Older horses - teeth "expiring"

[CHT]

Looking for other’s experiences.

There are three horses in my barn that are early 20s, and recently the vet has stated they all have “expiring molars” and each have a couple that have cracked. Two of the horses don’t seem to be bothered, but the third was not comfortable and the vet was not able to complete the float (will redo with a few days of pain meds on board). The vet suggested nothing was urgent, but that they will need the broken molars, unfortunately the teeth will need to come out through the top of the skull/head in surgery. I have prior experience with that with a teen horse, and it did not go well. Ended up a five figure bill…lots to spend on an older horse.

They are all in good weight on hay.

Is this a common thing in horses when they hit their 20’s? Does anyone have experience with this? Did you do surgery?

One of the horses is my good boy lesson horse. He goes bitless and is irreplaceable, but I am just not sure how I feel about the surgery after what happened with the other horse.

[Laurierace]

EROTH? I lost my mare to that last summer

[joiedevie99]

Personally, I’d get a second opinion if that was the case with several horses in the same barn at the same time. In my experience, it happens but it just isn’t that common for molars to break and need to be extracted through the skull simply because of age.

[cayuse]

Did they say why the tooth had to be removed through that area? My mini had a molar removed last year and a hole was drilled in his face and the tooth was tapped down and out through the hole. The only reason it had to be done this way was his mouth was so small the vets couldn’t access the tooth readily to pull it.
I’d get a second opinion. Any equine dentists near you? My mini’s procedure was about $3,000 but he had a sinus infection and was at the clinic for 3-4 days with drains and lavage and meds. That price includes a bunch of imaging, too.

[Weezer]

I agree with getting an opinion from an equine dentist. I’ve known a few horses to have molars pulled from the mouth, but I’ve never heard of having teeth drilled out. I agree that sounds pretty intense for an old horse.

[MorganMaresVT]

I was ready to write, “no big deal” until I re-read “surgery to bring them out the top of the skull”

My nearly 30-yr old mare had 4 molars extracted in two different surgeries over the past couple of years, and she did go into the clinic for the procedures. Two were broken, and had pockets form around them that led to a sinus infection, so they needed to come out. But the teeth themselves were fairly loose and essentially popped right out-they were basically just root with hardly any grinding surface left.

The extractions were no big deal-she went in around 8am and we picked her up the same afternoon. Both times she was banging on the stall door at the clinic demanding her freedom! She had a course of antibiotics for recovery, and we gave her a few days of soupy hard feeds, but that was really it. And I think the vet bills each time were a few hundred dollars, probably no more than $1k though I honestly don’t remember.

Maybe there’s something uniquely challenging for your horse, but three horses needing the same invasive procedure does seem really odd to me.

[SmlHpy1]

You lost here due to EOTRH? Can I ask how that happened?

[Laurierace]

She was not a surgical candidate

[SmlHpy1]

Interesting. My understanding is teeth are removed via standing sedation. My guy has EOTRH, but currently we have not removed any teeth.

[Bonnie2]

Find a vet with alot of grey hair. Pulling all the teeth on old horses is a relatively new phenomenon. I’m not saying it is wrong (or right) but a vet/dentist with decades of experience may be able to suggest alternatives. Good luck!

[Laurierace]

My mare was old and had been retired for over a decade. There was no point to put her through the procedure and the very painful recovery.

[Sdel]

I’ve had one done this way. The tooth was broken in half. Half had already fallen out and the rest was rotting away in her mouth. She had a nasty infection as well, although not in the sinus.

Vet punched it out from the top. He had to lay her down for it because she was so reactive to her face. Good thing he did. She’d had a bit of a jaw fracture and all the bone and tooth was so soft that he had to take X-rays just to see if he was in the right spot.

[Jarpur]

My 31 year old had eight molars taken out, under general anesthesia, by an older veterinarian recommended by my dressage trainer (he’d done the extractions on her two 30-somethings, and had a lot of experience with oldsters).

The vet called me immediately afterwards, while my horse was waking up and said that there were basically no roots left and the teeth had been ready to come out easily, and that my horse would stay in recovery for a while before he was able to rise to his feet, and eventually be returned to a stall.

While we were still on the phone, there was a commotion in the background and the vet said he had to go, click. Later, I got a message to come get my boy, earlier than planned. When I arrived at the clinic, a couple of techs told me that what had happened is that my horse woke up in the blink of an eye, got himself on his feet, and left the recovery room asap under his own steam – with techs hanging on, trying to restrain him.

He then marched down the aisles until he got to the stall where he’d been kept before surgery (knew where he was going), and put himself away, thank you very much. Yep, that’s my boy! (His mom had been very difficult to keep sedated at a similar age, too, she was impervious.)

My horse bounced back so fast that the vet told me it was better for him to go ahead and go home. There was aftercare, with prescribed mouth washing-out several times daily for a period of time – this was back when I boarded, and I went to the barn five times a day for this. Once recovered completely from the extractions, he went back to eating his normal diet of senior feed, grass hay, and grazing over the next few years. Eventually, he could only handle alfalfa hay, and moistened feed (still liked to graze until the end of his long life).

[beowulf]

@SmlHpy1

Interesting. My understanding is teeth are removed via standing sedation. My guy has EOTRH, but currently we have not removed any teeth.

Some do it standing but my understanding is that may be going away in the States. I had an aged gelding with EOTRH. My practice would only do surgical route, general anesthesia at a hospital. We called around and no vet clinic would do standing in field. The price difference between the two is high. Dentists here are very wary about administering sedation because of the then-recent law change. My horse had other age related comorbidities that made general anesthesia a concern. Like @Laurierace we ended up making the decision to PTS; the EOTRH was the nail in the coffin. I understand it’s very rare now for vets to do this in the field. I was getting quotes of $2k+ and this was in 2016-2017 IIRC. Reports on COTH were that dentists could do it standing for $400, so for someone who was on a budget I could see this making it a tough call.

[SmlHpy1]

Interesting. My guy was diagnosed in 2019 at University of MO. I spoke with them as well as Dr Easley in Louisville KY. Quotes were around the $2k range if I remember correctly. But both were standing sedation in a clinic. I would never even consider putting my guy under general anesthesia. I do not have the option of having it done at my barn, I’d certainly have to haul somewhere.

[alterblue]

Agree with those saying second opinion, ideally from a dental specialist if you can get it.

My mare is 26 this year and has lost 3 molars so far, with more expected to come. One fell out on its own, so that was a “freebie” lol. The other two were discovered because she had stopped eating her hay with the same gusto and we had done dental x-rays that showed the damage to the cracked tooth. She was referred to our excellent dental specialist who removed the tooth in the field - with heavy standing sedation (and this is a very reactive mare). Once that tooth was removed the tooth next to it was discovered to be very loose and unstable so they decided to remove a second molar as well. She recovered uneventfully from this procedure with just some mouth rinsing as regular maintenance. Total for both was just over $900.

I did have a different senior horse with EOTRH (I spend a lot of time with the dental specialist lol), and his incisors did have to be removed at the hospital, but what you are describing for cracked molars sounds very intense, especially for an older horse.

[ClearDonkey]

Not to derail OP’s thread, but @Laurierace and @beowulf I was hoping I could ask about your experiences with EOTRH and making the final call to euthanize. I just got a $3k quote to remove my 25 year olds incisors from my new equine vet, whereas my equine dentist’s stance was to remove as needed at home.

He’s healthy otherwise, with successfully managed Cushing’s, still riding W/T/C, eating hay and some grain.

After a terrible 2023 as far as vet bills goes, the $3k would be very tough to swing right now, and I’m always worrying about his quality of life and what will ultimately be his end.

[beowulf]

I am sorry to hear you are dealing with it. My gelding had advanced cervical arthritis at the time of EOTRH diagnosis. He had already been retired for five years at that point. It was becoming increasingly difficult to shoe him. I kept him at home and was the primary caretaker, so I was comfortable with the risks of daily handling - but my farrier was understandably not. We were all collectively worried about getting him up post anesthesia. Because his CA was not getting any better, it didn’t make sense to put him through a painful surgery just for a few months of better eating. If he didn’t have a neurological disorder significantly curtailing his life expectancy, I would have done the surgery.

My experiences with other people’s EOTRH horses is that the horses bounce right back after recovery. I’ve taken care of several immediately post-extraction as a barn manager. While the extraction is gristly, I have only seen improvements post-extraction. If it was within your budget, I would do it - there are minimum risks and complications. I noticed with these horses that their personalities became much bigger post extraction, which makes me wonder if they’d been dealing with low grade pain for a long time.

I’m sorry to hear of your rough go of 2023 in terms of vet bills. It’s hard.

[CHT]

A client had a gelding need his fronts removed due to EOTRH. He was still being ridden, but she opted to retire him after the surgery because she had a farm to retire him and knew he would be a nice boy to have in a yard with her other retired horses. He did very well for about three years before colic got him. It is a lot of money, and I would not have judged her decision either way. This surgery (although serious) seems less risky than the through the skull surgery, but still some risk, and I am not sure how likely it is for an older horse with considerable time of to return to work (if that is your goal)

[CHT]

When we had the other horse’s molars removed, I called the vet university, and the clinic we use was recommended as the best for the procedure. That said, with x-rays, it would be easier to get a second opinion. We do have two vet dentists in the area, but they don’t work out of clinics. My concern there is that their opinion may be shaded by what they are able to do not by what is best to do. On the other hand, the vet clinic we use is very “cutting edge” and wants to offer the best…which is not always in the budget.