Have you tried to remember when the last set of vaccines were given? Or the last set of hock injections? It’s pretty normal, but we’d bet that if horses could talk, they’d be concerned.
The fact is, we rely on our veterinarians to keep records for us, since they’re required by law to keep medical records and they have a great understanding of what was done. But, ultimately, you’re the one responsible for your horse’s health, so, you should also keep records.
Nothing Is Foolproof. When we rely on our vet to keep records, we assume our beloved horse docs can remember every detail of the appointment and dutifully record each fact. Unfortunately, as much as your vet might like to do that, reality is that when your horse was the first appointment of the day, and the vet returns home at 11 p.m. after two after-hours colic emergencies, details may get lost.
And sometimes the vet has staff type records. If the staff is interrupted, a sentence can get missed here and there. Plus, scribbled handwriting may get misinterpreted.
And, records can be lost. Fires, floods, robberies and technological disasters happen.
Consider, too, that with veterinary medicine becoming increasingly specialized, we may have one doctor for dental, another for lameness and yet a third as “primary care.” If this sounds familiar, then you must realize that none of these veterinarians know what the others are doing to your horse. That’s scary, because some medications and therapies can counteract others. So, an owner with a clear, accurate history to give to the vet at the time of an appointment will be ahead of the game.
In addition, recording your own observations can assist the veterinarian in sizing up the situation. Ten days of your methodical observation can outweigh the 10 minutes the vet spends looking at the horse.
Plus, it gives you a place to write down the questions you wanted to ask the vet, so you don’t forget. (Secretly, of course, we veterinarians hope to make it off the property before the fog clears!)
Helping Your Vet. Records also help you vets to learn about us. When the vet peruses through your records, he or she can tell a lot about your level of knowledge, and where you may be lacking in your understanding of what is going on with your horses.
More fundamentally, veterinarians who encounter a client that keeps a good set of records come to learn about the level of stewardship and husbandry that the client practices. All these factors can beneficially influence your horse’s case management.
What To Record. Now that you’re motivated, let’s get started.
If you haven’t been keeping records, ask for record summaries from the vets who have worked on your horse over the last two years or so. Your vet’s staff may grumble a bit, but they’ll do it.
Be sure to record visits from other professionals, such as farrier, chiropractor, massage therapist, including date and services.
Keep your insurance information in the binder as well as copies of any registration papers, Coggins tests, show circuits, etc. (For instance, if your horse is an FEI-level competitor, the vet needs to know that because it changes which medications may be given.)
Your horse’s diet, including supplements, should be up-to-date, with the date of any changes. Put it all in chronological order and keep the folder/notebook at the barn. Keep a separate book for each horse.
Now, you can simply record on the next line the new incident:
1. Include the date of the event, the symptoms observed, the professional involved, if any, what occurred, and why, if known.
2. List what procedures the veterinarian performed.
3. Include any medications/prescriptions. Include drug name with strength, dosage, start/stop dates.
4. Record any adverse reactions your horse has to the med. If a veterinarian used a certain sedative that really knocked your horse out, or your horse had a bad reaction to a drug, write it down.
5. Include your observations relative to the condition being treated. For instance, if your horse gets hives, record what occurred prior to the hives, such as feed/dewormer change or events (such as tree fell into pasture or trailered to a new park to ride).
6. Highlight any questions that you may have, and leave space for the vet to write.
Don’t hesitate to record changes in behavior or other oddities that occur. There’s no reason to go into blinding detail, but a notation such as, “November 8 – Munchkin lagged behind the other horses today” or “November 15 – Nelly didn’t clean up her grain” may be a clue or missed early warning sign if Nelly or Munchkin becomes “suddenly” ill at Thanksgiving.
Bottom Line. Although a busy veterinarian might just politely glance at your records during a routine teeth floating visit, if he or she is faced with a difficult diagnosis, that easily referenced history may be full of viable clues. But, above all, remember you’re doing this for your horse’s health.
Grant Miller, DVM, Contributing Veterinary Editor.
