Wow!
I think I remember you discussing transfaunation on a different thread; did you end up doing this procedure as well as the enrofloxacin?
Glad he is doing so well.
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Yep, 14 days of fecal transplant, with dozens of manure samples tested ā¦ but never did get the results of the manure testing, unfortunately. He also was always re-dosed when he went back through the spring and summer.
It didnāt make any obvious difference - although I was happy to try anything at that point.
I did submit manure samples pre/post enrofloxacin, and that should show up in a study from UGA. I also have (if you can believe it) a freezer filled with manure samples from when this started - sort of regularly saved but also every time he coliced.
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Iām sorry it didnāt make a difference. With what was going on, I guess in hindsight it makes sense. What a whirlwind you went through. I hope this helps other posters who are dealing with similar issues.
Did the vets have any idea how the stomach acid imbalance originally transpired? Ulcers?
Iāve never, luckily, had to test for stomach fluid pH. Is that something that could be done on a routine scope, I wonder?
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It doesnāt seem to be the SOP to look at pH or bacteria - though that may be changing. As I understand it, lots of new science is pointing to this as something to consider, and itās easy enough to pull during a gastroscopy. She just took some fluid, and had some way to measure pH right at the farm, and that took all of 60 seconds.
No one seems to be able to create a hypothesis that covers the grinding for years, and then the bacterial overgrowth. It seems pretty chicken-egg.
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That actually makes a lot of sense. The GI tract is incredibly complicated and there is a great deal that we donāt understand.
I ate some chinese rice and ended up with food poisoning except the symptoms wouldnāt go away. Then was diagnosed with gastroparesis. Further testing showed my entire GI tract had slowed down. Then I had repeated episodes of small intestinal bacterial overgrowth. I was treated with antibiotics every 2 months or so, on going for a couple years. This was not working and I became worse every time I was on antibiotics, better when I came off the antibiotics, then worse again when the bacterial overgrowth returned.
Then I developed C. Diff. colitis. Best bet is I picked it up at the dentists office? At least that was my guess. That turned into a 2 year battle. They would treat the C. Diff with antibiotics, I would recover and then 4-6 weeks later, I would relapse. Then they would pick a different antibiotic, and repeat. The insurance would only cover 1 course of the antibiotic that actually worked the best. Then you had to start over with a different antibioticā¦ My personal opinion was that a double course (28 days) of antibiotics would probably have beat it, but insurance wouldnāt approve that. (Total cost the insurance paid was $40,000 just for antibiotics). Anyway, I finally had a fecal transplant and that took care of the C. Diff.
After that, they recommended not taking any antibiotics at all to avoid having the C. Diff return. The last few years, I have avoided all antibiotics and take peppermint oil to help control the bacterial overgrowth. Iām fairly certain I still have bacterial overgrowth or bacterial dysbiosis and probably always will have that to some extent.
Now back to horsesā¦ If you are treating for gastric ulcers, you are reducing/eliminating stomach acid. Without stomach acid, any bacteria that is ingested can start growing in places it shouldnāt be growing. Use of PPI drugs increases the risk for both C. Diff colitis and small intestinal bacterial overgrowth in people, so it makes sense that it can cause issues in horses.
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Thatās incredible! Thanks for sharing all that.
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Thank you for the explanation. 
You can bet every COTHer with a mystery colic will check back for this thread & hopefully glean something from it.
Meanwhile, glad your horse recovered.
Itās so hard knowing theyāre in pain & being helpless to end it.
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What a fantastic update, congratulations for following through until you found a resolution!
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I was fortunate with a recent challenging colic that my clinic did pull pH and test stomach fluid when things didnāt resolve and there was no obvious cause for the continuing symptoms. They were able to do it via a routine scope while we were exploring potential causes. The pH was way off and they found bacterial issues which all also inflamed the bile duct (liver enzymes were also screwed up).
It didnāt really tell us the initial cause but was valuable in determining a treatment plan and giving us diagnostic markers. We re-scoped and pulled pH and fluid again about a week later as the final symptoms were resolving and it helped reassure that we were on the right track.
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Man, how frustrating that all was, only to come down to something so āsimpleā.
This is about the 3rd story Iāve read where stomach pH was tested, though the other 2 were well within range of normal pH. But, it IS something Iāll tuck away if I ever have, or hear of, repeated colic issues that donāt seem to be resolving.
What an amazing resolution!
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OMG - so glad it all worked out for you. We have also had moments where liver values were wacky but that was not consistent.
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Holy cow ā¦ I sure hope you are feeling better.
I am of the same mind with using acid inhibitors in the stomach, and probably would not consider using them again without careful consideration of objectives, timeline, impact, etc.
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Thank you ā¦ I slept very poorly for a long time worrying about him.
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It was both the most amazing learning experience, and the most traumatic long-term health event Iāve had to manage. I never thought words like eosinophil would be in my daily vocabulary.
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Thanks! Heās doing great now and back to full work but it was a rough stretch. Heād have one set of numbers improve just to have other symptoms move the opposite direction. Thankfully my vet is awesome and we were in consult with a specialist to help make sure we werenāt missing other potential causes.
Iām glad you finally found a solution as well!
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So happy for you and your horse and thank you so much for sharing. I think this is something many of us will tuck away in our minds, which we hope we will never have to use, but will be there if we need it. <3
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Thank you for sharing. You helped me when my horse was experiencing similar symptoms. Not only the medical advice, but also helped to not feel so āaloneā with these issues.
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Glad your horse is feeling better!
We had a similar story at our barn. Not colic, but years of loose manure and bloating. Horse was on gastroguard I think nearly permanently. It would go away a bit in the summer and then come back every winter. Horse was offered either a FMT or metronidazole. It was my BOās horse and she went with the metronidazole to start since it was less invasive. In the mean time I just so happened to be sneaking my horses manure onto a sequencing run at work (shhā¦if my supervisor is ever reading thisā¦sorry?), and she asked if I could include him. Being a research lab and not a company, it took me a month to do the sequencing. In the mean time, the metronidazole seemed to completely cure him, but we were waiting for the problems to come back. When I got the sequencing results back, and compared him to my horses he had about 12% of his microbiome as Streptococcus, where as my horses had none, and what I think was really the problem, about 5% Shigella, where as my horses had neither of those bacteria present. Sequencing the microbiome isnāt really practical diagnostically, but it was interesting.
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I wish I knew you! I would totally try to sneak manure in. : )
In retrospect, it just seems wacky how infrequently weāre looking carefully at the gut microbiome in diagnostics and treatment. I was beyond thrilled to not get just a report back on bacterial growth, but also specific antibiotics that showed both bacterial resistance and susceptibility.
Was the metronidazole indicated for strep and/or shigella? Iām guessing yes.
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Honestly not sure I will use it again - seems like it created so many problems.
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