Ulcers rant

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RHGR

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Feeling hopeless and defeated. Pony has been rescoped again, glandular ulcers still there and some reddening on the squamous region again that wasn't there last time. Insurance money is very close to gone. Vet is a little stumped as she was confident we'd rescope and find nothing today. These vets don't seem hugely fond of the idea of misoprostal, said they've seen a few horses get worse and they aren't sure of the clinical significance of the glandular ulcers he has so worried it may make things worse and send us back to square one. There's discussion of possibly doing a lameness workup (with sensors) to rule out any mild lameness that may be causing pain. Suggested I get a Shetland to keep him company, that would be lovely but I don't have an extra £250 lying around every month for the livery for another one. He's on a livery yard but the only other horses that can share a field with him bully him. Yard owner keeps shifting our fields around so at the moment he doesn't even have a horse he can touch over the fence. He has then nearby that he can see easily, just can't physically touch. He gets adlib hay. He's not been in work besides some long reining in the past 2 weeks. He's on speedi beet and thunderbrooks healthy herbal. He gets essentially the science supplements gastrokind (I bought ingredients individually as half the cost of the ready made supplement). Vets are going to get back to me on Monday and discuss possible next steps. Couldn't help crying when I saw the ulcers on the screen this morning. For so many it seems to be a case of treat and they're fine. My last mare I had to put to sleep as after 2 years of trying we were getting nowhere and she was miserable. This guy seems happy enough in himself so don't know if we should just stop and just manage it best I can. I feel I can't do right for doing wrong, like there's no real answer. If I could just win the lottery and not have to stress about all the costs it would be fine. I'd sent him to the dick vet for a week to have everything done and check every inch of him, but I haven't won the lottery. I don't have endless money. I barely have enough as is! I want to curl up in a ball and cry. My pony doesn't deserve this, I just want him to be healthy and happy
 
I really feel for you, I’m in exactly the same position. I’m treating for the second time this year. Unlike yours she isn’t happy enough when she has them, she’s very aggressive and agitated and it isn’t fun at all for either of us.

My vets agreed for this month to prescribe me esomeprazole which I have managed to source for £120 for a months supply, which is a relief compared to £350 a week for them to come out and do omeprazole injections. So far across the two treatments and her accident with a gate, she has cost me about £8000 this year. And I feel I barely know her in the year that I have had her as these ulcers have flared since the moment I bought her (she tends to stop eating when unsettled). I can’t offer much advice, just support that you aren’t alone.

And to further my pity party, I think my other horse also needs referral to a vet hospital but his symptoms are so odd I can already feel the bills stacking up.
 
I was going to being up esomeprazole too. It can cost less and still be effective in some cases. I have found (by reading about it and in one of my own a few years back) that effective dosage seems to vary a bit though. I had mine on the "standard dose" at the time, but we didn't see progress until I tripled the dose. It was still a safe dose, but kind of made me wonder when some saw results with 3 tablets and some with 13.

Then again, as you're seeing, some just don't respond to standard protocol. Misoprostal does make a positive difference to many horses, and if what you're doing now isn't working, I don't quite understand the hesitation. Sure, he could get even worse (and this can happen with some medications in general) but it could help. You just don't know.

Is he on any other gut support?

I do think it's worthwhile to investigate pain, lameness, and stressors. You can treat the ulcers, it if the "source" is still present, you're not really going to get that far. Usually it's something else in the body that's not right, but can be from lifestyle too.

Is he less stressed with company? Are there other yards that might suit him better? Any suspicion of anything off in his body?
 
CanteringCarrot said:
I was going to being up esomeprazole too. It can cost less and still be effective in some cases. I have found (by reading about it and in one of my own a few years back) that effective dosage seems to vary a bit though. I had mine on the "standard dose" at the time, but we didn't see progress until I tripled the dose. It was still a safe dose, but kind of made me wonder when some saw results with 3 tablets and some with 13.
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The dose thing has confused me as well. My vet has prescribed 25 x 40mg tablets a day for mine, but elsewhere I see people saying they feed 3!
 
CanteringCarrot said:
I was going to being up esomeprazole too. It can cost less and still be effective in some cases. I have found (by reading about it and in one of my own a few years back) that effective dosage seems to vary a bit though. I had mine on the "standard dose" at the time, but we didn't see progress until I tripled the dose. It was still a safe dose, but kind of made me wonder when some saw results with 3 tablets and some with 13.

Then again, as you're seeing, some just don't respond to standard protocol. Misoprostal does make a positive difference to many horses, and if what you're doing now isn't working, I don't quite understand the hesitation. Sure, he could get even worse (and this can happen with some medications in general) but it could help. You just don't know.

Is he on any other gut support?

I do think it's worthwhile to investigate pain, lameness, and stressors. You can treat the ulcers, it if the "source" is still present, you're not really going to get that far. Usually it's something else in the body that's not right, but can be from lifestyle too.

Is he less stressed with company? Are there other yards that might suit him better? Any suspicion of anything off in his body?
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I do find it odd that the vets seem against trying misoprostal when there does seem to be many positive results with it. Will see what they're saying on Monday about it but I'm happy to try it if I can still get it cheap at the local pharmacy like I did with my last horse.
He's on protexin gut balancer which he's been on since I bought him.
We were thinking his ulcers are stress related (10 years very easy life then the year before I bought him he was shifted from pillar to post 5 times with bad seperation anxiety to the point he was deemed dangerous (I wouldn't say he was actually dangerous but it was novice owners)) but with ulcers not going away and the only real stressor he's had in that time being that he doesn't have a field companion I'm not sure if I'm convinced any more, hence the lameness workup idea.
No real suspicion of body issues, physio couldn't spot anything obvious, vets have seen him trotted up and said he looks sound, no pain responses from touching any area of his body. Goes up and down hills well, crosses over behind well, over tracks and backs up well and has never been in full work to be thrashed around causing excessive wear and tear. He did fall in a ditch a few months ago while crapping himself at cows when out on a hack and my mind keeps going back to that. No lameness no heat nothing, but what if he did hurt something then, hasn't shown it and its just manifested as ulcers.
He gets bad seperation anxiety as he was living in a field with one other companion for 10 years and neither of then ever went anywhere or did anything, then they were taken away and seperated and so since then it seems he's had bad seperation anxiety. He has been in a field with three other geldings at the start of the year and seemed fairly happy, but they were divided into two groups of two as the other two are elderly/TB so need lots of grass whereas my guy and the other are natives that get fat on air. Sadly the other guy is a bully and the minute any hay gets put out in the field my guy just gets chased away constantly and bitten and kicked at. This stresses him out so have been keeping him in a seperate paddock within the field so he still has company over the fence but can't be chased away from the hay and bullied
 
Sorry you're going through this! My gelding is currently being treated for squamous ulcers and I'm really hoping he'll scope clear in a couple of weeks. From what you've said, it may be a possibility that his ulcers may be stress related from not having a field companion, especially if he has seperation anxiety? Have you thought about moving him to another livery yard where he'll have a companion/be in a herd?
 
Very odd they won’t prescribe misoprostal, both my vets (Three Counties and B&W) prescribed it.

I would look at moving yards as the current set up doesn’t sound like it works for him. If you have time on the insurance I would look at moving and then treat again and see if that helps.
 
Sadly we can't move yards as nowhere else around here we could go. Only other places available do individual turnout where he would be left alone when others took theirs in just the same. We've got him in a different paddock now where he has company over fences and seems much happier. One of the other liveries is also happy for me to try her veteran pony in with him and see how that goes so will be trying that in the next week or so, then in the winter fields he should be able to be in with the other geldings again (summer fields not big enough to have them all together). Think my plan is to give him a sectioned off area for day time where I can supplement hay as he needs, then let him out in the main field with the other geldings overnight. Lucky here that other liveries are understanding (and love my pony because he's adorable) so they're all happy to take him in for me if they know taking theirs in will leave him out alone. This helps greatly, paired with being at an area of the yard where he can actually see others as for the last 4 months or so him and his bully companion were in a field that had no view of any other horses.

We now have a prescription for misoprostal 🥳 should be able to collect from boots today for the grand total of £153 for 4 weeks treatment, fingers crossed it does the trick! Though I have heard some people say their horses coliced badly with it. I didn't have said issues with my last mare but feeling a little on edge!
 
Someone advised me that if I tried misoprostol to start it gradually, not just whack them onto the full prescribed rate.
 
BBP2 said:
Someone advised me that if I tried misoprostol to start it gradually, not just whack them onto the full prescribed rate.
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Thank you, will go up in increments of 2 I think? Fingers crossed no issues.
Had our first proper hack attempt today on vets advice to start bringing back to work after long reining a couple weeks. Did a great little 1 mile loop we have that goes down the road, up between two crop fields on a grass track, then a dirt track back to yard. Bit sticky leaving the yard, but could be like that at times before problems arose. Down the road fine, then turned onto the grass strip and I had a bouncy, joggy, snatch pony to deal with. We did jogged sideways half way up the strip before settling to go straight but feeling like we may disappear at any minute. Back along the track he was okay, jolted forwards a couple times but there was farm machinery in the field two fields over which was surprisingly loud and clattering every now and then. Felt he was going to disappear again at one point but made it back alive! I'm now paranoid that treatment has made things worse, or I'm completely missing another issue, but the other part says he's been out of work for weeks, getting fed more (supplements and meds mean a couple feeds with speedi beet when he only ever had a handful of chaff before), weather has turned, he's been clipped and don't think his saddle is perfect (waiting for saddle fitter to get back to me) so there's many other reasons that could account for his behavior and its best to persevere for at least a week or two and see if we have improvements or not. This is so horribly stressful and I feel like whatever decisions I make they're going to be wrong 🤦‍♀️praying having a horse will be fun again soon
 
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