8.3.5 Management of horses which collapse
Specific treatment of the conditions which result in collapse is seldom possible. Because these animals are potentially dangerous, it is incumbent on the veterto advise against riding horses which repeatedly collapse, unless a management regime which significantly reduces the chance of further episodes occurring can be suggested. It is more difficult to give advice to the owner of a horse which has collapsed only once. In these circumstances a thorough diswith the owner is required and each case should be judged according to individual circumstance. Sometimes the episodes are one-off events. It may be best to ride the horse in a fairly controlled area such as a sand school for a time rather than returning to competition or road work. If vas~vagal syncope is likely, raising the heart rate by exercising the horse before it is ridden is advisable. Unfortunately, it is very difficult to be sure that the condition will not recur and the owner should be advised accordingly. Any degree of risk may be unacin some cases such as children's ponies. However, in the author's opinion, conditions which result in collapse of an animal at rest are very unlikely to occur during exercise unless significant findings are made on a thorough clinical examination.
When investigating the cause of an episode of collapse, it should be explained to the owner at the outset that a diagnosis is seldom obtained. Furthermore, even if a diagnosis is reached, this may not alter the advice regarding riding the animal in future. The situation regarding loss of use insurance claims in these cases can be problematic. The role of the first opinion veterinarian in this instance is to make a thorough report of the clinical findings and any further diagnostic investigations undertaken and to reach a reasoned conclusion regarding further use of the animal. If this includes actual observation of the episodes the claim is easier to handle. The situation is further complicated because some animals appear to recover. A period of rest or change of environment may apparently resolve the problem, however, it is difficult to predict whether or not the animal may collapse again in the future.