Yep. I do them annually now, except for this horse who gets done twice a year. It’s been so helpful.
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The feet have been checked in the scintigraphy and have also been nerve blocked. Unfortunately nothing showed up or changed with blocking the feet.
The only thing I could really suggest is either treat for ulcers or perhaps ask if thermography is a good next step.
There certainly is research showing decreased stride length in horses with ulcers, and of course, the corresponding increased stride length upon treatment, to the tune of 5+ lengths over a mile. Often the symptoms mimic back pain, but the back will not present with the normal symptoms associated with back pain (sensitivity, etc.).
It would be on my list to rule out, for sure.
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Your not checking the feet for pain… your checking for a negative Palmer angle. You need to X-ray.
If the angle isn’t correct in hind end it causes sore stifles and hocks and sore lower back or SI pain. If left to long can also cause hind suspensory strain.
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Have you pursued body work? Chiro/acupuncture/myofascial release? On a regular schedule? Saddle fit?
After developing some relatively chronic pain and trigger point issues secondary to my own degenerative disk disease and experiencing my own relief from good human body work, I really think this is an area that can be under explored for horses with chronic issues like the ones you are describing.
I was suspecting hind gut ulcers, hocks or SI issues with my mare who has been crabby, girthy, resistant under saddle, kicking out at my leg etc. recently. We did a 2 week trial of sucralafate and also tried previcox with no improvement. It turns out she was very uncomfortable in the lumbar sacral area. Some good chiro, acupuncture and a saddle fitting later, and we are light years ahead.
I have to be really on top of saddle fit with her and she really cannot tolerate a saddle that is even remotely too close to the last rib. I spent years with saddles that appeared to fit and I was told fit (all of which didn’t seem to really work in my opinion). I only have recently truly resolved the length issue and in a short time, I’m already seeing a lot of improvement in attitude and comfort. This would be another area I would investigate and get a couple of opinions on just to be sure. I know everyone ALWAYS says it, but it is really crucially important in any issues with the lumbar area to really rule this out.
We can only x-ray, inject, etc. so much and diagnostics do not always represent what the horse may actually be feeling. If feet angles are on, I would really recommend committing to a regular body work program and seeing where you get with that.
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Really weird question - but did you take xrays of your horse’s back feet? This sounds like our mare that foundered on the hind feet only. Sore back, walking short all round. Just decided to do xrays before we started the nerve blocks. She recovered completely - with farrier and documentary xrays - with no laminar wedge and is now riding sound.
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If anyone is interested I have decided to try the Injectable Omeprazole as I have gone down every other avenue suggested by my vets. I am doing a video diary so you can see what he is like. Here is a link to week 1 and week 3. I will post another update in a few months.
https://www.youtube.com/watch?v=wpbbfXCIFlA
https://www.youtube.com/watch?v=anSX5-qqgT8
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Wow - the week 3 video is a huge improvement. Hope he continues to get better!
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Very interesting to see. I hope things continue to get better!
He appears to me to be landing toe-first, but the lighting is not great in the video and maybe I’m wrong.
Here is a great article for anyone whose horse IS landing toe-first.
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It’s pretty remarkable how relaxed he is in the second video. Were all things the same (i.e. he hadn’t just come in from turnout or any other differing factor from the first vid) - other than the omeprazole? Thanks for sharing and hope this is the answer! Even though you won’t be doing another video for a few months, could you keep us posted as to progress or changes?
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Brilliant idea to do the video diary!
There looks to be some improvement going on there!
Everything else was the same apart from the Omeprazole. Obviously he had had a few lunges since the first video but he has always been difficult and anxious to groom, tack up and rug even when he is in regular work. He has always been really sticky on the lunge in his first trot and taken a while to loosen up. He is now just trotting like a normal horse! I am riding him again now a few times a week and when I tack him up he looks worried about the saddle, rug, etc, but he is not actually moving around. I will keep updates coming. Fingers crossed!!
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Does he have shoes on in the first video ?
Im really curious about this injectable omeprazole. I was under the impression that omeprazole coated the stomach and treated ulcers that way. Does anyone know how injecting it has an effect on the actual stomach lining? Sounds interesting.
I believe you’re thinking of sucralfate. Omeprazole is a proton-pump inhibitor and reduces the production of stomach acid.
Thank you! It’s nice to see that there’s an alternative to only gastro-guard paste now.
Interesting article; [h=1]Recommendations for the management of equine glandular gastric disease.[/h]
[B]https://www.magonlinelibrary.com/doi…ve.2018.2.S1.3
Omeprazole long-acting intramuscular injection[/B]
A long-acting preparation of omeprazole that is administered by intramuscular injection at 4 mg/kg has been reported to be more effective than oral formulations in increasing the pH in the ventral stomach (Sykes et al, 2017b). Following intramuscular injection of the long-acting formulation, marked acid suppression occurs for between 4 and 7 days after which pH gradually decreases. The long-acting injection should therefore be administered at 5–7 day intervals. The greater consistency and magnitude of acid suppression achieved with the long-acting injectable formulation may be helpful in determining whether clinical signs are related to EGGD as a clinical response is usually seen within 1–3 days (Rendle unpublished data; Sykes, unpublished data).
Limited investigations have been performed to date, but the rates of healing of EGGD that have been reported with the long-acting injectable formulation of omeprazole are notably higher than the rates reported with the use of oral omeprazole as monotherapy. Sykes et al (2017b) reported 75% healing and 100% improvement in 12 horses at 2 weeks after two injections of longacting omeprazole in Thoroughbred racehorses with EGGD. In sports and leisure horses, Rendle (unpublished data) reported 64% healing (normal mucosa) and 96% improvement of EGGD in 30 horses with two injections at 7 day intervals and 86% healing and 93% improvement within 4 weeks with ≤ 4 injections. The injection is oil based and in <10% of cases (Rendle, unpublished data) transient, non-painful swelling may develop which resolves spontaneously over a few days. Most reactions are associated with injection into the pectoral muscles and reactions are seen less commonly with injection into the gluteals (which is preferred due to the greater muscle mass) or the neck. Injection is quicker and easier if the vial is warmed to body temperature prior to use. Further investigations of safety and efficacy with larger numbers of horses are warranted. There may be value in combining long-acting omeprazole with sucralfate, although there is currently no evidence to recommend this. The long-acting omeprazole formulation does not hold a veterinary licence and is therefore used following the prescribing cascade.
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I just finished treating a horse with it because the barn couldn’t seem to give the gastroguard on an empty stomach. Unfortunately it costs the same as the oral and my insurance doesn’t cover it. My horse is excluded for ulcers anyway, so it didn’t matter to me, but perhaps that’s part of why it is a bit slow to catch on.
