I think a culture is a reasonable step. But if it doesn’t point to a different antibiotic than those tried, I think euthanasia is not unreasonable. How is she feeling? If it is gross and frustrating, I would be more willing to wait for antibiotics to work than if she is feeling miserable.
My views may e influenced by a recent experience at my stable. IMO, the vet and owner let a horse suffer for way too long treating his many ailments.
Absolutely culture if you can. BTDT and it helped to sort out a complicated situation.
I think that euthanasia is always a kind and loving gift. By the time a client is thinking about it, it’s probably at or close to time for that decision.
Are you sure she is not older than you think? Do you have her papers with her foaling date? Teeth are less and less accurate as they age, my 28 year olds teeth said 20ish.
Anyway many old timers start having issues with infections. They seem to get them more easily, get more of them and cannot get rid of them. It is one way the body tells us it is tired and wearing out.
Think getting that culture is a very good idea and hopefully not too expensive but if you cannot do it? Please, please, please do NOT feel guilty. Death comes at its own time, you have done nothing to hasten it and have tried to fend it off, maybe it is her time. Maybe she snaps back, maybe not.
You have been an angel for her. Few others would have taken her on. Know you had plans for the next years with her but what is best for her? Leaving in peace instead of slowly wasting away with chronic pain and suffering might be a gift you can give her even if it is not the gift you dreamed of.
Tough choice but do NOT blame anything you have or have not done, its just the way of things. Fill her with pain killers and spoil her then let go.
It is not the vet’s decision whether to keep her going or not. I worry that your vet is in “fix it” mode vs. listening to you and the horse and what the horse’s life has been like for the past months (despite all your loving kindness that has indeed made her life worthwhile when things were not so bad).
I would offer another opinion that you are not a bad owner if you let this horse go. Horses are so stoic; every instinct they have is that they must minimize their pain, so no predators see their weakness. But I know how I would feel if my feet hurt, I was having multiple abscesses all over my face, my GI tract was a mess (and so was my butt), etc. I wouldn’t care if these things “might respond to one more thing.” I would be done. Still, it’s absolutely your decision because you know her best, so trust your instincts.
Thanks everyone for your kind words, ideas … Everything.
Ive been emailing my vet but she hasn’t been responding; I’ll phone her tomorrow.
I am struggling with this but I think it might be time to let her go.
Yes I have her papers still. Her name is Ima Magic Tootsie Pop. She’s a beautiful soul and I’ll be forever grateful for the time I got with her.
Twice. How many people can say that? 
Lets remember our beloved Willem’s words as he stepped onto the bridge
This It Be Right. 
We will be here for you.
Twice doesn’t happen often and it’s a blessing.
OP your mare is lucky to have reconnected with you.
Two of us that I can think of 
OP, best wishes and hugs
This happened with our pony last year. Cushings depresses the immune system. They get more susceptible to infections. Maggie pony went six years on prescend. That’s a good amount of time. We treated several infections successfully, but it was a tooth infection that finally made it too much. It would’ve required extensive cuts in her cheek to access the bad tooth and that would open her up to more infections with a weakened immune system. We put her on antibiotics and kept her on them to get her out of the coldest time of year. She was put down on the early spring grass. Your vet might be worried about surgical intervention and the risk of complications. That’s legitimate. Don’t feel bad for making a hard decision to spare her pain.
You brought her home. You showed her that she’s loved and gave her a safe place. She knows that.
I want you to think about what her life would be like if you HADN’T found her and given her the past 15 months with you. How would her life have gone? I can’t imagine it would have been anywhere near as good as it has been with you. She’s been safe, loved, as healthy as she can be, and cared for. You’ve done everything you can for her, which is more than she might have had otherwise. You have nothing to feel guilty for. We can only do the best we can, and IMO, you’ve done absolutely the best you can for her.
I’d also suggest the culture, but I have one question: when you did x-rays for the teeth, did you x-ray her entire skull, or just her teeth? I’m wondering if she had a foreign body slip past that broken tooth (or maybe even caused it) and it’s migrated somewhere that the imaging didn’t show. I think someone else mentioned that upthread, too. And I know it may not be feasible to do that again, but something to consider (or maybe have another vet look at the x-rays you already have? Sometimes one vet sees things that another misses.).
That said, we all say that one day too soon is better than one minute too late. But I know how hard it is to judge that line. If you decided to let her go, no one here is going to judge you for that. You’ve given her the best care and love for the past 15 months that she could have had.
So we’re putting her down tomorrow. She’s going to be buried at the farm shes currently at; they’ve been absolutely wonderful.
I tried to pay them for February’s board but they refused to take my money.
If anyone needs a seriously amazing barn for their senior or baby in the Ottawa Ontario area I literally love Sunflower Stables. They did all her medications, supplements, blanket changes, fly spray, wound care, you name it.
I’ll give her apples and horse cookies before she goes: luxuries she hasnt had in at least two years. I really wish i could offer her some grass before she goes but it’s the dead of winter here.
This’ll likely be my last update. Thanks everyone for following my story on how I bought back my old horse and got to love her a second time. If you’re ever offered the same I’d take it- I’d do it again regardless of the heartbreak.
Now keep me from buying that young tb at Bowie’s haha.
I’m very sorry for the loss of your old friend. You gave her the best retirement possible, and a dignified end. 
I’m so sorry that the two of you didn’t get the ending you had hoped for, but you are giving her the great gift of a kind end among people who love and care for her.
I’m so sorry. I know it’s not an easy decision and it’s never one you want to have to make, but you’ve done right by your girl every second since you got her back. She was loved and well cared for, and has a kind, loving person to make the hard people decisions for her.
Thanks for sharing and thanks for giving her a chance for you to love her for a 2nd time and giving her a last parting gift of a peaceful, dignified passing. And for giving a great shout out to the farm who helped care for her to the end. It’s never an easy thing to do.
You have been such a good owner, the love and commitment you have given to her means so much to a horse.
Hugs to you, the hardest part is saying goodbye even when it’s right.
So very sorry! I had to put down my first horse last December. She was 30 and while her mind was sharp, her body had just come to the end of the road. I’m grateful that I was able to have her home with me in her retirement years, but it’s always hard to say goodbye to these good old friends. It’s our last gift to them, making sure they don’t suffer. Will be thinking of you.
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