Help Please! EMS and Ulcers!

[Louisejane]

I've posted further down about out boys stifle op next week, he has a lot going on poor lad.

He has grade 2 and 3 squamous ulcers and grade 3 and 4 pylorus ulcers and has been put on Peptizole and Antepsin which we've just started this week. His bloods have also come back today and he has EMS (currently awaiting PSSM results but also looking a likely culprit).

The feeding advice for ulcers and EMS do conflict a little so I was wondering if anyone else is or has been in this situation. Vet is putting him on Metformin next week after his op.

Current regime BUT will be on a good 3 month box rest from next week after his op. He's turned out in a very bare, eaten down paddock with a small haynet morning and night. No hard feed as he chokes a lot due to acid reflux. Planning on ulcer supplement once he's done with the 6 week treatment and if clear when scoped.

Should he be having ad lib hay in his field?

I feel so sorry for him, and I'm pretty certain he will come back positive for PSSM which will be a nightmare with the upcoming box rest No specific questions really, just feeling a bit overwhelmed and feeling bad for our lovely lad. Would be great to hear from someone in a similar situation with a good outcome.

 

[be positive]

No specific help other than to say that the ulcers should be helped by him being pain free so the stifle op may reduce the ulcer issue as will treating the PSSM if he has it, which will help with ongoing management, ulcers are rarely the primary problem so concentrate on getting him fixed in the next few months and if you are "lucky" you will only have the EMS possible PSSM to worry about long term.

Obviously he requires plenty of forage for now so if you are not doing so already give him soaked hay while on box rest then a reasonable amount in the field but don't underestimate how much grass there is even in an apparently bare field it is bare because they eat it as fast as it grows.

 

[stimpy]

Should he be having ad lib hay in his field?.

I have been managing an EMS horse for the last 9 years and I'm afraid it's very hard. I have no experience of the other factors but I really could not give my girl ad lib hay, even if it was well soaked. I have experimented with feeding straw, and I know people do this, but one of my other horses had an impaction colic episode from feeding straw so it has really put me off. I have used the feed bricks from Halleys though, they do a 50/50 hay/oat straw one, and I found that feeding one of these after soaking them in a big trug lasted her much longer than a similar weight (1kg) of hay in a small holed haynet.

Good luck, I hope you find a way to manage him. And good luck for the op.

 

[stimpy]

don't underestimate how much grass there is even in an apparently bare field it is bare because they eat it as fast as it grows.

^This, this, this.

You need to look at the other side of the fence to see how much your horse is eating, not the bare patch.

 

[SEL]

Ive got a PSSM 1 horse with recurrence of ulcers. Soaked hay twice a day in her paddock - which isn't even that bare, but the vet wants more fibre through her gut right now. Getting this horse to lose weight is a thankless task. I strongly expect she has some form of EMS alongside the PSSM, but given its all low sugar / starch and exercise that's the ongoing (extremely hard work) programme.

I don't understand the mechanism of metformin well enough to know whether it's advisable for a PSSM horse. Not all uk vets are up to speed on PSSM, but I have found Dr Valberg very quick to help via email (& she's pretty much the expert).

 

[kinnygirl1]

In a similar place to you OP....my horse has had ulcers in the past and has recently been diagnosed with EMS. Also has just had a major op on his hocks with 6 weeks box rest and is now in hacking type work with smal pen turnout. I'm just sticking with the low sugar, low starch high fibre method ...soaked hay and a handful of molasses free chaff which he has his ulcer supplements and pro balance in. He is also on Metformin as being post op he can't do hard excercise at the mo. SEL .. My understanding of Metformin is it works by lining the gut and thus slowing down/preventing the absorption of glucose(and possibly other sugars) . I do think it is helping to reduce my boys fat pads.

 

[horsemadelsie]

I have a pony with the worst EMS my vet had ever seen, he is only ever turned out in a woodchip paddock, as the vets were worried even bare grass would be too much for him. When he was first diagnosed and had to go on a very strict diet I was worried about him getting ulcers, but my vet said as long as we can trickle feed the amount it shouldn't be an issue. He gets 5-6 separate nets spread evenly throughout the day and for the last 3 or 4 years this has kept ulcers at bay, although I realise he didn't have them to start with and your boy does. I have also done some research into ulcers and a lot of people say cabbage has stomach-healing properties- I'm not sure if there is any evidence to back this up, but as cabbage is so low in sugar it is the one vegetable we can give our EMS pony, so maybe feeding it to your boy could help?

 

[Louisejane]

Thanks all for the support and advice, we're a bit all over the place this week. I'm seriously contemplating postponing the surgery until we know if he has PSSM as the box rest can really worsen the symptoms.

He's in his bare paddock (must be some grass as he often has his head down) with 2 hay nets a day. He gets a handful of Alfa A after his meds to line his stomach and seems to be managing well. I'm hoping the Metformin will help the weight while on box rest.

What does everyone feed their EMS horses? I'm looking for a supplement but there's so many! I've ordered some Hack UP Bespoke which we've had success with before.

Horses!!! Who'd have em??

 

[Marmaduke]

Sounds like mine! He is on trot work after his bilateral stifle surgery for OCD. He has also been diagnosed with EMS. Hormonal so maybe two are linked? He was also becoming very touchy so I suspect ulcers as well (other horse was diagnosed so you do a lot of research!) plus lots of drugs/anti inflammatories can cause ulcers. With the EMS soaking the hay even for a few hours helps. I soak change water resoak etc a bit like washing detergent out of clothes as only so much sugar can be absorbed into each tub of the water before the hay just reasons it. I also feed the Phytolean (freestep) supplement which aids elimination of the fat pads and formula 4 feet. At the moment I add up to 500ml per day of basemix from thunderbrooks which is essentially a powder and mix additives to form a sloppy soup. Currently trying to avoid anything likelyvto cause sensitivities eg chaffs that use milled leftovers. From what I can determine it is the starch and simple sugars that make the glucose blood levels shoot up not so much the fructans as previously thought. As mine also started coughing (sigh) he is currently back out for 4 hours am and again 4 hours pm and now down to only approx 2kg dry hay from 8kg on diet. I am strictly watching his weight but his recovery from surgery was walking in hand from day 1 so the exercise is helping. For ulcers Im giving gastropro from equine science which treats the whole system. NFU insurance covered this a couple of years back. After 1 week of supplement he is now no longer touchy so am hoping it has worked like it did for my other boy. Good luck with your recovery, makes it a lot harder if they aren't moving.