Ulcer - performance or other symptoms?

[kjohnson]

Hello,
This topic is prompted by my reading of Madalyn's update on Cerise under the Personality category and the exchange on herbs that occurred as part of that. As far as I know I have not had a horse with ulcers (I'm qualifying this to acknowledge that I may just be missing something). However, when differentiating some of the symptoms of gastric ulcers and duodenum, you mentioned something, Madalyn, about tightening in the left or right shoulder or neck -- with duodenum being evidenced on the right (I think I recall that correctly?). That, and other similarities between Cerise and my thoroughbred mare Scarlett, is what is prompting this.

I think I have referenced Scarlett's problems only anectodally in relation to other topics, so to recap, last spring Scarlett started balking at moving forward to the right. When cantering she would almost go in place, and particularly when turning corners. Soon she did not want to be ridden at all. Her right side was always her weakest, but she was never so unwilling to move, she was just not as light on that side. After eliminating obvious lameness issues (none), kidney infections etc., my vet palpated her and found her right ovary was quite large. He said it was not too large if she were in heat, and I then realized that I had only once seen her with obvious signs of heat over a 4 month period. He prescribed regumate and said if she moved better that would help pinpoint the ovaries as a problem. Oddly, the regumate seemed to have no effect whatsoever -- and in fact, she seemed to tease a nearby gelding while on the regumate. I decided to address it osteopathically and over the course of the next few months, she had a few chiropractic adjustments (but not many, there were no back issues or saddle-fit issues), flushing of a low-grade infection in her uterus, acupuncture, manipulations and cranial-sacral therapy. With the exception of the low-grade infection, her symptoms all seemed to tie back to her right ovary, with a grapefruit-sized cyst that remained in-and-out of heat cycles, and extreme tightness. At one point even her left ovary was extremely tight and had to be manipulated (you could tell it was painful, but she did not buckle down as you described with Cerise, Madalyn).

The other thing we discovered is that she had a few fused vertebra in her neck from a past injury, possibly even just from setting back while being tied as a yearling. Her previous owner had no injury history of her (one owner only). It was determined to not be severe enough to affect being ridden or being jumped, but my ostepathic vet said she would never be an upper level dressage horse because the neck/head position would be painful (not an issue with me, as we ride hunter/jumper).

With these treatments and particularly the cranial-sacral follow-ups, she is once again being ridden and moving pretty well. She did develop some training issues and bad habits during those months that we have been working on, but overall is much better. We are trying to really strengthen and develop the right side with lots of cantering, circles, side-rein longeing, etc. She is still not her "old self," however, and in particular, wants to bow her shoulder out and turn her neck upward when going to the right (and sometimes bow her right shoulder out when turning to the left). I believe part of this is her trying to evade the bit BUT she does it more frequently when going to the right than to the left, which leads me to conclude that while part of it is bit evasion, it is in reaction to the difficulty in turning right -- not just laziness on her part. She does not appear to be in pain, it just seems like a lot of work (she is better when we ride with other horses, so I think she focuses more on the discomfort when we are training alone). Her cranial-sacral therapist says tightness in the neck on both sides, but particularly on the right side, seems to be an ongoing problem.

All of this leads me to wonder -- could she have an ulcer problem? Is that something that would have been diagnosed with her osteopathic treatments if it indeed existed, or do the symptoms need to come from other sources (eating habits, etc.). She is eating fine. But the other thing I noticed during this was she did seem to have a mild incidence of colic a month after this began -- just not eating and seemingly in discomfort but not lying down or thrashing or anything like that, but it continued off and on over a period of 2 days. It's just that she had never exhibited colicky symptoms before, even when she got into an alfalfa barn when with her previous owner. Then not another episode for over 6 months, until a few weeks ago (so enough time had passed that I couldn't relate it to the previous episode, it could have just been that occasional episode that a lot of horses experience). This most recent one seemed to last only a few minutes, but it was definitely present. I gave her my homepathic remedy (prepared) and she seemed to bounce back immediately. (She was given green clay by my osteopath in late summer but finished that long ago.).

I don't have any predictors when riding Scarlett as to whether she will bow her shoulder her twist her neck that day, versus the next. I can definitely feel when riding her that she is freer on her left, and I have to really "ride" her to keep her going on her right, and while many horses have a weak and strong side hers seems to be more magnified.

The cranial-sacral therapist also says she has some minor issues with her right lung. She has been on marshmallow root for almost six months but I have been thinking that mullein might be better for this? I have noticed that she blows a lot when we start working, with intermittent coughs. I just put her on a combination of herbs for congestion and licorice is one ingredient in the mix, so hopefully if an ulcer is a factor, this will help (it seemed to help the cough almost immediately).

Scarlett is just turning 6 years old this spring. She looks very healthy, standing about 16.2 h. She never gets sick, except when she picked up strangles with her previous owner but recovered immediately, she was 4 years old and had not received the strangles vaccination. She is the dominant mare and very protective of me when I enter the pasture, not wanting any other horses to seek my attention. She is a pleaser in general, and "takes care of me" -- if I lose my balance over a jump she slows and shifts her weight underneath me to help me regain balance. She never refuses a jump and in general has always seemed to enjoy it, if you look at photos of her, her eyes are bright, her face pleasant, and her ears forward. So I do not think it is a behavioral thing even though I know there is still some residual laziness and bad habits from when she was not being ridden much.

I would appreciate any insight on a possible ulcer issue that anyone might have. I was also wondering with the ovaries -- could those tightness problems resurface? (we eventually gave her hormone injections to shed the cyst on the right ovary). Should I get her palpated again? Is that tightness (or however one might describe problems like that with the ovaries) likely to be an ongoing problem with her?
-karen

[mward]

Karen,
I am sure getting why people prefer geldings as performance horses I think the ovaries are a huge issue for some mares. Think how many women have painful periods and ovulation. There is also the risk of bruising the ovaries with a fall or in Cerise's case a setback. Hormone therapy is not the answer as it has a supressive effect on the system. Homeopathy offers a way to balance the horse but remedies must be carefully chosen and require a good history.
An ulcer should have shown up as tightness in the thoracic segments between TH10 and TH15. Often with something like a sore ovary you will see problems with the diaphragm which persist after the ovary pain is past. The cranial sacral work should address the diaphragm.
Why don't you give us a full history on Scarlett and let me see if I can find a homeopathic remedy for her. Give as many details as possible. The more uncommon the symptom the more valuabel it is. I need to know any health problems past or present and her personality. I think it is interesting that her name is similar to Cerise. Cerise is also a red color. I wonder if she is a Fire horse. They are certainly more sensitve. Madalyn

[kjohnson]

Yes it was certainly not my intention to get a mare! I always say Scarlett chose me, but we are good partners and I don't want to give up on her, not as long as she seems to enjoy what we're doing. But I also want to do what's best for her performance-wise. Here is what I know of her background:

Scarlett is a Thoroughbred, bred to be a racehorse. She was trained at the track but never had the speed for racing. I know the breeder; he has a reputation for quality bloodlines and having trainers who train the horse to be ridden, not just raced. When he has horses that don't work out at the track, his daughter (my riding instructor) evaluates them and retrains the promising ones for hunter/jumper, which she then shows or sells. That is where Scarlett ended up. I recall seeing her when she was first 4, in 2005. She always seemed athletic and pleasant. Very tall and elegant (in fact, her registered name is Regal Ruler). She was a favorite of my instructor's daughter because of her willingness to please and jump anything -- the kids used to jump picnic tables with her! So that would have taken place when she was only 3 or 4, because I bought her months before her 5th birthday.

No known injuries except November 2005 she got out of her paddock and found the alfalfa barn. When she was discovered, she was standing with her legs back but never colicked or showed any colicky or laminitic symptoms. (She will still occassionally stretch out like that, with her hindlegs out, but it just looks like she's stretching). She also cut her nose and required stitches, but it seemed to heal nicely and there is barely a scar.

A few months prior to this she contracted strangles during a barn outbreak. She was one of the first to get it, but got over it very quickly and never got really sick. She may have been vaccinated for strangles as a baby but not since then.

We participated in our first show in May 2006. She did very well, got all of her leads without being asked. About a week later during a practice is when she started balking at moving to the right and "cantering in place." It started mid-lesson, she had been doing fine until I tried making a sharp right turn to a jump. When riding her a few days later, she started crow-hopping after a jump when landing on the right lead. She had not exhibited these behaviors before.

First week of June was when she had the colicky behavior over a 2-3 day period, seemed to come and go, she wouldn't want to eat, would lie down, but was always calm. She has not since had an episode like that until about 2 weeks ago, which lasted very briefly.

End of June my vet did lameness tests and she was fine, except she would not want to pick up her hind legs and have them held. I should also insert here that she was always nasty about picking up her feet; at first her hind legs were easier than her front. Then during this time period of difficulty, she was very reluctant to pick up her hind legs and would actually kick out. They seemed very tight. (She is much, much better now, freely picks up fronts and backs, although still does not like her backs held up very long. But does not seem to be tight as they were previously, this might be behavioral).

By end of June she was not moving forward at all, either direction. When longeing she would either twist her neck, or drop her nose to the ground. Again, almost exclusively to the right. We rode her in different saddles, bits, halter and lead rope, different riders, to rule out behavior, fit, etc.. No difference. We then gave her Banamine and rode her, and she was much better.

End of June we put her on Tucoprim to rule out kidney infection. No difference. We palpated her and discovered the large right ovary. She was put on the Regumate and tried riding again. No difference.

End of July (july 25) I took her to an osteopath. I will try to recreate findings and prescriptions:
-stands with elbows abducted away from chest, worse on left side
-right ovary larger than orange. Pulling on her, causing muscle spasms on right side of body.
-left ovary normal sized, seems to move.
-saddle fit is good
-TMJs are okay, recommend getting teeth table surfaces balanced.
-rectum tipped forward
-right uterine horn big and mushy
-cervix closed, even though had big 48mm newly ovulated follicle on right
-would quiver over flank when right ovary was handled
-has area of inflammation that bulges down into her pelvic cavity to the left of her left tuber sacrale. Not painful, no ultrasonographic evidence of past injury or fracture.
-painful if pull tail on left side
-acupuncture done on pelvis and sacrum, dry needles on neck
-adjusted left scapula
-given panacur power pak with 2 quests
-released right ovary
-right ligament to bladder tight and released

I had her teeth power floated during this time (she had previously only had floats with hand tools). There were some issues that could affect the bit set but my vet felt that basically that wouldn't be the sole cause of her problems.

One month later:
-parasite count was 3 PHPF (prior to panacur PPk and Quest)
-showed signs of heat on August 20/21
-bladder moving better
-less inflammation in uterus/bladder/tubes
-some inflammation on left underneath her vulva
-released a little on bladder, right ovary still big but mostly free
-cranial sacral therapy/lymph gland drainage - findings: Not enough movement in lungs, perhaps some scarring?; thoracocervical junction compression, needs to be decompressed; lumbarsacral junction: trauma? there is compression and edema and some residual tissue damage from ?; performed thoracic diaphragm release; neck not flowing, left corner high.
-right side of lungs slight congestion, no other abnormalities.
-Ulstrasound of LG-S1 joint
-Inflammation and kissing spines L5-L6
-Thickened dorsal-spinous ligament at lumbo-sacral area
-flushed uterus with Ticarcillin (3 flushings)
-put on marshallow root for lungs, 1 tbsp 2x/day (still on this)
-administered 3 bottles traumeel, 3 bottles zeel (injection at L5-L6)
-Acupuncture treatment
-Released diaphragm, adjusted CO and neck; adjusted sacrum; bilaterial anterior twisted facting right
-Stands with elbows turned away from her side
-Given green clay 2x/day for 2 weeks
-Detox (I think it was MOP)

She was ridden after this and was much freer, seemed to find contact with mouth or bending at poll painful. When I took her home and rode her, though, I did not find this to be true at all -- it seemed to be about 85% training (figuring out that she didn't have to work if she wasn't moving forward well) and 50% pain. I could still tell there was some discomfort. When I longed her in the round pen she still twisted her neck. But for instance she was more willing when I rode her down the driveway, then when I was in the arena. She was twisting her neck at the trot.

She had more cranial sacral treatments in mid-September, and work on the right ovary.
-released right ovary, 3x the size of the left with 25 and 20mm follicles
-adjusted C0, C1, did radiographs and showed changes between C1 and C2, and C4-C5
-put on HCG to shed follicles

She saw Janek the end of September. He found her right ovary to be normal, but said her left ovary, while not enlarged, was very tight. Felt it had been neglected with focus on right ovary. He loosened and while Scarlett was very well behaved you could tell she was in a great deal of pain from this. However, she got a stone bruise a few days after this (which I didn't know until I got on her) and was extremely eager to be ridden, I could hardly keep her from moving! It seemed to do her a world of good.

Personality: Scarlett is a dominant mare but not mean. She is pastured with a 13-year old pregnant mare, a yearling and a 3-year old filly. She gets possessive of me when I walk in the pasture and will pin her ears back to the other horses and chase them away from me.

Scarlett started "taking care of me" almost from the beginning, even though she was only 4. One of the things when I noticed when I first rode Scarlett was her sensitivity to my leg. I had ridden bareback all of my life but since I had lazy horses it was not an issue when I started taking English lessons -- until her. I liked the sensitivity, but on our 3rd lesson we had a "runaway" incident. I lost my stirrups and while she got faster because I was squeezing tighter, she wasn't really uncontrollable -- just confused. I got her stopped and the next day when I rode her and asked for an upward transition, she refused! It was though she was asking, "Are you sure? Remember what happened the last time you asked me to go faster ....!" We have since had to find the medium between her reluctance to respond to my leg, and responding when she should, and have done very well with this.

Scarlett does not seem to twist her neck so much when we jump a course with direction changes, as she does when she is just going consistently to the right. She also does it only at the canter. If I ride her with a crop and she sees it, she is visibly irritated that I have it -- shakes her head, speeds up, tries to crow hop a bit -- I don't even have to use it. But she tries to straighten her neck out. So I think she is trying to avoid working on that side, but she is trying to because it's not comfortable. I'm trying to eliminate that discomfort. It is also harder for her to quickly pick up that right lead, whereas the left is no problem (and this was not an issue before). Also, she will approach a jump with her shoulders bowed, but will straighten out and pay attention in time to jump, so she can do it if it's necessary. And she doesn't refuse a jump, ever. When we try a higher jump, she twitches her ears at me as though asking if I'm sure I want to do it -- and then she does it. Like I said, when I lose my balance, she shifts underneath me and slows down until I right myself, then keeps going. Because she still does all of these things, I can't attribute it all to behavior, yet when I have a more aggressive person ride her, she DOES do better -- but even they note the obvious tightness when going to the right.

My husband took some video yesterday at a show, I'll try to get it posted and send a link to see if you notice anything in her movement. I wanted to insert a photo so you could see her coloring and also her expression when jumping, but I haven't figured out how to do that yet! If I do, I will.

I would really appreciate any insights or thoughts anyone might have. Thank you!
-karen[/img]

[kjohnson]

Hello. Here is a link to some photos of Scarlett if that helps in determining her personality, etc.

http://www.msnusers.com/OneIronHorseFarm/shoebox.msnw

The one jumping barrels is from about 2 weeks ago. The show ones are from November.

(Also in my previous post I said after her cranial sacral treatments we determined her problems to be 85% behavioral and 50% pain -- obviously I meant 15%. Just thought I'd clarify ...).

I'll try to get the video posted as well. Thanks!
-karen

[mward]

Karen,
This is a wonderful history. The first thing that jumps out to me is all of Scarlett's symptoms seem to be right sided. I worked up inflammation on the right ovary moving to the left ovary and came up with Lycopodium. I feel this remedy could help prevent future ovary inflammation. I believe many of the osteopathic troubles in mares stem from inflammation when they ovulate. If we don't address the underlying constitutional issue then additional adhesions will occur with each cycle.
I would give Scarlett 1 dose of 30 or 200c Lycopodium and continue to work her gently until the soreness from the left ovary is gone. The abduction of her elbows is probably related to the pull on her thoracic diaphragm and will improve when all of the abdominal adhesions clear. This can take several months assuming no additional inflammation occurs. It may have been the anti inflammatory action of the licorice that helped so much with Cerise after her ovary inflammation.
The digestive upset and reluctance to lift her hind legs are also probably related t the adhesions around the inflammed ovaries. This should improve with time but you may still want to give something like Succeed or Stomach soother to help her be comfortable. The twisting of her neck is also related to the internal adhesions since the vagal nerve is sending signals back from the internal organs. The Vagal nerve comes back into the spinal cord at the level of the base of the scull and at the 1st and 2nd cervical vertebrae so these areas will always have blockades with internal organ problems.
With the remedy and continued cranial sacral and osteopathic support I would expect Scarlett to do very well. Madalyn

[kjohnson]

Madalyn:
I am so eager to try anything to get her through this. Where can I order the Lycopodium? The one thing I have been very concerned with is if this is a reoccurring thing, and how often would she need to be palpated to determine if her ovaries (or an ovary) are once again inflammed? So if that could be prevented it would save her so much misery.

So you think the Succeed or the papaya stomach remedy that has been mentioned previously would be better for her. I will get some right away.

I am creating a video library of all of our shows so I can track her progress (mine too of course, but mostly her!). She has already made so much progress but I don't want it to be by "force," I want her to be comfortable.

She has been an interesting case study in the argument of training vs. health issues. Many trainers/instructors -- including mine (by her own admission) -- tend to look toward training first when horses exhibit behavior such as Scarlett's. I hadn't had her very long, but I just knew it was something else. My instructor told me later that she was glad I bought her, because so many others would have given up on her. She said she herself probably would have returned her to her father to be a broodmare -- not a horrible life (because I know him), but she is so young!

(Incidentally, my instructor just achieved her Level 1 certification for lymphatic drainage, on her way to being a cranial-sacral therapist. This experience with Scarlett has made her a believer.).

Thank you!
-karen

[kjohnson]

I just ordered the lycopodium. Is this just a one-time dose, Madalyn? Also, would ointment be of any benefit to her. Thank you.
-karen

[mward]

Karen,
the lycopodium would be 1 dose and then evaluate after 3 to 4 weeks. I am now sure what you wanted to use an ointment on. Madalyn

[kjohnson]

I noticed that a prepared lycopodium ointment was also available. Thanks.
Karen

[mward]

I was not aware there was a Lycopodium ointment. I don't know where one would use the ointment. Madalyn

[kjohnson]

Hi Madalyn,
Well I still have not received the Lycopodeum but am expecting it this week. I started Scarlett on Succeed and surprisingly she won't eat her grain with it in it! Especially since there are other things added that I assumed would mask any taste (beet pulp, alfalfa cubes, oil, apple cider vinegar). So I am planning on ordering the Stomach Soother and see if she will try that. but was wondering if my herbal detox with the licorice might be okay to try as well? Her rides are basically the same, if I take her a full turn around to the right she starts to turn her neck to avoid the bit. Last week she also got really upset when I sat with a deep seat and worked on really getting to collect her hind legs under her at the canter -- twisting nd hopping up with her whole body then swishing her tail when I scolded her (it's easier to ride out a buck than those convulted twists!). I know she was in heat the week prior so I don't know if she was still in heat or if there was some residual discomfort. She seemed to work it out once we started jumping. I will let you know if the Lycopodeum seems to help in a few weeks.
-karen

[mward]

karen,
I have had a few other horses not eat the succeed. It may not be right for her. by all means try the herbal detox. It will interesting to see if she eats it. she could still be sore from her heat cycle. I hope the lycopodium will help her with that. Madalyn

[kjohnson]

Madalyn,
My Lycopodium finally arrived today for Scarlett. It is 200c potency. I can't believe I didn't think to ask this before, but what would 1 dose be for her? For humans it indicates mixing 4 drops in a tbsp of water 3x a day, so 12 drops a day. Is there a cc measurement that you would recommend since it's a one-time dose that I can administer with a syringe?
Thanks!
-karen