Kissing spine and neck issues - a thread

[Simkie]

You might also think about what you’re looking for from the vet? What are you hoping to hear?

Do you need permission to put him down?

Do you need to know there’s nothing else that can be done?

Is there something else?

If you’re up front with what you’re looking for in the interaction, that might be helpful. Vets as a general rule don’t look at a horse that’s not acutely ill, like unrecoverably ill, and advise euthanasia. They leave it up to the owner, because it’s such an emotional decision and so personal. People make that call in such drastically different places and points of suffering.

But I would ask, and consider, if you keep him going now…to what end? Given that he’s progressing, and you’ve lost pain control with this gabapentin dose, what does his future life look like? Do you want that for him? How bad does his life need to be before putting him down is the right decision?

And I know these questions may sound like they come with judgement, but please know they do not. These are absolutely the questions I ask myself when faced with these very difficult decisions. I’ve made choices I’m very comfortable with, and choices I regret. But…the regrets are all when I’ve waited. And they weigh so heavily.

Big hugs. And a big glass of wine.

[fivestrideline]

@Simkie

Do you need permission to put him down?

Yes. Cause I need the vet to do it.

I’ve never had to ask before, and I guess that’s the sticking point. I’m terrified of making the wrong call, terrified of being judged I guess too. I’m already going to have to lie to family IF I put him down, because they’re the ones that just don’t understand. I’ll get over it, because I know he’s my responsibility, but this is the first time I’ve been thinking along these lines where the horse wasn’t colicking.

Wine is definitely needed, tbh. Today he was almost snuggly, but then proceeded to go after my other horse for no real reason. It used to be a week to week thing, then day to day, and now I feel like it’s minute to minute.

[Simkie]

@fivestrideline

Yes. Cause I need the vet to do it.

For what it’s worth, I’ve had to tell the vet I wanted to schedule euthanasia for every single horse I’ve had to put down. (Nearly all of the small animals, too.)

Some I’ve had to explain why–a sentence or two–others were familiar with the case to just know. I’ve never had one push back, even though they themselves had not brought it up. Different vets, different states, different lengths of relationships.

I totally understand the fear of making the wrong decision. It’s definitely not one you can take back. But you also can’t take back pain and suffering, and that should be on the other side of that balance scale.

You don’t need permission to put him down. You just need to tell the vet he’s had enough. Breaking through the gabapentin is enough. Fear of how he’ll do through the winter is enough. This?

@fivestrideline

It used to be a week to week thing, then day to day, and now I feel like it’s minute to minute.

This is enough.

I am so, so sorry. And I’m really so sorry that you don’t have support here in your family, too. Do you have horse friends in real life that support you in this? Do you want to connect with someone here to meet in real life? If you’re near me (I’m in CT) I’d be happy to meet up. I’m sure others here would make the same offer. No one should be alone in this.

[endlessclimb]

@fivestrideline

He usually isn’t when there’s “stuff” going on that lights him up.

My Old Man will go sound when the vet is there. He also looks normal but will fear-dump his spleen. Adrenaline is a hell of a drug.

[MsM]

IME vets generally dont bring up euthanasia on their own except in the most obvious, extreme cases. For a number of reasons, I think.

First they dont want the owner to think “the vet told me to kill my horse” if it is not indisputable (broken leg etc) They wait for the owner to bring it up. In the cases I know, the vet was then supportive of the decision.

Secondly, some can be so invested in the case that they can also become barn blind to the realities. They want to try all the modalities and treatments they have heard of (while you pay and the horse suffers) in hopes of a miraculous result. They dont see the horse day to day and may not realize the degree of pain or dysfunction.

I know of a situation right now that I would handle differently. 25 yo horse with multiple problems. He has been being treated for one or many issues for the past year. He is thin, with sores from lying down and permanently lame along with chronic conditions. They go from crisis to crisis and the owner only asks " can you treat him?" so the vet continues to treat. I would have assessed the QOL differently long ago and let him go. He is currently between crises and fairly comfortable so on they go…

[Lunabear1988]

OP, In the past I’ve had to have a direct conversation with vets about euthanasia. It wasn’t anything anybody had directly brought up to me but when we talked in depth, I laid out all my concerns (It seem like there was no good prognosis and that the future was grim) they all came to the same conclusion.

I’ve had the sad outcome of euthanizing to not quite right horses. Each time, I had talked to multiple vets (including some at two different hospitals) chiropractors and heck even farriers. I was lucky that basically all of them came to the same conclusion. I straight up asked is it realistic to think this horse will ever not be in pain? And the answer, after much thought, was no probably not. And I do think having multiple opinions coming to the same conclusion helped my own vet feel right about it. In fact one horse I almost stopped it that day. I asked her if she thought I was doing the right thing and she looked at me and said “I’ve said no to people before. I won’t just put a horse down for no reason. You are making the right call.,”

So my advice is to not be afraid of having that direct and difficult conversation. I’m also lucky that most of the vets I work with are actual horse people. Meaning they have horses and they ride. They get what it is to live with an animal and how we can see when they’re in pain versus just a clinical exam at times.

[clipper]

@fivestrideline

I’m terrified of making the wrong call, terrified of being judged I guess too.

Better a day too early than a day too late.
Do not let other peoples outsides judge your insides.
You go this - you can do it - just tell the vet what you want.
{{{{HUGS}}}}

[Sancudo]

I had to make the call last year on my not quite elderly (20) guy with DLSD. He was slowly going downhill (not rolling, not laying down anymore, struggling up the hills, attitude change) but not the obvious call I’ve only had to make before.

I debated for weeks before I made the call to my vet, struggling with the “is he bad enough that they won’t judge me, even though I know he’s very unhappy now”.

I brought it up after, and my vet said, “Oh no, thank you for doing this peacefully now so I didn’t have to come out at 3am in an emergency, because I have to do that too much and it’s horrific.”

[MyDarkPassenger]

Agreed, vets aren’t going to make the call. In 2020, day 2 of moving to a new barn I received the call that we all fear, my horse was down in turnout and not getting up. When I got to him, he was seizing, his breathing was erratic and labored, and his ears were filling rapidly with liquid. I work in the medical field and knew right away that he’d had a TBI. The vet arrived and I stated immediately that I wanted to euthanize him, that it was the right choice. She continued examining him, determined that he was also paralyzed at the cervical level then proceeded to offer me a chance at trying to save his life for a few days. He was everything to me and it was not a difficult decision to maintain my first choice.

I can’t imagine the vastness of the emotional turmoil and expense choosing differently would have been. He would have undoubtedly suffered and still the vet delayed recommending HUMANE euthanasia. It’s your choice alone but rest easy in knowing that it is the greatest act of love you can offer him. Major sympathies

[Pepsy]

Hi,
BTW, you mentioned trying sucralfate, that you had some and thought you might just try it. Did you? Asking as currently working through some odd issues with my horse who is currently back on sucralfate after deteriorating after stopping.
Thank you

[fivestrideline]

Not yet - gotta wait until I’m home and able to dose consistently

[fivestrideline]

Small update: the saga continues.

I took him off the gabapentin (I know I know) in order to try sucralfate. Timing is an issue, trying to work around the drug interferences - the barn doesn’t have staff on site or available all day. They pop in and out for a couple hours to cover AM/PM shifts. I’m a bit limited on options, unless the sucralfate could be dosed 10-20 minutes after the other drugs.

He has been off the meds for less than a week and I think some of the neuro issues are back. He’s also being more protective of his space in the pasture and going after the others. This coincides with a gnarly cold snap, so worst timing on my part I think… but still.

I know that the setup isn’t perfect and in an ideal world someone would be free to give him meds as needed, but here we are. I’m going to have to research timing on sucralfate and see what I could possibly make work… and put him back on the gabapentin. Not that it solves 100% of his issues…

Anyway. I think this shows that nerve pain is the issue for him and/or the gabapentin has just been doping him into sleepiness.

[barnesthenoble]

Have you set yourself a timeframe for how long you’ll wait to see if the sucralfate works before restarting the gabapentin?

[Simkie]

What are you hoping to accomplish in discontinuing the gabapentin and adding the sucralfate?

@fivestrideline

Anyway. I think this shows that nerve pain is the issue for him and/or the gabapentin has just been doping him into sleepiness.

Didn’t you already know this, with what’s happened when you’ve run out of gabapentin, and how he’s broken through it?

I really encourage you to view him from a … hospice? … perspective. What will make his life better? Discontinuing the gabapentin, which you know is important in his neuro function and pain management, seems to be an unfair choice to make.

[Pepsy]

According to online research, there are no known interactions between sucralfate and gabapentin

[fivestrideline]

@Pepsy

According to online research, there are no known interactions between sucralfate and gabapentin

Sucralfate isn’t supposed to be given at the same time as any medications because it interferes with absorption. Usually it’s a several hour wait period.

[fivestrideline]

Two things:
One: outside pressure to “try everything”.

Two: proof of concept for my vet and myself. One vet wants to scope for ulcers before doing any other diagnostics/treatments/discussions, for example. This partially (to me) shows that our main issue isn’t ulcers, or PSSM, or MFM, or vitamin deficiency, or whatever. It’s nerve/bone pain, likely related to the kissing spines, and it makes him start looking neuro if he doesn’t get his gabapentin. That, plus the fact that he’s blowing through the gabapentin at the regular dose = we have a chronic, progressive issue. One that won’t be solved by scoping for ulcers, or buying a $350 BOT turnout, or buying a $10k BEMER (yes, these have been suggested by professionals).

He’s going back on the drugs, since it is clear I cannot manage him without them (and maybe with). I have to get a few pics and videos tomorrow for “proof”, but then we are back on the routine.

I’ve not had to argue/prove myself with a vet team like this before. It’s honestly stupid.

[Simkie]

@fivestrideline

I’ve not had to argue/prove myself with a vet team like this before. It’s honestly stupid.

It is. A lot. This sounds like something that’s been already well proven. And misoprostol could’ve been used to accomplish the same thing without pulling the gabapentin.

I’m sorry you feel so pressured to justify your concerns to your team. That’s really terribly unfair to both you and your horse.

[fivestrideline]

@Simkie

And misoprostol could’ve been used to accomplish the same thing without pulling the gabapentin.

True. But this would require a scope and script and they want to double treat with sucralfate in combo anyway, if there are ulcers. So I did the sucralfate alone due to having some on hand.

@Simkie

I’m sorry you feel so pressured to justify your concerns to your team. That’s really terribly unfair to both you and your horse.

I agree. Also frustrating.

This thread has been helpful at least in making me not feel like I’m insane for having these concerns. It’s one thing to tell a stranger on the internet to put their horse down due to QOL, it’s another to BE the stranger on the internet dealing with this IRL. But it is helpful to hear that I’m not way off base to feel like we aren’t getting anywhere, and in fact are going downhill a bit.

Unfortunately I’ve watched this play out for 3 separate people dealing with other issues, and it isn’t pretty from the other side either. I think those owners may have been on different pages than me, but… dang if the vets can’t spend owner money while not really accomplishing anything.

I’m drafting an email as we speak. Ugh.

[skydy]

I’m sorry you and your horse going through this. Hugs from Colorado.