My vet suspects that my 22 year old horse has EOTRH. We are taking X-rays this week to confirm dx. Has anyone dealt with this and how was the treatment process? Extracting all of the incisors sounds extreme and awful but the alternative is worse. Thanks for your input!
I know of one old pony who had all the incisors removed for just this problem. She has done wonderfully! She sailed through the extractions and recovery, and is back to her usual self. She had a period where her cute little tongue poked out a bit, as she had no incisors to hold it in, but has apparently learned to tuck it into her lips. If you have specific questions, I can see if someone who was more involved can answer them for you. I know that all involved, including the clinic (who are used to dealing with baby racehorses and not quiet old ponies), were thrilled with how well the pony did, and the clinic has asked for the pony to be a “spokes pony” for the extractions, as many people are understandably quite nervous about it.
Once the condition becomes painful, the teeth need to come out. It sounds and looks a lot worse than it actually is. Mouths heal well and nicely 
It doesn’t affect their ability to chew, and many horses are still able to eat grass pretty well.
This sounds totally adorable!
I know three horses that have this condition and all three had their teeth extracted. Horses were much happier after the extractions. There was no issue with eating afterwards. Their tongues may hang out a bit, but all three are happier without their incisors. There’s no problem eating hay or grain and it doesn’t stop them from eating grass either.
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My LL had her 20+ year old ISH’s teeth pulled due to EOTRH. It must have been his incisors as his tongue hung out all the time. 
While he was more comfortable afterward, he did struggle with the recovery from the anesthesia. I think that was what she said. But he has long been a delicate flower…so there is that.
Once home (we have a clinic 5 minutes from the house), he did great for several years. His diet was soaked senior, soaked alfalfa pellets, soupy beet pulp, and what grass he could nibble spring-fall.
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What @JB said.
My vet has posted several cases on her FB page.
As gnarly as the extracted teeth look, all of her patients recover well.
OP: hope your guy gets relief ASAP!
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My horse had all of his incisors removed 2 1/2 years ago. Recovery was fast. Horse much happier. He turns 25 next month.
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Was your guy able to eat hay? My vet seems to think that it would be no problem given that the molars would be intact.
Prior to incisor removal, he needed finer hay, that was when I discovered teff hay. He had started to have problems with thicker hays, and did not eat them well.
I have continued to feed him teff hay which he eats very well, and sometimes throw in a little bit of timothy for variety, and he will eat it, but prefers the teff.
He grazes on grass. If grass is short, he doesn’t get as satiated as the other horses and comes in to barn area, hungry for his hay. I believe he cuts the grass with his gums. He gets some TC low starch pellets that I wet and let get a little soft.
The 6 months prior to surgery to remove incisors, horse was getting quite grumpy. I believe he was in pain and I decided to do the surgery. To me it was either surgery or letting him go. Quality of life.
IIRC: he was not tolerating hay in general prior to the procedure. He had at least one colic episode of several colics, mostly due to trying to re-introduce to hay. Again “delicate flower”.
He was my landlord’s horse but we split chores. I was not at all vet visits so I just went with what she told me to feed him. I suspect that he thrived on the soaked feeds after the procedure and we just kept him on it. We only have 4-5 horses on the property and we are set up for efficiency. Soaked feed was no issue for us. YMMV
