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Ugh...behavior still not resolved!? (Very long)

So, there is no theraband going on him…all we re going to do is pony him, no tack or anything (which he seems to be slightly anxious but mostly okay for) until we get the scope done. Then he will continue that until he’s relaxed. Then we will add a blanket surcingle (which is definitely not a theraband…I am a PT - totally different items and purposes!)…to see if he can handle a small bit of girth pressure…then move to a saddle pad. Then saddle…but always assessing where he is first and giving him time to be accepting before we move on to the next step. It might take a day or two or a week or two or months).

Should also clarify that he is in tack that is fitting…she tried tack she knew he was happy in…she also has tried other tack to see if the issue was the way a specific piece of tack is fitting. The vets actually said it would be better to start him back in a Western saddle as the dressage saddle puts direct pressure right where the ribs were broken. Not using a rear cinch at the moment (though he was okay with them in the past). But the point is, we have options in trying different styles of saddles to see if he is more/less comfortable…and we will continue to play with that to make sure he is comfortable.

The ulcers we think actually came from when he had the laceration and had to get some massive doses of bute and exceed. I’ve had two vets tell me that they are seeing a significant number of horses come in with more severe ulcers after using exceed antibiotics. I think they may have started from that…and then when he broke the ribs, that just made it worse (as I had already been treating him for ulcers before the rib fractures happened)…suspecting he had some.

Bute trial might be worth it…though have to be careful with the ulcer history. Maybe a course of previcox would be less risky. For that matter, banamine might be as useful since that will target soft tissue and this does seem like it might be more of a soft tissue issue surrounding the ribs. Will have to chat with the vet more.

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It truly sounds like ulcers to me. I’d start there and I’d avoid bute until a scope. I’d also treat for hindgut ulcers.

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You’ve done a lot to try to find out what’s going on with the horse, and you deserve a lot of credit.

Just on the girth issue: Sometimes horses prefer (in an English saddle) a long girth rather than a short girth because of where the bucklea are. I’m wondering that, given that he had broken ribs, whether the pressure from the buckles may be painful to him.

I know that he’s had both a Western saddle and a dressage saddle on, but it’s possible that the cinch and the girth buckles are hitting the same area (?). Maybe? It might be worth trying a different saddle (even a close contact saddle) with a longer girth.

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Good idea…once we scope we are going to try just a lightweight saddle pad with a blanket surcingle, so that will be more like a long girth…so it will be interesting to see if that set’s him off or not. I am sure we can find a jumping saddle to borrow to pony him in just to see if it makes a difference.

He is on sucralfate twice a day (and has been for some time)…which is supposed to help with hindgut ulcers. Though maybe we need to change to a different product or add in something else. Just waiting for the vet to call back with when they are going to do the scope. I’m really interested to see what that result is.

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Have we talked about feed during/after ulcer treatment? What and how can make a huge difference to how well the drugs work, ime … ymmv, but it might be worth sharing his feed plan in case any of us ulcer survivors see any “red flags.”

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May I ask where you are getting sucralfate? My usual source says manufacture back order. :disappointed:

So feed has been 4-5 alfalfa cubes (soaked) and 1/2 lb Triple Crown ration balancer and 1/2 lb TC Senior…twice a day. Santa Cruz vitamin E. On 12g of sucralfate twice a day…I realize it is better to give empty stomach, but that’s not always feasible, so vets did say it was okay to mix in with his alfalfa cubes. He’s a bit on the fat side at the moment too.

We have a grass/timothy mix hay…recently tested and low protein but also low NSC, the rest of the nutrients look good/balanced. Has free choice hay (if in the stall, has a nibble net that is always full plus some on the ground). Outside, always has plenty of hay if no grass in winter.

Normally have grass in the summer (not super lush, but decent and ample grazing)…not much grazing in the winter.

@IPEsq I usually get it from FarmVet. But I must have gotten it before they backordered it (I got a huge bucket about a month ago so I could send enough with him to the trainer)…so maybe I was just lucky getting it then!

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My vet called it in to the pharmacy I use. I had to get tablets but they’re in stock.

I say Pain. It very likely is still pain from rib fractures, and my guess is there was other fx that you missed, including possibly withers and/or sternum. Even if bone looks ok, there is alot of other tissue involved, and this horse is in pain.

When he does get healed, which may be a good year from now, make sure he has a very well-fitted light saddle to start.

Also, I would be suspicious of Lyme.

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Only one example, we had a four year old mare with a spot with broken ribs that never healed to the point of being able to ride her.
We don’t know how the injury happened.
Initially we didn’t know why she bucked so violently, then the vet found where she at some time had broken some ribs.
The ribs were healed long ago, the pain subsided and there wasn’t behavioral residual anxiety.
She was ok with saddling and cinching, just not a weight on her back.
She palpated sore if you pushed hard, once the vet found the broken ribs spot.
The location made it even questionable if carrying a foal would not also cause her pain.

Just keep that in mind, along with the other stories where they were fine after they healed.

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In every horse I have ever had, ulcers have ended up being caused, not by poor management, but by chronic or acute pain. Your management sounds fine.

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Lyme testing is negative…as in no acute or chronic Lymes (which is actually a bit odd as I live in an area where nearly everyone and every animal has been exposed). We know he had anaplasmosis, but that was treated with IV oxytet and minocycline.

Still waiting on the scope for ulcers.

This sounds exactly like my mare with PSSM2 (now being called “MIM”. Not all vets know much about it but I definitely recommend looking into it!

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UPDATE…well, I never thought I would be happy about ulcers, but here we are. So they went to scope him yesterday, but his stomach didn’t empty enough (12+ hrs fasting). So I told them to keep him and wait until we could get a clear scope to be sure…they didn’t seen anything on the first one, but the food was obscuring the bottom of the stomach.
So scoped today…and he has severe ulcers again. Some with erosions and some that were bleeding. Poor guy…no wonder he was that cranky!

So, at least we do have an answer…now the question is why does he keep getting bad ulcers. He was on sucralfate and I had done full tubes of ulcergard a few days before shipping to the trainer. And we had already done other modifications to diet/turnout/stress to try and minimize ulcer risk.

Bottom line is we will go back to full tubes of ulcergard for the next few weeks (ouch$$)…and I’m going to leave him at the trainer, but he can just be on regular board (with 24/7 turnout except severe weather) for a few weeks. Bringing him home would probably just make the ulcers even worse…so he can chill there and we will start him back once we’ve rescoped to see that the ulcers have cleared.

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Well, answers are good! Even if they’re not instant fixes. I wonder how he managed to get them while being on all the meds - is misoprostol or other medication “better” for the ulcers he has? Or are they ones that generally are treated with gastrogard and sucralfate?

I’ve read that horses can get ulcers due to chronic pain, and that this is the generally accepted “reason” for the ones that are managed well but still get nasty ulcers. But how many owners are scoping sound, happy horses? Not many, I suspect.

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What is his turnout/pasture routine?

I’m sure not what you want to hear but I do think perspectives are helpful. I battled chronic severe ulcers despite modifications to diet/stress/turnout for 18 months. We finally arrived on some type of unidentified chronic pain that could not be unearthed by several top notch clinics. She has been permanently retired at 11 and even in retirement I am struggling to keep her ulcer free. I sincerely hope you have a better outcome.

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So if the weather is good, out nearly 24/7…inside for bad weather or because he was being worked. We did not have grazing in the winter, though I always put out more hay than they can eat in winter. Out on grass when we have grass. So maybe not having grazing for the winter is a factor?

He was out solo at home (with my old gelding nearby)…right now he is out with 2 other horses. I can’t put him with my old gelding…they roughhouse too much (to the point that my old guy injured himself and got a blood clot in his hind leg from goofing off last year).

Does he have access to shelter when turned out? If so, I would never shut him up in a stall. Especially since being stalled is not part of his regular routine. I think if a horse is going to be stalled for any amount of time, it’s better on them to have that as part of the normal routine than to just occasionally shut them up in a stall because of x,y,z. That’s more likely to interrupt their set routine and make them uncomfortable. Also, if there is any chronic pain, the ability to move as he needs (and not move as he needs) will be helpful as well.

Now, if he has no access to shelter in his turn-out, that’s a different story. Though when I’ve been in that situation in the past, I’ve always erred to the side of “leave 'em out” when the weather forecast was sketchy. Obviously, there were exceptions.