I would love insight on additional questions to ask or things to look into surrounding glandular ulcers.
Visit 1:
Diagnosis: grade 3 squamous, grade 4 glandular
Treatment protocol: full dose of Gastrogard, sucralfate 3x/day, misoprostol x/day, 24/7 turnout, no work, Gut-X, Contribute Omega-3, outlast 3x/day
Visit 2 (6 week follow up):
Diagnosis, squamous ulcers resolved (YAY!), grade 3 glandular
Treatment protocol changes: 1/4 dose of Gastrogard, misoprostol 2x/day [number of pills increased], 12/12 turnout (true free access hay when indoors), marshmallow root powder, slippery elm bark, prozac*
Visit 3 (12 week follow up):
Diagnosis: squamous still healthy, grade 2 glandular
Treatment protocol: pending full write up
Visit 4 (16 week follow up):
Scope #4 recommended.
*We started the Prozac at week 9 in case her inherent nervy nature was contributing to an unhappy stomach.
I know that pain can be a component with chronic ulcers so we have also done a full lameness exam at each appointment, 1 neuro exam, full neck and back x-rays, hoof x-rays, and have continued body work despite being out of work and daily carrot stretches.
Is there more I should be doing for the glandular ulcers? Better questions I can be asking back to my vet? Research articles to consider?