Kissing spine and neck issues - a thread

[Simkie]

@fivestrideline

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.

I mean, not everywhere. I treated with miso without a scope or using both. I totally get that your vet has a hard line, but it’s not universal. This isn’t a “we just have to do it that way” thing although do understand your vet might want it that way. Just know not everyone does.

@fivestrideline

This thread has been helpful at least in making me not feel like I’m insane for having these concerns

You are not insane. I’m really sorry that your team is like this. Is this the vet who refuses to put down anything? Or one of your other vets? Can we help you find a vet who’s more compassionate? I have a couple suggestions in Colorado, and hmmm maybe Utah? I think that one guy is licensed there. Or Connecticut/the CT side of NY. I’m sure other people here would have recommendations for other states.

One of the few really cool perks of animal medicine is that quality of life matters. It doesn’t really, in people medicine. Vets who don’t embrace that are…wrong. Just straight up. What the actual eff, really.

[fivestrideline]

This is the (I thought) more realistic vet. To be fair they put hands on this horse recently and deemed him “fine”. It has gotten pretty strict up here as far as prescribing things without “proper” diagnostics. I think they’re used to working with insurance - and this horse is NOT insured.

I’m in NC, but not ready to jump ship yet. I’m going to send this email and see what the response is. I’ve got to go dig up some of his records to add to my concerns.

[barnesthenoble]

I am so, so sorry that you’re having to convince your vets that your concerns are valid. That is an awful and unfair position to be put in.

You’re not insane, and you’re possibly the only person in this horse’s life who truly has his best interests at heart.

[RedHorses]

OMG! (((@fivestrideline))) I don’t know how I missed this in the last two weeks. I am so sorry you are going through this. In my admittedly very limited experience, neurological horses get worse quickly once their condition start going downhill.

I have been fortunate to have had a good relationship with my vets each time I made the decision. I was concerned when it was my Wobbler because I had only been with that vet for six months. I had some worries with my second horse, but I didn’t get any push back when I explained my fear of him going down in the winter with his weakened hind end.

I wouldn’t read too much into the vet saying to a third party that they have other patients who are worse. Especially when they’re seeing the horse under full medication - at the horse’s best. They’re cautious about mentioning euthanasia to the owner - saying anything to a third party would be extremely unlikely.

Laying out your observations and timeline is a great idea. I do think you will have to be absolutely black and white and say that you need to make an appointment for euthanasia, and here’s why you aren’t willing to prolong your horse’s pain any longer. Don’t skip the subjective assessment of your horse’s behaviour. You know the horse best, and you do know how he’s doing, and how he will handle the winter conditions.

I truly hope you will be surprised at how well the vet reacts. No one in your situation shoud have to argue with the vet for euthanasia.

[IPEsq]

I’m not 100% sure if I remember correctly the vet you used in CO, but if I’m right in the one I’m thinking of, I believe she passed away from cancer.

I would honestly put him back on Gabapentin and just add sucralfate. It’s not good to give at the same time as Gastrogard, but I have given it with other meds and didn’t notice loss of effectiveness of the others. Particularly Robaxin because my horse lived on both for a while. Which is also a CNS drug.

Or make the call, but I understand that’s difficult.

[Simkie]

@IPEsq

I’m not 100% sure if I remember correctly the vet you used in CO, but if I’m right in the one I’m thinking of, I believe she passed away from cancer.

Oh my that’s not who I was thinking of–both men–but Pam? I am so sorry to hear that if so.

[IPEsq]

Diane. She was good with the mystery cases.

[cayuse]

I’d do this to. I had to give sucralfate with other meds too and didn’t notice any loss of effectiveness. I know your not “supposed” to, but when my mini had surgery he was on so much stuff it just had to get done that way.

[fivestrideline]

Hey, at this point I’m willing to give it a go.

I don’t think it’ll change anything, but I’ll try it in the meantime since I have the meds anyway.

[Pico_Banana]

@fivestrideline I know you are processing a lot right now and I’m not going to wade in on the productive conversations you’re already having with others. But if you decide to PTS and your regular vets aren’t willing to do it, what about trying to find a vet who is more of a backyard/pleasure horse vet rather than a sports medicine vet? I feel like they can sometimes be more matter of fact/practical about QOL than the vets who have all of the latest technology.

Sending you virtual support.

[Simkie]

@IPEsq

Diane. She was good with the mystery cases

I don’t think I know her, but still sad to hear of her passing

[Lunabear1988]

I took my trigeminal nerve pain horse (The one that dragged his head on the ground) to her once and I will never forget how relaxed he was at her place. But also how she was so extremely worried about my horse and that there wasn’t much hope. Her and Pam M were so extremely worried while the sports medicine vets were still blowing me off for awhile.

So sad that she’s gone. I could tell how my horse was with her, horses loved her.

[MyDarkPassenger]

What was the rehab plan and his response after the initial diagnostics? What has his activity been like in the last 3 months?

[hallie2]

FYI- gabapentin has a short elimination half-life. It’s given up to 4x/daily in humans. Maybe increasing dosing would help.

[Simkie]

Super useful to know but holy shit when I had to do QID dosing for one of my horses, it nearly killed me, and I have them at home! That midnight & 6 am dose just sucks so hard. I can’t even imagine with a boarded horse, unless the barn’s schedule lines up juuuuuust right to take over two doses. Even TID dosing is such a trial for any length of time

Is there any new research in pregabalin in equines? Last I looked (few years ago?) there was only a little but it wasn’t great. I’ve wondered if that would work better for some.

[barnesthenoble]

Yeah, it was tough AF to do QID gabapentin for one of my cats. TID (every 8 hrs) was easier but still hard when you work. And that was with a cat where I could just roll out of bed and offer a Churu plus meds. I can’t imagine trying to do it with a horse for more than a few days, let alone long term. Having to board would make it impossible IMO.

[awaywego]

@Simkie

Is there any new research in pregabalin in equines? Last I looked (few years ago?) there was only a little but it wasn’t great.

Would love to know about this too because I have a huge bottle that New Bolton insisted I take home and I am still wondering why I paid for that

[Simkie]

@awaywego

Would love to know about this too because I have a huge bottle that New Bolton insisted I take home and I am still wondering why I paid for that

Wow, really?! For a horse? How did they want you to use it? I’m so curious!

[Libby2563]

@Pico_Banana

But if you decide to PTS and your regular vets aren’t willing to do it, what about trying to find a vet who is more of a backyard/pleasure horse vet rather than a sports medicine vet? I feel like they can sometimes be more matter of fact/practical about QOL than the vets who have all of the latest technology.

This, or if he can be trailered safely, you could try giving NC State a call and asking about donation for a terminal study. I drove my DSLD horse all the way down there because they were working on that specifically, and they were so wonderful about the whole thing. I also donated a different horse to a different vet school once and they didn’t make me jump through any hoops to justify why he was a terminal case. I’m not saying you’re there yet, but if/when you are I think it helps to go into the discussion with a certain degree of confidence that your decision is already made and here’s why.

This situation sucks and I’m sorry. OP, you’ve tried so much though and is he ever likely to be happier and more comfortable than he is right now (which seems to be, not that much)?

[fivestrideline]

@MyDarkPassenger

What was the rehab plan and his response after the initial diagnostics? What has his activity been like in the last 3 months?

So this horse has a history of being NQR, since… 2019? And even before that he was never in hard or consistent work.

Let’s see:

• March 2022: KS, NPA, and hock arthritis diagnosis. Prescribed equioxx and shoeing change, injected hocks, began PT (handwalking, stretches, EquiCore). Considering shockwave/injections for back but decided to work on feet first.
• July 2022: front suspensory injury diagnosis. We think this had been brewing since spring '22 but it took that long to find it. Negative for Lyme.
• August 2022: moved to rehab barn. Followed Gillis protocol for suspensory to a T: therapeutic shoeing, stall rest, progressive work. He got daily handwalks and was worked properly: hills, poles, MARCHING, etc. Back does not present as sore. On robaxin and some herbals for general body soreness we thought he’d have due to the stall rest.
• January 2023: started under saddle work, continued handwalking and groundwork. Exhibited some tripping, even going all the way down. His behavior had also begun to deteriorate, he became hard to handle on the ground and rank under saddle.
• February 2023: started expanding turnout. Stopped riding and remained on groundwork rehab for safety.
• March 2023: ceased rehab and turned horse out entirely. He had become dangerous to ride and very unhappy. Horse is very strange in turnout for a while - refusing to go into pasture (stayed in drylot even when the others went out), only backing into the shelter, generally being really strange.
• April 2023: suddenly normal in turnout. Happy, sweet, hanging out with the herd. Bodywork helps a ton.
• September 2023: moved horse from rehab to 24/7 turnout retirement barn. Hoping to be able to trail ride at the walk. Bodywork still helpful, but horse is NQR. Negative for Lyme again, low titer not clinically significant for EPM. We try acupuncture, chiro, shoeing changes, PT, bute, etc. Lots of slow easy handwalking on trails, tail pulls, other static stretching work.
• February 2024: start noting front leg crossing, back soreness increasing, etc.

This is when I start chasing rabbits with the vets, and he gets a neuro diagnosis. We tried OSPHOS, found a bone spur in a fetlock, started on gabapentin, xrayed the neck. Most of that journey is documented here. I stopped with any work by the end of spring 2024 and just left him alone.

The last 3 months have been 24/7 turnout, grooming, and hand grazing. Occasionally I’ll toss him in the round pen for 2 minutes to see how he’s looking. They have 7 acres to roam, IIRC, and it’s hilly. I have noticed he gets worse in the winter and stops wanting to go up the hill, he tends to hang out down by the barn even when everyone else leaves.

ETA: I realize we haven’t done anything specific for the KS besides PT and systemic drugs. My vet has been significantly more concerned about the neuro issues (me too), and I cannot/will not do surgery. Shockwave and meso and stuff like that is not completely out of reach, though I do have to think about my budget for repeat treatments. Even when his back isn’t symptomatic, we are struggling with other problems that prevent rehabbing the back (or so it seems in hindsight). Anyway…