Referral centers are those clinics or hospitals that offer diagnostic and therapeutic options not readily available or possible in a field (barn) type situation. These can include diagnostic modalities such as endoscopy with or without a treadmill, ultrasound, scintigraphy, and radiography, just to name a few. Referral centers can also offer a wide range of surgical care–on an elective or emergency basis–such as colic surgery, soft tissue surgery, and orthopedic surgery (such as fracture repair or arthroscopy). Furthermore, most referral centers are staffed with multiple specialists. These people are highly trained in their areas of interest, such as reproduction, medicine, surgery, radiology, etc. They can perform procedures many veterinarians are not comfortable performing, or they have seen many more “rare” diseases than an average general practitioner. Referral centers can also offer around-the-clock care for those animals requiring frequent administration of drugs and/or intravenous fluids, or for horses which require multiple diagnostic tests or intensive management. Referral centers can also offer peace of mind if a second opinion is needed, especially to confirm a terminal disease.

The initial conversation between a veterinarian and a horse owner about potentially sending a horse to a referral center/equine clinic hopefully will not be in a rushed manner, but too often it is. I prefer to have this conversation well before there is an actual emergency. I think all horse owners should decide ahead of time, before there is a crisis, if they want to–or financially can–send a horse to a referral center for colic surgery, for example. Too often, when emotions are running high, the wrong decision is made for the wrong reasons and the end result sometimes is not a happy one.

In a perfect world, all horses could receive the best medical or surgical care and cost would not be a problem. Unfortunately, we