Have you tried Outlast by Purina? My vet had me get some for my pony who has digestive issues. He had runny, stinky stools. We had treated for hind gut ulcers with Sucralfate as well. The Outlast worked. I think about this time I took all feed away that contained soy as well, as he seems to be sensitive to it. I believe you have to get it through the vet, but maybe you can give that a try.It’s a pelleted feed, and contains alfalfa I believe, so maybe at this point he would eat it. Jack will stop eating things suddenly, it seems that he knows it upsets his stomach. He has chronic right-dorsal colitis. The Outlast really did work, I only had him on it for a short time, but symptoms did not return.
Damn 
Have you seen the Well-Gel by Purina? It’s a highly concentrated complete feed that’s super kind on their gut. Maybe it would be a good choice until he’s doing a bit better? We had some discussion about it here. The last post on that thread is intriguing given what you’re going through!
Any luck on getting the water tested? Is it possible to pull him off well water until that’s done?
Just gonna chime in here as too have been a long time member of the frozen manure tail club. As in the title of your post I also don’t know the initial cause of my horses Inflammatory bowel disease–eventually dx via OSU–belly tap, biopsy, ultra sound, blood work, etc. Osu was the third group of vets to try and help fix my horse after 5 years. I will spare you the long list of supplements, meds and treatments that were tried to no avail. We’d been through winters with protein loss and dramatic ventral edema, but by late spring when good grass was available he was able to come back around to a reasonable condition but never in 5 years did the loose stools stop any longer than 24 hours. Sadly I had to help him cross over the rainbow bridge before the impending polar vortex in Feb. to spare him suffering the almost certain hypothermia.
Sounds like you OP are on the right track with removing long stem forage–even if you have not seen results yet it does protect your horses sensitive system and gives you time to figure things out. The long stem forage is really a key player when the mucosal lining in the gut is being trashed and can no longer absorb water or process the nutrients from it. For whatever reason they are not able to digest it properly. If you can imagine scratchy bits of it raking over the sensitive lining causing further irritation it makes sense that diarrhea and fecal water will result. I can’t see the original post but is your horse on sulcrafate? I don’t think it would be unreasonable for that to be ongoing to protect the hind gut. I did try succeed this fall to see if it would be the magic bullet. It seemed to calm a lot of gut rumbling going on and he seemed much more comfortable. Got no results from Equisure, which is surprising considering what it is for. It just made him gassy, bloated and projectile.
I do have a few more tips that might be helpful. I don’t know that the well water could have caused what happened with my guy but the disease puts these horses in such a hyper sensitive state so it seems likely it exacerbated his condition. The excess iron and magnesium are not good. To combat muscle atrophy I supplemented additional protein via nutramino. To counteract iron in the well, I supplemented him with grass mix harvest salt in hopes of getting a good balance of copper into the mix. I topped dressed electrolytes as needed also–not the ones with magnesium sulfate-- simple calcium, potassium type mixes. Those combos were helpful in balancing his water consumption and kept him from trying to eat dirt and gravel to replace the protien and minerals he was lacking. He also gained back some muscle and his coat was much better. Not helpful were probiotics or yeast as it would make him hyper-motile and gas colicy. If for some reason he needed those I tried to keep it as simple as possible and just fed the Probios product as needed.
I’m just going to throw this idea out there as my experience is not specific for diarrhea.
Had horse with super bad liver enzymes and nothing the vets could do; including putting him under(down on table) and biopsy (twice) did anything over the course of a year. Horse was going downhill fast. I told client to listen to our chiropractor as we had nothing to loose and We started the horse on Chinese herbs. Over the course of the next year his numbers returned to normal. He’s been on them ever since and he has returned to work and been fine ever since (3 years now)
From my own personal experience the doctors can’t help my neuro issues and autoimmune problems… quite frankly they don’t know what’s wrong with me. I’ve since sought out a homeopath and am on herbs… my health has increased substantially and if not cured at least my quality of life has drastically improved.
Best if luck and I hope your find something to help your horse. If all else fails try the herbs… nothing to loose and possibly everything to gain.
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Speaking of herbs… I have had tremendous success with Nouvelle Research herbs. My husband and I take them, after having good results with the equine products. The owner is a vet and has written numerous articles - many on nutrition and diet. I believe that he is also offering fecal testing.
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Have not read all the replies so forgive any duplication. I had good luck with bio-sponge (platinum performance) and switching over to 100% grass hay. The bio-sponge cleared up his ongoing, frustrating, mystery problem within 7 days, although I kept him on a maintenance dose for longer. Similar to your horse, he had no qualifying event, veterinary tests all normal, no health issues, no sand buildup issues, no worm issues, etc… I also dropped alfalfa hay, as he apparently developed a sensitivity or intolerance to alfalfa out of nowhere at 16 years old! I am feeding him a pound of low NSC ration balancer and Anigest digestive supplement for ongoing support along with his slow feed hay bags stuffed full 24/7 of grass only hay and he has been doing great for these last 2 years. I still keep bio-sponge on hand just in case, as it was the only thing that worked.
Liquid, foul smelling stool always makes me think this: https://ker.com/equinews/giardiasis-horses-underreported-threat/
I had a cat with it once. The vet couldn’t find any cysts and we finally just decided to treat with Metronidazole after several months. That cleared it up. The smell is awful and unmistakable.
Kind of a long shot but may be worth exploring.
The vets put a gelding of mine on Assure Guard Gold. Look it up when you have a chance. May help.
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Just an update, I had a feeling something was really wrong. The horse that had never been ill was not improving from this chronic GI problem no matter what we did. He spent a week at the local clinic and when I brought him home as a trial, I still knew something was wrong. I took my horse to UC Davis and they found two large masses on ultrasound. We’ve had multiple ultrasounds done and none showed the masses previously. In fact, they did other ultrasounds after the one that found the masses and they didn’t see them again. The horse was tested for pigeon fever and strep, both negative. He went into what was essentially colic surgery/exploratory surgery. One mass was cancerous (lymphoma), the other was an abscess, likely secondary to the tumor. His colon was essentially removed in the process. When pathology came back, it was aggressive lymphoma. He started recovery okay but then developed peritonitis on about day 3. Antibiotics only gave him horrible diarrhea, he had edema that only worsened and eventually started pulling on his internal incision site, he was losing protein. We tried everything from infusions, to drains. We couldn’t save him. The neoplastic cells were throughout his GI on path report and were revealed on what was maybe the fifth belly tap, all previous negative. That test rarely comes back with neoplastic cells. I knew we didn’t have a long time once the path report came back but I was hoping to at least get him through the peritonitis and home & comfortable for what little time he had left. Unfortunately, he never made it back home. He was tough as nails and I couldn’t ask him to try for me anymore. This is a sad outcome and hopefully not the ending most people encounter when battling a chronic GI issue but just know that if you think something is wrong with your horse, trust yourself. I’m glad I kept pushing. There are a lot of thoughts on GI issues but like the original veterinarian said, little is really and truly known. Lots of things promise a lot of ideas but the studies aren’t there. Get diagnostics. Repeat them. Repeat them again. Get a second opinion. Find the best veterinarians you can. Hug your horse. Tell them thank you. They are magic and we never have them for long enough.
So sorry for your loss. Sending you some virtual {{{hugs}}}.
My old mare tended to gas colic and sometimes impaction colic. I had her from age 15 months to 34 years. As the years went by we had to switch from coastal to Timothy/alfalfa then just alfalfa, senior feeds, etc. When she was about 29-30 years old, she had an impaction colic and went into severe diarrhea. We tried $4,000 of everything, biosponge, etc. at the horse hospital and I finally caught the Vet associate feeding her hay that we knew would impact her because “we have to stop the diarrhea” I told him I was bringing her home and if she went downhill and became weak, we would call them and have them put her down at home. On my way out, the vet hospital owner walked me out and helped me load her and said try Florastor saccharomyces boulardii (a probiotic) and Metamucil. She wouldn’t eat the Metamucil but I saw it was psyllium and she would eat Sandclear. A human dose is for up to 200 lbs so Since she weighed about 1,000 lbs, I gave her 5 human doses of the saccharomyces boulardii and a normal amount of Sandclear. Five days later she was much better, repeat one time, healthy poo. We had to do that on and off until I put her down for arthritis at age 34. One runny poo we would alert the barn to watch. Two runny poos then back on it. She had one more impaction colic cleared on the way to the horse hospital and in the stocks. Her heart murmur was so bad there was no pulse. She wasn’t very dehydrated and they didn’t want to give her fluids as it could shock the heart so I drove her back home and she carried on for a couple of more years. She was a tough old girl. Anyway, saccharyces boulardii and Sandclear is pretty cheap compared to biosponge. I don’t know if it works for every horse but it was a miracle cure for her. Good luck.
OP, I am so sorry for your loss.
Rebecca
So sorry for your loss.
Oh OP, so sorry for your loss.
