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

[Critter]

If he is at my place, we do not have outside shelter…so in the coldest part of the winter, I usually leave them out until late night and then bring in overnight and they go back out first thing in the morning. Once the weather breaks and is decent, then I will either leave them out all the time or bring in for a few hours…summer, when the bugs here are brutal, they come in late morning and go out at late night. So it depends on season. He is fine being in…doesn’t seem stressed to be in the stall for a few hours or overnight if needed. At the trainers there are outdoor shelters, so he can stay out more there…but normally would be in for the part of the day to get worked. So he does have some stall time…but it’s not one of those only out for an hour in perfect weather scenarios! Of course, I may have to change up what we have done given the ulcers recurring.

We did take him to have the ribs reultrasounded mid-February. He does get stressed about going to the vet clinic, given all the initial testing we did…so I am wondering if that trip might have been stressful enough to kick off another round of ulcers…and then once he did the longer trailer ride to the trainer, if that just pushed it all over the edge.

[Victorious]

Good luck, Critter. I feel your pain and sense that you are about to embark on a journey of questioning every possible care decision you have made in the past as well as all future decisions. It honestly feels like an unspoken aspect of horse ownership…the amount of space they take up in our head. I don’t really have feed or TO advice for you because I feel that is super subjective and also has to be realistic.I just want to wish you good luck on your journey-I hope you can land on success with this guy!

[RhythmNCruise]

@Victorious

I feel your pain and sense that you are about to embark on a journey of questioning every possible care decision you have made in the past as well as all future decisions.

This is true, and I didn’t mean to add to that with my turn-out question. As someone who has spent countless hours trying to make the world “perfect” for my horses over the decades that I’ve owned them, I know how maddening it can be. Especially when you see other people’s horses who seem to thrive in situations that would have mine looking and acting like he was at death’s door.

You’re doing a good job, OP! I hope my post didn’t add to the ulcers YOU may get from worrying about your horse’s ulcers, LOL!

[Critter]

No added stress from your post at all - I appreciate everyone who has taken the time to add their thoughts and experiences! That’s why I posted and that’s what this forum is all about! You get different perspectives and then you get to try and sort out what will work for your horse and situation.

It’s hard not to second guess what I’m doing (I thought I was doing right keeping him on sucralfate…but after reading apparently that is only effective in combo with omeprazole, ugh!)…and I think I already gave myself an ulcer worrying that maybe we were looking at another EDM situation (did that with the last youngster). So, really this is a relief and now it’s about trying to find the best management options for him. And that might take some experimenting…but he’s worth it!

So thanks to you and everyone who has added input and asked more questions and helped me think through this…and also having a place to vent (with people who understand) was a way of reducing the stress I was feeling waiting for the testing.

[outerbanks77]

Sounds like a tough situation to get to the bottom of!

I just wanted to add that I picked up an inexpensive laser from 100X Equine last year, and I’ve found it really helpful for finding where my horses might be sore. They really love getting lasered, and I wonder if it might be helpful around the fractured ribs to help with the soft tissue. Three other people at my barn have bought them since I bought mine. One mare totally skinned about a 10x4" area on her forearm and although it’s healed, she has a lot of tightness there from the scar tissue and she seems be be benefitting from the laser. Kinesiotaping might be another therapy to look into; I suspect he might just be tight all over despite not really palpating sore in specific locations.

[Critter]

@fivestrideline

misoprostol or other medication “better” for the ulcers he has

So right now, the vet that scoped said to go back on a full tube of UG and stay on sucralfate…since he did respond before (we know he scoped clean after 5 weeks of that combo before).

Interesting as I did some reading (published research, since I am used to reading those papers and have access through my university to get the papers)…and found one that said sucralfate was only effective in combination with omeprazole. Wish I knew that before! Vets didn’t mention that…so that might explain why the ulcers managed to come back. I thought keeping him on the sucralfate would be helpful…but apparently not without the added UG.

@GraceLikeRain…certainly might be pain, as he had the rib fractures, and those took months to heal. While they are now healed, I am sure they were painful for the past few months. Fingers crossed that we don’t have other pain issues…guess we will see how his behavior is once we get this round of ulcers cleared up.

@outerbanks77…I have a massage/PEMF blanket that may help…though it will have to wait until he’s back home. I may see if we can do some massage while he’s at the trainers…but will wait until he’s less touchy from the ulcers so that no one gets hurt.

[Pezanos]

Since you are experienced in reading scientific papers, do some looking into using esomeprazole instead of omeprazole,Since you are experienced in reading scientific papers, do some looking into using esomeprazole instead of omeprazole. my thoroughbred had more success with it then with ulcergard for some reason. In fact, ulcer guard actually made him worse but the esomeprazole In fact, ulcergard actually made him worse but the esomeprazole seems to have made him feel much better. The published papers seem to support this. There are generic options easily available, so it is in an extremely affordable solution.

[J-Lu]

Oh man, you are such an attentive owner!

I might add something that I haven’t seen mentioned here. Groundwork. From what I’m reading (correct me if I’m wrong) simple riding seems to be stressing him out. Consider making his work plan all groundwork, first without a saddle and then with the saddle. Have him associate grooming with ground WORK, and then with saddling with work but not being ridden. Groundwork is a very mentally challenging approach if done correctly (so much less than the physical challenge), but doesn’t involve the weight of the rider. If he has ulcers associated with being ridden and tacked up, could he learn to dissociate the saddle from being ridden but NOT dissociate the saddle from having to do work?

I wouldn’t typically longe a horse like this. He’s just going in circles - nothing challenging about that - and likely fretting. I’ve longed my horse and graduated to free-longing, where he goes in a circle around me without a halter or longe line and listens to voice commands. His longing sessions aren’t “brainless” because of this. As an alternative, you can try free-longing in a round pen where he is less constrained by a halter and longe line. Most horses really don’t care but your guy seems to have issues with work. Maybe taking the work out of work will help him see his new job differently.

The ponying is great. Your trainer can increase the work load by ponying over poles and later spaced at walk and trot to teach your horse that he has a job and he has to think about where his feet go. There’s nothing stressful about exercises like this.

For my guy, trails are very stressful. He’s going to get eaten even if he’s with others. Despite years of trail riding with calm horses.Trail rides are not relaxing for all horses. He’s not even relaxed in the arena he’s gone in for almost 10 years because he’s going to be eaten at the Gate of Doom, which leads out to the Playground we’ve frequently ridden in, which leads out to the pasture we’ve frequently ridden in.

All this is to say, horses are tricky. Try putting him to work but not under saddle and see how he handles it. Not saddled and then saddled. Make him work on the ground. I’m happy to provide simple exercises if you want.

[Critter]

Thanks…and totally agree that he was associating everything with the pain…even groundwork (trainer had tried that too…and just grooming he was being a jerk and kicking at people). And this is a horse that typically loves to be groomed and fussed over. That’s part of why I knew there had to be more to it than just issues going back to work.

Right now, he is just chilling for a few weeks (trainer needs to be sidelined a bit, so the timing actually works for both of them). He already is starting to seem a bit happier with general handling with the ulcergard full tube dosing…so fingers crossed. Trainer is a pro with groundwork and starting horses (believes in very minimal lunging only if needed/appropriate…prefers to pony out). Will start him back after we scope again, to make sure he’s good to go…then he will be staying on ulcergard (assuming it works) while he goes back to work (until I can sort out a long term management plan). My guess is she will do a combo of groundwork and ponying to start…then take him out on the trail…first without tack, then with.

He is usually a happy horse on the trail…before he came home, he was a horse they could put a beginner on to do a trail ride, he was that calm about it.

Knowing how bad the ulcers were again this time, I am guessing that once we get those healed he will be a totally different horse again. That’s what happened before - he got really tough - even biting/kicking at me to blanket, when we found the grade 3 ulcers…once they healed he was back to being mellow and easy. Guess I now know for sure that I need to trust him when he gets grumpy! Poor guy.

[4horses]

I would probably treat for ulcers first. Can you get some video of his behavior? Definitely something wrong. I can’t say what but it sounds pretty severe. How’s his ability to canter in the field?

[J-Lu]

Sounds like he’s in a great program for him. Please check in about how he’s doing! Bet of luck to you and him!

[Critter]

Well, time for an update…because I need the COTH brain to help again! UGH

So we had scoped April 1 and he had the bad ulcers again…so he went back on a full tube of UG, stayed on the sucralfate…moved him off grain to a vit supplement (Uckele’s)…he was already getting alfalfa cubes. No work…turned out on huge grass fields with my other horse.

Rescope him after 4 weeks…scopes clean. Did have a little delayed emptying again, but not as bad this time. Ulcers fully healed. Decide to start him back to work…but keep him on UG and sucralfate because I wanted to make sure those stay gone while we go back to work.

Seems better for groundwork…trainer does a easy walk ride on the perimeter of the farm…very sticky to start but then seems better. (Remember, he always has a good day after being off…then the behaviors start on ride 2 or 3).

Goes to do some work in the arena and he has a mini melt down. Spooking, running backwards, kicking out. Trainer thinks maybe behavioral and linked to being in the area.

Today, trainer takes him to trail ride with a group of well behaved horses…so lots of good company on trails he has ridden on tons of time. Figure this will help us sort out if it is just arena sour issues. Well, starts out a bit fussy…then gets progressively worse. Not as bad as before when the ulcers started again…but bad. Kicking out and trying to bite at his sides. Spooky (he was never spooky on trails before). Flies were not an issue.

So…UGH!!! Again, scoped clear recently…still giving him UG and sucralfate (making sure we cover hind gut)…because I wanted to make sure we rode and the behavior was gone before we stopped the ulcer meds.

Trainer asked if the old rib fractures could still bother him…but he’s a full year out (happened Memorial Day weekend a year ago). And we did the follow up ultrasound that said they were healed…and he doesn’t palpate sore there.

I am pretty much at my wit’s end. We are in the process of getting an appointment with a vet in the area who has not seen the horse, and is known for being a really good diagnostician with tricky cases. Just going to start with an exam…and then tell the vet what we’ve ruled out and share the imaging. Also exploring a bodyworker/chiro to see if he seems tight/sore anywhere. And I might just call an animal communicator because that will probably be the cheapest thing I can do after all the money I’ve put into trying to get this guy fixed!!! Really, at this point, I don’t know what else to do.

[greywithchrome]

Is any better doing those things from the ground? Walk the perimeter of the farm on foot? Go in the arena? Hand walk the trails? Has she tried ponying him again?

[starsandsun]

If you are seeing recurring ulcers and you are not (1) testing stomach fluid for pH and bacteria, and (2) exploring for gut inflammation, you’re not on the right path, IMHO.

If your horse has recurring ulcers and/or intestinal inflammation, he WILL hold his back and use the wrong muscles to prevent pain. That will show up as poor movement, bad behavior, etc. They will do whatever they can to keep from hurting more.

I would ABSOLUTELY start with a thorough internal review of digestive tract before you spend money on anything else. And if you need a world-class vet to consult with, please PM me.

If your vet says testing for pH and/or bacteria is not worthwhile, get another vet involved. I truly believe you are wasting money by bringing in a vet to explore what I think are the ‘results’ of gut pain, rather than gut pain.

[Critter]

He is definitely better on the ground…she sent me a video of him getting groomed before she tried the area ride and he looked like he was falling asleep. When the ulcers were there before he was not wanting to stand or be groomed. The day she did some round pen work in the arena (first day back) he also looked pretty chill and happy. The day she got on and walk hacked around the property he was sticky but seemed to settle. Then things went downhill again. We’ve not tried ponying again yet. Hand walking and leading around he seems to be back to being good about. Maybe a bit spookier than before, but not to the degree of spooking under saddle. So he is definitely better than he was…but he is still not good with the rider up.

One of the videos she sent of him free in the round pen, he does take a few lame steps in the trot up front…very inconsistent (not head bobbing, but definitely a bad step here and there and only in trot). So, maybe there is some foot pain? Again, she’s only tried walk rides the last two days and walking he looks fine. So she’s going to try and get some video to see if there is more to that. Definitely will be getting the vet out to check into that…but of course it’s a holiday weekend.

@starsandsun Agree that we can’t rule out GI stuff just yet. Especially with the delayed emptying showing up on the last two scopes. I will PM you for that vet’s name as I do think we need to make sure the GI is still not causing issues.

[Fancy_Free]

Did you ever end up testing for PSSM? This is 100% where I would be looking next if I was you. I had a mare like this, although she was a severe case and had an extremely bad tying up episode which led to her diagnosis relatively quickly. But all of her less subtle hints sound much like your guy. It’s a relatively easy and inexpensive test to check off the list. Best of luck to you.

[ProfAmEq]

Gosh, you’ve done a lot.

I will say that I tore a muscle between my ribs once and holy hell that hurt. It bothered me for two years! I guarded it for a long long time and it created some compensatory pain. Myofascial work, masterson, and groundwork maybe for a bit just to see if it needs more time.

Beyond that—have you guys ever attempted a gabapentin trial? Just throwing it out there in case it’s nerve pain? And I didn’t see but might have missed— did you do a bone scan? That’s what I would ask my vet about at this point. I’m so sorry you guys are stumped and I really hope you get some answers.

[Critter]

We did gabapentin in the very beginning, after the ribs were fractured. We’ve not done it again recently…but it was part of the initial treatment. Might be worth a try again once we exhaust another trip to the vet…because I am hesitant to do a bute trial given the ulcers (and it was probably the laceration with the bute/exceed that triggered the first round of ulcers).

Yup, bone scan was done last summer…that’s how we found the ribs. The only thing that lit up on the scan was the two ribs and a little uptake in the feet, more so both front. Vets felt we didn’t need to look at feet at that time given the ribs were the most likely issue.

@Fancy_Free we did not, though I did point blank ask two vets about it (my vet and one at the teaching hospital)…both said no for a variety of reasons. They just felt there were certain things that didn’t fit that as a diagnosis. Same with EPM…neuro vet was pretty confident we didn’t need to do further testing on that. But, I am at the point that if it’s not that costly to test, it’s worth ruling out.

[IPEsq]

My horse with recurring / ongoing behavioral problems under saddle had a lot of problems (ulcers, neck, SI as the big things, months off for a soft tissue pasture injury that healed and rehabbed fine, pedal osteitis in one foot following loss of sole due to time off from the other injury that was easily managed and fixed) but we thought we were managing everything well. Turns out he was also developing trash front feet although not lame until the end and then very intermittent and usually only with rider weight added. Took bilateral MRI to see how bad the DDFTs and navicular complex were. He had periodic X-rays for monitoring farrier work that never showed anything. I’d even blocked his feet and ridden to see if behavior would change. Unfortunately, he passed soon after the MRI from colic, so his vet dissected his feet (among studying some of the other problem areas), and both front feet and both SI joints were just garbage. I think I would have been chasing his behavior for forever, and I was already wondering what he would do with more extended rest. One of my vets suggested nerving him to see if that would make him easier to manage as a very young pasture puff. Not that he did well mentally just sitting around. An animal communicator did comment that his feet had hurt from time to time. But he told the communicator he was ok now (on the days I talked to her).

Anyway, your front lameness comment made me think of this. At this point WHO KNOWS.

[Critter]

He is being ridden in a Western saddle right now…saddle type doesn’t seem to matter. And also without a noseband right now (with or without has the same behavior). We haven’t tried bareback since his latest return to work, but in the past, that didn’t change the behavior…and was even ridden in a rope halter. So it seems that the tack is not the issue…though the addition of a rider is. Although when the ulcers were active, any tack was an issue. Right now he doesn’t seem to be objecting to having the tack on, just the rider.

He is shod up front…is well behaved for the farrier (just got done about 10 days ago and no behavioral issues getting his feet done).

@IPEsq - sorry you went through all that…though having some answers after the fact does help at least know why the behavior was happening.

Part of me wonder if he did other “stuff” that we just can’t find when he did the chest laceration and then the rib fractures. But…he’s also been pretty much “off” and just turned out for a year. But if the ulcers are recurring due to pain…maybe there is other pain we haven’t found because we thought we got it with the rib issue?

And, of course, the mention from the one neuro vet last year about EDM weighs heavily in the back of my mind…I just can’t fathom having a second youngster with EDM. Which means I will do everything I can diagnostically do before I toss in the towel with this guy. It does help that he is a super nice horse…so well worth the time and money if I can get him sorted out.