Diseases and Injuries

THE IMPORTANCE OF DISEASE AND INJURY MANAGEMENT

Good health is an important aspect of working equid welfare (1). Poor health leads to a negative welfare state, increases the energetic demands for the equid which will impact on the ability of equids to work, the longevity of their working life and their productiveness (2). Poor health not only negatively impacts the individual animal but also has wider population and One Health implications such as, where disease is spread to other equids or to humans through zoonotic disease. Poor health in working equids can also have detrimental impacts on human productivity and livelihoods as well as contribute to wider public health concerns such as an over reliance on antibiotics and the development of antimicrobial resistance.

HOW TO PREVENT DISEASE AND INJURY

Preventing disease and injury in working equids is vital for both the individual animal and the population.

• Biosecurity plans should be designed with consideration of the working equid population, current disease risk and seasonal variation as well as local cultural beliefs and sensitivities. Protocols should address the main sources of disease from equids, other animals and vectors, equipment, vehicles, air, water supply and feed.
• National health programmes should be in place to prevent, report and control emerging or ongoing disease outbreaks, for any species. Roles and responsibilities of different individuals should be clearly defined and understood by all animal health workers, including those working in government, private practice and for non-governmental organisations. All stakeholders must be familiar with equid notifiable diseases, aware of reporting processes and report concerns promptly.
• Preventative health campaigns should be in place to prevent disease outbreaks. This ensures a proactive as opposed to reactive response. Preventative methods are more cost effective and sustainable compared with treatments once outbreaks occur (3)
  
  A preventative health care plan should include vaccination, where appropriate and available for diseases such as rabies, tetanus, African Horse Sickness and equine influenza. This will be country and context dependent. A strategic and tailored parasite control plan that includes monitoring endo and ectoparasites and deworming only when indicated. Owners should be encouraged to provide hoof and dental care as part of a routine health management plan to help prevent lameness and dental disease respectively. Nutritional management is also vital to ensure good health and is for the management of some diseases such as endocrine disorders.
• Animal health professionals should maintain their skills and knowledge through regular CPD to ensure they remain up to date with current disease threats and trends, they are able to recognise signs of disease, provide appropriate treatment and know the appropriate reporting mechanisms.
• Outbreak preparedness and emergency response. Plans should be in place for disease outbreaks or disasters, these should include effective monitoring for early detection and effective plans for when outbreaks do occur, as well as disaster risk reduction and management.
• A safe and suitable environment, which is appropriate to species needs and protects equids from hazards and predators, should be provided to minimise risk of injury.
• Harnessing which is well fitted and made from suitable materials should be used to reduce equipment-related wounds and injuries. Equids should be handled appropriately, utilising headcollars where available and avoiding aversive manual handling techniques, such as ear twitching, which lead to distress and risk of injury.

Stakeholders should ensure that they are kept informed of any developing disease threats, including the recognition of the disease, risk periods, prevention, treatment, and notification channels.

RECOGNISING SIGNS OF DISEASE AND INJURY

Early recognition of disease, pain and injury is vital for good working equid health management (4)

Overworking can lead to increased risk of disease and injury and therefore workloads should be appropriate (5). Working equids must be given time to rest and there should be a controlled return to work following injury or illness.

General signs of disease, pain and injury can include, amongst others:

• Reduced appetite and / or water intake
• Lethargy, depression, and other abnormal behaviours including behavioural signs of pain (which require knowing both species-typical and individual ‘normal’)
• Poor body condition or weight loss
• Lameness
• Respiratory symptoms (coughing, nasal discharge, increased respiratory effort)
• Gastrointestinal symptoms (diarrhoea, colic symptoms)
• Neurological symptoms (ataxia, seizures, head tilt, behavioural changes)
• Ocular symptoms (ocular discharge, swollen and/or red conjunctiva, partial/full palpebral closure)
• Wounds
• Fever
• Unwanted behaviours such as resistance to the wearing of bits or harness

Donkeys are more subtle in their behavioural expression, having evolved to mask signs of injury and disease, and therefore pain, disease and suffering may be missed by caregivers but is still experienced (6) Diarrhoea is not a common symptom of gastrointestinal illness in donkeys (7) Donkeys are at an increased risk of hyperlipidaemia if they are in a negative energy balance (8,9)

MANAGEMENT OF DISEASE AND INJURY

Effective management of disease requires timely recognition, appropriate treatment, and when necessary, decisions regarding humane end-of-life.

• Access to veterinary care
  Equid owners and handlers should know where they can access appropriately trained animal health professionals for both preventative healthcare and treatment.
• Knowledge of owners and handlers and animal health professionals
  Owners and handlers should be able to recognise signs of disease, pain and injury and know when to seek veterinary advice and assistance. Animal health professionals should remain informed with current knowledge.
• Access to medication
  Animal health professionals need access to quality assured medicines and equipment such as wound dressings and bandages, to relieve suffering and pain and to treat disease and injury, and need the knowledge, skills and capacity to do this effectively. Animal health professionals must use drugs responsibly and in line with local legislation, at the correct dose and duration to prevent antimicrobial resistance and residues potentially entering the human food chain or environment.
• Euthanasia
  Euthanasia should be considered when an equid’s welfare is detrimentally and irreparably compromised.

	Donkeys often receive less and lower standards of care due to perceived low sociocultural or economic value and poorer recognition of their suffering (10) Donkeys metabolise many drugs differently to other equids such as horses and therefore animal health professionals must have appropriate knowledge of drugs and doses for donkeys. (11)
	There is little published evidence on NSAID and antimicrobial doses for mules. There is some evidence that mules may require higher doses of drugs however, more research is required (12)

WHAT ARE THE CONSEQUENCES OF NOT MANAGING DISEASE AND INJURY?

Failure to prevent and control the spread of disease and adequately provide treatment for working equids will have the following consequences:

• Poor welfare and the potential for prolonged suffering.
• Shortened working lives and reduced productivity (2).
• Inappropriate sale, disposal or slaughter e.g. for the skin trade.
• Spread of disease to other animals.
• Potential zoonotic risk to humans (e.g. rabies, glanders) (13)
• Impact on livelihoods through loss of transport, reduced income and food security, reduced access to education for families (14)
• Environmental impact when carcasses are not disposed of appropriately, there is a risk of environmental contamination and risk of harm to other animals and people (15)
• Increased need for antimicrobial use and contribution to antimicrobial resistance.

HOW CAN PREVENTION AND MANAGEMENT OF DISEASE AND INJURY BE ENSURED?

Effective management requires coordination and planning at household, regional, national and international level.

• Biosecurity policies should be implemented at household, community, and national levels.
• Access to animal health services is vital, including for vulnerable communities and those living in low income and low resource settings (16)
• Community-based approaches, to empower equid owners, handlers, and farriers to recognise early signs of disease and take action to prevent injury and disease through changing key human behaviours which improve welfare practices and day-to-day management.
• Stakeholders, including governments, NGOs, and veterinary bodies should collaborate to ensure that working equids are included in health initiatives.
• Reporting systems for animal health workers should be in place to easily and quickly report new disease outbreaks and to report notifiable disease.
• Record keeping and monitoring of disease to monitor the health status of the working equid population over time. Community level surveillance is required to support early identification of infectious disease outbreaks.
• The health of the working equid population should be considered in emergency preparedness plans. Emergencies such as natural disasters or conflict can worsen equid welfare. Disaster reduction and emergency plans for equid health management is therefore essential to reduce the risk to equid health and welfare during these situations.
• Animal health professionals should ensure their knowledge and skills are maintained through regular CPD to be able to recognise disease and respond appropriately and effectively.
• Raise awareness of traditional practices and customs that increase the risk of injury or disease.