Thanks for reassuring me it can take 7-14 days on the Bio Sponge to be effective. I was secretly hoping I would see some kind of improvement by now (starting day 4 with zero changes) but when I asked Platinum Performance, they said give it a full 7 days. If I see even a little improvement, to keep going with it. However, if at 7 days I still don’t see any improvement, then abandon it as it will likely never work. I’m also starting to think I might just have to manage this diarrhea for the rest of his life, maybe not cure it all together. Felt like a failure even thinking that but perhaps this is his new normal? I’m not ready to give up yet but it is something to ponder…
Definitely something I’m going to ask my veterinarian about. I have heard of this being utilized quite often from horses to cows. It makes a lot of sense. Thanks for the articles for further research 
Many moons ago, I knew of a horse that had intermittent uncontrollable diarrhea that was reliably cleared up each time by a dose of Naxcel. (AFAIK, normally it can cause diarrhea, so this was a head-scratcher and certainly not the first, second, or twentieth thing they tried.) Doesn’t sounds like exactly the same situation, and repeated though infrequent use of antibiotics seems less than ideal, but if you’re heading toward metronidazole, it may be something to look into.
My vet recently recommended Quadra Fac for this same issue. Prior to that, we had him on basically every probiotic known to man with some success (it definitely helped, but by no means did he ever have a sold stool, even when using Yea Sacc + a name brand priobiotic in combination daily). He’s been much much much more solid ever since. The same company also makes Absorb All, which seems to maybe be even stronger?
https://uckele.com/horse/product-categories/digestive.html
My vet said it was extremely common in older horses as some lose the ability to digest long-stemmed fiber. He chews fine and digests other things well (coat and feet looked great, etc so we knew he was getting nutrients), but he didn’t have a totally solid poop for probably 5 years before we switched to Quadra Fac (though I would say it was 85% solid with just some watery bits before and after the main event when he was on two digestive supplements; I promise he wasn’t miserable for 5 years, it was just the best we could do).
He still gets a probios soft chew when there is a weather change or he loosens up a bit, but overall he has been much better. If you use the probios treats, make sure they are the soft ones… we never noticed a difference feeding the hard treats, but the soft ones do seem to be a good probiotic “bomb” of sorts.
He is also on Purina WellSolve L/S… he doesn’t necessarily need a low starch food, but of the options in my area, this one seemed best for him since it makes a point of using highly digestible/fermentable fibers to reduce hind gut stress. I’m happy with the combination of all of the above, even if he isn’t always as solid as he was in his younger years. He seems happy and otherwise healthy and comfortable, which is all I can ask for!
I have an old guy, as in pushing 30, that started having trouble with this a few years ago. It happens every year when fall hits and the grass starts to die. Not totally liquid, but enough to make his hind end a mess. Something about being on only hay causes him trouble. We’ve tried all sorts of things with vet involvement but nothing really works. And he goes right back to normal when the grass starts to come back in. At this point I do my best to keep him clean, but I’m loving what Foxglove mentioned above about wrapping the tail. I never thought to do that, but I will give that a try when it warms up enough to totally wash his tail. Maybe this weekend… fingers crossed!
Good luck with your guy, and I’m curious whether it will be a similar situation as mine where things calm down when grass pops back up.
Have a horse who has gotten the squirts - poop pretty much normal, but gas and liquid at the end. Went on for 8 weeks, and he seemed just a tad uncomfortable. Internal med vet put him on a long course of metronidazole - 7 weeks, declining dose every couple weeks. It fixed him right up, but I also know that it was caused by orchard hay, which created enough imbalance that even when he was switched off that hay, there was some modest improvement but not cleared up until the course of meds. Result of the meds was immediate - ie a day or two - but vet said keep him on the whole time no matter what. Edited to add: probio’s had no impact, nor did the biosponge
Get a bottle of metronidazole from your vet and try it
someimes one horse at a barn will get diarrhea from bad water even thought others horses can drink it without diarrhea.
Get the water tested. Clean buckets and troughs with bleach
at one barn one pony owned by the BO started getting diarrhea 2summers in a row and a vet tech recommended the drug. I paid for it and it worked My horses were ok because I used bleach as the BO herself had her own problems year round. I had her have the county agent yes her well. There were some bad organisms swimming around in there.
Get some metronidazole from your vet.
Test the water that horse is drinking
Are you on a well?
I have a mare that had persistent cow patty poops that I just couldn’t solve. Tried so many different things. Finally gave up since it didn’t seem to bother her.
Moved to a different state and it cleared up OVERNIGHT. Same hay and grain. Was just the craziest thing. And it never came back.
Best guess is that there was a low level bacterial contaminant in the well water that bothered her and not the others. Facing that again, I’d take a good, hard look at the water.
Best of luck! I know how frustrating this can be!
SO frustrating. Under my vet’s supervision, I tried many many things. Finally, it was a few days of Metronidazole that zapped it. Once it was resolved, I added a cup of Aloe Vera Juice to my horse’s daily feed, and it seemed to help keep his gut happy. (Trader Joe’s – about $11 per gallon jug.)
I had a horse with chronic runs. Daily tail washing and the horse was clearly not feeling well. My vet ran all sorts of tests which came back normal. I tried every probiotic I could get my hands on. I also did bio-sponge. My vet suggested that I put him on arenus assure. I was skeptical but I did the assure and assure gaurd then dropped to just assure. He has been totally fine for years now even switching hays, barns, and pasture conditions. Apparently the company sent my vet some free samples that he tried on several perplexing cases all of which he had clear up. There is no one for solution for every horse but that is what worked for mine after trying everything. Mine gets free choice grass hay at night and irrigated pasture during the day. No grain, just supplements that he licks out of his bucket am and pm. It’s a very difficult situation to deal with.
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Another vote for metronidazole. I have a 23 yr old gelding who gets the winter squirts as soon as the grass dies and it does resolve in spring once grass is back up. His guts are noisy and he turns into a very smelly mess. We’ve tried BioSponge, Absorball, Equiotic, you name it and only a course of metronidazole has cleared up his issue and he remained in good shape for about ten weeks. Recently it starred back up again so we are trying a slightly lower dose for ten days and by day 2 he was right as rain. The pills are quite bitter and since my guy only gets a small amount of Purina Senior I grind the pills in a coffee grinder and then add a tablespoon or so of brown sugar to the baggie and he eats that right up. It also means the barn staff just dump a baggie in his feed along with his SmartPak so that’s easy for them to administer. I hope this current course will get us through until the grass reappears, although here in Wisconsin everything is still covered in ice so spring seems a ways off yet.
Thank you to everyone for all these wonderful suggestions and the outstanding commentary. These chronic GI problems are so disheartening 
I do wonder if this is a winter thing and will improve when the weather does. All it has done here in California is rain, just about nonstop, for the past month. Everything is mud, everything is miserable. We finished our week of Bio Sponge (2 tubes, 3 times/day) and zero change. My horse is an absolute saint for not disowning me after I pumped all that sludge in his mouth. We’re tapering him down off the steroids (Prednisolone) as they’ve also resulted in zero change. My veterinarian wants to start the horse on Platinum Performance Gastric Support. I left a message about starting the horse on metronidazole as well since so many of you have mentioned it and I also had fantastic success with in in cats with GI issues. One of my concerns with the metro was the absolutely horrible taste and potentially my horse coming off feed because of it. I also worry about an antibiotic as those cause GI issues but at this point, I’m open to it since we’ve seen no success with anything. I contacted Stride Animal Health about GI Calm and their 21 day hind gut program. They said it sounded like “leaky gut”. Their suggestion was to try the 21 day program first, if no success, then hold and start GI Calm. Said it can take 30-90 days to see changes on GI Calm however if no improvement after 2 weeks, then reassess. My veterinarian said it looked like a good pre/probiotic and I could either try that or the Platinum Performance option. Ultimately, not a lot is factually known about hind gut problems. sigh We can also try an injectable form of steroids but it carries a higher risk for founder than the oral steroids did. As for the water situation, yes, the farm is on a well. The horse has been on this property for 5 years so it’s not impossible but my veterinarian felt it a long shot. Not to mention, I can’t change the water. Is kind of is what it is. Hopefully the Platinum Performance Gastric Support helps and maybe we’ll start on the metronidazole.
Totally agree that the metronidazole is super bitter - that’s why I grind the tablets and add brown sugar. My guy is quite adept at eating what he likes out of his feed and leaving whatever offends him and this masking with the brown sugar has worked exceedingly well. Another thought would be using applesauce. Good luck!
You say the vet did a “fecal” but do you mean a fecal egg count, which looks for parasite eggs, or a fecal culture, which is a series of tests that evaluates the presence and frequency of certain bacteria?
Metronidazole (or Flagyl) is used in humans to treat infections caused by bacteria in the Clostridium genus, such as C. difficile, which as the name suggests, causes lingering, difficult-to-treat diarrhea in people. It seems that C. diff can infect horses too, but you don’t mention whether a fecal culture showed this organism.
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Re the metronidazole, it dissolves quite easily - we mix the dose for my horse in some apple juice and use a dosing syringe. He does not fuss with that. Note: not too much juice or it makes a mess!
You can change the well water. First take a sample which this horse drinks from to your county agent to be analyzed. Then wash out buckets and water troughs with bleach. Often.
The county agent will tell you to shock your well with bleach. My BO paid to have a well service do that. A shallow well has bad things swimming in it.
Get the metronidazole and use it now
A deep well can also have bad things swimming in it. I had a 435’ well in which the casing started to deteriorate. It did bad things to my water. My husband shocked it regularly, and no humans drank the water (although we couldn’t get around the animals drinking it–they didn’t seem to have problems from it, so the shocking was working). Shocking was just a workaround until we could assemble the financial wherewithal to drill another. The drilling project didn’t go well (pun intended)–the first replacement well collapsed during drilling. The second one tried to, but the driller got casing down and saved it. It was a relief to stop worrying about possible health issues from the well.
Rebecca
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If he’s been off all hay & grain, and getting Senior 4x’s per day, what does your vet suggest for counteracting the continued acid production during times he’s not chewing and producing saliva? Horses were designed to feed constantly. Saliva is an integral part in buffering stomach acid. For instances of chronic diarrhea, I agree completely with removing all grain from the diet as well as any other supplement. Basically the goal would be to get back to basics of a 100% forage diet. It typically takes 21 days for the hind gut to repopulate for a new/different fiber source. Not only would I have this horse on long stem hay, I’d have him on a slow feed net to force him to take smaller bites and chew more to increase saliva production.
Did your vet happed to check fecal pH? Foul smelling stools is usually a tip off for an acid problem in the hind gut. Equi-Shure from KER makes a hind gut buffer that is basically sodium bicarb encapsulated in hydrogenated fat. With out encapsulation, the bicarb won’t last long enough to make it to the cecum.
Long story short, if he were mine… he’d be on long stem hay only, fed thru slow feed net and supplement with Equi-Shure. I test fecal pH on day one, then recheck every few days to monitor any changes for the next 21 days.
JMO.
I’ll look into the well info and the hay, thank you all. I’m feeling VERY disheartened because yesterday he decided he absolutely would not eat the Purina Senior he’s been on for weeks. Wouldn’t touch it. Very abruptly and nothing changed. This is what he did on the other pelleted feed, Stable Mix. Gave him some small pieces of alfalfa to see if he would eat … yup, would eat that. Would graze. Still refused pellets. Tonight, he tried to colic again, emergency vet out. They tubed him, and he was running 101 temp with high respiratory rate. Banamine tonight and tomorrow, start small meals tomorrow. Bought some Triple Crown Senior to try. Again, nothing remarkable in full blood panel. I’ll ask about ph of fecal. They’ve checked him for everything in the fecals, not just egg counts. I’m SOOOOOOO frustrated. Multiple vets have absolutely no idea what is going on here. The only thing he presents with is cow pie poops and then after a few weeks on a pelleted feed, he’ll suddenly refuse it, yet still want to eat other stuff, then try to colic. I feel absolutely defeated
