flexions of all four limbs- I have had hock pain result in sore backs focal or widespread depending on how they compensate. Coffin joint or foot pain can also cause back pain, unwillingness to go forward, poor attitude under tack.
SI pain can also cause these symptoms. Ultrasound and palpation of spine will help diagnose changes and amount of pain.
Bloodwork for cushings- glucose, cortisol and insulin levels. Can do pre grain cortisol and 6-8 hr post. Usually do one draw. Can also do a dex suppression test. Cushings can cause muscle pain, poor performance, skin issues and definate foot pain. I have a few horses that fit this group of symptoms that after testing positive or high normal have been on pergolide and the symptoms improve greatly.
Saddle fit- this is especially true if he has changed shape in last 3-4 months, thin line makes a great pad for sore backs but it won't fix a bad fitting saddle
This is where I would start at least to rule out easy to diagnosis diseases and start narrowing down the list.
Thanks for your input Heather.
The more I consider things the more I'm confused as to why flexions haven't been done. The vets both seem really caught up on the horse being sound when they watch him go...He is a big boy at 18.1 hands, so having wear and tear at 11 years old seems reasonable. I have him on adequan, but I know that wouldn't take care of everything.
I don't think he would fit into cushings since he's not very old, if anything drinks too little, and he barely grows a winter coat. Do you still think it's a possibility? I'd have to look but I think glucose was on the bloodwork we've done before which was all normal. Of course this was not a specific test for cushings, but a general panel.
He did change a lot in his back when he finally gained some weight earlier this year, but I have had my saddle re-paneled since then. I'm not a saddle fitter, but to me it looks good. My only concerns with the saddle are that maybe the gullet is too narrow for his spine or that the saddle is too long and past his last rib. He is long in the area between his last rib and his hip (loin maybe?), so it's a bit deceiving. Hopefully I hear back from the saddle fitter I found, she was talking this Saturday or next to come look at him.
I do feel like we've been doing things in a weird order, but maybe it's just because I've been dealing with this for so long they assume it can't be something easy?
Had the saddle fitter out and she said I did a great job fitting my saddle. What she did find however was that the slope of his back was different on each side right where the back of the panels sit. He kind of drops off on the left, causing extra pressure on the right side. So after a shim on the left I am having a much easier time sitting straight. Horse did a month of Robaxin and is now done with that. His attitude is slightly better, but still not what I want it to be. He seems to relax sooner when I start cantering and not get as mad about my movements in the saddle so it's something. He started getting really pissy whenever I go to get him out of his stall, but I'm hoping that's just because he is tired of having a syringe of bad tasting goo stuffed in his mouth twice a day. Now that we are done with that we will see.
Now I've moved on to trying to get rid of his back leg scabby grossness, as I do believe they are somewhat painful. My vet sent me a jar of "magic" goo which I just started today, so we will see.
He is a problem child. So going to work on back leg scabs for a bit now but keep hock flexions/x-rays and scoping for ulcers on the list. The sports med vet is coming the end of February, so I can always do the hock check at that time.
Since the last time I posted a few things have happened. My horse finally became off in his gait, although never clinically lame. Lameness vet sent us to MSU for a bone scan which revealed kissing spines in three spots. The spots were injected and we've been working on getting back in shape. We are just starting to jump again but he feels good and his attitude is much improved.
I'm now hoping to get more information about the physical therapy available to help deal with the issue, instead of relying on the injections alone. I also plan to purchase the knock off Dover version of the pessoa lunging system to help my horse build up his back without me on him.
It has been a very long road but I finally feel like I'm getting my horse back. I honestly wish we had just x-rayed his back early on, it was obvious on x-ray. If you go to my blog I have posted some of his x-rays.