Chronic pain/ulcers and possible euthanasia

Faithfulanima

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Hi all, I have a "what would you do" question.

To give you a bit of history, my 7 yo OTTB was diagnosed with kissing spines when he was 5, involving four spinous processes, along with arthritis in both of his hocks. In the time I’ve had him, he has coliced five times. Once the first winter I had him with an impaction colic (requiring a week of hospitalization and resulting in grade 4 gastric and hindgut ulcers), three more minor colics last winter (mix of gas colic, possible start of a small impaction colic, and ulcers), and again last week (likely induced by grade 3-4 ulcers again). This most recent colic was a shock as he had not been worked really for the two weeks prior, and he was not showing his typical warning signs that tell us that he is dealing with ulcers.

I feel as though I have done everything I can along with our vets, saddle fitter, body worker, trainer, nutritionist, and yard owner to keep him sound, pain-free, and ulcer free. He has yet to have any major colics between the months of April-October aside from some manageable cases of ulcers, which suggests to me that he is still living in some level of discomfort even in the warmer months and really struggles in the colder months. He is not a stressy horse, he is not your typical hot or high strung OTTB. We have spent most of our three years together doing groundwork and he is quite mentally sound. He has freedom, 24/7 access to forage, and friends. As far as the life of domestic horses go, he lives a life full of love and leisure. I’ve consulted with my vet as well my family and friends after his most recent colic, and unfortunately the possibility of euthanizing him this fall is on the table. I have a lot of anxiety about putting him through another winter, risking increased pain and another colic. Regardless, I have decided that he's being laid to rest if he has another life threatening colic. He’s had steroid injections, he gets Adequan twice a year, he gets omeprazole as well as sucralfate/misoprostol as needed for his reocurrent ulcers several times a year, he gets pain management when he needs it, he gets body work as often as I can afford it. He's on MSM, hyaloronic acid, digestive supplements, very minimal to no concentrated feeds. It’s at the point where it feels like I have spent everything I can financially, emotionally, and physically, and nothing has been enough. I think we’re just masking symptoms enough to keep him sound.

It's especially hard because when he's doing well, he is a sound and a lovely mover. He is beautiful and well muscled. He has kept me safe and truly treats me like I'm "his person." But even when he is doing well, he does not like being brushed or saddled, and often resists being mounted. Retiring him from riding and turning him out to pasture could be reasonable; however, this would not cure his chronic issues/pain and I unfortunately cannot afford to keep such a high maintance horse. He is a very sweet, kind, sensitive boy, and I am struggling with what would be most fair to him. I love him dearly, and he is so young.
 
Faithfulamina I don’t think anyone on here would not support a decision to PTS in your circumstances and I am sad he and you have been/are going through so much.
Midwest I am sorry to hear about your cancer diagnosis and am sad but respect your decision not to have treatment due to side effects.
 
I would support PTS. His issues are only going one way and he's unlikely to improve from what is now. Retiring him would result in muscle loss, which could possibly make him feel worse, so I'm not sure what else you can do to help him.

I had one with KS. In hindsight I wouldn't have gone through all the rehabs and stress that I did. The outcome was the same and he was eventually PTS because of it.
 
Sorry if I've missed something but are his only known issues so far hocks? Colic is a very common side effect of ulcers, so that alone wouldn't worry me unless it was repeated impaction colics.

Having just been through a 4 month spell to treat ulcers on my own horse which stemmed from steroid injections, I'd really urge you to stop any steroids for a year, treat the ulcers again, and see where that puts him. Read up on the link between steroids and ulcers.

Did you do oral omeprazole or injections? I'm sure there are success stories with both but knowing how much of the omeprazole my horse spat out during a follow up course, and after speaking with multiple vets about bioavailability, if you can afford it, I would do injections for maximum affect.
 
Sorry if I've missed something but are his only known issues so far hocks? Colic is a very common side effect of ulcers, so that alone wouldn't worry me unless it was repeated impaction colics.

Having just been through a 4 month spell to treat ulcers on my own horse which stemmed from steroid injections, I'd really urge you to stop any steroids for a year, treat the ulcers again, and see where that puts him. Read up on the link between steroids and ulcers.

Did you do oral omeprazole or injections? I'm sure there are success stories with both but knowing how much of the omeprazole my horse spat out during a follow up course, and after speaking with multiple vets about bioavailability, if you can afford it, I would do injections for maximum affect.
Thank you. Do you mean the injectable form of omeprazole? I haven’t tried it but it could certainly be an option.

He has kissing spines involving several spinous processes as well. I’m not putting him through surgery for his kissing spines, but I injected his back last year. I have not injected his hocks yet, but he gets the Adequan twice a year. I was going to start injecting his hocks this year, but his most recent colic has changed my plan somewhat if I ultimately decide to PTS.
 
Sorry if I've missed something but are his only known issues so far hocks? Colic is a very common side effect of ulcers, so that alone wouldn't worry me unless it was repeated impaction colics.

Having just been through a 4 month spell to treat ulcers on my own horse which stemmed from steroid injections, I'd really urge you to stop any steroids for a year, treat the ulcers again, and see where that puts him. Read up on the link between steroids and ulcers.

Did you do oral omeprazole or injections? I'm sure there are success stories with both but knowing how much of the omeprazole my horse spat out during a follow up course, and after speaking with multiple vets about bioavailability, if you can afford it, I would do injections for maximum affect.
I apologize, I should have read your response more thoroughly. I was not aware of the connection between steroid injections and ulcers. Though I don’t know that this would be what caused them this time. I had him injected in October, and he was fine for about 6 months. He’s had severe ulcers prior to getting injections as well.
 
Thank you. Do you mean the injectable form of omeprazole? I haven’t tried it but it could certainly be an option.

Yeah. I tried both oral and injectable and the difference between both was night and day. I completely understand not wanting to do KS surgery.

I did miss the KS part, and to be honest given the ulcers might be a side effect from that, I probably wouldn't bother doing another round of ulcer meds unless you're going to do surgery beforehand. A round of 4 injections cost me just over £2000 and I had the liberty of knowing that my horse had nothing physically going on as he'd already been for a workup.

I would definitely consider PTS.
 
So sorry and saddened to read this.
His quality of life is paramount, I have cancer and will.not take any of the options offered, as the side effects are not for me.
Good luck with whatever you decide,
I know it is the worst part of ownership.x
Thank you for your kindness. I am sorry to hear about your cancer diagnosis. I work in critical care, and I see every day how difficult cancer diagnoses are. There is no wrong choice. Wishing you all the best.
 
I too would support PTS. You have gone above and beyond for him, and his QOL is not going to improve. Take time to look after yourself as well as him.

@MIDWEST so sorry to hear this, but totally understand your decision.
Thank you. I have been through some mental gymnastics trying to talk myself out of it, but I seem to be getting the same response from anyone I speak with about him. It's heartbreaking for him and I, and all the people who love us. But I think it is the right thing to do.
 
I would support PTS. His issues are only going one way and he's unlikely to improve from what is now. Retiring him would result in muscle loss, which could possibly make him feel worse, so I'm not sure what else you can do to help him.

I had one with KS. In hindsight I wouldn't have gone through all the rehabs and stress that I did. The outcome was the same and he was eventually PTS because of it.
Thank you. You make a good point. Even if I stopped riding, I would likely continue to do groundwork/liberty work with him as we both love it and it would help maintain some level of comfort in his body, but that won't cure his issues. I appreciate your kindness and shared experience. Personally, I have a hard time justifying putting a hrose through ks surgery, but I don't have any exsperience with seeing others go through it so I truthfully don't know what that process would look like. I just know with everything that he's already been through, that he is not a horse who would cope with being stalled and rehabbed for months.
 
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