Ethical issues concerning UK veterinary surgeons practicing in equine sports medicine.

BACKGROUND: The ethics of equine sports medicine is a complex subject that is currently understudied. It combines veterinary ethics, sports ethics and associated regulation. Equine sports medicine may raise unique ethical issues and combines common ethical issues in ways distinct from other forms of veterinary medicine. OBJECTIVES: The purpose of this research was to identify and describe ethical issues concerning United Kingdom (UK) veterinary surgeons arising within the practice of equine sports medicine. STUDY DESIGN: Survey. METHODS: An online questionnaire was distributed to UK veterinary surgeons via veterinary organisations and veterinary social media. Responses to questions were collated and descriptive analysis performed. Open ended responses were analysed thematically. RESULTS: Ninety-seven respondents completed the questionnaire. The most commonly identified ethical challenges were the conflicts of interest and the pressures faced by the veterinary surgeon. The primary competing interest was balancing the horse's health and welfare with client wishes for the horse to continue in training and competition. Specific ethical challenges were identified; these related to competition integrity, medication control and prohibited substances, treatment evidence and acceptability, among others. MAIN LIMITATIONS: As anticipated with the use of a questionnaire, the responses did not provide in-depth information about an individual veterinary surgeon's experiences, however, it did provide evidence of the extensive range of issues and concerns facing this group. There is also potential for response bias, whereby respondents may have provided answers they perceived were ethically desirable. CONCLUSIONS: This is the first empirical study that explores the ethical issues faced by equine sports medicine veterinary surgeons and has identified wide ranging concerns that demand further study. Areas which may pose reputational risk to equestrian sport, or the veterinary profession were identified. Governing bodies should consider how to improve support for veterinary surgeons facing ethical challenges, as for some, these cause moral distress and may impact retention within the profession.

Farming non-typical sentient species: ethical framework requires passing a high bar.

More widespread farming of species not typically used as livestock may be part of a sustainable approach for promoting human health and economic prosperity in a world with an increasing population; a current example is peccary farming in the Neotropics. Others have argued that species that are local to a region and which are usually not farmed should be considered for use as livestock. They may have a more desirable nutrient profile than species that are presently used as livestock. It may also reduce the pressure from hunting on other wild species, and cause less environmental damage than exotic species. We propose a sentiocentric utilitarian framework that could be used to decide whether species that are local, but generally not used as livestock, should be farmed. To illustrate the use of our decision-making framework, we employ two contrasting neotropical case studies: the Spotted Paca (Cuniculus paca) and the Capybara (Hydrochoerus hydrochaeris). We argue that it may be acceptable to use non-sentient species that are typically not farmed as livestock. However, research should determine whether farming them offers human, environmental or sustainability benefits. In addition, we recommend that if invertebrate species are considered for farming, research should be conducted to determine the likelihood that they are sentient. Finally, given the ethical failings of current livestock farming practices, we argue that a high bar must be met if 'new' species that are sentient are to be farmed.

Potential Benefits of a 'Trauma-Informed Care' Approach to Improve the Assessment and Management of Dogs Presented with Anxiety Disorders.

Dog caregiver reporting on the spectrum of fearful-aggressive behaviours often describes 'unpredictable' or 'exaggerated' responses to a situation/animal/person. A possible explanation for these behavioural responses considers that the dog is reacting to triggered memories for which the dog has a negative association. For many dogs undergoing veterinary behavioural treatment or rehabilitation through a canine rescue organisation, the assessing clinician relies on "proxy" reporting of the history/background by a caregiver (dog owner, foster carer, or shelter personnel). Detailed information on the event or circumstances resulting in this negative association may be limited or absent altogether. Consideration of a trauma-informed care (TIC) approach, currently applied in a wide range of human psychology and social care fields, may be helpful in guiding the clinical approach taken. The literature relating to adverse early experience (AEE) and trauma-informed care (TIC) in puppies/dogs compared to children/adults was evaluated to identify common themes and conclusions identified across both species. In the absence of known/identifiable trauma, behavioural assessment and management should consider that a 'problem' dog may behave as it does, as the result of previous trauma. The dog can then be viewed through a lens of empathy and understanding, often lacking for dogs presenting with impulsive, reactive, or aggressive behaviours. Assessment must avoid re-traumatising the animal through exposure to triggering stimuli and, treatment options should include counselling of caregivers on the impact of adverse early experiences, consideration of the window of tolerance, and TIC behavioural modification techniques.

Racehorse welfare across a training season.

Racehorse welfare is gaining increasing public attention, however scientific evidence in this area is lacking. In order to develop a better understanding of racehorse welfare, it must be measured and monitored. This is the first study to assess racehorse welfare using scientific objective methods across a training season. The aim of this study was threefold, firstly to investigate welfare measures which could be used in the first welfare assessment protocol for racehorses. Secondly, to understand the effect that a racing and training season had on individual racehorses and thirdly to identify risk factors for both good and poor welfare. Thirteen racehorse training yards were visited at the beginning and the peak of the racing season in England. Behavioral observations along with individual environmental and animal-based welfare measures were carried out on 353 horses in 13 training yards selected for variability. In our sample the horses were generally in good physical health: 94% of horses recorded as an ideal body condition score, no horses had signs of hoof neglect and 77.7% had no nasal discharge. The overall prevalence of external Mouth Corner Lesions was 12.9% and was significantly higher for Flat racing than Jump racing horses. The majority of horses (67.5%) showed positive horse human interactions. When stabled 54.1% horses had physical social contact and nasal discharge was not associated with increased physical contact. The training season significantly affected Human Reactivity Tests, Horse Grimace Scale scores and time spent resting and feeding. A total of 14.5% of horses displayed stereotypic behavior on at least two occasions. Horses with windows in their stables spent more time surveying their surroundings. Overall, in this population of racehorses, horses spent around a third of their daytime feeding (33.7%) followed by time spent standing resting (22.6%). The welfare assessment protocol used in this study is suitable for use in industry to collect welfare data on racehorses.

Awareness and Use of Canine Quality of Life Assessment Tools in UK Veterinary Practice.

The use of formal canine quality of life (QOL) assessment tools in veterinary practice has been recommended. An online survey investigated awareness, use and barriers to use of these tools in the UK. An anonymous 24-question survey was advertised through veterinary groups and social media. Ninety veterinary surgeons and twenty veterinary nurses responded. Thirty-two respondents (29.1%) were aware of the existence of formal canine QOL assessment tools. Of the three tools listed, current use was less than four per cent. No statistically significant influence of respondent age, role (veterinary surgeon or nurse) or possession of additional qualifications was found on the awareness of QOL tools (p > 0.05). Over half of respondents (55.5%) would 'certainly' or 'probably' be willing to use a QOL assessment tool. The main barrier to use was lack of time. Other barriers included a perceived resistance from owners. Although current use and awareness of canine QOL assessment tools in UK veterinary practice is low, veterinary professionals appear willing to use the tools within their daily practice. This discrepancy implies that QOL assessment tools are not well disseminated to veterinary surgeons and nurses in practice and that various barriers inhibit their use.

Risk factors for, and prediction of, exertional heat illness in Thoroughbred racehorses at British racecourses.

The development of exertional heat illness (EHI) is a health, welfare and performance concern for racehorses. However, there has been limited multivariable assessment of the possible risk factors for EHI in racehorses, despite such information being vital for regulators to effectively manage the condition. Consequently, this study aimed to identify the risk factors associated with the occurrence of EHI in Thoroughbred racehorses and assess the ability of the risk factor model to predict the occurrence of EHI in racehorses to assist in early identification. Runners at British racecourses recorded in the British Horseracing Authority database between 1st July 2010 and 30th April 2018 were used to model the probability that a horse would present with EHI as a function of a suite of environmental, horse level and race level factors. EHI was reported in 0.1% of runners. Race distance, wet bulb globe temperature, preceding 5-day temperature average, occurrence of a previous EHI incident, going, year and race off time were identified as risk factors for EHI. The model performed better than chance in classifying incidents with a mean area under the receiver operating characteristic curve score of 0.884 (SD = 0.02) but had a large number of false positives. The results provide vital evidence for industry on the need to provide appropriate cool down facilities, identify horses that have repeated EHI incidents for early intervention, and collect new data streams such as on course wet bulb globe temperature measurements. The results are especially relevant as the sport is operating in a changing climate and must mitigate against more extreme and longer spells of hot weather.

Broadening the Veterinary Consultation: Dog Owners Want to Talk about More than Physical Health.

Few veterinary professionals use formal quality of life (QOL) assessment tools despite their recommendation from veterinary governing bodies to enable holistic welfare assessments and target welfare improvement strategies. Perceived barriers include resistance from owners, and this study aimed to elucidate understanding of dog owner engagement with conversations and tools relating to QOL. An online survey that investigated owner experience, comfort, and opinions about vet-client discussions on topics connected to canine health and well-being, including QOL, was completed by 410 owners. Almost all owners (95.8%) were reportedly comfortable discussing QOL, yet only 32% reported their vets had addressed it. A high proportion of owners (70.8%) expressed interest in assessment tools, but only 4.4% had experienced one, none of which were QOL tools per se. Semi-structured interviews of a sub-set of four owners provided a more in-depth examination of their experience of a health and well-being assessment tool. Thematic analysis generated three themes: 'Use of assessment tools supports client-vet relationship and empowers owners', 'Owners want to talk about holistic dog care', and 'Owner feelings on the wider application of assessment tools'. Overall, our findings suggest that owners want to broaden the veterinary consultation conversation to discuss QOL and are interested in using tools, and therefore veterinary perceptions of owner-related barriers to tool application appear unfounded. Indeed, tool uptake appears to improve the vet-client relationship and boost owner confidence.

A "Good Life" for Dairy Cattle: Developing and Piloting a Framework for Assessing Positive Welfare Opportunities Based on Scientific Evidence and Farmer Expertise.

On-farm welfare assessment tends to focus on minimising negative welfare, but providing positive welfare is important in order to give animals a good life. This study developed a positive welfare framework for dairy cows based on the existing scientific literature which has focused on developing positive welfare indicators, and trialled a participatory approach with farmers; refining the framework based on their recommendations, followed by a vet pilot phase on farm. The results revealed that farmers and scientists agree on what constitutes "a good life" for dairy cattle. Farmers value positive welfare because they value their cows' quality of life, and want to be proud of their work, improve their own wellbeing as well as receive business benefits. For each good life resource, the proportion of farmers going above and beyond legislation ranged from 27 to 84%. Furthermore, barriers to achieving positive welfare opportunities, including monetary and time costs, were not apparently insurmountable if implementation costs were remunerated (by the government). However, the intrinsic value in providing such opportunities also incentivises farmers. Overall, most farmers appeared to support positive welfare assessment, with the largest proportion (50%) supporting its use within existing farm assurance schemes, or to justify national and global marketing claims. Collaborating with farmers to co-create policy is crucial to showcase and quantify the UK's high welfare standards, and to maximise engagement, relevance and uptake of animal welfare policy, to ensure continuous improvement and leadership in the quality of lives for farm animals.

"There Was a Sense That Our Load Had Been Lightened": Evaluating Outcomes of Virtual Ethics Rounds for Veterinary Team Members.

Clinical ethics support services (CESS) are employed in healthcare to improve patient care and help team members develop skills to recognize and navigate ethically challenging situations (ECS). The objective of this study was to evaluate the impact of ethics rounds, one form of CESS, on veterinary team members. An anonymous, online mixed-methods survey incorporating a 15-item instrument designed to assess the outcomes of moral case deliberation originally developed for human healthcare workers (the Euro-MCD 2.0), was developed. The survey was administered to veterinary team members prior to and following participation in a 90-min virtual ethics rounds session. A total of 23 sessions of virtual ethics rounds were held. In total, 213 individuals participated, and 89 completed both surveys (response rate 41.8%). Most respondents were female (n = 70, 81%). Most were veterinarians (n = 51, 59%), followed by other veterinary team members (practice manager, animal attendant) (n = 18, 21%), veterinary nurses or animal health technicians (n = 10, 12%) and veterinary students (n = 8, 9%). Age ranged from 20 to 73 (median 41, IQR 32-52, n = 87). While there was no statistically significant difference between overall modified Euro-MCD 2.0 scores between T1 and T2, there were statistically significant changes in 7 out of 15 Euro-MCD 2.0 items in the domains of moral competence and moral teamwork. Reflexive thematic analysis of free-text responses identified themes including the types, impact and barriers to resolving ECS, the impacts of ethics rounds on veterinary team members and constraints preventing veterinary team members from speaking up in the face of ECS. While participants largely described the impact of ethics rounds as beneficial (for example, by facilitating clarification of thinking about ECS, allowing participants to see ECS from the perspective of others and providing a safe space for discussion), reflecting on ECS could be stressful for participants. Active participation in ethics rounds may be inhibited in the context of power imbalance, or in settings where bullying occurs. Overall, carefully facilitated ethics rounds has the potential to improve the ability of veterinary team members to identify and navigate ECS, and potentially mitigate moral distress.

Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic.

BACKGROUND: During the ongoing COVID-19 pandemic, many veterinary practices around the world have shifted to a low or no-contact consultation model to ensure the safety of their team members and clients, and comply with public health orders, while continuing to provide veterinary care. METHODS: We performed reflexive thematic analysis on a subset of data collected using a mixed-methods survey of veterinary team members globally. RESULTS: There were 540 valid responses available for analysis. Low and no-contact euthanasia we raised as a common and/or stressful ethical challenge for 22.8% of respondents. We identified five key themes: no-contact euthanasia as a unique ethical challenge; balancing veterinary team safety with the emotional needs of clients; low and no-contact protocols may cause or exacerbate fear, anxiety and distress in veterinary patients; physical distancing was more challenging during euthanasia consultations; and biosecurity measures complicated communication around euthanasia and end-of-life decision making. RECOMMENDATIONS: In light of concerns highlighted by respondents, we recommend the development of a toolkit of protocols that will assist veterinary team members in performing low-contact euthanasia in a range of circumstances, in alignment with their values and professional ethical codes. Professional bodies may be involved in developing, updating and disseminating this information, and ensuring a continuous supply chain of PPE.

Advancing a "Good Life" for Farm Animals: Development of Resource Tier Frameworks for On-Farm Assessment of Positive Welfare for Beef Cattle, Broiler Chicken and Pigs.

There is increasing recognition that farm animal welfare standards should ensure positive welfare, as well as prevent negative welfare. Resources that are valued by an animal and that provide opportunities to engage in motivated behaviours can elicit positive physical and emotional states and therefore positive welfare and a "good life" for farmed animals. Evaluation of resource provision is considered the best way of assessing positive welfare at present, in the absence of validated and practical animal-based measures. Previous research has outlined a framework of three tiers of increasingly positive welfare (Welfare +, Welfare ++, Welfare +++) containing resources that incrementally increase the opportunities for a good life over and above the requirements of UK law and code of practice. Based on this blueprint, "Good Life Frameworks" were developed for beef cattle, broiler chickens and pigs, containing resources that increase good life opportunities according to the scientific literature and expert consultation. We describe the initial development of these frameworks, including a piloting exercise with the UK farm assurance industry, to further refine the frameworks according to auditor and farmer feedback, and test the frameworks as a method of on-farm assessment and assurance of a "good life" for farm animals.

Risk Factors Associated With Increased Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic.

Ethically challenging situations (ECS) are commonly encountered in veterinary settings. The number of ECS encountered by some veterinary team members may increase during a crisis, such as the COVID-19 pandemic. This study aimed to determine the risk factors for experiencing an increase in the frequency of ECS in the months following the beginning of the COVID-19 pandemic, utilizing data from a global survey of veterinarians, veterinary nurses and animal health technicians collected from May to July 2020. In this study, descriptive analyses were performed to characterize veterinary team members who responded to the survey (n = 540). Binomial logistic regression analyses were performed to determine factors associated with an increase in ECS encountered since the beginning of the COVID-19 pandemic. Being a veterinary nurse or animal health technician, working with companion animals, working in the USA or Canada, and being not confident or underconfident in dealing with ECS in the workplace were factors associated with an increase in ECS encountered since the beginning of the COVID-19 pandemic. Results suggest a need to explore the ECS encountered by veterinary team members, particularly veterinary nurses and animal health technicians working in companion animal practice, in depth. Identification of risk factors may facilitate better preparation of veterinary team members for managing ECS, and minimizing the negative impact of ECS on the well-being of those who care for animals.

Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice.

Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.

Longitudinal national-level monitoring of on-farm broiler welfare identifies consistently poorly performing farms.

A range of welfare outcome measures relating to on-farm welfare are monitored in UK slaughterhouses to check compliance with the European Broiler Directive. A national dataset from 438,155 batches of chickens between 2010 and 2014 and from 228,795 batches between 2016 and 2018 was analysed. The data contained information about 3.1 billion chickens. The highest mean proportion for a single condition was for ascites/oedema in 2016-2018 at 0.384%, affecting 3.9 million chickens/year sent to slaughter during that time, followed by abnormal colour/fevered at 0.324%, affecting 3.4 million chickens/year. Identifying farms most likely to have poor welfare is an important strategy for improving animal welfare overall, and for maximising the capacity for checking regulatory compliance when resources are limited. We found a greater proportion of broiler farms overall remained consistently in the best quartile (16.4%) rather than the worst quartile (6.6%). Farms that exceeded a Government 'trigger' threshold for poor welfare were significantly more likely to subsequently improve than 'non-trigger' farms, although they usually remained in the worst performing quartile of farms.

Frequency, Stressfulness and Type of Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic.

Ethically challenging situations (ECS) are common in veterinary settings and can lead to moral stress. However, there is no published information about how a global pandemic affects the frequency and types of ECS encountered by veterinary team members. An online mixed methods survey was developed to determine the frequency, stressfulness and types of ECS experienced by veterinarians, animal health technicians and veterinary nurses since the advent of the global COVID-19 pandemic in March 2020. Responses from 540 veterinary team members from 22 countries were analyzed. With the advent of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman Rank Correlation 0.619, P < 0.0001). The most common ECS (encountered at least several times per week) were: challenging decisions about how to proceed when clients have limited finances (64.4%), conflict between personal well-being and professional role (64.3%), conflict between the interests of clients and the interests of their animals (59.6%). These were followed by challenging decisions about what counts as an essential veterinary service (48.1%); conflict between well-being of family/household members and professional role (46.3%); and challenging decisions about whether to perform non-contact veterinary visits (46.3%). The most stressful ECS (reported to be very or maximally stressful) were: conflicts between the interests of clients and the interests of their animals (50.2%), other (42.9%), conflicts between the interests of my employer and my own interests (42.5%), challenging decisions about how to proceed when clients have limited finances (39.4%), conflict between personal well-being and professional role (38.0%), and conflict between well-being of family/household members and professional role (33.6%). Thematic analysis of free-text responses revealed biosecurity, client financial limitations, animal welfare, working conditions, and client relations as prominent themes. This is, to the best of our knowledge, the first study to describe the impacts of the pandemic on ECS experienced by veterinary teams globally. It identifies an increase in the frequency of ECS associated with the COVID-19 pandemic, and a number of stressors unique to the pandemic. We identified a number of resources and strategies that may help veterinary team members navigate ethical challenges that may emerge in their daily work, as well as in the context of global crises.

Capturing Beneficial Changes to Racehorse Veterinary Care Implemented during the COVID-19 Pandemic.

In March 2020, the World Health Organisation called for countries to take urgent and aggressive action against a global pandemic caused by COVID-19. Restrictions were introduced in many countries to reduce transmission of COVID-19 and ultimately deaths. Such restrictions have been colloquially referred to as "lockdown". Anecdotal evidence of the beneficial practices that facilitated safe veterinary treatment and equine care had been reported together with an increase in the use of electronic communication and information technologies during the first "lockdown". Thus, the aim of this qualitative study was to capture any beneficial changes to racehorse veterinary care that were implemented during the first "lockdown" period in the UK that lasted from 23 March to 12 May 2020. Ten equine veterinary surgeons who primarily treat racehorses and 10 racehorse trainers were interviewed either by telephone or by videoconferencing. After using thematic analysis from a critical realist social constructionist perspective, four themes were identified. These were, firstly, according to our participants, the trainer-vet relationship is predicated upon a good working relationship, secondly, there had been little or no change in the vet-trainer relationship during the first "lockdown" period. Thirdly, when COVID-19 restrictions were in force, more remote consultations took place using images or videos as well as telephone consults, viewed favourably by both trainers and vets, and finally, intermittent connectivity and poor-quality images and videos limited their effectiveness. In order to fully benefit from the positive changes employed by some vets and trainers in their working relationships, we recommend that rural connectivity is prioritised.

Factors Affecting Site Use Preference of Grazing Cattle Studied from 2000 to 2020 through GPS Tracking: A Review.

Understanding the behaviour of grazing animals at pasture is crucial in order to develop management strategies that will increase the potential productivity of grazing systems and simultaneously decrease the negative impact on the environment. The objective of this review was to summarize and analyse the scientific literature that has addressed the site use preference of grazing cattle using global positioning systems (GPS) collars in the past 21 years (2000-2020) to aid the development of more sustainable grazing livestock systems. The 84 studies identified were undertaken in several regions of the world, in diverse production systems, under different climate conditions and with varied methodologies and animal types. This work presents the information in categories according to the main findings reviewed, covering management, external and animal factors driving animal movement patterns. The results showed that some variables, such as stocking rate, water and shade location, weather conditions and pasture (terrain and vegetation) characteristics, have a significant impact on the behaviour of grazing cattle. Other types of bio-loggers can be deployed in grazing ruminants to gain insights into their metabolism and its relationship with the landscape they utilise. Changing management practices based on these findings could improve the use of grasslands towards more sustainable and productive livestock systems.

What Would You Do? Types of Ethical Challenging Situations Depicted in Vignettes Published in the Veterinary Literature from 1990 to 2020.

Veterinary team members encounter a wide range of ethically challenging situations (ECS) in their work. Inability to resolve ECS in accordance with their values may negatively impact the wellbeing of veterinary team members. We sought to determine the types of ECS described in published ethical vignettes in the veterinary literature. We performed a strategic literature search, followed by a thematic analysis of vignettes published in the veterinary literature from 1990-2020. We identified 567 published vignettes in 544 publications. In the majority of vignettes, the protagonist was a veterinarian (61.6%) and the most common categories of animal involved were dogs (28.0%), livestock in general (10.8%), and cattle (10.6%). The primary type of ECS was coded for each scenario, generating 29 themes. These findings extend knowledge about types of ECS that may be encountered by veterinary team members. These themes can help to inform curricula and better prepare veterinary team members to navigate ECS. They may also highlight factors that contribute to ECS that can be addressed on a broad scale, such as through regulation, continuing professional development, or stakeholder education. Knowing that others may experience similar ECS may help veterinary team members feel part of a moral community.

Slow-growing broilers are healthier and express more behavioural indicators of positive welfare.

Broiler chicken welfare is under increasing scrutiny due to welfare concerns regarding growth rate and stocking density. This farm-based study explored broiler welfare in four conditions representing commercial systems varying in breed and planned maximum stocking density: (1) Breed A, 30 kg/m2; (2) Breed B, 30 kg/m2; (3) Breed B, 34 kg/m2; (4) Breed C, 34 kg/m2. Breeds A and B were 'slow-growing' breeds (< 50 g/day), and Breed C was a widely used 'fast-growing' breed. Indicators of negative welfare, behavioural indicators of positive welfare and environmental outcomes were assessed. Clear differences between conditions were detected. Birds in Condition 4 experienced the poorest health (highest mortality and post-mortem inspection rejections, poorest walking ability, most hock burn and pododermatitis) and litter quality. These birds also displayed lower levels of behaviours indicative of positive welfare (enrichment bale occupation, qualitative 'happy/active' scores, play, ground-scratching) than birds in Conditions 1-3. These findings provide farm-based evidence that significant welfare improvement can be achieved by utilising slow-growing breeds. There are suggested welfare benefits of a slightly lower planned maximum stocking density for Breed B and further health benefits of the slowest-growing breed, although these interventions do not offer the same magnitude of welfare improvement as moving away from fast-growing broilers.