Neurological conditions in horses — from wobbler syndrome to equine herpesvirus myeloencephalopathy — cause significant welfare compromise and complex management decisions. Evidence-based approaches guide better care.
Neurological equine welfare presents some of the most complex decision-making challenges in veterinary medicine. The horse who cannot maintain balance, whose proprioception is severely compromised, or who experiences the distress of altered perception lives in a welfare-compromised state that quality of life assessment must carefully evaluate. Treatment decisions — whether to pursue surgery, medical management, or euthanasia — require honest welfare-centered assessment rather than only consideration of owner attachment. Neurological signs can be deceptive: some horses maintain apparent quality of life despite significant deficits measured clinically, while others show obvious distress from conditions that appear less severe on examination. Welfare-centered management of neurological horses requires regular reassessment of quality of life, clear communication between veterinarian and owner, and willingness to consider euthanasia when welfare cannot be maintained.