As a horse owner, we strive to provide our companions with a good quality of life (QoL), and as they age and become more susceptible to disease and degenerative changes, this often becomes more of a concern. But what does quality of life actually mean? And how do we measure it? 

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What is quality of life (QoL)?

Oxford languages defines quality of life as “the standard of health, comfort, and happiness experienced by an individual or group”. In the human population, this definition encompasses physical and mental health, living standards, comfort and an individual’s ability to enjoy life. 

It can be more difficult to define and assess quality of life in horses; especially in the context of mental well being and ability to enjoy life. Assessment relies on human observations and interpretations of animal behaviours and interactions.  

The term QoL is often used synonymously with welfare in animal populations. But in reality aims to include a broader range of factors to include mental well being and “general enjoyment of life” (Broom, 2007), as it does in the human population. 

How do we assess QoL?

Although several systems and measurement scales are well established in human populations, such as the Quality of Life Index (QLI) and the Quality of Life Scale (QOLS), fewer exist for companion animals, especially equines. 

There is currently no validated equine quality of life measurement scale. But several tools for assessing welfare are in place, which take into consideration factors; such as body condition score, hydration status, lameness and physical parameters.

Health-related quality of life (HRQoL) focuses on the physical health element of QoL. And is well established in small animal medicine, including measurement systems for canine chronic pain, diabetes and cardiac disease. Although these systems cannot be extrapolated directly to the horse population due to their differing requirements and behaviours, combined with welfare assessments and the like, they can contribute to developing an effective method of QoL measurement in equines. 

Examples of human scales adapted for animal use include The Schedule for the Evaluation of Individual Quality of Life (O’Boyle et al. 1993) which has been adapted for dog owners with spinal cord injuries. This suggests similar scales could be adapted to apply to horses. 

The British Horse Society (BHS) has produced a ‘Quality of Life Indicator’ which sets out a list of ‘Yes’ or ‘No’ questions. This is aimed to track changes over time and help owners make an informed decision around euthanasia. Similarly, The Donkey Sanctuary has produced a quality of life assessment pack; which combines assessment forms from both the owner and vet which are designed to be completed regularly to assess and keep track of a donkey’s quality of life. 

In reality, adaptation and extrapolation of a combination of these tools is needed to produce a comprehensive QoL measurement tool in horses. Owners, vets and other health care providers working collectively is essential in giving a holistic overview of an individual horse’s quality of life.

Why is assessing it important?

Subtle changes in behaviour that can hint to underlying problems often go unnoticed in older horses due to their progressive nature and gradual onset. Using a standardised measurement scale or group of scales to define and track these changes is important to ensure they are identified; allowing our horses to continue to live fulfilled and happy lives as they age. 

Understanding a horse’s quality of life also often plays a big role in an owner’s decision as to when euthanasia is appropriate. A study conducted by Advancing Equine Scientific Excellence (AESE), The Donkey Sanctuary and World Horse Welfare found “the key influence in owners’ end-of-life decisions was their own assessment of quality of life”.

How do we know if our older horse has a good QoL?

Domestic horses are now living longer than ever before and geriatric medicine is a growing field of veterinary medicine. This means owners are becoming more aware of their horses’ quality of life and susceptibility to age-related disease and degeneration. 

As prey animals, horses are naturally good at disguising pain. Recognising subtle changes in behaviour can be key to understanding changes in our horses’ well being. Often, clinical signs such as stiffness or gradual weight loss are considered as ‘normal signs of ageing’ by owners and medical attention may not be sought. Chronic disease and degenerative change can have a detrimental effect on quality of life if left untreated. So acting on these changes is vital in determining a horse’s QoL.  

Although physical health plays a large part in determining QoL, factors such as mental well being and daily enjoyment of life are equally important. Measuring these factors is clearly much trickier in horses than it is in people. So called ‘activities of daily living (ADL)’ such as time spent resting, activity when turned out and interaction with other horses can be assessed to contribute to a measurement of QoL (Ireland, 2020). Owners being aware of what is important to their individual horse’s wellbeing is essential; e.g. does your horse usually enjoy rolling? Do they usually groom their field mates? Have these behaviours changed?

Seeking help from your vet is crucial in building a picture of a horse’s quality of life. As well as, diagnosing possible underlying chronic health conditions; such as Cushing’s Disease (PPID) or joint disease which may be impacting this. But it is equally important that owners play an active role in recognising changes in their horses behaviour and monitoring them.

Summary

QoL is a complex and often poorly defined term; encompassing factors such as physical health, mental well being and an individual’s general ability to enjoy life. A clear cut definition is difficult for the human population; let alone in the animal kingdom where factors rely on human interpretations of behaviour. 

There is currently no validated equine QoL assessment. But several systems used in human and small animal medicine can be utilised and extrapolated to develop a tool for horses. 

Although vets play a large role in assessing QoL, veterinary assessment alone is unlikely to provide a holistic measurement of QoL. And owners’ insight is vital in providing long-term perspectives of their horses behaviours and daily activities. Combining thorough physical examinations performed by a vet with comprehensive owner questionnaires that aim to pinpoint factors owners feel are important to their individual horse and their participation in daily activities is key to understanding and assessing an individual animal’s QoL. 

Further research is needed to develop a comprehensive QoL measurement tool in horses. But there are various tools available to help vets and owners alike; some of which are linked in the references below. 

If you are concerned about your horse’s quality of life, or you would like to gain a better understanding of how to measure it, contact your vet to discuss your options. 

Further Reading