Hi,
I will be curious to hear if anything gets better just with the Ulcergard/Sucralfate. My young mare is back on Ulcergard,one week so far. We have been trying to diagnose a hind end issue. Just had a bone scan with no red flags.
I would also look at the neck. ECVM specifically given age and the description of one rein issues and cantering and not coming back any better after a growth break.
She did not bounce back like before with the ulcer treatment. Iām really disappointed on that account. The hind end lameness has dissipated and back soreness is still come and go.
Lyme test came back very low, so donāt think itās that. Still waiting on vitamin E but I think Iām just going to supplement anyways.
Did you end up X-raying the hind feet?
I have not yet. My regular vet I trust for blood draws and the like but not lameness evals or to take and look at x-rays.
This is my thought.
She eats a diet pretty congruous with what Iāve heard about PSSM. Very low starch in grain, a fat/protein supplement. I know supplementing with vitamin e is helpful. Iāve been wary of restricting her hay because of the ulcer history but she does eat mostly from the slow feeder.
I just went through veterinary hell with my NQR mare. She was doing well in Maryland but when we got to Florida for the season she was just not herself. It started gradually as resistance to contact, not wanting to use her hind end and progressed to literally doing one tempis behind only at the canter.
We did countless X-ray and injections to no avail. Robaxin didnāt help, previcox didnāt help. Tested technically negative for EPM at 250 but since 251 is positive we treated with both Marquis and something compounded, canāt remember exactly what it was and took her back to Maryland.
Definitely improves with EPM treatment but still not right. We test for PSSM-1 and tested vitamin e levels which was negative and normal.
Finally put her on the trailer and took her to New Bolton where they decided to do a muscle biopsy to test for MFM and PSSM-2. They also did a tailhead biopsy for VEM and we finally had our answer! She has VEM which not only explains why she declined the longer she was in Florida and off pasture but also why she improved on EPM treatment because the compounded one that I canāt remember had 10,000iu of e in it.
Moral of the story is if you canāt figure it out, keep looking. Lots of things you mentioned sounded similar so wanted to tell you my experience. We have our horse back finally! Or we did until a few weeks ago when she somehow punctured her hock in turnout and is back at New Bolton recovering from emergency surgery to pick bone fragments out of her collateral ligament but thatās a different story!
Best of luck in your search, do not give up until you find the answer.
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Iād be thinking about PSSM2/MFM/VEM as well . Some of those symptoms are very like my mare who is diagnosed and managed for MFM.
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My mare isnāt diagnosed, but I do 8ā000iu vitamin E, 10,000mg magnesium, hempseed oil, ALCAR, and Vitamin C. I think the. ALCAR in particular helps.
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What is ALCAR?
Acetyl L-Carnitine. It helps with muscle function in PSSM/MIM horses. I get the Nutri-Cost powder from Amazon. 10 grams/day is the recommendation for a 1,000# horse.
Thanks, I think I remember having a similar conversation with you on a previous thread of someone elseās. 
She seems a little more herself since starting the Vitamin E though it was only a few days ago. Sheās on 2k iu/day. I could bump her up. I still donāt have the lab result back for the Vitamin E and itās been over a week. I feed Renew Gold for extra protein and fat which was recommended for PSSM horses but she gets only a little because of her weight but I could add the ALCAR supplement as well.
I did ride this weekend with freshly fitted saddle and there was some improvement. Still not super willing to step under with the left hind but will if asked. Lastly, my vet said she would sell me a round of IM Adequan if I wanted it. Itās not that expensive and might target a few issues so it will definitely go in the consideration pile.
Well, lab results say āmoderately deficientā but seem very low to me. Going to double or maybe triple vitamin E supplementation and see where we end up. None of my other horses Iāve ever tested were this low and they all eat relatively similarly in terms of forage (hay and grazing) but she does get less grain than the others. Ration balancer and forage is clearly not doing it for her. If this is all it is, I will feel sorry I didnāt explore it last year when it was on my radar but glad my badass little mare is back.
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I was also going to chime in with PSSM2 and was glad to see others named it. The low grain / starch / sugar is really for PSSM1. PSSM2 is less about starch / sugar and more about proteins and muscle oxidization.
For my mare she is on a ration balancer and forage-based diet. Then for supplements she gets ~5-8k IU Vit E (depending on season), loading dose of MagRestore (as maintenance), and 60g Whey Protein daily. I also try to give her as much turn out as possible and sheās on a 6-7 day exercise schedule. Doesnāt mean sheās worked hard every day, but she gets at least a 20ā walk to get her out and MOVING (her preference in turn out is to stand as still as possible and eat).
Her ulcer sensitivity resolved once PSSM2 was managed - they were a symptom in and of themselves of the physical discomfort she was in when unmanaged. She had other āstressā symptoms in hindsight too - like prone to getting coughs / ācoldsā, prone to scratches, prone to cellulitisā¦basically her body and immune system were under stress from the discomfort so she was susceptible. Havenāt had issues since managing the PSSM2.
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Where do you source your whey protein?
I got my whey protein at bulk supplements.
Amazon - link here, I get a 5lb tub and it lasts about 2 months (my mare does half her daily dose of protein through the whey and half through Purina SuperSport)
