Advice on EOTRH in 26 year old

[JenePony]

Okay, so I’m at a loss for what to do. I have a 26 year old Dutch Warmblood who was recently diagnosed with EOTRH. He could not get his teeth done this year because he was in so much pain (despite having been on gabapentin and bute for five days prior to appointment). The vet suggested having his teeth pulled.

HOWEVER, aside from cost, there are a few issues I’m worried about. He is, of course, 26 years old. He also has a heart murmur which is Grade 2 (was Grade 4 when he was underweight a few years ago - no diagnosis on that beyond what the vet can hear so chances are it’s benign). Also, there is a good chance he has Cushings or is on the verge (I’ve spoken to the vet and he’s on a Cushings diet but I’m not able or willing to test and treat him at his age and his relative health).

Aside from the mentioned issues, he’s doing well. He’s eating just fine - we soak his food to make it easier for him. There’s not an arthritic bone in his body and he runs circles around the younger horses (and looks good doing it). But I’m concerned because the vet said he is probably in near constant, intense pain and I don’t want to extend that until it’s unbearable. I wish I could afford the $1500 without an issue, but both my husband and myself are in graduate school and won’t be in a financial position to do the surgery for at least a year, if that.

Now, the cost alone is extreme plus the stress of taking him to the office for the procedure, and given his other health issues I’m not certain what to do. If anyone has dealt with something similar or has any advice, I’d love to hear it. He was adopted two years ago as a babysitter for my TB and none of these issues were disclosed to me or I probably wouldn’t have agreed to take him on knowing my limited financial situation in regards to expensive procedures.

[jetsmom]

I’m sorry your guy has this and you are having to deal with it. To be honest I had to Google it ilto find out what it was.
If you were wanting a way to afford surgery I’d say Care credit, so you can make pmts or even a go fund me.
Otherwise given the cushings, heart murmur and teeth condition euth might not be inappropriate. Or maybe contact prior owner and see if they would be willing to contribute to cost of surgery.
Not an easy decision.

[Laurierace]

If you can not afford to make him comfortable you must put him down. It is inhumane to do nothing.

[beowulf]

[QUOTE=Laurierace;8588802]
If you can not afford to make him comfortable you must put him down. It is inhumane to do nothing.[/QUOTE]

Well, that depends on if he is in pain from EOTRH yet, or if the difficulty in floating/dentistry was from another issue since he was apparently a rescue case - lots of geriatrics have a hard time getting their teeth floated for reasons aside from tooth pain - neck pain, etc.

Extraction is not cheap, but they recover very well from it. I’m surprised by the quote - we were told almost double that for our geriatric EOTRH gelding…

OP, I feel for you. We have a similar issue with one of our geriatrics and the decisions/discussions have been very hard.

[JRG]

I am living this now. My horse is 20 and had 6 teeth pulled yesterday, originally it was supposed to be 3. When they got in there and had a closer look, the other three needed to go. They do it standing which is easier on them. When I saw him last night he was so bright and happily eating. I don’t know the cost of the procedure yet. I can tell you when teeth are moving it is extremely painful for the horse.
Have you ever had braces? Think of your mouth, how it felt. Now add puss draining and sores. Horses are stoic animals.

[Sister7]

My 24 year old TB had all of his incisors and lower canines extracted last spring due to EOTRH. He is doing fantastic, and I’m so glad that I got them taken care of. I was pretty freaked out about the extraction but it was really not that bad. I’d be happy to answer any questions you have about it.

Were you unable to have his teeth floated with sedation? If so, that is him telling you how much his teeth hurt. If he is in that kind of pain it’s not right to make him wait a year.

I agree with the PP who said 1500 sounds like a deal. Mine was about triple that price.

[SMF11]

A fragile 27 year old TB boarded at my farm had all of his front teeth extracted last fall. He was too skinny and this was the last adjustment to try and get some weight on him. He handled it just fine, and in fact has been able to put weight on over the winter. I believe his owner paid between $1,000 - $1500.

I guess I’m just writing to say that he not only survived, but has thrived after his extraction. If you look on my farm’s FB page, the horse in question is “Spatz”.

[beowulf]

[QUOTE=SMF11;8589158]
A fragile 27 year old TB boarded at my farm had all of his front teeth extracted last fall. He was too skinny and this was the last adjustment to try and get some weight on him. He handled it just fine, and in fact has been able to put weight on over the winter. I believe his owner paid between $1,000 - $1500.

I guess I’m just writing to say that he not only survived, but has thrived after his extraction. If you look on my farm’s FB page, the horse in question is “Spatz”.[/QUOTE]

Was it done in field or did he go to a hospital?

Around here vets are telling us it’s a 2k deal at least, and has to be done @ hospital – and horse has to stay for a few days, etc. Deeper digging tells me it’s a 2k-3k expenditure which would be one thing on an otherwise healthy young horse but our TB with EOTRH is older and neurologic (cervical arthritis) – at this point we are simply managing him to be as comfortable as possible until it is time to be PTS. I should note that our vet says he is not bothered by the EOTRH presently.

[SMF11]

[QUOTE=beowulf;8589177]
Was it done in field or did he go to a hospital?

Around here vets are telling us it’s a 2k deal at least, and has to be done @ hospital – and horse has to stay for a few days, etc. Deeper digging tells me it’s a 2k-3k expenditure which would be one thing on an otherwise healthy young horse but our TB with EOTRH is older and neurologic (cervical arthritis) – at this point we are simply managing him to be as comfortable as possible until it is time to be PTS. I should note that our vet says he is not bothered by the EOTRH presently.[/QUOTE]

It was done in a stall at the barn. In our case, the teeth were clearly interfering with the horse’s ability to eat enough, so it made sense to do it; otherwise, it is a question of weighing the pros and cons with these older more fragile horses, isn’t it.

[beowulf]

[QUOTE=SMF11;8589483]
It was done in a stall at the barn. In our case, the teeth were clearly interfering with the horse’s ability to eat enough, so it made sense to do it; otherwise, it is a question of weighing the pros and cons with these older more fragile horses, isn’t it.[/QUOTE]

See, this is why I am frustrated by our area – I used to live not that far from you and I bet I could get a vet out for a field extraction in a hot minute… and it would cost me what other posters have said on this forum, $300-700… that, to me is justifiable and doable – but to spend $3,000 on a retired, geriatric horse with other (IMHO) more important issues to address makes this decision quite hard. Both vets I contacted pushed hard for a hospital extraction – but I still don’t understand why – he would only be getting a few out, not his entire mouth.

[JenePony]

Wow. I’m kind of overwhelmed by how many other people have gone through something like this.

As of right now, he’s eating fine (soaked, low starch senior feed and soaked alfalfa for weight) and is actually gaining/maintaining weight.

However, his pain was severe enough that even with sedation the vet did not feel comfortable floating him. Two years ago this was not an issue - he stood perfectly comfortably for his teeth. Last year he was a little upset about it. This year he was immediately in so much pain he yanked back and threw his head up as soon as the device was in his mouth (before she even tried to open it).

From my understanding, the $1000 - $1500 (the vet thinks closer to the high end because of the amount of pain) is the cost of trailering him in and having the teeth out. He does need all of his teeth out so having someone come to the farm is out of the question. From what I understood, the reason it’s at the office is because it would be an all day procedure and not able to be done all at one time since the blocks and anesthetic wouldn’t completely alleviate the pain.

Now, I’ve had horses with no front teeth (no idea how she lost hers, as we got her at 28 years old and they were already out) so I know there is minimal to no loss in quality of life from the extraction.

I’m trying to make the best decision for him and myself. If I had a spare $1500 lying around, I wouldn’t hesitate. Unfortunately, the cost is substantial and with his other issues factoring in, the procedure itself might be fatal.

[JenePony]

My discussion with the vet was limited yesterday, but she’s coming back out to do injections in my other horse in a few weeks (waiting for the shots and any possible side effects to go away). I will be discussing options in more detail with her, but I’m hoping to learn as much as possible in the mean time.

[Ruth0552]

Is there anyway you can get a 2nd opinion?

Not all vets are great dentists- are there any real dentists in your area?

I’m surprised that in a year all of the teeth got so bad that they all need to be pulled.

I’m lucky enough that my dentist will pull a couple teeth standing in the field with my vet there as well. My OTTB has had several incisors and several molars pulled and it has not been very expensive. My understanding from talking to them though, is that this is unusual and most dentists and vets would insist on the horse being at the hospital.

If that was my only option for my 23 year old OTTB with EOTRH and multiple other issues I’m not sure what I would do. The horse has been retired for over 10 years and I’m not sure I could justify a 1500 expense.

[JenePony]

I could get another opinion, but I’m honestly really happy with my vet and honestly feel like she is looking out for me and my horse. With his other conditions I wouldn’t feel comfortable having an equine dentist come out and do it in the field even if that were possible.

Also, the quote is from the dentist that is employed by the vet practice, not the vet. She does the floatings but anything beyond that is referred to the dentist.

I spoke at length with her today and we’ve decided to give him prevacox for the pain, and a rice bran supplement to help with weight gain and reevaluate in a month or two. If he gains weight and seems relatively comfortable, she is fine without the surgery. If not, we’ve already discussed humane euthanasia. She’s excellent in that she isn’t afraid to refuse to euthanize if she doesn’t feel it’s called for (ie. financial reasons as opposed to what is best for the horse). I really trust her opinion and I’m happy knowing that we’ll be doing what is best for him. Recovery from surgery with Cushings is an iffy thing, and after $1500, I wouldn’t be able to afford euthanasia if it came to that worst case of scenarios. My number one goal is his comfort and quality of life.

[JenePony]

@Ruth0552;8590687

I’m surprised that in a year all of the teeth got so bad that they all need to be pulled.

It’s actually been two years.Two years ago he was okay. Last year he was bad, and she mentioned the surgery as the next stage. This year she said something has to be done for his pain and surgery is the most efficient option. He’s just unlucky in that it’s affecting all of his teeth at the same time, and not progressing to just a few at a time.

[MrPerfection]

EOTRH

[QUOTE=JenePony;8590857]
It’s actually been two years.Two years ago he was okay. Last year he was bad, and she mentioned the surgery as the next stage. This year she said something has to be done for his pain and surgery is the most efficient option. He’s just unlucky in that it’s affecting all of his teeth at the same time, and not progressing to just a few at a time.[/QUOTE]

The horses Heath starts in their mouth. Good nutrition and good teeth. What did you end up doing? My horse is 26 and is Cushings but I can’t be afraid of the what ifs. The syndrome is horrible and chronic. I’m scared but it has to be done. My quote is close to 3k in hospital setting. Home same day.

[JenePony]

[QUOTE=MrPerfection;8984396]
The horses Heath starts in their mouth. Good nutrition and good teeth. What did you end up doing? My horse is 26 and is Cushings but I can’t be afraid of the what ifs. The syndrome is horrible and chronic. I’m scared but it has to be done. My quote is close to 3k in hospital setting. Home same day.[/QUOTE]

That’s definitely true. I’m not sure what my guy ate before I got him, but I’ve always fed him the best (Seminole Wellness Senior +Ultra Bloom as a fat supplement). I would rather pay the extra $5 a bag than deal with health issues down the line.

Anyway…it’s funny that you would post this now because I literally JUST had his teeth out yesterday. Even one day post extraction I’ve noticed a HUGE difference. He’s eating without hesitation and isn’t ‘mouth shy’ (he was fine with touching his ears, eyes, etc but would freak out if you tried to touch near his mouth).

The end of the line for me was when I came out and he wasn’t able to drink. He was licking at the water like a dog because his teeth hurt too much to put in the cold water.

So…I switched vets (same practice, though) due to a lot of reasons, and the new vet said she could do it at the farm (they have a mobile dental unit). She quoted me ~$800 and the final cost was $870. I was able to do a payment plan (50% down and paid off in two months) which made it possible.

Ivan was a trooper. They did x-rays before the extraction and found out that four of his teeth were still unaffected so we elected to keep them in (she said in a few years they may need to come, but he’s 27 so he may not live that long anyway and we’ll deal with that when the time comes). It took about 1.5-2hr to pull 8 teeth and they just sedated him as they went (and of course lots of blocks). He had some infection in 6 of the teeth so he had to get an antibiotic shot but she doesn’t think he’ll need another one.

It was very nontraumatic and he was out grazing about an hour after they finished (waiting for the sedation to wear off). I 100% think the surgery was worth it, even having to deal with the care after (hosing his mouth out and spraying in an antibacterial).

$3k does seem like a lot…maybe ask other vets in the area? My original quote was $1.5k+ and had to be in the clinic and it got down almost half plus on site at the farm when I found the right vet. For reference, I’m in central Florida and we have a lot of vets, but not many that come out to the area I’m in.

[MrPerfection]

JenePony WOW I am so happy to hear that your horse did so well! YAY and i’m touched that you were able to afford it over time. $800 at the farm… OMG that is huge savings. About $100 a tooth! But worth every penny to see your guy drink water and graze within an hour. You must of been horrified when he stopped drinking. This is a story with a happy ending. You deserve a medal! Keep us posted… I’m in the Boston area, and will be taking him to Tuft’s as an out patient (home same day). So, the price for a Dental Vet etc. I also will be on the payment plan LOL.