Helping horses when they need it the most

"Breeding horses is fleeting moments of joy in a lifetime of pain!”

This is a playful quote recounted to me recently that admittedly made my heart flinch in some empathetic recognition of the scale of what it takes to breed and raise horses.

Thankfully, when the painful moments do come, there are specialist vets and hospitals who can help. At Anglesey Lodge Equine Hospital in Co Kildare, the 25-strong vet team includes Dr Monica McNicholl,

Dr Áine Rowe and Dr Pia Kristen Randleff-Rasmussen, who all support horses in their most vulnerable moments.

Monica McNicholl is a senior vet and has been in practice for 20 years, Áine Rowe is an internal medicine specialist based primarily in the hospital, and hailing from South Africa, Dr Pia Randleff-Rasmussen has been a vet for 15 years and is also an internal medicine specialist.

Between them, these vets treat thousands of sick horses. Inevitably, some leave bigger marks than others.

“Last season a foal came in from a farm that I have had a career-long connection with,” says Monica. “The mare was black type [a black type horse refers to a racehorse that has won or placed in a stakes race] and she had died during foaling. The owners rushed to the hospital with the foal in the back of their jeep. He had collapsed and was very compromised, he had a lot of problems.

“Every day that went by, I questioned whether or not to continue, the foal was making very slow progress. But the owner kept saying, ‘no, no, we’ll give it another day’.

“The foal was 10 or 12 days old before he ever nursed a mare. He had a leg in every county, he was very weak, but always making a little bit of progress.

“The owners eventually took him home and I got a video of him latched straight onto his foster mare, which was just amazing. Two weeks later, I wouldn’t have recognised him, galloping and bucking. It was a bit of a miracle. That was really nice to see. The support staff here were very attached to the foal too, so it also meant a lot to them to save him.”

“I think when you take on a case, you’re just so invested in it and you do everything you can to get that horse home, then you’re immediately met with another challenging case,” says Áine.

“We did a very difficult case recently with a broodmare in foal who had severe pneumonia. She went on to make a good recovery after draining her chest of fluid, and she’s due to foal very soon.”

Difficult job

Veterinary is a famously difficult job, certainly not for the faint-hearted – it takes a physical and emotional toll. Early life motivations can often be a steering factor.

“My parents have a strong work ethic, so maybe it’s genetic,” Monica says.

“I started seeing vets practise on the Curragh when I was 16, and I’m working 20 years there myself now. I get to work with really good horse people in the yards, I find that very motivating.

“I’ve had the honour of looking after horses that have become superstars. You never know when you’re going to touch the next Prix de l’Arc de Triomphe winner or something.

“I think that’s what helps you get out of the bed in the morning. We’d all agree that the sleep deprivation can be very hard,” admits Monica.

“It’s a lot of night work and very long hours. Sometimes you do everything right and don’t get the results you want. We all get very invested in our cases, and you get a bit attached to them, but that can’t be helped.

“You want to get the good result but sometimes you just can’t: I think that’s probably the hardest part. Or, if you’ve fixed one problem and then a new one rears its head, and you thought you were winning then suddenly you’re losing. That can be very hard to deal with.”

“The client’s financial constraints can become a problem too,” Pia adds. “You know that you can help an animal, but the client maybe doesn’t have the funds to pay for it, or they don’t think that animal is particularly worth it, and you have to give up when you know there’s something you could do – that can be so frustrating.”

Áine says, “In the hospital, supporting us is a massive team and they’re equally invested in the outcomes. Those nurses, interns, fellows and yard staff are all working with the horses every day, treating them.

"Our office staff are supporting the owners. When cases don’t go as you would like, it can be demoralising for the whole team. It’s difficult to keep the spirits up through the whole season.”

Wraparound care

The day-to-day routine operates much like a human hospital. The vets check on their patients in the morning and as a hospital team, do their rounds.

If you’ve ever watched House, the American hospital drama with Hugh Laurie, you’ll have seen the medics get together to reel off ideas to try and solve difficult cases. So do vets.

“We discuss cases together frequently,” says Áine. “The medical team and the surgery team do the rounds together. There are often a lot of components to individual cases. So multiple heads are usually better.

“You never know when an emergency is going to come through the door, which can completely blow up your plans for the day,” Pia adds.

“I really enjoy the internal medicine,” says Áine. “I grew up on a farm and always loved working with animals. I was very inspired by my dad farming. I enjoyed minding calves and lambs and foals, so it came pretty naturally to me.”

Pia adds, “My interest in internal medicine came when I started working as an intern. I was in a clinic which had a very similar sort of population to that around The Curragh; a lot of thoroughbreds, broodmares, foals. And at the time, there were very few vets around that actually had that much experience with intensive care management of foals.

“I felt it was a bit lacking. I spent a few months each year going to America and elsewhere, to learn from people with that experience. I have a lot of interest in other aspects of internal medicine too – not just the foals – such as cardiology and respiratory workups.”

Owners and breeders also play their part in successful foal management.

“We always need the owner to be quite committed,” Monica says. “It allows us to do as much as we can possibly can. I think maybe people who have never met us before don’t realise that we are so invested in every foal and mare that comes in, whether it’s two o’clock in the morning or one o’clock in the day.”

“Most people involved with horses understand, that as much as we try our best to prognosticate or give guidance regarding costs, it’s very hard to give guarantees,” Áine adds. “Often, we have to push on, to make decisions quickly in an emergency situation. That can be really tough on the owners.”

You never know when an emergency is going to come through the door, which can completely blow up your plans for the day

“We might try and give them some other options,” says Monica. “We are responsible for the welfare of the animal, but it is the owner’s animal at the end of the day, so we have to respect their decision. But if we thought the foal had a chance of survival, we would try and help them manage it in a more cost-efficient way at home, if that was possible,” she says.

There is currently a well-documented shortage of equine vets in Ireland. “I think it’s important student vets have their eyes open,” Monica says.

“My dad was a vet, but I would hear him going out in the middle of the night and I’d just pull the duvet over my head. I must have ignored all that side of veterinary when I was younger. My advice is to see a lot of practice, understand what the job truly entails. Get the best understanding of the job before you sign up for it.”

Áine adds, “I think if you have that realistic understanding and you go for it, there are huge opportunities to specialise in different areas. Ireland is one of the largest producers of horses in the world, so someone has to look after them.”

As well as a dedicated team, cutting-edge equipment is also important to improve diagnostic and surgery outcomes. “The ultrasound machine is my favourite piece,” Pia admits.

“It allows us to see the internal organs of the horse from the outside. So, we can look at the heart, the lungs, the ribs, even the abdominal organs.

“We can see the functionality of the gastrointestinal tract and check whether the urinary bladders are filling up and working in the young foals, that kind of thing.”

Monica is thankful for something less technical but equally vital, and a reflection perhaps of her 20 years with clients, “For me, it’s not a piece of kit.

"Having the luxury of some time to talk to the person who looks after the foal, or was at the foaling, or from whom you can get a really good history of what’s been going on – that is important. Then having the time yourself to put your hands on the foal and examine it.

“We always want the clients to know we are on their side. We’re on their foal’s side, you know? We really want them to do well. We get very excited when we see them at the sales or at the show or racecourse, that foal that we remembered, it means more than just a pay cheque,” she concludes.