013-2054-6pubmed: 24287504google scholar: lookup
  57. World Horse Welfare. Equine End of Life.. .

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