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post #1 of 21 Old 03-27-2020, 12:39 AM Thread Starter
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I'm stressing out

I need some perspective.



Horse is a cripple, jacked stifles, hocks, ect. Had everything injected last August. Needs them done again.

I always float his teeth yearly, but because of the massive vet bill from dealing with his lameness last year, I put off his float. Still needs to be done and I'm also noticing some bridle issues that could be teeth.

He has ulcers from his Previcox(has been off it since late Dec). Been treating those with esomeprazole since January. Tried to wean him off it once and as soon as I lowered the dose he started colicking again. Put him back on full dose for another month, start another taper. This time he lasted until the second lowering of the dose before he colicked.

As far as colicks go, they are pretty minor. As far as I can tell, they pretty much only happen when he gets his extra hard feed(beep pulp + low nsc pellets). He'll start eating, then stop, be really still like he's holding his breath. Sometimes he'll paw a few times or shake his head. Then in a few minutes it passes and he wants to eat again. There have been a few times I've noticed him do this under saddle too. Usually after a trot. Tho, I'm not riding him currently because his hocks are making his back sore. He's already on hay 24/7. He's otherwise in good weight, good coat, not girthy or abnormally sensitive, solid poops, nothing else that makes him look like an ulcery horse.

I'm having the barn staff continue the taper. He only has 5 days left and I don't know if I'll be able to get enough esomeprazole for another round of treatment without risking him having to come off it suddenly. I called a few pharmacies today, either they don't have any and had their shipments delayed all week, or they only stock like two at a time. Even before the whole pandemic mess, it was hard to find a large enough quantity of boxes. Often out of stock. Ordering online will take way too long to get here.

I'd like to get him scoped since he isn't responding as desired after 3 months. Contacted my vet, scoping is preferably done at the clinic. If they had to do it during a farm call they can't take any images to document and it sounds like it's overall more difficult to perform. I don't own a trailer. I'd need to hire someone to haul the 1h to the clinic. There is someone at the barn who hauls, but understandably they don't want to be making any unnecessary trips if they don't have to.

I asked for a quote. ~$450 for the scope. The ulcerguard afterwards for 28 days is $975! Then another $400 for the dental float to be done at the same time. $100+ for hauling. $35 for a stall as he needs to be fasted. $2000+ by the end of it. No joint injections for a while(but of course, the pain from his joints can be a contributor to the ulcers...).

I literally just finished paying off the vet bill from his injections last year and it wasn't as large.

So I forgo the expensive meds and make a trip to every pharmacy in the city and stockpile esomeprazole(~$70 for a month)? And hope I don't catch covid in the process? I still feel like it's irresponsible not to scope him at this stage. Then that goes back to farm call vs clinic. I'd much prefer the farm call option, but if they can't diagnose him reliably from it, what's the point? With the Gastroguard, apparently the company will pay for the second month if there are still ulcers after a 28 day treatment. Idk, maybe that would be most effective, taking a gamble that his ulcers are bad enough that it would take longer than a month to heal...

I also have no idea if we might end up in a lock down or something in a few weeks, so if I put this off, he might not be able to get anything done for a while and then he's off any meds. So far there isn't any talk of lockdowns, at least. My job is safe(100% remote), I got a raise last month, and we have quarterly bonuses coming next week. No extra financial stress at least, just normal levels.

Gahhh
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post #2 of 21 Old 03-27-2020, 07:19 AM
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First, give Thanks you still have your job:). Many horse owners are at risk of not being able to pay board because they have lost their job.

Second, if you havenít already wiped the shelves clean of esomeprazole, donít do it. If you have a credit card buy this stuff and see if it helps.


Egusin

Your horse may very well be dealing with hind gut ulcers. No type of omeprazole will help the hind gut. This Egusin addresses both front and hind gut issues and is all natural:)

Itís not cheap but it helps more than anything else Iíve tried on my IR/Cushings/founder damaged hooves horse with the re-fractured sacrum.

I fed Joker the 2-phase program the beginning of last November and he is just now starting to act like he might need it again.

Both horses are due for spring de-worming, so I will put them both on the Egusin to help ease that discomfort.

3. Unless your horse has points on its teeth, dismiss the floating. He shouldnít be ridden at all with his current stifle & jock issues. Teeth donít re-grow themselves so having them perfect to avoid bit discomfort isnít an issue right now.

4. You can always get him off the hard feed and start adding a condensed it/min supplement to his beet pulp. Try and buy something that is in meal or powdered form:)

5. Are you POSITIVE the people who feed him are giving him what they are supposed to and. It taking short cuts so they can hurry up and get the chores done?

That would be a big worry, especially if youíre at a big barn.

6. I donít know what your BOís barn policies are but, for now, I would make whatever horses are there a ďclosed herdĒ and not even let anyone in or out for shows or big organized trail ride; trail riding would be fine if done locally and only with horses at the barn. That way even annual vaccinations could be delayed, as your horse may not receive those too well right now.

7. You are better off than many:). TV news casters are starting to devote time to handling the possibility of increased domestic violence due to families being shut in small living environments.

Things could be much worse:)

A Good Horseman Doesn't Have To Tell Anyone; The Horse Already Knows.

I CAN'T ride 'em n slide 'em. I HAVE to lead 'em n feed 'em Thnx cowchick77.
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post #3 of 21 Old 03-27-2020, 07:31 AM
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Are you doing anything else for his gut health/ulcers? Because omeprazole only helps stomach ulcers(not hind gut ulcers at all) by stopping stomach acid production. This does indeed help, if the horse is on little & often, low carb meals(horses cannot digest high NSC food in the stomach without the enzymes), by giving a reprieve to the damaged tissue. But it does not actively aid healing. So if ulcers are significant, they tend to need more help than just preventing further exacerbation from the acid.

Aloe, liquorice, and other 'herbs' can help, as can supps such as Kelato Gastro Aid, altho if ulcers are serious, they may need to be given in combo with omeprazole or such. Insufficient Mg in the diet(which can be due to too high Ca) is linked with stomach ulcers, BUT more Mg in the diet can also exacerbate ulcers, so I'd be inclined to use Mg Chlor applied to the skin, while ulcers are severe.
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post #4 of 21 Old 03-27-2020, 07:56 AM
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Quote:
Originally Posted by walkinthewalk View Post
6. I donít know what your BOís barn policies are but, for now, I would make whatever horses are there a ďclosed herdĒ and not even let anyone in or out for shows or big organized trail ride; trail riding would be fine if done locally and only with horses at the barn. That way even annual vaccinations could be delayed, as your horse may not receive those too well right now.
I would completely disagree with that. Vaccines aren't just for contagious diseases, but also things that bite and can be transmitted through animals. I would never, EVER skip vaccinations, worming, or farrier.
Everything else can be talked about as a one on one basis for each horse.
You can lose a horse real quick to WEE or EEE or Rabies...

So from this I'm getting your horse is lame in multiple places and has ulcers that are super bad.
How old is this horse?
Is it worth it to pour all of this money into him right now, when there's no competitions or really anything happening for the foreseeable future? As well as... is it fair to him to keep pushing him to work if he's this unsound and hurting?

I'd sit down with your vet and really look hard at the nutrition your horse is getting from everything he's eating, as well as his turnout situation, living situation, and overall stress and workload.

A lot of vets are now looking at studies of omeprezol and how it really doesn't do much for horses. The reason gastrogaud works is because it has a coating over the medicine that allows it to be protected from the acid in the stomach so it gets all the way to the hind gut.
Honestly why scope him if the answer to the question is going to be try gastrogaurd? Why not just try that first and save the other $1000 for a possible emergency?

Coming from the show world, I love gastrogaurd and we give it quite often when traveling and competing. It really does help.

All of this said though.... it sounds to me that this horse is trying quite hard to retire himself... It's always a sucky decision to make, but they tell us when they're done, and all of this sounds a lot like 'hey mom, at the very least could I have a break?'
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post #5 of 21 Old 03-27-2020, 08:18 AM
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Quote:
Originally Posted by Interstellar View Post
I would completely disagree with that. Vaccines aren't just for contagious diseases, but also things that bite and can be transmitted through animals. I would never, EVER skip vaccinations, worming, or farrier.
Everything else can be talked about as a one on one basis for each horse.
You can lose a horse real quick to WEE or EEE or Rabies...
Alternatively, if you need to forgo some spending on vets, depending on the state you can order and administer your own vaccinations. I saved quite a bit of money the last two years just administering my own vaccinations, plus I learned how to give vaccinations just in case I will have to in the future.

Toofine - 1998 Half Arabian
Minnie - 2013 Morgan
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post #6 of 21 Old 03-27-2020, 11:05 AM Thread Starter
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Quote:
Originally Posted by walkinthewalk View Post
First, give Thanks you still have your job:). Many horse owners are at risk of not being able to pay board because they have lost their job.

Second, if you havenít already wiped the shelves clean of esomeprazole, donít do it. If you have a credit card buy this stuff and see if it helps.


Egusin
Haven't bought any esomeprazole yet. I'm really wanting to avoid going to the store if I don't have to, I haven't been in 3 weeks and was hoping to make it a bit longer.
I haven't heard of this product. I'll read into it.

Quote:

Your horse may very well be dealing with hind gut ulcers. No type of omeprazole will help the hind gut. This Egusin addresses both front and hind gut issues and is all natural:)
Quote:
Originally Posted by loosie View Post
Are you doing anything else for his gut health/ulcers? Because omeprazole only helps stomach ulcers(not hind gut ulcers at all) by stopping stomach acid production.
Hind gut is possible. His symptoms don't seen to strongly correlate with hind gut, though. The colics are always within minutes of eating, too soon to be passing from the stomach. No loose stool, no girthyness. Staff haven't seen him colic at any other point during the day(but he's also very storic. Took me a while to clue in that he was colicing initially). Difficult to assess any of the common performance symptoms because of his stifles and hocks. I do understand that extended PPI use can contribute to hind gut ulceration.

That's in part why I think a scope is important now. Scope and see a gastric ulcer, that's low hanging fruit. Scope and don't see, we can look elsewhere and use something like Sucralfate. I still haven't responded to my vet's email, but I'll mention hind gut.

Quote:
Originally Posted by walkinthewalk View Post

3. Unless your horse has points on its teeth, dismiss the floating.
He's always sharp by the time his yearly float happens, so I'm pretty sure he needs it. I've also noticed some uneven wear on his incisors. I'm also wondering if there is any degree of mouth ulceration/discomfort that could be contributing to the overall situation.

Quote:
He shouldnít be ridden at all with his current stifle & jock issues. Teeth donít re-grow themselves so having them perfect to avoid bit discomfort isnít an issue right now.
Quote:
Originally Posted by Interstellar View Post
So from this I'm getting your horse is lame in multiple places and has ulcers that are super bad.
How old is this horse?
Is it worth it to pour all of this money into him right now, when there's no competitions or really anything happening for the foreseeable future? As well as... is it fair to him to keep pushing him to work if he's this unsound and hurting?
He's 10, really a trainwreck. There's other stuff going on too, but this is the major stuff. He pretty much is retired. All the vets who evaluated him for his lameness last year concluded that he is ok for light work as long as he's comfortable with it. When I ride him 1-2 times a week, it's for ~15min mostly at the walk with some straight line trots. Since his injections have worn off, his back gets sore so me sitting on him is pointless. I haven't been on him for a month or two at this point, but I have been doing in-hand bridle work and long lining to keep him mobile. I have long forgotten about ever bringing him back to the point that we could show.

The injections can easily be pushed off as he's comfortable enough to be pasture sound. I have enough Pentosan to keep him going for most of the year too. The ulcers are the more immediate issue since I can't just ignore those in the same way.


Quote:
Originally Posted by loosie View Post
This does indeed help, if the horse is on little & often, low carb meals(horses cannot digest high NSC food in the stomach without the enzymes), by giving a reprieve to the damaged tissue. But it does not actively aid healing. So if ulcers are significant, they tend to need more help than just preventing further exacerbation from the acid.

Aloe, liquorice, and other 'herbs' can help, as can supps such as Kelato Gastro Aid, altho if ulcers are serious, they may need to be given in combo with omeprazole or such. Insufficient Mg in the diet(which can be due to too high Ca) is linked with stomach ulcers, BUT more Mg in the diet can also exacerbate ulcers, so I'd be inclined to use Mg Chlor applied to the skin, while ulcers are severe.
Quote:
Originally Posted by walkinthewalk View Post
4. You can always get him off the hard feed and start adding a condensed it/min supplement to his beet pulp. Try and buy something that is in meal or powdered form:)
Quote:
Originally Posted by Interstellar View Post
I'd sit down with your vet and really look hard at the nutrition your horse is getting from everything he's eating, as well as his turnout situation, living situation, and overall stress and workload.
He's already getting a powdered vit/min supplement. The pellets are compatible with the vit/min and allow me to feed it at a lower overall volume, but he doesn't like it if it's just the powder. The pellets are a low NSC feed, something like 10%, he gets only about a lbs of them. In general, I am very skeptical of herbal supplements and their efficacy. Purina Outlast is one I've heard good things about, but I don't know how I'd get that now. I'd have to call around but I wouldn't be surprised if no one stocked it here.

Last year I had gone over his diet with my vet and they consulted with an Internalist as we had pulled blood and he tested as Mn deficient (not Mg) repeatedly. There was nothing overly concerning about his diet otherwise.

He's eating 24/7 hay, full outdoor board with friends. He doesn't go anywhere. He's a sensitive guy and a worrier, but is very relaxed and comfortable day to day. Very low stress. Low work. I'm assuming these ulcers are a holdover from several years ago that were exasperated by the Previcox. 3-4 years ago he was boarded at a place that hand fed hay in the winter, so he's usually go periods without hay + was getting more grain and was in training.


Quote:
Originally Posted by walkinthewalk View Post

5. Are you POSITIVE the people who feed him are giving him what they are supposed to and. It taking short cuts so they can hurry up and get the chores done?

That would be a big worry, especially if youíre at a big barn.
Yes, I'm quite confident the staff are giving his medication daily. They have a program where they will give supplements and meds to the outdoor boarded horses, there's a fair number of horses who get this service. His is by far the simplest to give, everyone else needs feed pans so if anything they would skip the others'. Haha. Really, though, I provide them with cut up granola bars to hide his medication in, so based on the rate they go through the bars and just knowing the care standards of the trainer and BO, I am very confident he is getting it daily.


Quote:
Originally Posted by walkinthewalk View Post
6. I donít know what your BOís barn policies are but, for now, I would make whatever horses are there a ďclosed herdĒ and not even let anyone in or out for shows or big organized trail ride; trail riding would be fine if done locally and only with horses at the barn. That way even annual vaccinations could be delayed, as your horse may not receive those too well right now.
Quote:
Originally Posted by Interstellar View Post
I would completely disagree with that. Vaccines aren't just for contagious diseases, but also things that bite and can be transmitted through animals. I would never, EVER skip vaccinations, worming, or farrier.
Everything else can be talked about as a one on one basis for each horse.
You can lose a horse real quick to WEE or EEE or Rabies...
Quote:
Originally Posted by ClearDonkey View Post
Alternatively, if you need to forgo some spending on vets, depending on the state you can order and administer your own vaccinations. I saved quite a bit of money the last two years just administering my own vaccinations, plus I learned how to give vaccinations just in case I will have to in the future.
The barn is more open than other I've been at, but is no means the busiest. There's not many people going in an out, but people do(did?) trailer in for lessons and the trainer would trailer out for clinics and shows, but not many of the boarders are interested in shows.

I had considered the impact on vaccines, but those are pretty easy to deal with. I can always put in an order and drive over there to pick them up. I can administer myself, including the strangles IN. He's not due for vaccs until closer to June anyway. I do need a FEC ran, though.


Quote:
Originally Posted by Interstellar View Post
A lot of vets are now looking at studies of omeprezol and how it really doesn't do much for horses. The reason gastrogaud works is because it has a coating over the medicine that allows it to be protected from the acid in the stomach so it gets all the way to the hind gut.
Honestly why scope him if the answer to the question is going to be try gastrogaurd? Why not just try that first and save the other $1000 for a possible emergency?

Coming from the show world, I love gastrogaurd and we give it quite often when traveling and competing. It really does help.
Is the answer to use Gastroguard? Because that is a lot of money. Gastroguard is the other $1000.

My understanding is that Gastroguard only effects gastric ulcers because it's a PPI. And gastroguard is omeprazole.

My vet also mentioned using a 1/2 tube a day vs full tube, or using gastroguard + compounded omeprazole. Was going to ask the cost on the compounded. Neither of those have any recourse if it doesn't work, though. With the full GG treatment, the company will stand behind its treatment.

But $1000 is a lot...

So it's:

No scope, no float, GG = $1000. Hope it works and he doesn't have anything extra going on. I'm assuming for the company to uphold their second treatment policy, they'd need a confirmation via scoping. If it works, fantastic. Still needs a float.
Scope + GG = $1500. Would at least have confirmation(if we see anything), presumably the company would pay for round 2, but that also means 1-2 more trips to the clinic to scope. (if there's no lockdown by then). Still needs a float.
Scope + float + GG = $2000+. Still no promise of it working, but company would back it up. Float would be done, eliminate one potential source of discomfort. Still need the 1-2 more clinic trips.
Get more esomeprazole = $100. ??? Outcome. Way cheaper, it has been providing relief so far, but evidently not enough to heal fully. Then the supply issue. Not only is it hard to find right now, I would be taking it away from other people who might need it.

Or do all those scopes on farm with potentially less diagnostic value. Farm call would be a little cheaper than trailering fees. Would need to ask if the company would back up the eyepiece scope vs digital scope.


Quote:
Originally Posted by walkinthewalk View Post
7. You are better off than many:). TV news casters are starting to devote time to handling the possibility of increased domestic violence due to families being shut in small living environments.

Things could be much worse:)
I definitely understand that. I'm don't have to worry about making rent or board like some are right now. Not exactly flush with cash though.
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post #7 of 21 Old 03-27-2020, 02:32 PM
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What are you wanting to achieve by scoping and putting the horse on gastrogaurd? Right now I'm not understanding how your horse is 'colicing' and then fine a few moments later? That seems more like he's just a little sore instead of a colic.
Colic = medical emergency which doesn't seem to be happening here. Or he's getting sore from chewing if his teeth are as bad as they normally get.

Have you tried to just let him be? Will this really improve his quality of life greatly or make you feel as if you're doing something?
For a pasture sound horse, I wouldn't scope it and put $2000 into it unless it was worth a lot or was very close and special to me. I understand wanting to do all you can to help, but is he really suffering to the point of spending a lot on treatment?

Also, here are some good reads on why gastrogaurd works so well and why feeding normal OTC or compounded omeprazole never works in horses.
Gastrogard vs. Generic Omeprazole: Not Worth the Risk - Equine Veterinary Associates
https://www.ncbi.nlm.nih.gov/pubmed/14649361
Omeprazole Alone Doesn?t Heal Ulcers | Equine Chronicle
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4895457/

The basic premise is that the general compound on it's own needs a vehicle to get past the acidic stomach to be absorbed in the hind gut to work through the bloodstream. Remember that this isn't just a coating that you put on like a bandaid to the ulcer, it heals it from the inside out as well as calming the stomach.
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post #8 of 21 Old 03-27-2020, 03:12 PM
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Could he be allergic/sensitive to an ingredient in his feed? What about trying alfalfa pellets as a carrier for his vitamin/ mineral and see if that makes a difference?
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post #9 of 21 Old 03-27-2020, 04:16 PM
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Quote:
Originally Posted by ApuetsoT View Post
Purina Outlast is one I've heard good things about, but I don't know how I'd get that now. I'd have to call around but I wouldn't be surprised if no one stocked it here.


So it's:

No scope, no float, GG = $1000. Hope it works and he doesn't have anything extra going on. I'm assuming for the company to uphold their second treatment policy, they'd need a confirmation via scoping. If it works, fantastic. Still needs a float.
Scope + GG = $1500. Would at least have confirmation(if we see anything), presumably the company would pay for round 2, but that also means 1-2 more trips to the clinic to scope. (if there's no lockdown by then). Still needs a float.
Scope + float + GG = $2000+. Still no promise of it working, but company would back it up. Float would be done, eliminate one potential source of discomfort. Still need the 1-2 more clinic trips.
Get more esomeprazole = $100. ??? Outcome. Way cheaper, it has been providing relief so far, but evidently not enough to heal fully. Then the supply issue. Not only is it hard to find right now, I would be taking it away from other people who might need it.
Let's address the lockdown issue first. Veterinary care and animal/livestock transport is considered essential, so if you have to haul for a scope, haul for the scope. You won't be prohited from that.

Purina Outlast is good stuff. I used it before they added it to their feeds, bought it by the bag and added it myself. I had a foal who was having some health issues and on antibiotics/steroids for an extended period of time and not able to eat hay that hadn't been soaked, or cubes and was feeling pretty stressed. He came through it all without any ill effects. But it won't HEAL the ulcers (if that's what he has) but it will help to protect his gut while you treat him.

Maybe see if you have a compounding pharmacy that you can order from? I have one here in OK that I ordered a liquid omeprazole/ranitidine compound from for another horse who did have ulcers and it worked like a miracle. You can order the powder from NexGen (you need an RX from your Dr. for it) and mix it up yourself. Here's a link: https://nexgenvetrx.com/omeprazole-1...-200-mg-scoop/. I don't know the price.

If you're going to haul him for a scope, then I would have his teeth done at the same time, no point in 2 hauls or sedating twice if you don't need to. I would postpone any vaccines until he's feeling better.

I don't like that he's eating and "colicking" and a few minutes later feels better and eats some more and colicks and so on. I had a mare who seemed to have little colics and she'd park out, bite her sides, and then get better and go on about her business. I had her checked several times. No ulcers, no real reasons that we could see for colic. One day she colicked, went down and I took in to be examined again and determined she had twisted her gut (torsion colic). They suspected that with her history that perhaps she had some lipomas or something that was blocking the passage of feed periodically. We ended up having to put her down.

And that brings me to the cold hard questions about the money. He's 10 and you describe him as a "trainwreck". That means you don't really expect him to get better. If that's the case, would you (and he) be better off considering euthanasia for him and later on when money isn't such a concern, getting another horse?

At this point, I would not buy anymore esomeprazole (throw $70 down the trash chute 10X and you've just about paid for the more expensive drugs and diagnostics) because it's not doing what you need it to do. It's making him more comfortable, sort of, it's not healing the ulcers, if that's even his problem. I'd also have the vet do a fecal occult blood test which is a LOT cheaper than anything else, and will test for blood in his stool. If it's there, you pretty well know he's got hind gut ulcers and can treat that and see if it helps. That could be your least expensive way to go right now, and might solve your problems. At least the gut ones.

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post #10 of 21 Old 03-27-2020, 04:50 PM
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I
Is it worth it to pour all of this money into him right now, when there's no competitions or really anything happening for the foreseeable future? As well as... is it fair to him to keep pushing him to work if he's this unsound and hurting?
I don't believe that decisions on looking after an animal's health should be at all dependant on whether you can *use* him 'in the foreseeable future's or otherwise.

I also didn't see where Apuetsot said anything about riding or working the horse while he was lame. I def don't think you should be, if you are doing so OP??
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