Ulcers and hocks

[Ceriann]

Having scoped clear following treatment for fairly nasty ulcers back in September and seeing virtually no improvement in my mare's behaviour under saddle,i went back to my vet. Given hocks, on initial exam and blocking, indicated an issue, next step is to inject. This wasn't done initially as vet advised a that jock issues are often caused by ulcers and hock x ray showed nothing. So I'm waiting for slightly better weather and light to do this (she's currently turned away - no work) BUT I'm starting to have doubts. I've spent a small fortune already on treatment with limited results (she is better in herself) and vet who told me not to inject hocks initially due to clear x rays now telling me that doesn't mean no issues makes me nervous. My mare is relatively new to work (backed early last year) and a little older being backed (not 100% sure of age (charity horse) but no older than 8) - would hock issues causing significant riding issues (she plants, cow kicks, bucks or tears when asked to trot - never v bad but message is clear) not show on an x ray? She's had back checked, suspensories ultrasound and all normal checks (saddle, teeth etc). It's not just the cost of treatment but the risks (appreciating they are low).

 

[FfionWinnie]

Have you considered PSSM. Often at the root of behaviour you just can't put your finger on and ulcers often a secondary with it too.

 

[emfen1305]

Having scoped clear following treatment for fairly nasty ulcers back in September and seeing virtually no improvement in my mare's behaviour under saddle,i went back to my vet. Given hocks, on initial exam and blocking, indicated an issue, next step is to inject. This wasn't done initially as vet advised a that jock issues are often caused by ulcers and hock x ray showed nothing. So I'm waiting for slightly better weather and light to do this (she's currently turned away - no work) BUT I'm starting to have doubts. I've spent a small fortune already on treatment with limited results (she is better in herself) and vet who told me not to inject hocks initially due to clear x rays now telling me that doesn't mean no issues makes me nervous. My mare is relatively new to work (backed early last year) and a little older being backed (not 100% sure of age (charity horse) but no older than 8) - would hock issues causing significant riding issues (she plants, cow kicks, bucks or tears when asked to trot - never v bad but message is clear) not show on an x ray? She's had back checked, suspensories ultrasound and all normal checks (saddle, teeth etc). It's not just the cost of treatment but the risks (appreciating they are low).

Sounds similar to my situation. My boy was slowly getting more and more reluctant to go forward and started refusing jumps, couldn't even get him to want to canter on the stubble fields. The vet came and scoped and found he had grade 4 bleeding ulcers so we treated and he scoped clear after 4 weeks. Gave him another 4 weeks off to complete the treatment so about 12 weeks off in total and then slowly brought him back into work. Still reluctant to move forward, canter was stuffy and he wasn't tracking up at all. Suspected KS so sent him to Leahurst for a bone scan. He was clear bar his right hock so they nerve blocked with no difference so moved straight to xrays. Both hocks showed very mild arthritic changes so he was injected with steroids and sent home. This was about 8 weeks ago and we are just coming back into "normal" work and he does seem to be better, he's much more forward and despite being unbalanced he just looks much more willing to move forward.

I don't know whether the problems you are having could be hock related, my boy is super honest so never did anything untoward despite awful ulcers and hock problems but some horses express their pain differently! Not to try and frighten you but have you thought about KS? I know you said you had back checked but I don't know whether you meant just by physio/chiro or it's been scanned. Alternatively, sounds like SI joint problems too. The vets told me any hind end issues can be anything from the hind hooves to the jaw hence why i went for the full bone scan as he wasn't lame just a bit off. Hock injections are fairly inexpensive and to my knowledge the only risks are potential laminitis in the first couple of weeks due to steroids and a small risk of a joint infection but that is why box rest is recommended for a couple of days after. If I could go back, I would do it again (bone scan and all) because until you can pinpoint the exact problem, it can be quite difficult to know what to do for best..

 

[kinnygirl1]

I think if there are no changes on xray, I would investigate other areas before treating the hocks... SI, KS suspensory - that type of thing, just to avoid setting off down the wrong road and leaving something untreated so to speak. I feel your pain, mine has had SI dysfunction, grade 3 ulcers and hock arthritis which is currently being treated - its v stressful!

 

[Birker2020]

I went to a lecture once given by a vet about diagnostics for lameness.He not all conditions will show up on an xray, it can be hit and miss at times and dependant on factors like the type of xray machine used and what part of the body being xrayed.And then there are cases where things will show on an xray yet the horse will never have suffered from those problems they are a misnomer.Ihave never heard of the link between ulcers and hock problems myself but then have heard someone say a bean can cause a gelding to be lame on its off hind so there you go there are weird connections everywehre.

 

[SEL]

Mine has PSSM, hock arthritis and ulcers. She is currently bilaterally lame behind and therefore lame on her front fore too.

I am still not convinced that injecting her hocks is going to solve all her problems, but currently that's the next option open to me and my cheque book.

What breed is your horse? PSSM is cheap to check off your list.

 

[Ceriann]

Have you considered PSSM. Often at the root of behaviour you just can't put your finger on and ulcers often a secondary with it too.

I have considered it and she has no symptoms beyond what I've said (no muscle wastage etc) - I'm struggling a bit with my vet, to have a proper "what could this be" discussion above and beyond what they want to treat next. I'm one step from changing them but as I'm paying (not insured) I'm loathe to start again with a new vet. I will discuss this with them.

 

[FfionWinnie]

Type 1s don't have muscle wastage. What breed is she? The diet won't hurt her so you are as well to try it.

 

[Ceriann]

Sounds similar to my situation. My boy was slowly getting more and more reluctant to go forward and started refusing jumps, couldn't even get him to want to canter on the stubble fields. The vet came and scoped and found he had grade 4 bleeding ulcers so we treated and he scoped clear after 4 weeks. Gave him another 4 weeks off to complete the treatment so about 12 weeks off in total and then slowly brought him back into work. Still reluctant to move forward, canter was stuffy and he wasn't tracking up at all. Suspected KS so sent him to Leahurst for a bone scan. He was clear bar his right hock so they nerve blocked with no difference so moved straight to xrays. Both hocks showed very mild arthritic changes so he was injected with steroids and sent home. This was about 8 weeks ago and we are just coming back into "normal" work and he does seem to be better, he's much more forward and despite being unbalanced he just looks much more willing to move forward.

I don't know whether the problems you are having could be hock related, my boy is super honest so never did anything untoward despite awful ulcers and hock problems but some horses express their pain differently! Not to try and frighten you but have you thought about KS? I know you said you had back checked but I don't know whether you meant just by physio/chiro or it's been scanned. Alternatively, sounds like SI joint problems too. The vets told me any hind end issues can be anything from the hind hooves to the jaw hence why i went for the full bone scan as he wasn't lame just a bit off. Hock injections are fairly inexpensive and to my knowledge the only risks are potential laminitis in the first couple of weeks due to steroids and a small risk of a joint infection but that is why box rest is recommended for a couple of days after. If I could go back, I would do it again (bone scan and all) because until you can pinpoint the exact problem, it can be quite difficult to know what to do for best..

My mare has a lovely nature - she can be a bit stressy but there isn't a nasty bone in her body so if she's refusing to go forward there will be a reason for it. With bleeding ulcers she was cow kicking only, and the bucking/rearing is happening now when I push her and its never v committed! I have considered KS and can't discount it - vet has x rayed her back but we haven't had a scan. My gut feel us it isn't her back as she shows no discomfort being mounted etc, and whilst she instantly puts her ears back etc being asked to trot she doesn't feel stiff in the back. SI issues are definitely on my list of things to consider. Mine sounds so much like yours - not lame, just off and a bit sticky at the back. I really need a good chat with my vet - she went in for a full lameness work up when they found the ulcers, so I need them to start considering options not just ticking off treatment options!

 

[Ceriann]

Type 1s don't have muscle wastage. What breed is she? The diet won't hurt her so you are as well to try it.

Papers say Friesian x but not convinced (papers are questionable on age too) - she's a 15h lightweight cobby type (v hairy but if you clipped her you might not think cob). Diet wise she's not far off what I've looked at as being recommended for pssm horses - out 24/7 (ok grazing given winter), hay ad lib and low sugar chaff/hay cob based feed. Should I be testing sugar levels in grass and hay? Can I test for pssm?

 

[FfionWinnie]

High risk breed wise then. You can test for type 1 easily (£30 tail hair test you pull the sample yourself). The other variants aren't as easy to test for. Lots of supplements can cause issues so that's something to think about. If you list makes of absolutely everything she eats I can tell you if there are any red flags.

For a horse like this I would keep a behaviour, diet and exercise diary to try and help establish if there is a pattern.

It could be so many things and obviously you want to get there as efficiently as possible.

 

[Ceriann]

Mine has PSSM, hock arthritis and ulcers. She is currently bilaterally lame behind and therefore lame on her front fore too.

I am still not convinced that injecting her hocks is going to solve all her problems, but currently that's the next option open to me and my cheque book.

What breed is your horse? PSSM is cheap to check off your list.

Sorry to hear the problems you're having - it's hard isn't it? With mine so early in her ridden career I'm questioning what I expect to achieve and to what end but I do want her comfortable and happy in herself.

 

[emfen1305]

My mare has a lovely nature - she can be a bit stressy but there isn't a nasty bone in her body so if she's refusing to go forward there will be a reason for it. With bleeding ulcers she was cow kicking only, and the bucking/rearing is happening now when I push her and its never v committed! I have considered KS and can't discount it - vet has x rayed her back but we haven't had a scan. My gut feel us it isn't her back as she shows no discomfort being mounted etc, and whilst she instantly puts her ears back etc being asked to trot she doesn't feel stiff in the back. SI issues are definitely on my list of things to consider. Mine sounds so much like yours - not lame, just off and a bit sticky at the back. I really need a good chat with my vet - she went in for a full lameness work up when they found the ulcers, so I need them to start considering options not just ticking off treatment options!

At least you can see a difference, sometimes it's difficult to tell whether they are grumpy by nature or grumpy for a reason! I would keep pushing your vet, I did have to push mine quite a bit, to the point where I felt like I was badgering them but it did mean that he kept coming out regularly and could see him deteriorating. I did make suggestions of what I thought it could be and what we could try but tried to err on the side of caution and try not to tell them how to do their job. He's finally seen him going well now and did agree that he was quite stiff and short behind before.

Another thing to consider if you can't really find the source of the problem is memory pain maybe from the ulcers? The first signs my cob showed of something being wrong was putting his ears back, shaking his head and swishing his tail when asked to trot or canter. Although I am fairly sure he is no longer in pain, he still looks annoyed (for lack of a better word) when I ask him to trot and the vet told me to ignore this as he will be expecting it hurt so his automatic reaction is to be grumpy. I think this definitely is the case now as as soon as he takes one stride of trot his ears are forward and he happily goes along, as soon as i apply leg or wave the whip on the lunge the ears go back for a stride and then forward again, almost like a habit.

My vet suggested that I either continue working Toby until he got better or went lame or send him for a scan and flexions, I had the insurance so chose the latter but if the money isn't there then you could potentially try carrying on with her to rule out memory pain, though if she has been clear since September that is quite a long time. I do completely feel your pain, especially when no lameness is present, feels like it could be absolutely anything!

 

[Ceriann]

High risk breed wise then. You can test for type 1 easily (£30 tail hair test you pull the sample yourself). The other variants aren't as easy to test for. Lots of supplements can cause issues so that's something to think about. If you list makes of absolutely everything she eats I can tell you if there are any red flags.

For a horse like this I would keep a behaviour, diet and exercise diary to try and help establish if there is a pattern.

It could be so many things and obviously you want to get there as efficiently as possible.

Thank you - I'll get the test done. She gets thunderbrooks herbal chaff, soaked thunderbrooks hay cobs and their daily essentials balancer. Otherwise grass and hay. Her first symptom was to refuse to move under saddle - literally couldn't get a step (circa august last year) - everything checked and no different (v grumpy to have leg on). Post clear scope she will now walk mainly happily but I've managed one trot only. We did an inflacsm trial and when I voiced trot I felt her engage but then react, head shake and v grumpy. Pushed more she bucked and reared. Before first symptom she was v forward and a happy, ears forward little mare! I kept a diary but now I stopped riding about a month ago as I'm conscious of her ulcers and stressing her out.

 

[Ceriann]

At least you can see a difference, sometimes it's difficult to tell whether they are grumpy by nature or grumpy for a reason! I would keep pushing your vet, I did have to push mine quite a bit, to the point where I felt like I was badgering them but it did mean that he kept coming out regularly and could see him deteriorating. I did make suggestions of what I thought it could be and what we could try but tried to err on the side of caution and try not to tell them how to do their job. He's finally seen him going well now and did agree that he was quite stiff and short behind before.

Another thing to consider if you can't really find the source of the problem is memory pain maybe from the ulcers? The first signs my cob showed of something being wrong was putting his ears back, shaking his head and swishing his tail when asked to trot or canter. Although I am fairly sure he is no longer in pain, he still looks annoyed (for lack of a better word) when I ask him to trot and the vet told me to ignore this as he will be expecting it hurt so his automatic reaction is to be grumpy. I think this definitely is the case now as as soon as he takes one stride of trot his ears are forward and he happily goes along, as soon as i apply leg or wave the whip on the lunge the ears go back for a stride and then forward again, almost like a habit.

My vet suggested that I either continue working Toby until he got better or went lame or send him for a scan and flexions, I had the insurance so chose the latter but if the money isn't there then you could potentially try carrying on with her to rule out memory pain, though if she has been clear since September that is quite a long time. I do completely feel your pain, especially when no lameness is present, feels like it could be absolutely anything!

I thought it was remembered pain but not any more - I've given her periods off etc, ridden indifferent places, got someone else to ride and never really different. It feels like she wants to trot but can't. I'll do the pssm test and maybe go for the hock injections- I'm told they can be better quickly if that's the issue.

 

[Casey76]

She does sound quite typical for PSSM1. It is often late onset, especially with new or increased workload.

I'd take her off the TB feed, tbh. Some PSSM1 horses react badly to linseed, even though it is theoretically a very good source of fibre and omega 3 oils; however the general idea of the diet is sound. Keep a total of <10% NSC (starch and sugar combined), with a good vitamin and mineral balancer. Supplement extra vitamin E (upto 10,000 IU per day, natural if possible, but synthetic is OK, though you would need to feed double the amount due to differences in absorption and availability. You can also add ALCAR (acetyl-L-carnitine), 1g per 100kg bodyweight. If you supplement with ALCAR you don't usually need a high fat diet, actually you don't really need a high fat diet unless your horse is getting insufficient energy from forage; it is just an alternative energy source than carbohydrates, which PSSM1 horses don't metabolise correctly.

Avoid supplements which affect insulin regulation (chromium, cinnamon, ginger)

You can check to see how hard the HQ muscles are - be aware that the surface muscles may feel OK, but the deeper muscles could still be very solid. Does she have a good panniculus refex (does she tuck her bottom under if you scratch down the hamstrings?)

 

[emfen1305]

I thought it was remembered pain but not any more - I've given her periods off etc, ridden indifferent places, got someone else to ride and never really different. It feels like she wants to trot but can't. I'll do the pssm test and maybe go for the hock injections- I'm told they can be better quickly if that's the issue.

Let us know how you get on, PSSM test was the next step for my boy and I am still considering it!

 

[Ceriann]

At least you can see a difference, sometimes it's difficult to tell whether they are grumpy by nature or grumpy for a reason! I would keep pushing your vet, I did have to push mine quite a bit, to the point where I felt like I was badgering them but it did mean that he kept coming out regularly and could see him deteriorating. I did make suggestions of what I thought it could be and what we could try but tried to err on the side of caution and try not to tell them how to do their job. He's finally seen him going well now and did agree that he was quite stiff and short behind before.

Another thing to consider if you can't really find the source of the problem is memory pain maybe from the ulcers? The first signs my cob showed of something being wrong was putting his ears back, shaking his head and swishing his tail when asked to trot or canter. Although I am fairly sure he is no longer in pain, he still looks annoyed (for lack of a better word) when I ask him to trot and the vet told me to ignore this as he will be expecting it hurt so his automatic reaction is to be grumpy. I think this definitely is the case now as as soon as he takes one stride of trot his ears are forward and he happily goes along, as soon as i apply leg or wave the whip on the lunge the ears go back for a stride and then forward again, almost like a habit.

My vet suggested that I either continue working Toby until he got better or went lame or send him for a scan and flexions, I had the insurance so chose the latter but if the money isn't there then you could potentially try carrying on with her to rule out memory pain, though if she has been clear since September that is quite a long time. I do completely feel your pain, especially when no lameness is present, feels like it could be absolutely anything!

She does sound quite typical for PSSM1. It is often late onset, especially with new or increased workload.

I'd take her off the TB feed, tbh. Some PSSM1 horses react badly to linseed, even though it is theoretically a very good source of fibre and omega 3 oils; however the general idea of the diet is sound. Keep a total of <10% NSC (starch and sugar combined), with a good vitamin and mineral balancer. Supplement extra vitamin E (upto 10,000 IU per day, natural if possible, but synthetic is OK, though you would need to feed double the amount due to differences in absorption and availability. You can also add ALCAR (acetyl-L-carnitine), 1g per 100kg bodyweight. If you supplement with ALCAR you don't usually need a high fat diet, actually you don't really need a high fat diet unless your horse is getting insufficient energy from forage; it is just an alternative energy source than carbohydrates, which PSSM1 horses don't metabolise correctly.

Avoid supplements which affect insulin regulation (chromium, cinnamon, ginger)

You can check to see how hard the HQ muscles are - be aware that the surface muscles may feel OK, but the deeper muscles could still be very solid. Does she have a good panniculus refex (does she tuck her bottom under if you scratch down the hamstrings?)

Thank you - I've started doing some research into this and will definitely test her. She does exhibit some other symptoms now I've looked at type 1 properly - she sometimes paws the floor ridden and always rolls after being ridden. I've looked at this before but discounted it as she looks well, no obvious muscle weakness and her muscles are soft (though hadn't appreciated you had to get into deeper muscle to test this). I will take the TB chaff out of her feed - I mix it with a basic natural hay/straw chaff and will look into the supplements. The info is appreciated.

If she is type 1 and exhibiting these problems ridden now (it's every time I ride not occasional) realistically is there hope for a ridden future? Bottom line is I want her to be ok so don't want to keep pushing the issue if it's always going to be a problem. It's no fun for either of us!

 

[SEL]

If it is PSSM then there are various quoted statistics that state around 75% of horses have a good prognosis with the right diet and exercise regime. I have absolutely no idea where those stats come from and suspect it is based on the quarterhorse population in the US.

If your horse does carry the gene then you probably need to give it a year to see whether the changes make a difference, although there are many people who see improvements very quickly. I suspect my mare has something else underlying which is why she struggles - even on a dry lot and with soaked hay her bum muscles were solid and that's likely to be why her hocks are knackered.

 

[FfionWinnie]

Thank you - I'll get the test done. She gets thunderbrooks herbal chaff, soaked thunderbrooks hay cobs and their daily essentials balancer. Otherwise grass and hay. Her first symptom was to refuse to move under saddle - literally couldn't get a step (circa august last year) - everything checked and no different (v grumpy to have leg on). Post clear scope she will now walk mainly happily but I've managed one trot only. We did an inflacsm trial and when I voiced trot I felt her engage but then react, head shake and v grumpy. Pushed more she bucked and reared. Before first symptom she was v forward and a happy, ears forward little mare! I kept a diary but now I stopped riding about a month ago as I'm conscious of her ulcers and stressing her out.

Ok the balancer contains yeasacc which can contain chromium which is contraindicated in type 1.

Worst case their hay cobs are 12% NSC which is too high in my opinion.

Again the chaff is worst case 13% NSC so there could be issues with this diet if she does have PSSM.

Refusing to move under saddle - have you had any blood taken. Could she have tied up? When my type 1 tied up you would hardly have known anything was wrong with her but it was catastrophic internally.

Just some things to consider.

 

[Achinghips]

One of my boys had ulcers which was eventually traced to pain form hock arthritis. Treated ulcers with ranitidine but they kept coming back. Once I had steroids injected and got him in some low level danillon for winter, the ulcers went away.

 

[Ceriann]

Ok the balancer contains yeasacc which can contain chromium which is contraindicated in type 1.

Worst case their hay cobs are 12% NSC which is too high in my opinion.

Again the chaff is worst case 13% NSC so there could be issues with this diet if she does have PSSM.

Refusing to move under saddle - have you had any blood taken. Could she have tied up? When my type 1 tied up you would hardly have known anything was wrong with her but it was catastrophic internally.

Just some things to consider.

Thanks - I will change the diet, its ulcer focussed but I'm pretty sure they've not returned (she was v quiet and a little depressed when she had them). I haven't had bloods done - I will speak to my vet Monday and get them out to walk through options. They've gone directly to hocks and I'm just not convinced. I've kept notes of all of this and shared them with my vet but they've not suggested this at all. When you say catastrophic what do you mean? I don't think she's tied up but given what you said about yours I can't be sure. I had a Physio and chiro out to her and neither mentioned hard muscles or any specific tightness. If it is this I guess my idea of giving her time out in the field (I'm currently doing this for the third time since ulcers) doesn't actually help?

 

[Ceriann]

One of my boys had ulcers which was eventually traced to pain form hock arthritis. Treated ulcers with ranitidine but they kept coming back. Once I had steroids injected and got him in some low level danillon for winter, the ulcers went away.

Glad you got a resolution with yours - it seems it's often a hard journey so good to hear a positive.

 

[FfionWinnie]

Thanks - I will change the diet, its ulcer focussed but I'm pretty sure they've not returned (she was v quiet and a little depressed when she had them). I haven't had bloods done - I will speak to my vet Monday and get them out to walk through options. They've gone directly to hocks and I'm just not convinced. I've kept notes of all of this and shared them with my vet but they've not suggested this at all. When you say catastrophic what do you mean? I don't think she's tied up but given what you said about yours I can't be sure. I had a Physio and chiro out to her and neither mentioned hard muscles or any specific tightness. If it is this I guess my idea of giving her time out in the field (I'm currently doing this for the third time since ulcers) doesn't actually help?

Well normal levels are in the low hundreds, after she tied up they were off the scale. The scale goes up to 100,000. So she was in danger of death internally but outwardly she was a bit grumpy, quiet and not tracking up. In over 2 years she's never had hard muscles, only tied up once when I was feeding her and keeping her in a way that encouraged it, if she hadn't tied up I probably would never have got to the bottom of why she isn't "normal".

I had not seen a horse tie up before and I imagined there would be a lot more too it.

 

[Ceriann]

I've looked at videos of horses with Pssm and they look so much like her - do you feed supplements to yours now? There are some great suggestions already on here - I've taken her off her TB feed (she's just on a very basic chaff now) but what do you feed yours generally? I don't need to feed mine - I do it to carry supplements in the main.
I'm calling vet tomorrow and telling them I need to test her.

How is yours now? Has the management worked? Thank you for all the help.

 

[FfionWinnie]

Safe feeds I have used are alfalfa chaff, alfalfa pellets, unmolassed sugar beet, coolstance copra. Most supplements will contain things which can cause issues. The only mineral supplement I feed is rockies chelated licks as they aren't molassed. You have to look at everything that goes in their mouth. Much cheaper to do a DNA test through animal genetics without involving the vet. You just pull the hair out the tail and send it to them. It's £30. That only tests for type 1. Type 2 and other varients are more expensive to test for and less straight forward. Personally I would test for type 1 and change the diet as a starting point. Keep an exercise and feed diary too.

Mine has been turned away all winter and is going on loan in April as I've had to accept for various reasons she is not going to be up to the level of work I want to do with her.

If you search on here you will see the protocol I suggest for supplements. None of that will harm her if it's not PSSM.

 

[SEL]

Both mine are on kwik beet, honeychop & copra in varying quantities (one is a very good doer). The fat one pretty much only has hard feeds to hide supplements and drugs - she's been symptomatic on & off all winter.

Natural vitamin E and magnesium are supplements both of them get together with salt.

 

[Ceriann]

Thank you - she loves unmolassed beet and I'd read about cool stance copra. I was weaning off feeds anyway as I'm not feeding ulcer related supplements. I'm not exercising her at all at the minute - ridden she's got worse not better so I'll test and go from there. I'm pretty much at the point where I won't push it further as honestly I've had years of struggling to ride (she follows an unpredictable mare!) and just want something easy (if that's possible!). I can't face another summer of no riding! I'm very lucky they both live out happily and I have lots of grazing so can collect pets - though another horse would have to earn its keep. I still want the right diagnosis for this mare though whatever happens so I can manage her properly - she's a lovely little thing and didn't get the best start so deserves some attention.

 

[Ceriann]

Test is done and waiting for results. I've stripped back her feed completely so now gets a natural chaff only - I haven't bought vit e yet - I will wait for results. She's been turned away with my other for 5 weeks now and seems v happy and content. No nasty saddle and riding to bother her.

 

[Ceriann]

Pssm test came back clear, which is a huge relief! She's none the worse for the diet changes and looks really well so back to the drawing board on ridden issues!