Can chronic hindgut issues be caused by EMS?

[ihearttbs]

Let me start by saying I have been working with a vet ongoing to deal with my pony’s hindgut ulcers that seem to pop up again once or twice a year and have to be retreated. I know how to treat them, but they keep recurring and I’m starting to think there must be some underlying pathology that is causing him to keep getting them, especially if his diet is pretty steady and is managed by the vet. I tested him for cushings and that came back negative but I’m starting to wonder about EMS, my vet hasn’t suggested it…. But wondering if anybody else has experience with that being an underlying cause of hindgut stuff.

He is currently fit and a good weight but was very overweight when I got him and is a very easy keeper. He is also prone to thrush, and doesn’t seem to sweat well if at all.

He had a bad flare up of hindgut ulcers that we think was from eating leaves in the fall that fell into his paddock (on a dry lot). They cleared up with sucralfate. Now the ulcers seem to be coming back mildly again but I’m not sure why, he is currently on 1st cut untested hay but a very limited amount (~5 smallish flakes) mostly fed in slowfeed haynet spread out into 5 feedings so he’s never long without it even though limited, and on a carb safe grain that’s basically fortified alfalfa pellets (5% NSC) 3x a day to supplement the hay since I don’t have the ability to test every batch of hay I want to keep it lower plus vet said that’s better for hindgut if it’s inflamed to keep the hay fairly low. He is also on GutX and a clay supplement similar to bio sponge.

Ulcers manifest as diarrhea, general crankiness/naughty behavior. No appetite changes or colic. He is a large pony, a fjord cross.

[starsandsun]

Why do you think he has ulcers? Because he has diarrhea? I don’t think so.

If he were my horse, I would be looking at gut biome changes, some of which may be normal on a seasonal basis. If you’re feeding first cutting that is pretty stemmy, his gut bacteria may change and could contribute to diarrhea.

Sucralfate helps provide a ‘wound’ cover for ulcers, but even with its benefits (increased blood flow, for example) I think of it as a protective mechanism, and not ‘healing’ for ulcers.

You might find something like Platinum Performance Gastric to be useful in building a better biome.

[Scribbler]

I have a probiotic I swear by, from Herbs for Horses, and have added YeaSacc for more troubled horses to fix biome and end chronic diarrhea.

[ihearttbs]

He was scoped and diagnosed by the vet with hindgut ulcers before I got him. I saw the vet report and those were the symptoms associated with it

[JB]

@ihearttbs

He had a bad flare up of hindgut ulcers that we think was from eating leaves in the fall that fell into his paddock (on a dry lot). They cleared up with sucralfate.

@ihearttbs

He was scoped and diagnosed by the vet with hindgut ulcers before I got him

You can’t scope the hind gut. You can ultrasound and see thickening of the intestines.

sucralfate would help both gastric and hind gut lesions.

Either issue could cause diarrhea and a generally cranky horse.

If the first instance was suspected to be some toxicity due to leaves (I would assume something like wild cherry? red maple?) then that’s obviously not related to EMS

Is this the first recurrence? What does “once or twice a year” mean?

1st cutting hay can be a little stemmy, which might not agree with his hind gut. What does it feel like?

How many pounds does he get, and what’s his ideal weight? 5 small flakes of grass hay could be 10lb, max 15lb, which may just not be enough for his stomach or hind gut health

[walkinthewalk]

I can tell you that my Senior fella who developed EMS ended up developing strangulating lipomas. I don’t think the two were related but strangulating lipomas may be something for you to consider.

My horse had never colicked a day until he was 24 and colicked nine times that year. The vet diagnosed him with lipomas and gave him six months, Another vet at the same clinic suggested I put the horse on Succeed. The colics stopped for 2-1/2 years until they didn’t and I lost him when he was 27.

Granted colics and ulcers aren’t the same thing but your hind gut issues may not be what you think they are:)

Succeed is also good for managing digestive issues that cause ulcers AFTER the ulcers are resolved. I feed it to my current over 25 fellas a week before, during, and a week after I de-worm them just because Senior digestive tracts don’t function near as well as they did in their youth:). My horses are lucky I know that first hand, lol

[JB]

@walkinthewalk

I can tell you that my Senior fella who developed EMS ended up developing strangulating lipomas. I don’t think the two were related but strangulating lipomas may be something for you to consider.

definitely not related. Lipomas in general are much more common in older geldings to start, than younger geldings, or mares in general. I lost a 20yo gelding to a strangulating lipoma, and personally knew 2 other >15yo geldings who died as a result of one as well. None of them were IR.

[ihearttbs]

I saw the vet report, it says he had hindgut ulcers primarily but a couple in the stomach. I believe they can see the top of the hindgut with the correct scoping mechanism, at least according to my current vet, even though they can’t see the whole thing.

The leaves were not from a toxic tree, but we are thinking they messed up his hindgut environment anyway because that was the only major change around the time that ulcers flared up. I don’t know his whole history and I’ve only owned him a year but apparently in recent history the ulcers tend to flare up once or twice a year.

His symptoms in general seem to get worse if he is fed more hay. I would estimate he’s getting about 15 lb per day but am not able to weigh it, but I do feed by feel of weight of the flakes even though that’s approximate. This was all suggested by vet. He has basically free choice hay overnight in a very slow feed haynet, and during the day gets hay every 4 hours. Stemmier hay definitely makes his issues worse. The hay source I have isn’t perfect but I would call it in the middle, it’s not fine but not super stemmy either but occasionally there will be a more stemmy bale.

Succeed sounds promising!

[ladipus]

Maybe try sourcing some nicer second cutting low sugar hay , and adding something like Uckele GUT or Succeed

[FjordBCRF]

@ihearttbs

His symptoms in general seem to get worse if he is fed more hay. I would estimate he’s getting about 15 lb per day but am not able to weigh it, but I do feed by feel of weight of the flakes even though that’s approximate.

Are you familiar with free fecal water syndrome? FFSW or FWS. It sounds an awful lot like that to me having a horse that has it and having learned a ton about it. Most peoples tells on that is it getting worse with increased hay; it seems the majority of horses struggle with it more in the winter. Is it true diarrhea or just really wet/runny poop?

These are super handy to have especially if you are feeding hay in hay nets to weigh https://www.amazon.com/South-Bend-Capacity-Batteries-Included/dp/B07HCFP4MD/ref=asc_df_B07HCFP4MD/?tag=hyprod-20&linkCode=df0&hvadid=241931344467&hvpos=&hvnetw=g&hvrand=1806723826905634902&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9015286&hvtargid=pla-611748372366&psc=1

[FjordBCRF]

Here are some resources on FWS:

Facebook group: https://www.facebook.com/groups/2825821607521075

Feedroom Chemist Podcast on FFWS (I reached out to Dr Jyme on this one and she obliged ) https://podcasts.apple.com/jp/podcast/105-ffws/id1506330860?i=1000577478215&l=en

Penn State Extension recently did a webinar on the topic as well https://extension.psu.edu/understanding-and-managing-free-fecal-water

The short version is its a pain to manage, what works for one horse may very well not work for another, what works for your horse might not continue to work, the triggers are not the same in all horses who have it…my fjord only gets it in the summertime…the hotter it is the worse it gets like clockwork. Its generally thought currently to just be a pain to manage and no real detriment to the horse unless you are unable to keep their butts clean. There are a couple threads here on COTH as well if you search the topic.

[JB]

@ihearttbs

I saw the vet report, it says he had hindgut ulcers primarily but a couple in the stomach. I believe they can see the top of the hindgut with the correct scoping mechanism, at least according to my current vet, even though they can’t see the whole thing.

A long enough scope can see a few inches past the pyloric valve, that’s really not anywhere near the hind gut. If “hind gut ulcers” was a diagnosis, then that had to be via ultrasound.

Leaves are things horses have eaten since horses were horses But leaves on the ground can coincide with an environmental change, like significant temperature or barometric changes.

More, and stemmier hay, causing issues, really does make things sound like colitis to some degree. Have you ever done a course of metronidazole? Removed hay altogether for a few months, and then reintroduced soft hay?

[ihearttbs]

Unfortunately changing the hay supplier is not an option, it’s extremely hard to find good consistent hay suppliers in my area that will deliver smaller loads, I can only get about 75 at a time. My current hay supplier never sends me a moldy bale or light bales, is extremely consistent in quality and reliable. I would be hard pressed to find a consistent source of what you describe so would end up having to change the hay all the time which would be bad, plus even if I could find it it would literally break the bank

[ihearttbs]

Thanks, it could definitely partially be that, just with the behavior changes and him having a history of hindgut ulcers I would think some of that would be involved and he has behavior changes that I haven’t seen before with other horses that just have the fecal water.

He is a fjord cross by the way! Is the breed prone to that sort of thing?

[FjordBCRF]

@rubygirl1968 has a fjord that has it too but it’s not known to be a breed issue to my knowledge. In fact, there seems to be thought that it is more common in paints but that just may be observationally.

[ihearttbs]

Maybe I missed that they ultrasounded him too or maybe they used other techniques to diagnose him (I know they did blood work), but hindgut ulcers were the primary diagnosis with some mild ulceration (grade 1) in the stomach, which was also treated.

Hay is also a normal part of an equine diet and shouldn’t bother him and doesn’t bother my other horses but it does bother him at times, so I don’t really think just because leaves have been eaten by normal horses without issues means they didn’t cause him an issue…just like any change in hay or feed for a horse with gut issues I would think suddenly eating a lot of leaves would be a problem for it. I ended up muzzling him outside for a while after I noticed this happening and that helped even before I treated him for ulcers.

He is out with another horse so I don’t have the option to completely remove hay, but could get him down to 2 flakes a day outside only, I’m just worried about him overnight in his stall with nothing to do and developing regular ulcers because of lack of hay, I don’t understand how people do that treatment regime and keep a horse sane. I could soak his evening hay, do you know if that would help?

[FjordBCRF]

I’d want confirmation on whether they did an ultrasound or not. If they didn’t, I’d question the certainty on the hind gut ulcers personally.

I have an auto feeder that I put hay pellets in for when my guy is in his stall. He gets about a quarter pound dispensed every hour from 9PM to 6AM and if he has to stay in due to the weather, he gets some in the afternoon too. Huge peace of mind for me not being on an empty stomach https://ifeednaturally.com/

Outside of that, he is on really nice, soft second cutting hay now, 3-4 flakes AM and PM in Hay Chix extreme slow feed nets and has netted round bale access in the pasture. He’s an easy keeper so I have to be careful with his intake, but he’s held his weight consistently with that much hay. If it weren’t for the haynets though, he’d blow through it all way too fast. Hay will go bad if you don’t eat it as fast as you can if you didn’t know

[JB]

@ihearttbs

Hay is also a normal part of an equine diet and shouldn’t bother him and doesn’t bother my other horses but it does bother him at times,

Yes, it’s a requirement for horses, but that doesn’t mean it’s ok to use right in this moment. There are medical reasons why a horse should not have hay of any kind other than in pelleted form. Colitis is one situation. It’s something to look into with your vet

@ihearttbs

I don’t really think just because leaves have been eaten by normal horses without issues means they didn’t cause him an issue…just like any change in hay or feed for a horse with gut issues I would think suddenly eating a lot of leaves would be a problem for it.

Just how many leaves, of what kind, did he eat? I can’t imagine how many he’d have to eat to cause actual damage, if they are safe leaves. My guess is they weren’t (all) safe, or he at a ton of them, OR, it’s just coincidental with some other change that didn’t register at the time.

@ihearttbs

He is out with another horse so I don’t have the option to completely remove hay, but could get him down to 2 flakes a day outside only, I’m just worried about him overnight in his stall with nothing to do and developing regular ulcers because of lack of hay, I don’t understand how people do that treatment regime and keep a horse sane. I could soak his evening hay, do you know if that would help?

This needs to be a discussion with your vet. Well-soaked hay cubes may be an option, in addition to pounds of a complete feed (like a good quality low NSC senior feed). Chopped hay may be an option. But yes, sometimes you HAVE TO remove all long-stem fiber to allow the hind gut to deflate and rest and heal.

[rubygirl1968]

I do have a Fjord that’s had fecal water syndrome for years. Like @FjordBCRF said I don’t think it’s a breed issue, or at least not one that I’ve found.

[DMK]

@JB

You can’t scope the hind gut. You can ultrasound and see thickening of the intestines.

I interpreted this as the vet saying, “scoped, ruled out severe enough ulcers in stomach to cause this issue, default dx as hindgut ulcer activity”… Which is how it works for most dx of hindgut ulcers.