It is totally fair to have a budget and a limit on what you can put towards basic quality of life things. Especially if you think he is still suffering even with all the special care and your best efforts.
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I find it helps to be very vocal with your vet. I have a horse that was retired at 5 after spending a fortune to try and fix him. Heās almost 8 now and last year was declining in a way I wasnāt comfortable with. I made it very clear to my vet that I was considering euthanasia and why. I laid out what conditions he had to be ok with (pasture board) what changes I had noticed. He was no longer trotting or cantering in the field and was sore in his back all the time. Financially I have limits on him. Weāve tried bute and Equioxx and neither helped. As a Hail Mary we tried osphos and it did significantly help so heās still trucking. But I find most vets want to know where youāre at. Explain that heās been retired, is declining, youāre considering euthanasia and need a second set of eyes to look at all of the symptoms with you.
This horse also had major ulcer issues that didnāt go away until he was retired and more comfortable.
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Many TBās have PSSM. In fact, a lot of PSSM in QH can be traced back to TB sires. Northern Dancer was a major carrier, and of course influenced a lot of North American breeding. If you are thinking PSSM, buy a short term membership at Bridgequine.com, and do the research, or pay Sharalee to do it for you. I was stunned to find out how prevalent it is in some bloodlines, but it explained a LOT.
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If you wait until the people walking by your horse for one minute can see that he needs to be euthanized for his sake, then you will have waited too long.
I have euthanized horses that appeared to be doing all the healthy horse things to the casual observer. Iāve said it in other threads - YOU know your horse best. YOU see when heās uncomfortable, painful, unhappy, and behaving abnormally long before anyone else.
When I euthanized my second horse I was in a large barn that had a clique of āmean girlā women who loved to trash other boardersā decisions, care, training, etc. I told my BOs, and maybe three other boarders who loved my horse too so they could say goodbye. I asked that they not tell anyone else before my horse was gone.
This is why I advise people not to talk about it within their barn. The other boarders casually glance at your horse as they walk by, and donāt see the little things that you do. You donāt need their permission or blessings for anything you do with your horse.
Iām sorry, this is a mean thing to say, but Iām going to say it anyway, for your horseās sake - By allowing your worry about what others will say to affect your actions, you are putting them ahead of your horseās well being and quality of life.
We have to be our horseās advocates. We have to do the hard things. Maybe this blog entry will help:
The other blog entries might help you feel less alone, but please read this one about how do you know when itās time.
You have my deepest sympathy. I know youāre in a difficult place. ((((hugs)))) 
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Fabulous post!!
The ulcers were the beginning of the end for my neuro horse. It was a nightmare getting rid of them the first time, and when they came back ā¦
My gut feeling was that there was something else, some other thing going on that had brought on the ulcers.
VERY VERY well said, @RedHorses! 
There were days you would have thought my horse was training for the KY Derby in the paddock before we could put him down, but then heād limp in for dinner after with a āthat was kinda stupid, wasnāt it?ā look on his face. Depending on when someone saw him would give a very different impression.
I always felt bad for his vet, who really did everything he could think of for him. When he looked at the horse the first time, he was really confident he could get him sound again. A year later, he admitted, āthe foot is doing what I want it to. The horse isnāt.ā Just one of those āI donāt know why it didnāt workā moments where weāre reminded vets are educated humans, not God.
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We pulled blood for EPM and Lyme, and are putting this horse on Gabapentin tonight. X-rays didnāt happen (for various reasons) but the vet agrees the horse is way too uncomfortable for a horse that has been retired, though the KS isnāt actually as bad as Iād thought (not pretty, but not so bad that it should be causing this issue). I had an audience so will be having a phone or email conversation about QOL later, maybe once the EPM titer comes back. Vet also thinks the ulcers could be the issue and wants to scope - in their defense theyāre new to me and this horse. Iād be willing to scope again, but have to wait for $$.
He got his teeth done and we had some good conversations about what supplements heās on (E and Mag) so Iām hoping maybe we get somewhere once Iāve checked the āeasyā boxes and I can have a private conversation with them.
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I hope the gabapentin gives him some good respite. Did he ever get more agreeable about eating the Tylenol? That seems to be such a nice combo, esp for horses with an ouchy belly.
It sounds like a good day of moving the ball forward. I really hope youāre able to get answers or at least some agreement about where he is from a QoL perspective, and a path forward.
One thing we do know about KS is that the imaging doesnāt mean a whole lot. Same for spines in general, in humans also. One horse could be trucking along fine for the most part with horrible imaging and another horseās supposedly āmildā condition is, to them, the end of the world. Some vets are hesitant to even suggest spine xrays for PPE (even though they are increasingly common, and I definitely do them now) because potentially a perfectly good horse (meaning, asymptomatic, not clinically significant) might be passed over due to some KS findings, which can be a shame for the horse trying to find a good home. But, as you know, KS often comes along with other issues like foot balance problems and related joint problems, and ulcers and other things, and so perhaps itās the cumulative effect that winds up being worse for some. Perhaps it is in some cases just more neuro type pain. We donāt really know, as they canāt talk to us other than with their behavior. And being retired is sometimes not the best thing for KS (compared to a horse that might tolerate a good core conditioning/fitness program), but retirement may be better than having a rodeo bronc ride due to KS.
Iām sorry that you had such an audience for the vet appointment. But Iām glad you have a vet who is listening and trying to see the whole horse.
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If you really love your horse you would listen to him. He is telling you loud and clear that he would like to be euthanized and out of his misery.
How can you communicate to your horse that you just NEED a few more tests with more concrete answers about HIS pain? It is OK to ask any of the vets you have already seen to put him to sleep/euthanize.
Horses are not people and deserve to be treated with respect for their needs.
Who cares what others think? Do not judge your insides by other peoples outsides.
I wish both you and your horse the strength to act in his best interest.
So sorry you are going thru this.
As hard as it is to accept, sometimes we can never find the cause of the pain in horses like this.
My first horse was retired in his late teens after several years of chasing on-and-off severe lameness in his hind legs. We x-rayed and ultrasounded everything we could think of multiple times. He would become sound if we blocked his fetlocks, but no one could find anything that explained the degree of lameness he exhibited. We tried joint injections, with limited success. By the end of his life, he was on gabapentin and Equioxx daily, topped off with Banamine and xylazine on farrier days. Despite all that, heād shake from head to toe and nearly fall down from the pain when the farrier finished trimming a hind hoof. He would mosey around the pasture, get up and down, and even do the occasional stilted lope, but he would not trot voluntarily. He was 21 at this point and had been retired for 5 or 6 years.
I decided that Iād let him have one more good summer, and I hauled him to our vet school to be euthanized on a gorgeous October day after stuffing him full of alfalfa and sweet feed (he was also PPID and not eating well by then). It was the most peaceful euthanasia Iāve ever witnessed. The vet looked at me after it was over and said, āSee how quietly he went? He was ready.ā
I had a full necropsy performed to try to finally solve the mystery. The results? āMild to moderate osteoarthritis in hocks and fetlocks typical of a horse this age.ā Nothing else of note other than the PPID and some small abdominal lipomas. NOTHING to explain his pain, even after every tissue in his body had been examined from head to tail.
I know I did the right thing for him, but I hate that there was no explanation to be found. Our best guess is that it was some kind of nerve issue that canāt yet be diagnosed. But thatās just a wild guess at this point, and I will never know for sure.
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All tests came back negative. Going into week 3 of ulcer treatment and a week of gabapentin. The horse might seem less crabby? But ironically, the weather has also improved greatly so it may just be me and my brain.
Debating the merits of a scope and neck X-rays on my own appointment. Then at least I have exhausted my options unless I haul him out somewhere, which is a good way to set him off again and not high on my list of āworth itā options.
The response to gabapentin (assuming itās not an ulcer thing) makes me think itās nerve pain. I know gabapentin also works on arthritis and musculoskeletal pain, but the horse doesnāt respond to bute or robaxin all that much.
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To me, pain thatās been persistent such that it created these issues will require a while for the animal to realize is gone and for there to be a change in behavior.
I was injured almost a year ago and the discomfort has only just begun to reliably resolve the last two months.
I am just finally not acting like Iām that painful person, while in many ways I am still very defensive and protective, even though I know Iām ābetterā.
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Hello, I am in a very similar situation. My vet has/had basically given up on my horse, she basically said, put him in a field or put him in the ground (andā¦she may be right). But I am where you areā¦first of all, I love this horse, and love riding him. He has basically said no to riding. I will try something and have a few perfect rides, then back to NO GO! He also has a twisting right hind which we have been trying to figure out, as well as negative plantar angles that we have been semi successfully managing. We think he may have a few things going on, causing this, making a diagnosis difficult. But that is where I am stuck, as you are. I donāt want to retire a horse I love with no definitive diagnosis, and so far he is not in what appears to be tremendous pain for turnout. Although, like yours he has gone from low man, to ādonāt mess with meā. I had actually found a retirement farm, but recently had acupuncture done by a dvm to just get her thoughts. I have had concerns it could be neuro and she concurred that he had enough symptoms, although none are super extreme or classic, to think it was worth testing for EPM. I called my vet and said for piece of mind can we do a CBC blood panel, vitamin E test and EPM titer before I send him off to retirement. She said she understood, but did not think that was it. Well, yesterday she called and his titer came back as high positive for epm 1:4000ā¦so I am still not sure if he has active disease, but I am going to treat and see if it helps. I only wish we had done it sooner. We also had ultra-sounded suspensories a while ago and there is some chronic damage, so if he makes improvement with the epm med and I can ride, but is still NQR, I will most likely follow with some shockwave to hopefully get him right. I guess I am saying it may be worth it to do the epm titer. If nothing else, have some solace that you are not alone. I really hope you find an answer.
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