Would you rescope? Ulcers and not great scope experience

Love

Love

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Sorry for another ulcer post from me but just would like some opinions on this

Scoped for ulcers before Christmas and found both squamous (grade 1) and glandular. Nothing too horrendous, to the point I worried it might be a red herring and not severe enough to be causing the symptoms we had, but treatment has worked wonders and I feel like I’ve got my old boy back. I went for the once weekly omeprazole injections rather than the daily syringe treatment and he also is on sucralfate and Pectigus.

My question is regarding rescoping. Not knowing what to expect the first time I did some research on here and was put at ease reading quite a few stories about how the fasting and scoping were straight forward and far less stressful than first feared. Sadly that wasn’t the case for us. The morning of the scope he was absolutely beside himself with stress, trying to come over the door, screaming, doing the wall of death round the stable. He nearly flattened my friend who went in to take his water away 1 hour before the scope - me and my husband had deliberately stayed out of sight for fear of stressing him more and it’s a good job we did because he went up another notch when he finally saw us as the vets arrived. This was all first thing in the morning too. The scope itself was not straightforward (although we did finally get in and get what we needed) and refeeding him was equally pretty stressful because as soon as the sedation wore off he was back up to maximum stress, wanting more food than his timed rations allowed but wouldn’t poo so we had the worry of impaction on top. Luckily it didn’t come to that. He stayed stressed for a good few days afterwards. This is all behaviour that is usually unheard of from him.

I did ask my vet if we *had* to rescope and I do completely appreciate her response that it’s best practise to (because he might be fine after 4 weeks of omeprazole or he might need 6 weeks like some do). But ultimately she said it’s up to me if I want to make the call not to rescope. The whole thing really was just very unpleasant last time and I feel horrendous at the thought of putting him through it again.

So my question is, do you think we need to rescope given the huge improvement I’ve seen? Or do I just grin and bear it and rescope him. My vets asked for a 16hour starve whereas everything I read said 12 is the standard. Could I ask to maybe shorten it to 12? This absolutely isn’t a cost saving exercise either - I’d rather just do the 2 extra weeks of omeprazole jabs without rescoping if it was an option (might it be? I’ve not asked the question yet but is this a thing)?

Thank you all x
 
Blimey that does sound tough, poor fella. Makes me grateful that mine have all been really good. Were other horses being fed/hayed/turned out around him? I made sure that I gave all my others enough hay the night before to last u til after mine had been scoped and I didn’t feed or turn out anyone until it was done. I also put the other horses hay on it of view to mine around the corner (I made a pen for my one to be scoped on the hard standing with a field shelter and outside space, and then 11 hours before scope scheduled time I removed hay and put a muzzle on in case they wanted to chew wood. I didn’t remove water at any point.)

In your situation though, I wouldn’t rescope given the great improvements you have seen (mine continued to be tricky even after age scoped clear due to pain memory, so I needed scope for certainty). But I would probably ask for a few weeks of the paste and sucralfate so I could taper off rather than go cold turkey.

The other thing I’d say is, some vets dismiss grade 1 as unlikely to cause an issue and say loads of horses probably have them. To which I say loads of horses have low grade anxiety, ridden issues, shut down, poor movement etc that people dismiss as ‘oh they are always like that’. My heart horse BBP only had grade 1 near pylorus, that was it, and his behaviour was extreme anxiety wise. So because my vets always bring loads of vet students with them, I always pull them up if they try to be dismissive of low grade ulceration, especially pyloric.
 
My vet seems to have a very different attitude to ulcers than most. It’s made sense to me up till now so I’ll share it as one perspective. She says most horses grow and heal ulcers repeatedly through their lives and random scoping would show plenty of asymptomatic horses with ulcers. Over-scoping is common and there are lots of horses being unnecessarily stressed and then treated. Ulcers are never a standalone problem - they are a secondary issue related to lifestyle or pain/injury elsewhere. They can develop very rapidly so the scoping itself can trigger them.

So her approach to a horse that looks ulcery: assume ulcers and change lifestyle and diet.

If already fed and managed in ulcer-friendly ways, be suspicious of underlying pain/ injury and assess for that. (This is what we did with Lottie).

If injury is addressed but ulcer symptoms remain, scope and treat. Only rescope if clinically necessary. Not if horse seems fine.

In your case I’d want to understand why ulcers developed in the first place and make sure the conditions that led to them were no longer an issue. And I’d stop treatment and definitely would not rescope.
 
i wouldn’t rescope in your situation, but i would ask to do the 2 extra injections “just in case”. my vets gave diva another 6 when all the symptoms came back close to a year later without scoping again, and especially with what you’ve dealt with i imagine they’d completely understand you wanting to take the precautions!

is it going through insurance? that’s the only thing i can think of that might be difficult and it’ll be up to the vets to argue the case for you - my insurance tried to argue it because the claim was still open from the year before.
 
Ample Prosecco said:
My vet seems to have a very different attitude to ulcers than most. It’s made sense to me up till now so I’ll share it as one perspective. She says most horses grow and heal ulcers repeatedly through their lives and random scoping would show plenty of asymptomatic horses with ulcers. Over-scoping is common and there are lots of horses being unnecessarily stressed and then treated. Ulcers are never a standalone problem - they are a secondary issue related to lifestyle or pain/injury elsewhere. They can develop very rapidly so the scoping itself can trigger them.

So her approach to a horse that looks ulcery: assume ulcers and change lifestyle and diet.

If already fed and managed in ulcer-friendly ways, be suspicious of underlying pain/ injury and assess for that. (This is what we did with Lottie).

If injury is addressed but ulcer symptoms remain, scope and treat. Only rescope if clinically necessary. Not if horse seems fine.

In your case I’d want to understand why ulcers developed in the first place and make sure the conditions that led to them were no longer an issue. And I’d stop treatment and definitely would not rescope.
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my vet said to me that almost every horse will have some level of ulcers at some point & it’s a management game!
 
I wouldn't rescope but I would buy 28 days of omeprazole granules from Abler online, cost about £150 and you could do the taper dose so you're not going from being fully covered to nothing in his system overnight.. worth discussing with the vet. Omeprazole is a very low level medication in terms of side effects/overdosing/using if I understand correctly so I don't think your vet is likely to be adverse to suggestions of treating without rescoping to err on the side of caution
 
I didn't rescope ours after his treatment for this very reason, and vet agreed. His behaviour had returned to normal and has been ever since, so am glad I didn't put him through the stress of starvation again (ours was 16 hours too).
 
See how it goes and if symptoms return scope, could you overnight at the vets for the starving?

Both of my vets have advised 12 hours without food and 6 without water. I also muzzle her with the hole taped over. But my mare is super chill.
 
Thank you all so much for your replies. As was probably evident from my post I was firmly more in the don’t rescope camp but was just worried I might have been letting my heart rule my head. Will definitely discuss the option of just 2 extra weeks of jabs without a scope. It is going through insurance so will have a chat about this too.

Ample Prosecco said:
In your case I’d want to understand why ulcers developed in the first place and make sure the conditions that led to them were no longer an issue. And I’d stop treatment and definitely would not rescope.
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We have fairly recently relocated from Worcester to Yorkshire and the yard move has been quite stressful for him - he was on his last yard for 8 years and was very settled there. In this time we have also repeat treated his hocks for arthritis (first found in 2023). I think these 2 things together were sadly the perfect storm for triggering the ulcers
 
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