Struggling to put weight on my TB - second line ulcer treatments?

Gnildron

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My 10yo OTTB lost a lot of weight after moving yards 8 months ago. I'm in the southern hemisphere, so it's been winter here, so it's been difficult to put weight on him. But I worry I'm doing something wrong—it's a long story, but TLDR: he's been scoped, treated for ulcers, feed has been modified, and there's some success but his coat remains ratty and he's still ribby.

When he first lost weight, I upped his food and put him back on lucerne, which he'd been off before the move. He was getting breakfast and dinner concentrates, and then good amounts of teff and oathay during the day and overnight. We started with one cake of lucerne per night, then two. I also decided to give him some sucralfate (ulsanic) as he was also very girthy and was giving textbook ulcer signs. I also gave him a two-week course of esomeprazole, during which he improved a bit faster.

After about a month, he looked better but still thin. So I got the vet to scope him. She thought he'd have grade 3-4 ulcers based on his condition, but she only found grade 1 ulcers. I asked about hindgut, but she said he had none of the signs of it. She suggested another two weeks of esomeprazole and more lucerne. So we went to four cakes/slices of lucerne per day (my poor bank account). Again, the esomeprazol treatment seemed to speed up his gains, but afterwards he appeared to stall again.

To now: He is looking much better than the middle of winter, but with the amount of food he's on he should be FAT. I've noticed that the extra lucerne I'm feeding, as well as lunch (I have spread his concentrates over three meals instead of two) means he isn't really finishing his teff. He's loving his oathay at the moment, but there's a lot of sugar in that. WE had terrible teff over winter, and they have slightly better quality now, but his condition in no way reflects what's going into him. He isn't going mental with all the lucerne, which I'm not sure whether it's a good or bad sign!

Before he moved he was fat on small amounts of concentrates and lots of teff and some oathay. But the quality was better than he has at the new place. An experienced rider who rides him for me when I'm away reckons he might have ulcers that need different treatment. She says a friend of hers had to have his horse scoped in hospital, and given different treatment to the usual omeprazole/sucralfate.

I'm giving him sucralfate again in the mornings before breakfast. I know this helps with pain rather than fixes the ulcers themselves. I wonder if I should try a longer course of omeprazole before going that route. Or wait and see if he gains as the weather gets warmer and he changes his coat? He's on grass half the day, which is also growing in now, meaning he might be turning his nose up at the hay in the morning. I have spoken to my vet, she seems to think we should wait and see, that it might take time for him to regain the weight... It's about 6 weeks since his scope. He's building muscle, and he's still to drop his winter coat fully, which might be why it still looks a bit ratty?

For supplements, he's on acid ease twice a day, brewers yeast twice daily (probiotic), fenugreek seeds in the mornings and aloe vera juice in his concentrates. I also give him lucerne chaff in with his concentrates to promote acid buffering. i've got to see how much concentrates he gets—probably around 1 kgs per day, perhaps more. Should I cut the concentrates a bit? The people I know who put weight on TBs do it with just good quality roughage and hardly any concentrates.

Sometimes I look at him, when he stands a certain way, and feel so dejected. I worry something is really bothering him, even though he doesn't appear stressed and he's pretty pampered, if I'm honest.

How long did it take you to put weight back on your TBs after they lost it due to ulcers? Has anyone had experience of treatments not working, and having to go to second-line ulcer treatments? Did you ever have a scope and the vet missed the ulcers, and only a follow-up scope found them? I'd welcome all insights and experiences from others, as I'd really like to see him thrive.
 
I can’t really add anything on the ulcers horse front and hopefully you’ll get some helpful replies. Is Cushing’s a thing where you are? It just hit a cord with the looking a bit depressed and not being themselves although I know that can be ulcers as well and was pretty much the sign that my previous horse had ulcers. Fortunately, his treatment worked. Again as above, I hope you get some helpful feedback which I’m sure you will.
 
I can’t really add anything on the ulcers horse front and hopefully you’ll get some helpful replies. Is Cushing’s a thing where you are? It just hit a cord with the looking a bit depressed and not being themselves although I know that can be ulcers as well and was pretty much the sign that my previous horse had ulcers. Fortunately, his treatment worked. Again as above, I hope you get some helpful feedback which I’m sure you will.
Hi, it is but he's not got a cresty neck or a pot belly. And the coat is not that long (plus he's not got sore feet). His winter coat has a yellow tinge, but his gums aren't yellow (thinking about liver function).
 
Equisure is encapsulated bicarbonate of soda. It's specifically for the hind gut.
I think a 3 week course is usually recommended.
 
Many years ago we went through something similar with our thoroughbred. He was on a huge volume of feed but the results were not forthcoming. He remained thin and had very little energy. Went through all the ulcer treatment as well.

After 6mths with the vet I asked directly for a referral to equine hospital. She was a lovely vet but we were getting nowhere.

Went to hospital, had some tests and he was absorbing between 10-30% of his available calories. Had the work peer reviewed by vets in Kentucky USA and then was put on medication for severe inflammation of the gut.

Worlds most expensive tests, followed by eye wateringly expensive meds that he had to be on for 3mths and be tapered over time.

Results were almost immediate and he continued to improve, came off the meds after 3mths and never looked back. He was supposed to have the tests repeated but hospital thought he looked so good they were not required.

Lived to 28yrs with us, well conditioned on very little feed.

Get him to a hospital where specialists can diagnose.
 
Equisure is encapsulated bicarbonate of soda. It's specifically for the hind gut.
I think a 3 week course is usually recommended.
Sounds cool! I can't find it being stocked in South Africa. Let me compare it with pronutrin and see, that is also time release. Otherwise I'll have to see about importing it if I want to try. Thanks for your input!
 
Many years ago we went through something similar with our thoroughbred. He was on a huge volume of feed but the results were not forthcoming. He remained thin and had very little energy. Went through all the ulcer treatment as well.

After 6mths with the vet I asked directly for a referral to equine hospital. She was a lovely vet but we were getting nowhere.

Went to hospital, had some tests and he was absorbing between 10-30% of his available calories. Had the work peer reviewed by vets in Kentucky USA and then was put on medication for severe inflammation of the gut.

Worlds most expensive tests, followed by eye wateringly expensive meds that he had to be on for 3mths and be tapered over time.

Results were almost immediate and he continued to improve, came off the meds after 3mths and never looked back. He was supposed to have the tests repeated but hospital thought he looked so good they were not required.

Lived to 28yrs with us, well conditioned on very little feed.

Get him to a hospital where specialists can diagnose.
Wow, this is interesting. Do you know what caused it? Because mine was so tied to the move I think of the change of routine disrupted his system. Did you have anything that you could pinpoint?

As sod's law would have it, I got to the stables today and he suddenly looked pretty solid. So we are making progress, and it seems that the food is starting to stick on him better. But your story is a very interesting one, and definitely gives me food for thought. Does gut inflammation present like ulcers, with girthiness etc?
 
Wow, this is interesting. Do you know what caused it? Because mine was so tied to the move I think of the change of routine disrupted his system. Did you have anything that you could pinpoint?

As sod's law would have it, I got to the stables today and he suddenly looked pretty solid. So we are making progress, and it seems that the food is starting to stick on him better. But your story is a very interesting one, and definitely gives me food for thought. Does gut inflammation present like ulcers, with girthiness etc?
Mine was also tied to a move, despite leaving him on the exact same diet. I think the move and new owners stressed him. He was a laid back dude, so possibily just internalised his worries? Who knows.

Ulcers seems to be the catch all for everything now. Yes, they definitely exist and need to be treated but post our experience with the TB all those years ago, I don’t hesitate now to get them to the hospital for additional tests. First two visits with local vets, then off to specialists.
 
Mine was also tied to a move, despite leaving him on the exact same diet. I think the move and new owners stressed him. He was a laid back dude, so possibily just internalised his worries? Who knows.

Ulcers seems to be the catch all for everything now. Yes, they definitely exist and need to be treated but post our experience with the TB all those years ago, I don’t hesitate now to get them to the hospital for additional tests. First two visits with local vets, then off to specialists.
Thanks so much, this is a fresh opinion, and I really appreciate you giving it.
 
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