When to consider PTS?

[{123756}]

Im sorry if this is in the wrong section, theres a lot of vet talk and medical problems driving this post. Ive posted about this before, i'm really really struggling to call it a day with my mare and i'm wondering what others would be doing in my position. She's 6 in June, but has had an exhausting (both mentally, and financially) couple of years. Sorry this is going to be a long one, for context;

Since August 2019, she has been treated for grade 4 open and bleeding ulcers that took 3/4 months to clear up. Started work in December 2019 (walking hack 2/3 times a week for max 40 mins) for 6 weeks before showing bad ulcer signs again. SI treated and ulcers treated Jan 2020. Still had a painful back after follow up in Feb 2020, had 8 joints in the back injected, only some of which were possibly arthritic. Rehabbed with lots of long reining and in hand over poles for around 8-10 weeks. Got back on in May, lots of hacking slow, hill work and introduced to slight school work at walk and trot. Didn't get to canter work, managed to hack to have a lesson once a week for approx 3 weeks before she showed signs of ulcers again but before this was going beautifully. This was in September, stopped all work, tried to treat with abler (she had done £7K in ulcer vet bills, only £5K covered by insurance) and has been on Sucralfate as a maintenance ever since. Got her a new saddle, chiro, dentist... Got on in November, still bad. Carried on as i was, got back on in December, much better for about a week then bad again. Coming up short in front, went to vets in Feb this year and sent to RVC for suspected neuro issues in March. Came clear for neurological issues, however RVC vet said very strange gait in front. Said lameness coming from further up, wanted to do bone scans, CT scans etc of shoulders and neck. I cant afford to keep taking her to the vets, its costing a few hundred in transport alone every few months.

Heres my problem, RVC vet said she shouldn't be in any pain from the lameness she's experiencing. However, she's become quite territorial over the years. She does not like horses in her personal space and will actively lunge/try to reach and bite them. She's much better with people, but she's awful to rug and if people walk to close to her stable she will pull faces at them. She particularly hates children passing her stable for some reason. This doesn't appear to be an issue in the field, other than bringing in/turning out.

Ive had her on inflacam for a couple of weeks to see if she improves, and although i *think* she's moving better (I cant really tell at this point if she's lame or i'm looking for lameness), her aggression seems to be getting worse. RVC vet said realistically, how much money do you want to spend on this because the lameness isn't likely be causing pain, the only thing that should be happening is some dodgy dressage scores (I bloody wish i could ride this mare, she's absolutely beautiful). Clinic vet who has been with me from the start says retirement or PTS.

She's very hard work, and even if i did manage to get her back into work she's very high maintenance. The type to shiver in rain on a summers day, waits at the gate to come in, loves her stable. But when it actually comes down to it, i get so upset and feel so guilty because if she's possibly not in pain, and just a grumpy chestnut mare, can i really justify PTS? She's so so sweet with people when they give her attention, absolutely loves a neck scratch, pesters you for more. She's incredibly gentle, and does absolutely anything you ask for. She was the easiest horse to back, even in pain did everything i asked of her and tried so so hard, at 4/5 years old, i trusted her entirely. It's causing me huge amounts of emotional turmoil, and it's a whole lot of 'what if i do this/what if i do that'. Ive had this mare for 5 years since she was a yearling, and she's been with me through my entire adult life as i bought her with my first full time wage. The whole situation is giving me huge anxiety and i feel so so incredibly stressed out, wondering if i should be keeping her as a companion as I don't care if she cant be worked for the rest of her life, but i'm more concerned about her welfare and my being able to afford all this on going treatments/supplements or her issues deteriorating in the future.

 

[SEL]

You have pretty much described the horse I knew who was finally diagnosed with wobblers. I doubt he'd pass a neuro test now, but he did at one point and the rider was told to crack on - it was behavioral - and with a tough trainer on board the horse performed 'ok' but was far from happy. His stable was barricaded off because of his habit of launching at anyone who came near.

In the end he was at hospital for something totally unrelated and they x-rayed his neck and found the issue.

I have a mare who is now 11 and has barely been in work for years due to a succession of issues so I understand your position. I can afford to keep her and she isn't in pain - just struggles with her litany of issues under saddle - so she continues to keep me entertained and occasionally obliges with a light hack. It would break my heart to PTS but if she deteriorates or I couldn't afford to keep her then I would bite the bullet. Its never an easy decision but if you aren't in the position to keep her as a field pet - and you need to ask yourself if she'd be happy retired so young - then it is an option and it sounds like your vet would be on board.

Perhaps give yourself some breathing space by turning her away over summer and seeing how she goes and how you feel?

 

[meleeka]

Could you turn her away for the summer somewhere so she can just relax and then reassess in the Autumn? It might make things clearer rather than going round in circles as you currently are. I don’t see much point in just continually treating the symptom when you haven’t yet got to the bottom of the cause yet. Has she been on the same yard all the time you’ve owned her or has any anything changed?

She’s sounds very much like my elderly Chestnut mare who lives a nice life with her chosen few friends, but would probably ended up with ulcers too if I kept her on a yard.

 

[Spirit2021]

I wouldn’t put to sleep for that you don’t know the cause of the symptoms. I agree with others Turn away for the summer .

 

[Roasted Chestnuts]

She sounds like A very unhappy horse and if she were mine I don’t think I’d be keeping her going.

When m boy list his spark and became very high maintenance with his issues I made the decision. He was very old, older than we initially though but the situation is the same. He was unhappy and had issues and it was causing me huge amounts of emotional turmoil. Afterwards the weight that lifted was immense and a huge relief for me. I wasn’t constantly second guessing his pain, his discomfort, his issues. I wasn’t having to micro manage him and work my life around his issues.

She may be young but if you look at it the other way you could have 15-20yrs of worry with her and her issues. Can you handle that?

 

[Errin Paddywack]

Could be partly PSSM related.

 

[MiJodsR2BlinkinTite]

So very sorry; I really do feel for anyone in this position who just doesn't know what to do for the best.

I have a mare who at 10yo when she should be in her prime, is a headshaker - and a field ornament - and I know that "if and when" she gets any worse i.e. exhibiting pain and/or behavioural issues, I'll have to be looking at the same decision as yourself OP. Her only function at the moment is as a companion.

This mare of yours is costing (rather HAS cost) you a fortune, and methinks you are going to throw an awful lot more of good money after bad in this situation in your search for a diagnosis let alone a cure; you say she is exhibiting occasional behavioural issues and from what you say, she is needing to be handled very carefully indeed, and possibly, just possibly, her "grumpiness" is due to pain? My girl is the same, when she's having a bad day she'll take pieces out of the rest of the herd and is very bullish to handle.

I wish I knew what to advise you; yes you are considering the PTS option, and sadly, unless you have a limitless pot of gold and there's someone somewhere can sh!t a miracle for you, I sadly feel this is the decision you will end up having to make.

Wish I knew WHY it always has to happen to the decent horses........ just doesn't seem fair

 

[IrishMilo]

I'm really sorry you're faced with making such a shit decision. It's everything: the not knowing, the emotional, the financial, the getting your hopes up and then going back to Square One again...

Mine was 6 too, he had arthritis but I'm pretty sure he had other things going on physically, and something not right in his head as well. He would be fine one minute and then turn himself inside out the next. He didn't like being out unless it was sunny/warm, but had to be on restricted grazing or he blew up/was lami prone. He was generally happy in his stable but had a tendency to jump out if worked up, so that was never going to be a long term option for a horse with arthritis, never mind one with 20 odd years ahead of him.

I treated him as PSSM positive, he had ulcer treatments, shockwave, steroids into his SI, Danilon, time off, physio, new saddle, retirement livery (had to go get him as he was making a nuisance of himself!) - I even tried riding tackless for a stint to see if that would be a solution. Nothing made him right. In the end I felt like I had very few options left as he wasn't the happy horse I bought two years prior.

No one here would judge you for PTS. My PMs are open if you need a chat/support.

 

[webble]

It sounds like you have been through a lot without finding a solution.

Will she be happy and comfortable if you do turn away for a bit or do you think that will just kick the problem down the road?

You have to be fair to yourself emotionally and financially too, how much more can you take?

You have my sympathy, I had to pts my boy last month at a young age and it's never easy

 

[AandK]

If you don't have endless pockets to fund every diagnostic possible (and it sounds like you have tried hard so far!) and the mare won't be the sort to settle into retirement, then I don't see any other option then to PTS. She doesn't sound like a happy, content person, which is usually a big sign something is not right. I don't buy the "just a chestnut mare thing" btw, it's a really tough decision, I really feel for you OP.

 

[{123756}]

Thank you all for your kind words, I’m finding the situation a bit too much to deal with, to the point I thought about taking some leave from work.
I can imagine she would test positive for PSSM, and this is something I would like to test for although I’m not sure it would actually change the situation much and I don’t have the spare £300 just this minute while I’m trying to pay off the other £1000 I’m still owing for various horse related things.
I don’t think moving to retirement would be beneficial, solely because I tried to move her last year and she completely lost her mind and would stand shaking. Where we are she’s in a small 4 horse herd (including her and my other mare) and will be living out once it’s a bit warmer.
I have no idea what to do, I think logically I should be putting her to sleep after a few months in the sun. But everytime I go to do it I feel so incredibly guilty! And I can’t help but think what if for the rest of my life.

 

[ycbm]

If you don't have endless pockets to fund every diagnostic possible (and it sounds like you have tried hard so far!) and the mare won't be the sort to settle into retirement, then I don't see any other option then to PTS. She doesn't sound like a happy, content person, which is usually a big sign something is not right. I don't buy the "just a chestnut mare thing" btw, it's a really tough decision, I really feel for you OP.

Saves me writing it.
.

 

[PurBee]

If you can afford to just turn her away at current yard for summer/autumn living out - reassess mid autumn how she’s doing - try some gentle work - if she quickly declines again, and you dont have a pot of gold, then i’d PTS too.

I’d only do this if she hasn’t yet had time off from the various treatments and re-working schedule. Yet, if last year she was mostly out doing nothing and still behaviourally challenging, symptomatic and not workable - i’d pts now.

That’s the head decision due to finances not being an open check book. Also knowing the issues are severe enough to not be able to sell/rehome/share etc, or even give away as companion mare. It’s that part really that would help me pts without guilt - knowing i’d maxed myself out on insurance and private funds, got no-where, tried giving her time off, got nowhere - and im left with a miserable horse, that i know wouldnt fare better in a different home, if one was offered.
So i’d see pts in that situation as a kindness.

It’s heart-breaking, because we hope for a different story to have been lived. I feel for you so much. You’ve tried so hard. Really give yourself some slack, as the horse, if she could speak, wouldnt want you to be in so much anguish over her. As you said, she was a dream to train and gives what she can - so have you. We can never do more than try our hardest, and you’ve certainly travelled that path together with her.

 

[lucy_108]

Firstly, you are in a really rubbish situation and for that I'm sorry. At the end of the day, you know your horse - you know what she might cope with and what she absolutely will not cope with.
A lot of people turn them away hoping it will solve everything - I have found, from personal experience, that it rarely does. You also have to ask yourself if you do turn her away and she is in pain, are you just prolonging her suffering in a last ditch attempt?
It is impossible for you to tick every box. Unless you put her in an MRI scanner and have exploratory surgery, you may never get a firm answer and that is the worst feeling imaginable.
I had a horse with a long list of problems, none of them ''bad enough'' on their own to warrant putting to sleep, however, when you stepped back and looked at everything - each condition, his temperament, my bank balance, his happiness, it quickly became clear that there were very few options left. I tried retiring him. He lasted 6 months and it was clear he was not a happy horse, even just chilling in the field/stable with all the love in the world so I made that call.
So many people will say ''if you had unlimited funds...'' - yes that is an aspect, but no amount of money in the world will fix a horse who can't be fixed.
Ultimately, this is your horse and your decision. People will always have differing views and opinions, what matters is yours. If you decide to PTS you need to be sure that decision isn't going to haunt you with ''what ifs'' for the rest of your days, I'm not saying it's the wrong decision but if you have doubts, then maybe it's worth ticking a few more boxes before making that decision. With horses like this, you will forever hope that the next thing will solve everything - that it will be the fix you've been waiting for...sadly it never usually works that way.
Make sure you step back, look at the whole situation and remember, whatever you decide, she won't know any different. She's lucky to have you.
Sending hugs x

 

[w1bbler]

I've been there, so know how you feel.
For me I sent mine to a rehab yard (run by a chiropractor) for a month to see if they came up with any suggestions to investigate.
After a couple of weeks my stress levels were so much better that I actually was able to think clearly & unemotional. Pretty much made the decision to PTS as I felt like a huge weight had been taken from my life. I realised what an emotional drain the journey had been.
As it happens with yards help my old vet was sacked, new vet employed & we are hopefully at the route of her issues.
Not saying every horse can be sorted with this option. What it did give was fresh eyes on the issues & most importantly a breathing space for me. If nothing had been found, then I think the PTS option would have been easier.

 

[TPO]

No one can make the call for you but youd have support here should you choose pts.

She doesnt even sound like being turned away would be a pleasure for her sadly.

I had a sweet mare who went territorial and pulled a lot of ugly faces out of the blue. It turned out that she had a cyst in the upper part of her nasal passage. It had been slow growing but vet diagnosis was that it was now creating pressure resulting in a sort of headache. I know how I feel with a low grade headache rumbling on. She was pts as she was 21 so I didn't want to put her through such invasive surgery and it was affecting her behaviour so must have been horrible for her.

So while one vet is saying that the lameness shouldn't be causing her pain there might be something that is. That could also explain the development of the ulcers.

You have gone above and beyond for your horse and turned over as many stones as you can.

I've posted about it before but I had 6yrs of veterinary intervention for my last TB. He never "needed" pts but it was just a constant stream of one thing after another. The vet was out at least weekly for 13wks on the trot at one point and insurance ran out by then.

I managed to get him ok enough to be a pasture ornament (not that he had been much more than that at any point!) before he was pts at 16. He was an exracer who had been started at 16 or 18mths according to his groom, broke his pelvis aged two, raced again, was sold as a stallion, was cut and raced again before ending up with me via someone who bought him out of racing and left him in a field with a couple of others and saw them weekly if that.

My mums horse needed put down and I decided to let me horse go then too. He hadnt come out of winter as well as normal and age/racing life started to catch up with him. He went slightly short and as I could feel a slight heat in a knee I'd assume arthritis.

Getting to my point...while I was really upset making the call and losing him I felt an unexpected relief and weight lifted when he was gone. I hadnt appreciated the daily stress and worry that I'd been carrying about for all of those years. Dont underestimate the toll that all of this will be taking on you too.

I'm glad that I tried for my boy and dont regret it (much, it was a bad day when I added up the bills) but making the call was the right thing for both of us (mainly him because I would have carried on of it was in his best interests).

You dont have to make any decisions right now and you also have the support of the vet who has been with you since the start.

Go easy on yourself

 

[Ample Prosecco]

Maybe it would help if you break the decision down into different stages:

I know from experience with several horses hat diagnostics can run into thousands and there is always some other possibility to try or avenue to explore. And at some point you have to draw the line and say you will not spend more on investigations and let go of the need for an answer. I never found an answer on 2/3 horses despite bone scan AND MRI not to mention any numner of other things.

Once you have said no more to the merry go round of investgations the question is what next: turn away and re-assess later, retire, PTS? I have 2 retired. Both happy living out and both without management needs and both happy/contended. So that's easy. But our pony was miserable and so she was PTS instead. Horrible decision to make but the right one for both of us. Yours sadly does not sound happy WITH lots of management. And she certainly does not sound like she could cope with being turned away. So for me that decision would flow from the 'no more spending money on this' decision. And I would PTS I think. Thouigh withiout the horse in front of me it's hard to know.

Incidentally the pony had good days when she was amazing. But few and far between with lots of pain and unhappiness and a gradually deteriorating picture overall. Can you take a step back and see which way this is going in general?

 

[rabatsa]

The horse sounds unhappy. The ulcers are most likely a symptom due to discomfort elsewhere. The mare sounds as if she is struggling to manage, especially when she has to cope with an increase in stress/work.

There are worse things than pts, for some living with a background pain is worse.

 

[Melody Grey]

I had a really similar situation with my last horse- an OTTB who had undergone full KS surgery and several rounds of ulcers that we just couldn’t get to the bottom of. Money ran out and I was out of options, she was depressed and I PTS. She was 7 and outwardly looked amazing.

I still stand by that decision and would agree with others that there’s certainly no shame in PTS having been what you’ve been through and just not knowing what next.
My current horse has been through the mill too and knowing what I know now, in your situation if you’re confident the lameness issues aren’t the main problem, I’d be tempted to turn away and try:
- addressing hind gut balance- there are inexpensive ways of doing this (brewers yeast, yea sacc, aloe Vera juice, supplements). On reflection, I think ulcer drugs had ruined her gut balance.
- testing/ treating PSSM
If I had time again I’d have given these more of a go.

 

[fredflop]

I’d PTS. You may feel guilty before the event, but afterwards you will feel relief. As mean as that sounds but the stress and financial drain will end.

 

[Red-1]

IME, once an owner is considering PTS, it is the correct thing to do.

The horse does not sound happy. Sounds like the vets have no idea why. Sounds like you are at the end of what you have to give.

I always say, the owner is always correct. Even if the horse could be 'cured' the horse is yours and it is your decision.

If you decide to PTS, the good thing is, no one will ever be able to say that you were wrong, as no one has a crystal ball and the horse will be gone.

If you would like to try to treat the PSSM, then do that. But, if you think it is time to PTS, then do.

My heart horse, Jay, was PTS. He was only 12. He could have stayed retired here forever, for me. But, he wasn't happy. Wobbler, with associated ligament issues from moving 'wrong'. Because he looked in show condition and trotted 'sound' I had a struggle with the decision. I called Fiona Varian, a genius with horses, for her help to make the decision. Not to diagnose or treat, just to talk me through the decision. That helped. He was PTS the very next day. No regrets about the decision, just regrets that I couldn't salvage him.

The decision was hard, the day of PTS hard, but afterwards, along with the loss, and yes, I properly grieved for that horse, there was also a knowledge that it was the right decision. Can I be sure that no one else could have saved him? No, but he had been to the best vets, had a number of treatment options, had been semi retired for 18 months in light work and completely retired for 6 more. I had done everything that I, personally, could. That was good enough.