To rescope or not?

IrishMilo

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Sorry I know this has been asked a lot, but I genuinely can’t make my mind up and I keep going back and forth!

Rocky was scoped on the 22nd Jan for ulcers, following a vet stay and a yard move which triggered some very severe behaviour. He had multiple grade 2 and 3 ulcers, one was actively bleeding. This was the first time in a year that he had ever been ulcery.

Treatment was:

- 2 weeks of oral omeprazole and sucralfate while waiting to be scoped
- 4 omeprazole injections every 6 days plus twice daily sucralfate
- A subsequent 14 days of oral Gastroguard (one week at full dose and the second week at half dose) and another tub’s worth of twice daily sucralfate

He is 90% back to normal and due to be rescoped mid March but I’m worried that scoping him again is just going to set us back to square one. Any new thing or change is always very anxiety inducing for him.

Scoping at my own yard was a nightmare, they were 3 hours late and he was climbing the walls, so I decided it would be less stress potentially for the both of us to drop him off the night before where he’s not expecting to go out with the others etc. He’s a crap patient, weaves like crazy if stressed/at first light and it always takes 2 or 3 doses of IV to actually knock him out.

The only thing is I’m having his SI injected at the same time (which is pretty much the only thing left to rule out of a really extensive work up.)

I will absolutely kick myself if he flares up again after more vet care but also want to know where we’re at ulcer wise.

Thoughts? (Also accepting wine 🥴)
 
Happy to share the wine 🤪
I would go with your gut instinct. If he is 90% better why risk setting back.
Can you organise the SI injections to cause the least possible stress.
 
He’ll need to be sedated for the SI joint medications, it’s a vet up on a stepladder job with an ultrasound probe and giant needles. My mares were done in the stocks in clinic, but I believe that ambulatory vets will do them at the yard.

If he has to be sedated anyway for the SI, then get him scoped as well while he’s sedated?
 
Happy to share the wine 🤪
I would go with your gut instinct. If he is 90% better why risk setting back.
Can you organise the SI injections to cause the least possible stress.
He’ll need to be sedated for the SI joint medications, it’s a vet up on a stepladder job with an ultrasound probe and giant needles. My mares were done in the stocks in clinic, but I believe that ambulatory vets will do them at the yard.

If he has to be sedated anyway for the SI, then get him scoped as well while he’s sedated?

Thanks for your thoughts!

If it was just the SI being done I could turn him out as normal/feed etc. and have them come to me to do it which he would cope much better with. I’m pretty sure my old TB was done at home.

It’s the keeping him in so he doesn’t eat, starving him and change to his routine which is what I’m worried will set him back.

The other option is to just get his SI done and if the behaviour is still there after that I could assume the ulcers are still present/work on the process of elimination. Might need to chew it over with the vet tomorrow!
 
I would look at treating the SI, at home if possible, and then give another course of ulcer treatment without re-scoping. Do the SI rehab, keep his diet and management ulcer freindly. If you you still have problems, then you might have to re-scope.
 
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I would look at treating the SI, at home if possible, and then give another course of ulcer treatment without re-scoping. Do the SI rehab, keep his diet and management ulcer freindly. If you you still have problems, then you might have to re-scope.
I think this is what I’m leaning towards now!
 
I would look at treating the SI, at home if possible, and then give another course of ulcer treatment without re-scoping. Do the SI rehab, keep his diet and management ulcer freindly. If you you still have problems, then you might have to re-scope.

THis is what I'd do, I wouldn't rescope unless I felt it was needed because he was getting worse again.
 
I would look at treating the SI, at home if possible, and then give another course of ulcer treatment without re-scoping. Do the SI rehab, keep his diet and management ulcer freindly. If you you still have problems, then you might have to re-scope.

This!
 
The SI pain is probably the cause of the ulcers, it was in my TB. We treated the ulcers and injected the steroids immediately after. No recurrence! We did scope after but he was fine with it apart from very mild colic following the first scope
 
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