Gastric/gut issues affecting movement

[P0psters]

Hello HHO forum users

I've lurked on here for years but never actually posted, so hello from me and my horses!

I've found so much good advice on here over the years and so I'm hoping some of you may be able to offer up any experiences you may have had regarding gastric/gut related issues and if it affected how the horse moved.

My horse was diagnosed with gastric ulcers via gastroscopy and was treated with Omeprazole injections over the course of 3 weeks. There were 2 ulcers next to the pylorus which the vet described as very mild and as such he was a bit hesitant about treating them, but we went ahead.
There has been no change to her symptoms since the treatment, which was in October.
Vet advised not to re-scope, their view being that she had the best drug available to treat so if it's not worked then nothing else will, or it could be that her symptoms are actually related to something else (still under vet).
Along with the normal ulcer type symptoms she also seems to be struggling particularly in trot on a circle. If she were human I'd say it looks like she's trying to run with stitch. She is reluctant to trot and when she does she tucks her tummy up so you can see her heave line and she is very tense and tight through her flank, stifle and across her bottom. She cannot bring her feet underneath her to track up and just sort of shuffles along behind. She looks like she's bracing herself against something.

She has had a lameness check and nothing found. Physio couldn't find anything really significant other than muscular soreness either side of the lumbar region, particularly on the right and she didn't like the left fore being stretched as she didn't want to take the weight through her right hind.
She has also had and internal rectal exam, cushings test and blood test, the only thing of note was that the inflammatory marker in the blood was slightly raised.

So, sorry, after a bit of a rambling post I'd like to ask if anyone has experienced anything similar with their horses way of going when they have had gastric/gut issues? Or similar but it was something else causing the problem?

Thanks in advance for reading

 

[littleshetland]

Following with interest....

 

[ycbm]

How old is she, what breeding is she, has she been like this for a long time?

If no injury or arthritis can be found I think I would start looking for a muscle myopathy like PSSM, and if that doesn't produce any results then possibly a whole body scintigraph if you can afford it.

I'm sorry this doesn't answer your question but it doesn't sound like any gut issue I've ever come across.
.

 

[P0psters]

She is 20, Welsh sec D. It started August/September.
Sorry, two things I forgot to add; we have done a bute trial, no change, and ran bloods 24hrs after exercise to check muscle enzyme levels, the result was that they were very slightly elevated but vet didn't think it was enough to point to anything specific.
I will speak to him about PSSM. Thank you

 

[P0psters]

These are her symptoms in addition to what was in my first post:
Depression
Lethargy
Reactive to touch on the back half of her belly
Very windy
Droppings are sometimes half the size/amount they would normally be and she has had short periods when they have been lose
She eats really slowly

She lives out with 2 others, nothing has changed in terms of her management
Prior to this we regularly hacked out

 

[Regandal]

Hind gut? One company offers a test, but I’m not sure how reliable it is. Could be worth trying equishure as a trial?

 

[View]

When was last dentist visit?
And has she been tested for Cushings (the comments about depression and lethargy made me wonder)?

 

[P0psters]

I think Succeed offer a test for hind gut, I'll look into it, thanks.
We have tried Protexin Acid Ease, Quick Fix and Gut Balancer. Will look into Equishure.

Also tried Science Supplement Vit E as I know a difficiency can cause muscle problems

Last dentist visit was November
Tested for cushings and it was negative

 

[ycbm]

I wouldn't pursue the PSSM thing, it would be unlikely to have started at 20.

It does sound like a gut thing with those extra details, have they done a peritoneal tap? I think I might be looking for that next of there are no identifiable indicators of hind gut issues.
.

 

[Squeak]

Hind gut? One company offers a test, but I’m not sure how reliable it is. Could be worth trying equishure as a trial?

I was going to suggest hind gut too. Hind gut ulcers are often particularly related to the right hind and I *think* I've read that the treatment for foregut ulcers doesn't work for hindgut and can actually make the hind gut ulcers worse.

Will have a look ad see if I can find any of the articles on it.

 

[P0psters]

I wouldn't pursue the PSSM thing, it would be unlikely to have started at 20.

It does sound like a gut thing with those extra details, have they done a peritoneal tap? I think I might be looking for that next of there are no identifiable indicators of hind gut issues.
.

No they haven't done a peritoneal tap, for some reason I've only ever linked that to colic investigation but makes sense that it could be used for any suspected abdominal disease! Thanks, will look into

 

[Tiddlypom]

Just a quick heads up, the succeed faecal test for hind gut issues is notoriously unreliable.

 

[P0psters]

Just a quick heads up, the succeed faecal test for hind gut issues is notoriously unreliable.

OK, thank you. I'll probably not waste my pennies on that then

 

[JackFrost]

Following with interest....

Another following with interest. I have one with similar things, it feels 'bloaty' when ridden, some days more than others. Vet thinks not ulcers, but I'm not so sure.

 

[ycbm]

Have you tried an exclusion diet, or done any allergy tests? The bloating might suggest a new food intolerance and humans grow into allergies with age.
.

 

[Birker2020]

I think Succeed offer a test for hind gut, I'll look into it, thanks.
We have tried Protexin Acid Ease, Quick Fix and Gut Balancer. Will look into Equishure.

Also tried Science Supplement Vit E as I know a difficiency can cause muscle problems

Last dentist visit was November
Tested for cushings and it was negative

I'm curious and this question is not a criticism. But if I've read this right you found gastric ulcers, she was treated over 3 weeks with Omeprazole. This was in October, so must have been towards the end of October/beginning of November that you started trying Protexin Acid Ease, Quick Fix and Gut Balancer in quick succession (2 1/2 months). Why did you keep changing supplements? Surely it would have been better to keep her on Protexin Acid Ease for example for three or four tubs, I'm not sure you would get results in just one tubs worth.

Mine has been in PAE since end of October, he's on his third tub now although I am still not convinced his girthiness stems from Gastric Ulcers as he has absolutely no other symptoms. But I wouldn't keep flitting from one supplement to another, you need to try for a few weeks on one first.

 

[JackFrost]

Have you tried an exclusion diet, or done any allergy tests? The bloating might suggest a new food intolerance and humans grow into allergies with age.
.

Thank you. I have actually been thinking about posting with my particular query, but don't want to derail this thread. I would really value your input, and others'.

 

[ycbm]

It was a comment for both of you. I did a thread recently about food intolerance and they are popping up a lot.

I would, if possible strip back to hay/haylage only and reintroduce only single foods, nothing with more than one ingredient. If the horse needs hard food I'd move it onto grass nuts, either all soaked or with about 1/3 soaked to prevent choke. Then add things one at a time.

Hope that helps.
.

 

[JackFrost]

I will post separately (bit of a story), but I think there is overlap for OP too.

 

[P0psters]

Have you tried an exclusion diet, or done any allergy tests? The bloating might suggest a new food intolerance and humans grow into allergies with age.
.

No, but good point, thanks

 

[P0psters]

I'm curious and this question is not a criticism. But if I've read this right you found gastric ulcers, she was treated over 3 weeks with Omeprazole. This was in October, so must have been towards the end of October/beginning of November that you started trying Protexin Acid Ease, Quick Fix and Gut Balancer in quick succession (2 1/2 months). Why did you keep changing supplements? Surely it would have been better to keep her on Protexin Acid Ease for example for three or four tubs, I'm not sure you would get results in just one tubs worth.

Mine has been in PAE since end of October, he's on his third tub now although I am still not convinced his girthiness stems from Gastric Ulcers as he has absolutely no other symptoms. But I wouldn't keep flitting from one supplement to another, you need to try for a few weeks on one first.

You're right, we probably should have tried things for longer. I guess I was expecting/hoping to see just even a small improvement after finishing a tub but haven't so moved on to the next.

Just had a look back at time frame; gastroscope was 16th Sep then the omeprazole was administered 1st, 8th and 15th October. I started the Acid Ease 18th Sep, vet said it would be OK to use whilst omeprazole was being administered. The Acid Ease would probably have finished second week in Oct.
Nothing given through November.
Quick Fix was administered over 5 days from 14th December then started straight on Gut Balancer, which has recently finished

 

[SEL]

I'm sure it was the osteo vet Tom Beech who did a blog on how gut problems can affect movement - basically they brace against the pain, muscles tighten and they get compensating patterns.

I've had a lot of success with Ron Fields potions for hind gut and I know people who've had great results with Immubiome products too - but none are quick results.

 

[Bellaboo18]

So what jumps out at me is she only had 3 weeks treatment, that seems really short even for the injections. I'd want to rescope to see if they've actually gone in that time otherwise you just won't know. She could easily need twice the treatment time and might even need antibiotics to help shift them. I wouldn't have been happy the vet saying he was tempted not to treat them, imagine the pain of any ulcer in an acid environment.

Secondly yes ulcers can definitely show up as lameness but I'd be more inclined to say the ulcers are secondary to a pain issue that you've not yet found and the ulcers haven't cleared up yet.

 

[Birker2020]

So what jumps out at me is she only had 3 weeks treatment, that seems really short even for the injections. I'd want to rescope to see if they've actually gone in that time otherwise you just won't know. She could easily need twice the treatment time and might even need antibiotics to help shift them. I wouldn't have been happy the vet saying he was tempted not to treat them, imagine the pain of any ulcer in an acid environment.

It was my understanding that treatment was 4 - 6 weeks at a ridiculous cost of £600 a week! Or so I was told by my vet.

 

[P0psters]

I'm new to to world of ulcer treatment/management and didn't know if affecting movement/causing lameness was linked and didn't know if we were looking at one or multiple areas for concern.
I had no idea that omeprazole treatment would normally be over 6 weeks.
Including call out it was £300 per injection.

Lots still to discuss with the vet! Probably start by re-scoping then

 

[Melody Grey]

I (unfortunately) have quite a bit of ulcer experience. I’d want the horse scoped again. My horse’s ulcer treatment went on for about 12 weeks with numerous scopings along the way. He had a mixture of Gastrogard, Sucralfate, injectable Omeprazole at one point and an antibiotic (Karidox?) which seemed to really help. He’s now on Gastric Comfort as an ongoing maintenance supplement which seems to really help.

if you don’t re-scope, you can’t rule ulcers out and I think you need to before starting to look elsewhere.

Hind gut imbalance/ ulceration/ acidosis are also a distinct possibility with the symptoms you describe. Ulcer treatment can exacerbate these, so worth talking to your vet.

Re: the cost of treating ulcers, see if your vet will issue a prescription for you to order meds online if you need to re-treat. Peptizole is a recognised gastrogard alternative which is cheaper and no doubt there are probably more products available now too.

 

[Lady Jane]

@Squeak is correct re hind gut comments. Hind gut issues can cause an abnormal hind gate. I used Max Gut Health with good success. It will not do anything for ulcers

 

[P0psters]

Thank you. Numpty question; could hind gut issues cause stomach ulcers?

 

[Tiddlypom]

Thank you. Numpty question; could hind gut issues cause stomach ulcers?

Interesting question. The discomfort caused by the hind gut ulcers would be a cause of pain and stress for the horse, and both of those can lead onto foregut ulcer formation.

My own mare was a classic case symptomatically for foregut ulcers, but surprised us all by scoping clear. It turned out that she had hind gut ulcers - diagnosed initially by symptoms and a very good response to Succeed paste. Since then, I have had an Equibiome analysis run and her hind gut flora were completely out of kilter.

 

[Squeak]

Interesting question. The discomfort caused by the hind gut ulcers would be a cause of pain and stress for the horse, and both of those can lead onto foregut ulcer formation.

My own mare was a classic case symptomatically for foregut ulcers, but surprised us all by scoping clear. It turned out that she had hind gut ulcers - diagnosed initially by symptoms and a very good response to Succeed paste. Since then, I have had an Equibiome analysis run and her hind gut flora were completely out of kilter.

I'm really tempted to try an equibiome analysis. Ron Fields' supplements really helped and got rid of the little niggles but when we get a rush of sugar in the grass I can see very slight symptoms coming back and he's really not holding his weight as I'd like.