Tuesday, May 31, 2016

The 80-15-5 Rule

I read another interesting article a few days ago by David Ramey, DVM. I've shared a few of his articles over the years as I often find his perspective interesting and refreshing. I don't agree with him on everything, we are still talking about horses so unilateral agreement on all topics will never happen, but I do agree with him on many things. His latest article was titled "The 80-15-5 Rule." 

The gist of the 80-15-5 article was that horse owners tend to spend way too much time worrying about their horses, and that we would all have more enjoyment with our horses if we learned to worry less. From his perspective, 80% of the time a horse is going to recover from whatever ails it regardless of what treatments are or are not performed. Hence, why he feels a lot of people think ineffective treatments are actually effective. The horse was going to get better anyway, and the supplement/laser therapy/shockwave treatment didn't actually contribute anything. We horse owners just feel like it did because we did the treatment and the horse got better, and his point is the horse would have gotten better anyway. 

He does feel that about 15% of the time the only way a horse is going to recover from something is with intervention. Some colic cases are only going to recover if colic surgery is performed. On a side note, he said in a previous article that he gives banamine to horses with a gas colic for the owner's sake, not because it does anything for the horse with gas - that the majority of the time the gas colic will resolve on its own. A bone chip interfering with a joint will need to be removed surgically. A horse with an eye injury needs medical treatment. A horse with an upper respiratory infection, cellulitis, or any other type of infection needs antibiotics. A horse with a soft tissue injury needs to follow an appropriate protocol of rest and controlled exercise. 

Then he feels you have the dreaded 5% of issues, where it doesn't matter what you do or how much money you are willing to spend, the issue is not treatable. For some diseases there is no cure. A big one that we see people fret about is horses looking and/or acting old. Your 27 year old horse is not going to look and act like it did at 20 no matter how much money you are willing to spend, aging is simply a reality of life.  The majority of the time a broken leg isn't going to be treatable. You can't prevent your horse from having a heart attack or an aneurysm. If your horse is in kidney failure there is no dialysis treatment for horses.  These are a few examples that fall into the 5% category. 

Jason and I spend a lot of time worrying about the horses in our care. It can sometimes be hard to discern when you are seeing something in the 80% category, and when you are in the 15% or 5% category. We've gotten better at knowing when we're in 80% land and when we're not. However, we still see our vets a lot, and many times we have a horse seen by a vet out of an abundance of caution just in case we're not in 80% land. I feel that's a reasonable approach. I think Dr. Ramey's overall point is important though - worry less about your horses and enjoy them more. His article made me realize that sometimes Jason and I spend too much time and effort worrying about our residents rather than simply enjoying them. What do you think, do you worry too much?


Thanks to help from my friend Kate all of the blankets are ready to be dropped off to be washed and repaired. Amazingly, this project was finished a week ago which has got to be a record for me.

Moe and Thomas 

Tony, Chance and Convey

Miel, Taco, Happy and Murphy

Baby and Hemi

Elfin, Thomas and Apollo 

Walon and Johnny

Roho and River

Bruno and Merlin

Walden and Fabrizzio


Bonnie, Griselle and Sabrina

I never get tired of pretty morning skies


KY Cowgirl Chris said...

good advice. I've had horses for about 40 years, and this 80/15/5 rings true to me as well. When I was a kid, my horse mentors often said, "it's a long way from the heart" as a way to reassure an anxious kid that the pony would recover. And usually they did! LOL. 2 years ago I had to make the decision to put my 29 year old Appy down. He had a growth near the hinge of the jaw, below the ear, somewhat along the skull at about eye level. He had arthritis, and sarcoids, and a small cancer on his outer sheath. None of it bothered him much, and he enjoyed his 24/7 turnout, and twice daily soaked mashes that substitute the hay/grass he no longer chewed that well. I knew it was coming, after 25 years together I knew every expression on his face and every gray hair. Finally one morning he took only a few bites of his beloved grain, and no more. I tried a new bag of grain that evening, same thing. A few mouthfuls, then no more. I called the vet and he asked me did I want him to come that night, and I said "no, he's not in any obvious pain - tomorrow is fine". When the vet got there the next day, he said he expected that the growth had finally started to hurt when he chewed to the point he could no longer chew. To rule out any simple solutions, I asked him to please check his teeth (in case it was a 15% problem) but he confirmed his teeth actually looked good. Sadly I knew that it was time to say goodbye. It's no life for a horse to not be able to enjoy his grain, and I didn't want to see him in pain, or slowly starving to death. He was a great horse, and my dear trail buddy, and the least I owed him was to be with him and help him to have a painless, peaceful death.

EvenSong said...

Sounds like your friend Kate is awesome! First baths and clipping, now dirty blanket sorting!

Melissa-ParadigmFarms said...

Kate is VERY awesome!!

Calm, Forward, Straight said...

Dr. Ramey is the king of common sense. The 80/15/5 rule is comforting, though I'm guessing melanoma (our latest pony concern) goes in the 15% category. ;D

Melissa-ParadigmFarms said...

If it helps at all most greys have melanomas. On very rare occasions they cause issues and need treatment. The rest of the time you ignore them. Hope Val's are the latter!

Melissa-ParadigmFarms said...

If it helps at all most greys have melanomas. On very rare occasions they cause issues and need treatment. The rest of the time you ignore them. Hope Val's are the latter!

Calm, Forward, Straight said...

We're removing the one on his anus, as that could be problematic. He's a champion pooper - I'd hate to mess with that talent lol. There's another one on the underside of his dock which is growing rather rapidly. I started a 3 month course of cimetidine this week. Any experience with cimetidine or frankincense?

Melissa-ParadigmFarms said...

Around the anus and under the dock are probably the most common areas for melanomas, so it sounds like he's at least following the standard play book so far. I've only had two experiences using cimetidine for melanomas. It didn't help in either case, but in both cases the melanomas had been present for a long time and it the cimetidine course was done just to see if it might have any effect.

I think there's now some sort of injectable that can be given for melanomas? I believe it's been around awhile. Luckily we've not had any of our grey horses have any issues from their melanomas so we've had no reason to try it. I did have a good friend whose gray mare started developing rapidly growing melanomas in several locations later in life and she did not have good results trying to treat them. They can be problematic, but thankfully it's rare.

Calm, Forward, Straight said...

Thanks Melissa :D