Hindgut issues or something else

[KarenRO]

I did a search on “hindgut” but did not find anything that really addressed my question so I’ve started a new thread.

Backstory - my 9-year old mare, Emma, (Canadian Sport Horse - PerchxTB) has always had an excellent work ethic, wants to please and was progressing beautifully earlier this year. During my horses’ spring health exam, the vet opined that Emma looked a little thin, pointy across the croup and suggested some extra calories, such as Sentinel LS. We slowly added that to her beet pulp and a balancer ration. About 10 days after adding LS to her diet, she started to display several behavioral changes - became girthy although not consistently, started to give little hops while trotting, and her formerly stellar downward transitions became awkward. Basically, she was resistant to collecting or lengthening, which was very new. I tried a different girth, a different saddle with no change. Towards the end of April, she coliced but recovered quickly. I had a well respected chiropractic vet evaluate her and the vet said neck and recommended another vet for anti-inflammatory injections. That vet evaluated, agreed that it was neck and did the injections but Emma’s behaviors continued. It then occurred to me that the LS product has grain and maybe that was causing inflammation throughout her GI system. I called Triple Crown and rattled off her symptoms and the rep said “hindgut”. Emma is now on TC Senior Gold and Balancer Gold. The girthy-ness is gone but the reluctance to collect or extend remains.

Any thoughts?

[JB]

Being a draft cross, and losing muscle tone at her relatively young age - have you tested for PSSM1? If not, do that asap.

Sentinel LS has starch at 10.5% - too high if she is PSSM, and could have easily triggered her newer issue. Total NSC Is 14% - not terrible, maybe too high, all depends on how sensitive she is.

TC Sr Gold is MUCH lower starch at 3.6%, and total NSC is 11.4% (not a huge difference there, but the starch difference is much more significant)

So, test for PSSM1 asap.

[leheath]

I agree with the PSSM testing, but also suggest at least considering scoping and/or treating for stomach ulcers too. Sucralfate can help hind gut issues as well as stomach ulcers so that is maybe something to ask your vet about. GI issues can also be caused by chronic pain (such as joint issues/arthritis, kissing spine, etc.), so that might be another avenue to explore if the more “obvious” answers don’t pan out, especially since the girthiness has resolved but not the undersaddle issues.

[KarenRO]

Ah, I did not even think about testing for PSSM1. I will ask my vet. Thank you for that observation!

[KarenRO]

Thank you for your reply! I did try Ulcerguard and saw absolutely no change. Another person mentioned sucralfate and I will follow up with my vet.

[leheath]

Sucralfate was a game changer for my horse that had both stomach ulcers and suspected hind gut ulcers. I also had one in the past with just hind gut ulcers/issues and she responded very well to Succeed - it was pricey, but they do have a money back guarantee, so that makes the initial investment more palatable!

[No1]

How much Ulcerguard did you give her? You have to give a full tube to achieve a correct dose for treatment. Possibly more if you horse is on the larger size.

Also, consider that she may have gotten ulcers later but actually started with EPM. The changes in muscling and inability to use her hind end could be indicative.

[KarenRO]

Thank you for your reply! I gave her one tube of Ulcerguard (4 doses). I have a call into my vet’s office about PSSM1 testing and a prescription for Sucralfate.

[walktrot]

I’ve had my gelding, now 27 on Sentinel LS for 5 years or so. It is high fat, high fiber, low carbs and 12% protein. He needed more calories, and he was on pasture board so I wanted to ensure he was getting proper nutrients. His teeth are still pretty good. Sentinel products are all extruded to make nuggets, not pellets. Senior feeds have been extruded for a long time because they are more easily digested. There are about 6 choices in the Sentinel line, all extruded, and ingredients and nutrients are all listed on the website. They added additional products a few months ago. Sentinel XT Pro has 3.5% starch and Sentinel Care Carb Guard is 5.5% starch.

We have a Blue Seal company store 5 minutes from here with a manager who knows her products and the competitors extremely well. They have been in New England for over 150 years. The store manager said all of their products are manufactured in Vermont. They schedule production so that a product for horses will not be processed on a line that processed something toxic to horses.
Ingredients and nutrients are on the bags and on the website. You get the same stuff in every bag. If a change in a recipe is approved new bags and a website update have to be ready to go before production starts. I like the Sentinel choices. If I need to make a change, digestibility isn’t a problem so I can pick out the best recipe.

Kent and Blue Seal are regional companies that joined up about 10 years ago into a family-owned company. They sell the same products. Triple Crown owns its formulas but it contracts production to a mill that they don’t own, for about 5 years per contract I believe. I prefer to avoid very large operations in favor of local/regional when available. I pulled my horse out of a barn last November because he was not getting adequate hay and his condition was seriously deteriorating. The new barn uses Purina. I decided to stick with Blue Seal after crawling through Purina’s website. I question some of the information in articles about horse feed that they provide. I feed my cats canned Friskies. I quit feeding my first cat Purina Cat Chow in the mid-1970s. He was throwing up all the time. The Cat Chow absorbed enough moisture in the stomach to make it swell and exit where it entered. There were very few choices of pet food back then. Dogs usually ate Ken-l Ration. At some point Science Diet debuted with specialized products for things like kidney disease in cats. It was available from a veterinarian and ridiculously expensive.

Choices for horses have exploded over the past 10-15 years. So have grain prices over the last 6 months. I don’t want to know what a bale of hay goes for. I have my brain set at $5 per bale.

[KarenRO]

Thanks for this info! I’ve used Blue Seal for years and am glad to know that they are a quality operation.

[KarenRO]

I made the switch to Triple Crown Gold (Senior and Balancer) when the regular barn manager was out on medical leave. I just saw her today and she was concerned that if Emma was PSSM and/or had a grain sensitivity, Triple Crown Senior Gold was not appropriate as it had wheat middlings as the 4th ingredient. Weirdly, TC advertises the Gold line of products as “grain-free” but that is not true. The barn manager recommended going back to Blue Seal Sunshine Plus, soaked beet pulp and add canola oil for fat. I’m still trying to get her tested for PSSM as she is not right. I noticed a couple of weeks ago that when I sprayed her with fly spray, she acted like it bothered her and when I sprayed her again yesterday, same reaction. Something is going on.

[JB]

@KarenRO

Triple Crown Senior Gold was not appropriate as it had wheat middlings as the 4th ingredient. Weirdly, TC advertises the Gold line of products as “grain-free” but that is not true.

It IS true that there are no cereal grains in their whole. Wheat midds are lots less of the “bad” (sugar and starch) and lots more of the “good” of wheat (protein, fiber).

You can’t look at one ingredient and declare a feed as good/bad/suitable/unsuitable. Low ESC and starch are benefits of TC Sr/Gold, despite molasses and wheat middlings.

That doesn’t mean a diet like beep, a v/m and some fat, isn’t as good or better since PSSM1 horses need not just lower NSC, but also higher fat. Lots of PSSM horses do well on the TC Sr products with added fat as well.

[KarenRO]

Thanks, this info is very helpful!

[KarenRO]

UPDATE Finally called the vet to get his assessment of Emma’s reluctance to collect or extend and generally being uncomfortable under saddle. He liked her body condition and thought being on a grain-free diet helped to manage many potential issues, including ulcers, PSSM and hindgut upsets. He thought as Emma’s reluctance to collect/extend and her general change of disposition under saddle was rather sudden, the cause was physical. Emma had already been evaluated by 2 other vets for ortho issues and they both said neck. He said that as injecting the neck with an anti-inflammatory did not resolve the issue, he thought she had an injury somewhere in her hindquarters, which in turn would impact the neck.

Bottom line, there is an injury between the top of the fetlock and the middle of the cannon bone in the right rear leg. X-rays showed nothing so he thought it was a soft tissue injury.
Blocking to the top of the fetlock did not stop her strong reaction to being flexed or her difficulty in trotting off. Blocking to the middle of the cannon bone resulted in minimal reaction to being flexed and she easily trotted off. He said I could take her to have a CT Scan and an MRI but thought the first thing to try was a change in her turnout. So, for the next 6 weeks, she will stay in her field and only come in to her stall for her 2 meals. He said to tack her up and ride her at the walk during this period but no collection, extension or lateral work.Then bring her slowly back into work and see what happens. sigh

[Feliz]

@KarenRO

Blocking to the top of the fetlock did not stop her strong reaction to being flexed or her difficulty in trotting off. Blocking to the middle of the cannon bone resulted in minimal reaction to being flexed and she easily trotted off. He said I could take her to have a CT Scan and an MRI but thought the first thing to try was a change in her turnout.

Did he ultra sound the area that she blocked out to? I would have thought that would be the cheapest/easiest next step.

[KarenRO]

The vet did not have a portable ultra sound machine. I’ll see how she does with the change in turnout and taking walk hacks in a big field. She will still come into her stall twice a day for meals and has another mare for company who is on the same turnout schedule. And, a spiffy large run-in to get out of weather and sun.

[No1]

In that case, it’s very possible she has a suspensory injury. Full time turnout may be the exact opposite of what she needs.

[Feliz]

I’m with No1 here - I’d be very concerned about it potentially being a suspensory issue and that turnout/hacking may not be the best course of action. Loss of performance can be an early sign of a soft tissue injury - well before visible lameness (ask me how I know …). I’m also concerned that your vet is fairly sure it’s soft tissue but hasn’t made ultra sounding a priority and has given you a non-traditional “rehab” plan …

Honestly, my next step would be to take her to a really good clinic with all the diagnostic equipment on site. You’ve had issues since April (or earlier?) - some possibly gut, some possibly pain, definitely an issue in that hind, but no firm diagnosis. Over 5mths without really making progress would make me pretty concerned - it may well be that there are a few different things going on.

Good luck with her

[KarenRO]

Thank both you and No1 for your thoughts! Yes, I am getting conflicting info and the bottom line, as both of you have flagged, is that Emma is not getting any better. I have requested an appointment with a vet who is known as “the” lameness specialist in the area. I know he has portable equipment to evaluate soft tissue. I’ll keep you posted!

[IPEsq]

It may have been difficult to ultrasound that day anyway because of the numbing fluid in there after blocking. Given the location, you shouldn’t need an MRI. Ultrasound ought to be sufficient. I would also worry about suspensory, because if it was tendon, you’d probably see/feel some heat or thickening during this time. Walking may be fine to continue doing, but I’d get an ultrasound done ASAP. If you need to go to a clinic, consider also scoping for ulcers. If she’s had this pain going on from some time, she could well have ulcers too. It takes at least a couple of weeks of Gastrogard (in the easier cases) to notice an improvement in symptoms, not one tube.

I wouldn’t rule out PSSM and other issues to be on the radar. The injury she has in the leg could create a pain response that leads to a whole body windup type reaction for ones sensitive to that. But given that you have a clear, blockable lameness, start there.