Delayed gastric emptying causing impactions

mousesmum

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Hi, has anyone had experience of the above. Our 14 year old Connie has been off his food for some time, he was scoped around 6 weeks ago and grade 1 - 2 ulcers found. When he was scoped his stomach was impacted but he was still pooing so this was a surprise to us including the vets. He's been treated for ulcers and went back into Leahurst to be rescoped yesterday, only to get a call from vet today to say he's impacted again so they can't scope as stomach full of food. Obviously this is no coincidence and the vet said his stomach is not emptying quickly enough but they don't know why. They are suggesting management changes and keep out at grass 24/7 and not give hay and rescope in a month. We moved yards in Feb and since then all these problems have happened, his previous owner said he's always been fussy and gone off feeds for days at a time which implies this problem isn't new. Any thoughts at all? Anyone been through this ? Please help xx
 

Midlifecrisis

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Yes absolutely I have…my mare went off her food..had high temp on and off ..we treated her for infections but she d have good days and bad..drinking and pooing all the time. We were referred to Weipers in Glasgow. When fully examined and scoped her stomach was completely blocked and scope couldn’t get into stomach hay and grass were poking out into gullet. Her other internal organs were shoved backwards and to the sides. She was starved and flushed for 8 days…trying to empty and soften the mass. Three quarters of the stomach emptied and obviously she had ulcers from the stretching. She came home and was allowed soaked grass nuts and fresh grass only.I fed her every 2 hours through the day and night for another 2 weeks then back for a scope…and stomach wasn’t emptying again (I had to weigh the poo too). She came home but within a week developed colic badly..very badly and she had to be put to sleep. We never got to the bottom of why the stomach wouldn’t empty properly….This was 2016 and at that time it was written up as a very rare occurrenc. My memory is failing me regarding names at Weipers but the lead vet there at the time was renowned for his stomach problem research work.

My apologies for it not being a happy story.
 

HobleytheTB

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Not my own horse, but I knew of one who developed the same problem seemingly out of the blue. I think the horse was put on a grass and soaked nuts type diet, no hay etc. The first time it happened it took around a week in the equine hospital to clear the blockage. Rescoped after a month and the stomach was totally full again. Owner decided to pts rather than put the horse through the same ordeal again. Sorry to say it wasn't a better outcome. Vets at the time didn't know what had caused it. Horse had been on same property for 10 or so years without any stomach issues so it was a real mystery.
 

Tash88

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What type of soil are you on at the new yard? If it is sandy, that could be causing the issues, especially if they have started since you moved. My horse had a similar episode and I gave him psyllium husks which completely resolved the issue. I did do a faecal sand test via Westgates which didn't show up a major problem, but due to having ulcers in the past my horse has a sensitive gut, and so I think it was enough to cause discomfort. He wasn't impacted to the extent of colic, but it would take him a few 'goes' to do a dropping and he was generally uncomfortable, with a slightly decreased appetite. He is now on a probiotic feed and has a course of psyllium each month for 5 days (if you give it continuously it loses its effect as the gut gets used to it).

Wishing you all the best.
 

mousesmum

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What type of soil are you on at the new yard? If it is sandy, that could be causing the issues, especially if they have started since you moved. My horse had a similar episode and I gave him psyllium husks which completely resolved the issue. I did do a faecal sand test via Westgates which didn't show up a major problem, but due to having ulcers in the past my horse has a sensitive gut, and so I think it was enough to cause discomfort. He wasn't impacted to the extent of colic, but it would take him a few 'goes' to do a dropping and he was generally uncomfortable, with a slightly decreased appetite. He is now on a probiotic feed and has a course of psyllium each month for 5 days (if you give it continuously it loses its effect as the gut gets used to it).

Wishing you all the best.

We have only moved 200 m from our last yard but very sandy soil as we are coastal. He is obsessed with sand and eats it in chunks, has been tested for all sorts of mineral deficiencies but there isn't any. The muzzle acts as a convenient shovel for the sand and it's impossible to stop him. He's done it all his life and he's 14, so I guess the obsession is catching up on him now. We do the psyllium flush and it does work as no sand found in his guts last time. It's hard because we've been told not to give him hay/haylage and just let him graze 24/7 which means he has access to unlimited sand/soil. I do think the sand is the underlying cause though.
 

mousesmum

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Could there be something in the sand that he is craving? Salt, or another mineral?
He's been tested at Leahurst for deficiencies and has none. They think he just enjoys eating it but ultimately that is what is causing the problem I'm sure. The trouble is the vets want him on grass 24/7 to improve GI motility but it just gives more access for sand/soil. Very difficult management situation I think
 

Iris1995

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Psyllium husks can create a blockage if there is not enough fluid in the stomach. It forms a solid mass that doesn’t move through.
 

GrassChop

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Does he get any hard feed? If so, what does he have?
Mine basically has soup as her tea as she doesn't drink enough water and recently had impaction colic due to this so more water might help in your situation.
 

mousesmum

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I’m sure I saw a video of a vet tubing a horse with Coke to dissolve a mass of organic matter in the stomach. I could be wrong though.
Yes this is exactly what Leahurst have done both times, usually unblocked with 3 applications? of coke over a 24 hour period. He has slow GI motility so surely starving him for 14 hours prior to scoping is going to really slow it down and cause things to get stuck? They said if he is impacted next time then it is PTS. He shows no signs of discomfort / colic anything, is bright, alert, normal respiratory, heart rate etc, just has a firm mass of food inside him that needs breaking up. He is still pooing cos stomach isn't full of the mass but has reduced appetite. Very weird.
 

Midlifecrisis

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Coke was used on my mare and she reacted really badly due to the ulcers..her reaction really upset the vets. I’m so sorry mousesmum…it’s a rotten time you re having.
 

druid

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It's worth discussing Misoprostol (now considered superior to omeprazole for ulcers) and bethanechol (pro kinetic to treat delayed emptying) with your vet. I would be feeding only grass and a complete senior feed soaked, no more hay ever if he was mine. Hay cubes/pellets perhaps.
 

mousesmum

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It's worth discussing Misoprostol (now considered superior to omeprazole for ulcers) and bethanechol (pro kinetic to treat delayed emptying) with your vet. I would be feeding only grass and a complete senior feed soaked, no more hay ever if he was mine. Hay cubes/pellets perhaps.

He's on Bethanechol now and 24/7 grazing, he comes in twice a day to stand for an hour and has a pink mash feed with his medication in. The ulcers went very quickly as they were so mild so no need to treat them now. He's due to go back in to Leahurst for another scope next week but I am dreading them saying he is impacted again. He shows no signs of pain at all but never has, but the stomach is definitely delayed as he poos loads when ridden but if in stable for any length of time doesn't poo. It's a real mystery but such a sad situation for a cracking pony with loads of life left in him for work, he loves work more than anything and always looks so happy :(
 

Dominope

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Hi all, just wondering if anyone who has dealt with this has any updates on their horses? I have a 2013 warmblood gelding who was diagnosed last year around this time with chronic gastric impactions/gastritis/delayed gastric emptying. He was previously on free choice hay/pasture, but always struggled to put weight on no matter what we fed him. Since diagnosis, we changed his diet to only soaked hay cubes, beet pulp and low sugar complete feed and began bethacechol 3x day. We have been unable to wean him off the full dose as when we try he immediately reverts to impaction colic symptoms, but have managed him for a year with some days that weren't great but always manageable at home. Lately he has been struggling... not eating his cubes, looking unhappy, with mild colic symptoms off and on. Curious if anyone else has fed bethanechol for this length of time and had any side effects? Or managed to manage delayed gastric emptying/chronic gastritis for long periods? I have been in touch with my vet throughout and we are planning on taking him in for another scope next week but since this is not a common problem we have really struggled to find others with similar cases.
 

Peregrine Falcon

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Can I ask what symptoms your horses display with this please? Had issues with my mare with very mild colic symptoms, not wanting to eat, looking miserable. Guven buscopan then is fine an hour or so later. Had a troublesome few months with suspected virus too (bloods run). Went in for investigations last week and they found a mass of dried up food at the entrance to her stomach. Reading these posts has set me wondering....
 

Dominope

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Can I ask what symptoms your horses display with this please? Had issues with my mare with very mild colic symptoms, not wanting to eat, looking miserable. Guven buscopan then is fine an hour or so later. Had a troublesome few months with suspected virus too (bloods run). Went in for investigations last week and they found a mass of dried up food at the entrance to her stomach. Reading these posts has set me wondering....


The first indicator for me is that my guy got really anxious. He always had runny cow-pie type manure. He will paw occasionally at the corner of his stall. Urinate constantly but very small amounts at a time. But the weirdest one and the one that really let me know there was a problem was that he would do this weird stretch where he would stretch out his front legs and drop his withers to the ground in a downward dog type stretch. It took a couple of visits to the vet before we were able to determine the problem as he didn't present as a typical colic even though he had a huge gastric impaction. His temperature, respirations, blood work etc were normal. I hope for you and your horse's sake that this is not the case as it is an awful thing to constantly worry about and it is not a good prognosis.
 

Connemara24

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Hi, has anyone had experience of the above. Our 14 year old Connie has been off his food for some time, he was scoped around 6 weeks ago and grade 1 - 2 ulcers found. When he was scoped his stomach was impacted but he was still pooing so this was a surprise to us including the vets. He's been treated for ulcers and went back into Leahurst to be rescoped yesterday, only to get a call from vet today to say he's impacted again so they can't scope as stomach full of food. Obviously this is no coincidence and the vet said his stomach is not emptying quickly enough but they don't know why. They are suggesting management changes and keep out at grass 24/7 and not give hay and rescope in a month. We moved yards in Feb and since then all these problems have happened, his previous owner said he's always been fussy and gone off feeds for days at a time which implies this problem isn't new. Any thoughts at all? Anyone been through this ? Please help xx
Have you ever thought about grass sickness? It's very hard to diagnose. My horse had it, the vets first thought he was impacted so they tried to treat with tubing, but after a few days he was referred to a equine hospital. They got rid of the impaction in a week but then he got a fever and then impacted again. But he was impacted in the large colon. Then he started getting a droopy eye and a ulcer on his eye twitching ect. He was getting better, after 5 weeks in hospital. then developed another ulcer on his eye. And sadly he started having seizures and got a twisted gut so had to be pts it was neurological so nothing we could do.

I hope your horse gets better soon.
 

mousesmum

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Hi, we have still got Ralph who was sent off to Arley Moss in Cheshire last August as a last ditch attempt to let him improve his gastric motility by eating grass only 24/7. He looks great after a winter out and the vet now wants us to try bringing him back but to leave him out 24/7 and not be stabled. This seems to be the best way to manage anything like this. The sand may be a problem again but I think last time the psyllium that I gave him caused a massive blockage. My plan is to see how he goes over the summer and if that doesn't suit him then we will be looking at finding him a new address where he can live out sand free as he is still such an amazing pony with loads to give.
 

alibali

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Thanks for returning to update. It's always interesting and informative to hear outcomes. I'm glad you've managed to find a workable solution for him
 

sbloom

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I would imagine that slightly different pasture management - low sugar species of course but allow them to grow longer and remove horses when it's down to 2" long - would help with sandy soils? Equicentral type approach, though of course not a route available to everyone by any means.

I would look at Equi-biome as part of a possible solution, though of course major medical issues, impactions etc should be ruled out first.
 

Peregrine Falcon

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Coming back to update this thread on my mare. She had 3 more mild colic episodes and after a field accident last Thursday she colicked worse than previously. Taken into hospital and a scope revealed another gastric impaction half the size of her stomach. I decided that enough was enough and made right but heartbreaking decision to PTS. There is a vet in Kent doing some research into gastric issues and my vet had spoken to him regarding my beautiful girl. I agreed that they could take samples from her to aid this.
 

SO1

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Just an update to this my beloved NF is being PTS on Friday as he has this.

He is 20 so must be acquired rather than congenital as I have had 15 years only in the last 12 months has he had colics.

He had 4 colics August, October, May, June. The one in June was very bad and I nearly lost him but after walking him through the night he survived. He had had a long period of box rest with controlled walking and we originally thought that it was lack of movement that was causing the problem or getting too hot as he was not full clipped like he normally was. His poos also became very small and firm but we thought that was due to being on course hay and not drinking enough.

The colics in May and June happened when he was on getting some turnout.

After June colic YO suggested we scoped for ulcers. When scoped we found the gastric impaction and it took the vets nearly a week to clear it in hospital using coke and regular tubing.

They found a glandular ulcer.

Came home went on a special diet of grass 7 hours a day, plus 4 meals of one scoop of dengie mollasses free 6.45 2.30 4.20 and 10pm.

Went into vets to rescope and his stomach was full again. Vet said on this diet it should not be full and that they think his stomach not working properly and therefore he is at risk of stomach rupture.

So sadly the vet advised PTS he did not give option of any drugs to help the stomach clear the food more quickly.

I am heart broken he is my best friend and I don't know how I will cope without him. I live on my own and he and the yard are my social life.

However it sounds like others have had more success in managing this.

I think the diagnosis is difficult as it doesn't get picked up on a normal colic exam and they still poo the normal amount.

My lovely boy was not born with this otherwise it would have been picked up earlier so not sure what caused it.
 

Midlifecrisis

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SO1 I am sorry and it sounds very like my mare s scenario in 2016…we never found out the reason for her stomach not emptying either. Have a hug from me and a virtual hand hold at the end.
 
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