The bad news was that the images confirmed what we suspected: The disease had spread through all of his front teeth, and they would need to be removed.

swelling and recession in the gums around the affected teeth. At first, the horse may not be bothered, and as long as he remains comfortable, a veterinarian may recommend simply monitoring the case. But as the disease progresses, the horse will develop more serious complications, such as ulcers in the gums and fistulae (draining tracts) with purulent discharge. Antibiotics and anti-inflammatory drugs may provide some relief, and early on, a veterinarian may opt to remove only one or two more severely affected teeth, but over time, all are likely to need to be taken out. Removing all of the incisors at once is more extreme, but in advanced cases, it is the best way to relieve the pain. One of the more upsetting things I learned was that the condition can become very painful as it advances. Horses with EOTRH may be reluctant to accept carrots or apples, and they often become head shy or start refusing the bit. They may begin headshaking, and if they have difficulty cropping grass or picking up hay or feed, they lose weight.

Loopy hadn’t shown any signs of discomfort---but he can be very stoic, and it bothered me to think he’d just been soldiering on when I could have helped him. I did make some management changes that I hoped would make him more comfortable while we waited to go to Cornell. I secured enough soft, second-cutting hay to feed him that exclusively, and he was on grass during his turnouts, so he was able to eat softer forage all day.