Eorth?

[ciscolark]

My horse is somewhere between 30 and 35. Over the last few years, he has gone from being an extremely easy (fat on air) keeper to a horse that needs soaked senior feed three times a day and doesn’t eat hay extremely well. He drops pieces of carrot (so he doesn’t get them anymore). He drops a lot of (soaked) grain when he eats, but he’s always excited to eat and eats all of his food minus some of the spills.

He’s maintaining weight pretty well on this diet and looks good, but he has lost a bit topline. He has good feet which are trimmed every 6 weeks. He has a history of colic surgery around the age of 13ish (before I got him), but (knock wood) he has not seemed to having ongoing problems although he has had minor colics over the years. He’s always been very hairy in the winter, but he always sheds out well in the spring. Currently, he’s sound and seems happy. He’s mostly retired, but I will occasionally get on him for fun.

I have known that he is old and will not live forever, but he’s been doing well so far, and I am hoping to keep him around as long as he wants to stay if he can be comfortable and relatively pain free.

He’s seen by the vet every 6th months and gets his teeth checked then. He is typically floated once a year. He has previously lost a molar and does not have great teeth, but he is old so I thought the state of his teeth was normal.

Today, when feeding him dinner, I found a bit of blood on his mouth and upon checking in his mouth saw that one of his outer lower incisors was barely hanging by his gum tissue. It came out in my hand. The tooth had been eaten away at the gum line…ouch. In looking online and then looking in his mouth, it appears to me that he has moderate or severe EORTH although I don’t see any visible dots/draining tracts in his gum line per my flashlight exam tonight.

The plan for tomorrow is, of course, to call my vet and see what need to happen. That said, has anyone gone through this? Is teeth removal fair to him/feasible at this age? If he does have EORTH, it is clear it is very painful so it is not fair to let him continue the way he is. I know the best answer it to wait for the advice of my vet, which is the plan, but I’m just starting to think through what this might mean for him and would appreciate the experience of others if you are willing to share.

[Weezer]

I don’t have any experience with this but I just want to send you and your horse best wishes. It makes me so happy to hear that you are taking such good care of an old soul!

[Scribbler]

They do better than you’d expect without front teeth

[doublesstable]

I have had two horses with EORTH. My first (10 years ago) was diagnosed via x-rays. His signs prior to me calling the vet was he started getting hesitant when I put in the bit. I noticed small areas on the gums of abscesses’ and sores. He was 20 years old and I never did have the incisors removed. I kept trying to make an appointment with the veterinarian that did the surgery and she didn’t have time… I gave him Equioxx and that resolved the sores in his mouth. Sadly, he ended up passing with necrosis of the colon. My current horse (11 years old) was diagnosed with ulcers two years ago, then dilute urine, and as he started getting strange fat pad and weight gain; I had him tested for PPID. He was positive for PPID and EMS. He had two teeth removed because of abscesses. During that time I noticed the gum line looking very similar to my other horse with EORTH. I questioned the dentist about it. He didn’t think he had it but x rayed as I asked. And sadly; he does have EORTH. My horse has been on a supplement by Mushroom Matrix called Equident. This has been a product I read about that has really helped horses. I would not get too worried as you will need x rays to confirm. If your horse has EORTH, you can feed the supplement and if he’s painful have the incisors removed. I have talked to others that have had no issues with the removal of the incisors. I was told they will graze and eat fine.

[alterblue]

My guy was diagnosed at age 24 and had all 12 of his incisors removed surgically by a local veterinarian who specializes in dental work. His biggest symptom that my vet and I noticed was he started getting really fussy/upset when put in the speculum for dental work. He is normally a very laid back guy who previously had no issues so it was a red flag for her. We had him x-rayed and it was confirmed he had early-ish EOTRH. We also realized after thinking about it that he was a very slow eater and would not take bites out of apples. It was recommended to take all of the incisors since it is a degenerative disease that is very painful, and eventually the other teeth would be more affected. My vet wanted to do the surgery while he was otherwise healthy without other issues so he wouldn’t have to endure a second procedure. They did it at the local hospital as a day surgery - they do not undergo full anesthesia. It is a heavy standing sedation with a nerve block in the jaw. He was able to come home that same day and was eating at dinner. His diet has not changed at all - still eats senior grain and some hay although he does prefer a softer cut. He learned how to graze by ripping grass with his lips/gums as well - you would have no idea if I didn’t tell you, other than his tongue sometimes hangs out (adorable!). It has been almost 5 years since his surgery and I don’t regret it for one second - knowing he isn’t it pain anymore is such a relief and it was only about $2K in my (expensive) neck of the woods. If your vet thinks your horse is a good candidate for the surgery I would definitely recommend it as there is no other treatment at this time, and like humans NSAIDs and other pain meds barely touch tooth pain. Best of luck!

[2DogsFarm]

{{{JINGLING}}} for your OldGuy & you.
No personal experience with EOTRH, but my vet posts a lot of cases on her FB page.
She does a lot of the extractions herself & works with an Equine Dentist for the gnarlier cases.
All of her clients seem to do well & owners are pleased with the results.

[TBKite]

EOTRH is very painful, and because of horses’ stoicism the degree of pain is often really only realized when the problem is fixed and behaviours you had thought nothing of change. They do really well with the incisors removed, often gain weight because they feel better and eat better. X- rays are really helpful to identify all affected teeth, milder ones aren’t noticeable on visual exam.

[ciscolark]

Thank you so much for all of the responses. I was feeling overwhelmed and stressed yesterday about him being in pain that I had failed to recognize and wondering if this was going to be the thing that ended his life. I feel reassured that I don’t need to jump to that conclusion just yet although we do need to move quickly to a correct diagnosis and plan since he likely is experiencing tooth related pain. Thanks for letting me know that others have been in my situation and how it worked out.

My vet is not able to get out to see my horse until next week as he is out of town, but as of this morning we are on the schedule for his clinical day next Wednesday, and hopefully we can get x-rays at that time. I was really hoping for a more immediate visit, but it doesn’t seem to qualify as something his emergency service would typically cover, and I think my vet’s insight will get us to the right plan, referral, and/or difficult conversation we need to have sooner. I have a lot of trust in my vet, and I know he will help me prioritize my horse’s comfort.

Today, he is perky, eating treats, picking at grass, and excited for his meals. That said, I’m not okay with the idea that he is possibly experiencing a lot of pain (and I recognize now that he might be regardless of how he is acting) so I will certainly have a very low tolerance to get the emergency service out if his eating or attitude changes at all before the appointment.

I don’t have much of a horse community where I live now so thank you for being my sounding board when I really needed it. I really want to do right by my horse.

[MapleBreeze]

I had to euthanize one with eothr. She was in so much pain. Quirky under saddle and a nut on the ground and would bite the stall when eating. She dropped weight rapidly. Always uncooperative.

[PonyPenny]

Osphos has been recommended for my horse with EOTRH to receive bi-yearly. His EOTRH was diagnosed through X-ray. So far teeth removal has not been recommended. He will be 23 in March.

[Pico_Banana]

In case it’s helpful, here’s an article written by a vet/dentist local to me and who I have a very high opinion of:

EOTRH — Northeast Equine Veterinary Dental Services, LLC - Leah Limone DVM

[ciscolark]

Thank you for providing the article and link to pictures. I wish his teeth looked like the “normal” picture, but they do not.

[alterblue]

Dr. Limone is who did my horse’s surgery, she is wonderful and does a lot of education for other vets on the topic such as at national conferences. We are so lucky to have her in the area!

[MrPerfection]

My horse was 26 when we had all his incisors removed. He was not able to bite into an apple, or a carrot. Then he stopped drinking water. Luckily I had the appt. for the removal the day after he stopped drinking water due to it probably being to cold for his gums. He was fine afterwards. Ate grass, hay and grain just fine. He was a bit sore after the surgery, for about 5 days. It took him a while to snap back, but he did just fine. Also, you can clean and save your horses teeth if you’d like afterwards. I still have his teeth in a bag.

[ciscolark]

Thank you so much for all the replies. My horse had several of his teeth pulled by my vet. It looks like he needs a lot of incisors removed so the plan is to let him heal from the teeth he just had removed for a a few weeks and then work on getting him to the vet school for more extractions.

[SmlHpy1]

My horse was diagnosed with EOTRH in 2019. I haven’t extracted his teeth yet. He just turned 27. I’m unsure what to do after some consults with one of the best dentists in the country. He told me EOTRH can progress really slowly, some cases he’s been watching for 10 years. My guy is in early stages he said (stage 1-2 out of 6). But I don’t know. I’m really torn. So far his normal eating/drinking doesn’t seem to be impacted. I’ve done anything my animals have ever needed, but this has been a road block for me. My current barn situation is such that the grass is not plentiful so I don’t think he’d be able to eat the little bits with his lips. I’d prefer to find a more grassy living arrangement but that’s proven difficult.