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I believe that most people with service animals have help in cleaning up and grooming their animals. After all they are blind and sufficient or not they are still with needs. Most people with such problems have help that stops by once or more a week to assist them in general chores, shopping, etc.
As for smell, so long as the horse is washed like a guide dog is there shouldn't be any issue with smell as they would spend alot less time outside left to their own amusement than the average equine.
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