You’ve done a lot. Sometimes they are just “one of those horses” that has a cascade of things going on. It is not unkind to consider QOL- in fact, it might be the kindest thing to consider. I’m sorry you have to go through this.
3 Likes
Out of curiousity what was the EPM titer? I am currently treating both of my horses for EPM. The one titer was not super high but there has been a difference in behavior since treatment. You could try treatment without your vet 
2 Likes
QOL is #1 in my book. You have done what you can. I feel like euthanasia should be on the table vs living in constant pain.
You have done what you can, I’m not sure what stone is left to upturn.
3 Likes
Well, seeing as the treatments are prescription, I’m not sure how this would work?
If it were me and I wanted to try it, I would just tell my vet: it is my horse, I’m considering euthansia, so is there any harm in just trying to treat and see what we have? I would be pretty unhappy with a vet who would care that much how I spend my money with a low-risk hail mary.
I say this is a person who asked 3 vets in the past year, “do you think this is EPM?” and I trusted all of them when they said “no, that’s not what EPM looks like.” His titer was 1:2000 when I finally put my foot down and said I want him tested. Who knows what it would have been if I had tested last fall when I could barely keep him moving and basically overnight started twisting both hocks.
As to how to treat without vet cooperation: it seems there are a number of people on here who have had success with a Decoquinate/Levamisole treatment. Apparently you can get both of these without a rx - I joined some facebook groups and there is one group that swears this is the only way to effectively treat EPM. It definitely gives a cult-like conspiracy theory vibe, but it’s an inexpensive option.
You can get generic toltrazuril online internationally.
I have two weird horses. I truly understand how awful it is. I wish I was just one of those people who could say “he just needs a wet saddle pad” or a few months with Dr. Green. I have a lot of guilt over stuff we didn’t know about 20+ years ago, so I may be overcompensating now. It’s a terrible place to be mentally.
4 Likes
There is a treatment protocol using all OTC.
I haven’t read through all the comments, but if you feel like it could be EPM-related the treatment is pretty darn affordable and I know people personally who’ve used it with success. Feel free to reach out.
1 Like
Treating EPM with compounded ponazuril from farmvet is dead cheap.
But you’ve also got a horse with increasingly severe nerve pain, and that’s really really unlikely to be epm. I’m really sorry. You’ve tried so much to get this horse well but he’s got so much wrong, and nerve pain is so awful to live with 
In your shoes, I’d up the gabapentin to keep him comfortable and schedule the last appointment with the vet. I’m so very sorry. This is just the hardest part.
8 Likes
I’m sorry to hear he isn’t doing any better.
1 Like
Well, super fun, the vet was out today and I had them run their hands over him. They assessed his back pain as “not that bad”.
I know they don’t see him daily but I’m just unsure how the horse I’m seeing is so different from who he is for the vet. So… now what.
Don’t get me wrong, I’m fine with managing him as a pasture pet! But I don’t feel like that’s what’s happening here.
Hmmmm
But it’s not just about the back pain?
I say this gently, and with much kindness, and much understanding, because I also have a neck horse and worry about her…
But this all sounds like very little quality of life.
Nerve pain is awful. It’s no way to live. It’s inescapable. That he did better on gabapentin and it’s now not as effective for him is concerning, and diagnostic. This isn’t just a “get him over the hump” sort of thing…it’s progressing. Unfortunately, there are some things we just can’t make better.
You’ve tried SO MUCH to get him well. You’ve tried just about everything you can. But he’s getting worse. Gabapentin isn’t working anymore.
If you’re not ready to make the call–and I totally understand, it’s so hard–can you at least up his gabapentin dose until he’s comfortable? His sharky attitude is a direct reflection of his pain, and it’s just not fair to have him live in that sort of pain. It may be easier to communicate to the vet about how bad he is, too, if you can point to dose adjustments that have been necessary to keep him comfortable.
A kind death isn’t a bad thing. But having him continue in pain is. I’m so, so very sorry, and I know how hard this is.
13 Likes
I agree. 100%. Like I’m right there where I’m convinced he’s pissed because he hurts - this was a very cuddly sweet horse.
Vet 1 is known for never wanting to make the call unless the horse is actively trying to die. I’ve heard tales of them limping horses through things I wouldn’t, but I’m also aware that the owners weren’t ready to make that call either.
Vet 2 is new out of school, and I think overestimates my budget. I haven’t talked to them directly about this horse recently though.
Vet 3 is the one who saw him today and said he’s not that bad. Now, I wasn’t there for the appointment so maybe I need to have a one-on-one, and collect some video to explain what I’m seeing.
I don’t think I’m overreacting. I don’t think I’m wanting to put my horse down because I’m tired of dealing with him. I’m just… confused. Uncomfortable. Sad.
8 Likes
I’m so sorry you’re going through this. You have done SO much for this guy, more than I think many would have. Possibly more than I would have. He’s very, very lucky to have you in his corner.
I’ve found with vets sometimes that they’ve gotten so used to seeing really severe, obvious cases of pain and discomfort that anything not blatantly crippling is deemed “not that bad.” I am close with some folks who work in equine critical care, and their response sometimes to a problem is “Oh I’ve seen way worse, horse will be ok, this isn’t thay big of a deal,” which, yes, sometimes that’s true. But just because they’ve seen animals pull through worse doesn’t mean it’s not a significant or crippling pain to a completely different animal in a different situation. IDK. I definitely have had mixed results in terms of vets taking discomfort as seriously as I wanted them to.
Plus, there’s no light at the end of this tunnel–his back isn’t ever going to get better. It will only get worse. So vet 3 doesn’t think it’s that bad right now–is their plan to wait until it is “that bad?” How do they define that? If it’s understood that he’s in chronic, intractable pain more or less all the time right now, and there’s no realistic path to improvement…how much worse does it have to get for the vet to agree it’s “that bad?” That just makes it much more likely for his last day to be his worst, which is not what anyone wants, I imagine.
I know you know all these questions and have asked yourself them. You’re obviously an incredibly conscientious and caring owner. I think the idea of having a one-on-one conversation with the vet where you ask more pointed questions is a good one.
Sending you many hugs. You’ve done SO RIGHT by this guy and I know that whatever the outcome, you will continue to do so.
5 Likes
Hi there,
I commend you for everything you have done for your horse. Although unable to “fix” him, you have made the life he has better than it would have been without you in it. I feel your pain.
I am not there, so can’t say exactly what I would do. You are the one who will know if it is time.
Have you point blank told the vet that you are seriously considering euthanasia? I usually have to come right out and say it to the vet. I usually end up realizing he/she was grateful that I was the one to bring it up.
5 Likes
I am so sorry if you have people in your life that are telling you these things. Neither one of them is true.
To echo @barnesthenoble’s sentiments…
I recently had the vet out for my old lady mare. She’d yanked her hamstring pretty badly and while she was improving every day, I wanted to make sure I wasn’t missing something. Despite being very much not sound, the vet said she was the soundest horse she’d seen that day. I think about that a lot, because how does that skew their “normal”?
You know your horse best. You’ve been with him from the start. You know how he was before all of this. You–and you alone–can compare his “good” days now to his normal days from before. Your vets may be comparing his “good” days now to other horses having bad days, or to his bad days. That’s not really a fair comparison, is it? When you think about him now, vs how he was before all this, what does that look like?
Last year, my grey mare, who was about the same age as your guy, very suddenly became pretty dangerous to handle. It turned out that she was growing melanoma in her eyeballs, which was really quite the shock and just very, very sad. We threw a lot at her to get her pain under control (which, much like in your horse, was driving her behavior) and I think the specialist we’d brought in for the diagnosis was really surprised when I scheduled the euthanasia a couple weeks following the diagnosis.
But. There was really nothing we could do for her. I mean, we could’ve tried oncept again, but she hadn’t responded particularly well in the past. We could’ve tried torigen. But in the end, it was really unlikely that she was going to get better. And I really wanted to let her go when she felt okay. We had her pain under control, but I knew that there was going a time where our pain management strategy stopped working. And I really didn’t want that for her. Why would I? Why would I want her to suffer?
There is a day in every horse’s life where the general direction is down. Not that every single day is worse that the one before, but that the trend is down. In an ideal world, we’d know when that day is, so we can say goodbye. But (stupidly) that’s not the way it works. And while we talk a lot about losing horses, esp young horses, to acute unrecoverable things like colic or broken bones–things that are at least fairly black and white decisions–there are also so many young horses that require really hard judgement calls. Like my grey mare. Or like your horse here.
If you got a call from the barn that this guy was found dead in the morning, it seems like he died in his sleep, a peaceful end, how does that sit? Sadness, of course. It’s terrible to lose one. But any relief? Because you can provide that peaceful end.
Again, I am so very sorry. These decisions are never (and shouldn’t be) easy. If we were friends irl, I’d hand you a glass of wine, because this surely does suck.
9 Likes
Since you use this thread as a journal, go back and read your posts from how he was the last time it was regularly cold and muddy weather. How many more winters do you want him to live like that? Sometimes, there isn’t enough we can do no matter how much we want to or how much money there is.
8 Likes
Thank you, this is a good reminder. I think I’m going to pare down my posts into a coherent email to send to my vet, and make a one-on-one appointment to talk to them about it.
I wish it was as simple as equioxx and retirement.
6 Likes
Hi there,
I think an email to vet is a GREAT idea. Take the time to reread and edit (tweak) before sending. This is the best way to attempt to get vet to give full attention, without the distraction of back and forth conversation. I have used this method with great results with more than one vet.
I will add that only one vet seemed annoyed, I guess because i was questioning the treatment plan, and as it turned out that vet did NOT have the best interest of my horse in mind.
Good Luck
2 Likes
I think vets do like to see notes in a timeline.
I think this is what’s happening. I talked to the person who was actually there and it sounds like the vet said “I’ve got another client with a horse like this and they just don’t do anything with him and he’s okay”.
My standard for “okay” for my animals is higher than “not currently dying or limping so bad someone will call animal control”. But, again I wasn’t there for this conversation so I’m sure I’m missing nuance and I know he was not being his usual sharky self. He usually isn’t when there’s “stuff” going on that lights him up.
Thank you to those who have been so supportive through this. I’m would be thrilled to find a magic bullet that makes him comfortable but I’m thinking we are past that point.
3 Likes
The mental picture I had when reading that he was biting the wall to keep from biting you, was horrible.
If he were mine I’d end his suffering. I’m sorry. Sending hugs {{{{Fivestrideline}}}} from Colorado.
4 Likes
