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Update - new imaging - Diagnosing back pain from behavioral symptoms, or, kissing spine differential diagnoses

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    Update - new imaging - Diagnosing back pain from behavioral symptoms, or, kissing spine differential diagnoses

    Another thread on my horse's many spinal issues.

    Diagnostics and treatment done:
    Took him in for a bone scan mid-Feb. Showed hot spots in lower T spine and lower hocks. We had complete spinal X-rays from April 2015 on file, and these were repeated and compared. Cervical spine X-rays were not done at this time but had been repeated in July 2016 and ultrasound repeated most recently in September 2016. Radiology report is that X-rays look the same for T and L spine. Noted some changes to articular facet at L2 and sclerosis of dorsal spinous processes T14-T17. These were the same as on original X-ray, which at the time was deemed not clinically significant. Taken with new bone scan results along with behavioral problems under saddle, T spine issues now deemed clinically significant. Dx is loosely inflammation within the supraspinous ligament. Injected hocks and between dorsal spinous processes from T14-T18. Shockwave done on this area of the back as well. No signs whatsoever of withers injury or kissing spine. No major issues going on in the hocks (no arthritis or OCD, doesn't flex positive); we think he probably strained the hocks by evading using his back for a while now versus the other way around.

    Response to treatment:
    Horse given some recovery time, then worked in hand for a bit, which was going fine. Started under saddle showing improvement over the course of a week and a half, with the last ride in that time period being the best ride in months. Rides were kept short and sweet to reward good behavior with canter work being done mostly in 2 point.

    Other self-destructive setback:
    Then horse plays over fence with new neighbor, hurts his face and gets staples in his nose to close the wound plus put on antibiotics. He gets time off for swelling to go down. Starting back under saddle, behavior starts to deteriorate each ride. Consider gastric upset from antibiotics and don't do much work. Can't work in hand much due to location of wound, but long lines ok. Staples come out, antibiotics done, GI appears to be back to normal, and shockwave repeated. Been about 4.5 weeks since first round.

    Current behavior:
    Behavior under saddle only getting worse. To the point of completely shutting down or lashing out, which he hasn't done since before his first round of neck injections in 2015. He will back or spin into a corner and get stuck there, as he figured out that bucking and propping up in place doesn't phase me. If I try 2 point, it's worse. Sometimes he responds ok to sitting way back in a driving posture. Put him on Robaxin and have one good day after a long warmup on the ground. Then back to even worse than before the next ride.

    Riding vs Not and Saddle Fit:
    He works just fine on the longe line and doing other in hand work. If he gets stuck under saddle and won't move, if I dismount, I can immediately send him into a trot with only a little snark. He will longe in the saddle without issues. The saddle was custom made for him and re-fitted in July after a big growth spurt. Changing saddles has no effect, although he hates most saddles, tending to result in a refusal to move forward. I have also tried playing with padding--in his last saddle adjustment, we took some padding out at the base of the withers where previously he had more lift. When he grew, he beefed up there some making the saddle too tight and wanting to slide forward. Saddle stays in place after adjustment and still does. He's had periods of working fine in this saddle. Had it re-evaluated recently, and fitter thinks I still have enough withers clearance with my weight in the saddle. Tried another demo with more minimal padding in the shoulder area with a tree we knew he liked (my saddle still has some lift in front that may need to come out as his shoulder widens), and his behavior was the same, although at the time of this, he was doing relatively ok. I tried adding an Ultra Thinline. He likes this some days, not others. Added an Ogilvy gummy which I've used on my old saddle and some demo saddles in the past to get a little more lift at the withers while his saddle was being made or remade (and he was ok with that), and it was way worse--got off, removed pad, and behavior improved.

    During times of poor behavior in the past (pre-neck injections), I have walked and trotted some bareback during times of no turnout due to weather (in lieu of hand walks), and he's been fine. He's generally a sweet horse. So, I think ok, if it's his particular saddle fit, then he should walk out ok bareback. If his back is sore, then bareback riding should be worse. Well, I lived to tell you about it, but bareback was for sure worse. He was very upset and would not even walk without starting to melt down. I experimented with putting my weight on different parts of his back while he was standing still. He didn't much like me sitting anywhere, but if I moved up towards his withers, he started dancing around and throwing his head up.

    Now what?
    He's never shown soreness under the saddle area for the acupuncture/chiro vet or other bodyworker. It's always been lower T spine and lumbo-sacral area. In particular, he tends to get very flinchy around the psoas and glute attachment areas. But when he gets bodywork, we tend to treat all of the musculature along the back.

    This walks and talks and quacks like a kissing spine horse or a withers injury, but we don't see ANY of that. His most recent X-rays were reviewed by a board certified radiologist and a very experienced surgeon. We had ultrasounded the back in 2015 as well. Should we do that again? Might need his sports med specialist vet to do that.

    Regular sport horse vet is coming back out tomorrow to see the behavior.

    We have talked about mesotherapy, in which case I'd do back AND neck. In the past, have talked about Gabapentin. Anything else I should bring up at the appointment? Anyplace else we need to be looking?
    Last edited by IPEsq; Apr. 12, 2017, 02:50 PM.

    #2
    Originally posted by IPEsq View Post
    Another thread on my horse's many spinal issues.

    Diagnostics and treatment done:
    Took him in for a bone scan mid-Feb. Showed hot spots in lower T spine and lower hocks. We had complete spinal X-rays from April 2015 on file, and these were repeated and compared. Cervical spine X-rays were not done at this time but had been repeated in July 2017 and ultrasound repeated most recently in September 2017.
    Unless your insurance covers time travel, I think maybe the 2017 dates quoted above should be 2016?

    OP, I have nothing but respect for your thoroughness and persistence with respect to figuring out this horse and his many issues. I have next to nothing to offer - maybe there could currently be a pinched nerve or something that would make the Gabapentin worth a try?

    Also, something in your post triggered memories of our first horse - an OTTB who would balk and back without much regard for where she was going or why. In her case, it typically only happened after she had cantered and the behavior was pretty much attributed to being "brain-fried" from her racing days at the low end of industry. I really doubt that is the case with your guy, but the thought did occur to me that at this point (after so much in work/out of work/rehab work) maybe he would benefit from a lot of relaxed hacking on trails - maybe even in a western saddle. Realizing that's not where you want to go with him, but it might kind of help him reset mentally if you can't come up with anything physical to pursue further.

    Comment

      Original Poster

      #3
      Yes, sorry, fixed those dates! X-rays of spine re-done in Feb 2017 but all the other second rounds of imaging done mid to late 2016.

      The current farm doesn't have a good place to hack out. The pastures unfortunately have prairie dog holes right now (and mr. self-destruct goes out in a smaller lot), and he gets anxious being out there after horses are brought in anyway. Monsters live in the grasses by the creek. I used to hack out at the last farm in a big, empty pasture during turnout time for the neighboring pastures. Then got kicked out of hacking there by BO and progressed to being able to hack out in smaller pastures alone as well as on an open field around the other side of the property's bridle path. He really seemed to enjoy that...to the point of throwing a temper tantrum when it was time to go back in. The wild alfalfa growing may have had something to do with that. BUT, we also appeared to be on top of his pain issues at that time.

      Left that barn for various reasons. Current farm has a short bridle path that I have used in the past as a bit of a conditioning hill ... trotting up, walking down. He has never gotten comfortable working by the road on the flat part of the path (cue squealing and leaping--i.e., not relaxed!). With winter conditions, it's been a while since we worked on the hill part of the path either because of footing or high winds. I have started doing some walk rides out there again to get him used to the scenery. He seemed to have a very sheltered upbringing that wasn't helped by all of his layup time, so trailering him out or going even across the street to one of the quiet dirt roads might get us both killed until he has done more traveling in general. I didn't get much of that done last year because of his controlled exercise rehab schedule which immediately was followed by further problems.

      Training options for a next step would be to get a colt starter on him who has done some groundwork with him and really helped me turn him around on the ground. He may or may not tolerate a western saddle, but she can try one if she wants. There's also another rider who will be coming to the barn while one of the trainers is out for maternity leave who is experienced with starting jumpers and is an event rider, so I can also try her and she can try whatever saddle and take him out of the ring if she wants.

      Comment


        #4
        Your story reminds me in bits and pieces of four different friends horses, so I am throwing them out there, so you know you are not alone in your quest to find an answer.

        #1- rearing, balking, only would canter on one lead and very heavy on front end. Did the robaxin, shockwave, massage, chiro, blah, blah, blah. Tested for EPM and treated with Marquis 2X. Bute did not make much of a difference. Bone scan came back clear except for small areas of hocks, front ankles, stifles. X-rays of back and various joints came back ok. Neck showed some signs of OCD's that were perhaps pinching on nerves. Neck and various joints injected. Bad behavior continued. The horse eventually was retired but continued to get 'rank' and dangerous even to people on the ground. Euthanized months after retirement because of that. Necropsy showed major EPM problem especially in neck and boney fragments in neck. The reason boney fragments did not light up on the bone scan was that they were 'cold' and no longer aggravating, but probably damaged the nerves a long time ago perhaps due to a flip as a young horse. It was the combo EPM and bone fragments that they think did him in mentally.

        #2- No real behavior problems, but odd behavior such as tilting head, playing with mouth a lot, difficulties chewing. X-rays of neck and back were fine, but it was an ultrasound of the neck that showed fragments of cartilage (and the radiologist kind of knew how to really dig in between the facets to find them.) Neck injections and monitoring of his neck movements (i.e.: no chiro or massage work was to be performed there type stuff) made a difference.

        #3-lameness in front, balking, difficult to tack up...X-rays of the back were ok, ultrasound of the back revealed chronic ligament inflammation. Pretty much lives on Robaxin, lots of ground work and time off. No real answers! But they are still working on it and dealing with difficult behavior.

        #4- fine without a saddle, doesn't love a surcingle though, easy to tack up, but oh so tense and stiff when under saddle. Very stiff on one side and leans in. On seriously long term high doses of Robaxin, tried a few saddles, mesotherapy, Banamine. They are still working on that one too, but owner is hesitant about spending big (like bone scan) money on the horse.


        Have you tried a Sarapin block anywhere? I would also try to find a super radiologist and ultrasound his neck and back. Have you tested for Lyme and EPM? And what about a Naproxen test (Naproxen is better for backs...think Aleve in human form)? I wish you all the success in the world. I know what my friends went through and it is discouraging when all we want is answers. Jingles to your horse.

        Comment


          #5
          Has he had any recent chiro/body work? Perhaps he has a rib out in that area. It can cause a lot of the reaction you're talking about.

          Comment

            Original Poster

            #6
            We tested for EPM in 2015 because he had spent some time in Florida, and I thought a lot of his behavior pointed to that. Negative. Have not repeated because EPM pretty much non-existent here. A friend who is a vet in the SE suggested I put him on Oroqin anyway, but then we started imaging the neck, and when that wasn't clean, just went further down that road. Have not tested for Lyme but discussed with vets who think it'd be pointless. Although where horse grew up, Lyme is a possibility. Vets don't think it's likely because he would not have gotten infected here and doesn't think horse has some kind of chronic Lyme.

            The areas of the back were injected with Sarapin. He's had very extensive imaging done of his neck. Does have an OCD at C3-4 and some arthritis at C4-5 and 5-6, all on the left side (also has some poll damage on left side--must have had an accident as a baby). Bone scan showed very minor uptake on the OTHER side of the neck at 5-6 and 6-7. C6-7 looks clear on imaging. We think that the arthritic sites cause him the most problems but inject bilaterally at all 3 sites (C3-C6). After injections in September 2016, he didn't really have as good of a response behaviorally as I was expecting. But his ROM improved drastically and is still quite good. Turns out he had pedal osteitis brewing in one front foot that we didn't catch (was jogged barefoot on asphalt at the time of neck injections and was the soundest he's ever been since things went south following his PPE). Caught that in October after a Bute trial dumped out the lameness. Fixed that and horse was going quite well in December. Downhill slide starting in January 2017, leading to bone scan in Feb and where we are now. Of note, the PO foot had no uptake on bone scan.

            The ultrasounds of the neck in July 2016 and Sept 2016 showed significant effusion at the C4-5 and 5-6 sites. So, if these sites are "active" right now, we would have thought bone scan would show something significant. That's why I'm leaning towards some kind of nerve root pain and/or muscle spasm. He had drastic behavior improvement after the first time we injected the facets in June 2015, and none of his neurologic question marks have returned since (such as front limb intermittent lameness). Specialist vet thinks that the facet pathology is well controlled. We've done monthly acupuncture on the neck for pain management, suggested by specialist after I said that I wasn't thrilled with his response to 2nd injections.

            We could do some blocking up in the shoulder or neck but haven't done that. Since bone scan results, all the focus has been on the back. When his neck was the #1 issue in the past, he did not want to go forward, but as I said, he didn't really have issues with saddles (other than his princess nature towards all saddles) and was fine to ride bareback--just not a fun time doing that on my end .

            But I'm here to explore the possibility of there being a large connection between how the musculature and ligaments support the entire spine and work together...whether there's a connection. Maybe he's got widespread nerve pain.

            He's extremely mouthy and has gotten even more so as a way to express his anxiety. Like, he NEEDS to grab the reins or something when he is anxious about moving his feet. But he's always been mouthy and doesn't do anything weird like head tilting, he can eat fine, etc. Dental is up to date unless something odd has happened way up in the mouth recently.

            I have not tried Naproxen.

            Elouise, I'd be interested for my own education if nothing else to hear how #3 and #4 turn out.


            Now that he's been pretty pleasant during the groundwork, I really want him to keep having a job. He likes it. In the past, when his neck was painful, groundwork was as impossible as riding. Maybe even more so. Vets tried to longe him to evaluate his way of going, and he would rear and leap and spin. I usually had to get on because that was better, with some encouragement from the ground. This time is not the same. He's only 6 1/2 and needs interaction to stay sane. I would hate to retire him, but at this point, I don't really care what job he has so long as he wants to have it.

            Comment

              Original Poster

              #7
              Originally posted by UrbanHennery View Post
              Has he had any recent chiro/body work? Perhaps he has a rib out in that area. It can cause a lot of the reaction you're talking about.
              His last bodywork is pre-bone scan. I delayed his usual appointments because of the injections and shockwave treatments. Next one I could get on the books is for the 19th of this month. Vet practice seeing him tomorrow has a chiro vet but I don't know if she will be at the appointment, as she often works in a different territory from horse's primary vet. Sometimes she is there, sometimes not.

              Comment

                Original Poster

                #8
                Oh, to add...horse goes completely loco on Previcox, so I will not give that. Before the bone scan, I did a Bute trial with no improvement. In the past, neither Previcox or Bute had any effect on spine-related behavior problems (which we tried pre-neck injections). Also have tried HA, both oral and Legend. Haven't tried Bute again since behavior has escalated the past couple of weeks, as vet wanted to repeat shockwave and next try Robaxin, which is where we are now. His dose is 7.5g BID.

                Comment


                  #9
                  OP, I have nothing but respect for you, especially as I am in the very beginnings of this journey with one of my horses. It frightens me that there are just so many tests, possibilites, things to try- and that they can all come up dry and you can still be left with a miserable horse under saddle.

                  My guy is an 8 yr old NSH. He presents as something along this line: sometimes he looks off on the longe - tack or not. Sometimes there are irrigular steps behind. Sometimes even in front. Definitely bracy in the back.

                  Under saddle, it generally goes like this: rider gets on and walks off. Halt/walk a-ok, no problem. Use your leg to ask him to step to the side/straighten/under himself, he'll balk. First time you ask to trot- head throws up and body scrunches under saddle and grind to a halt. Persist with the ask and on bad days = kicking out, good days sloppy transitions forward and eventually he "clicks in" and goes forward just fine. Hates any and all contact with a bit- most success on getting forward is riding on the buckle.

                  He has a dedicated saddle fitter and all indications are saddle fit (and i have tried multiple saddles, even ones that look like they don't fit and the behavior never changes). Routine chiro and massage body work. Many a bit tried, its not the bit.

                  He had his first initial vetting with a top lameness vet in our area who started simple: flexions and palpation. He flexed clean, even to the point where I sensed that the vet thinks I'm a crazy horse owner looking for trouble. (I assure you if i could save the thousands of dollars and just have a happy horse I'd be right there doing that and not having to move mountains to get this vet's time or expertise). He did seem sore across his back/SI and the vet thought that was indication enough at this stage to try a round of bute/robaxin. The first 4-5 days I didn't think much was changing, and then whammo- day 5-6 things took a turn for the better. He was great - super happy under saddle and felt normal - green horse (he is that), but a normal green horse. I did not increase any workload, as I didn't want to introduce/complicate things. We've been off that medication regime for almost 2 weeks now, and it has been miserable after about day 2 being off it, dareisay almost worse than before we tried the meds. Waiting now for vet to call me back with next steps as now we know for sure things improve on meds.

                  This is the short version with some highlights. I could write a book about this horse and I haven't even gotten that far, but i'll save everyone's eyes. I have no idea what will come of our journey, if anything will ever truly be diagnosed or resolved with some form of treatment. I just wanted to share my snippet to say you are not alone and I feel for you...and I am following your story (and others suggestions/stories) with great interest.
                  My blog: Change of Pace - Retraining a standardbred via dressage

                  Comment


                    #10
                    I really, really think you have more then one thing going on and that the spinal issues might be complicated by EPM or Lyme. All it takes is one tick bite you never see evidence of, maybe even in a trailer driving through or an overnight stop while in transit. Or one little taste of Possum poop that a single EPM test is notorious for coming up inconclusive or negative for despite the fact they've got the little buggers swimming in their spinal chord. I would really test for Lyme and either retest for EPM or just get him on the Oroquin.

                    At this point with your insurance depleted and out of pocket costs rising? What's to lose?


                    When opportunity knocks it's wearing overalls and looks like work.

                    The horse world. Two people. Three opinions.

                    Comment

                      Original Poster

                      #11
                      Findeight, it's a new year and new insurance $ (until they decide to drop him or get better at writing their exclusions). So, that helps a great deal. But neck things are for sure excluded at this point, and the bone scan took a big chunk out of this year's coverage.

                      Comment


                        #12
                        Oh yeh, on that #1 horse...
                        his EPM test came back as "exposed", but not like 'you need to treat him', but they treated him twice anyway. And when they did the necropsy...he was a 'poster boy' for positive results. So I don't hold a lot of weight in those tests sometimes. Something to think about.

                        Comment

                          Original Poster

                          #13
                          Thanks. I don't think my horse's test results were zero (which is possible for horses who have lived here their whole lives), but it was way on the low end. I also consulted with horse's PPE vet in Florida about whether or not to re-test and a vet at CSU who used to be at UC Davis (where we sent the blood to be tested), and both said no need to re-test and considered the result to be squarely negative for EPM. For whatever that's worth.

                          Comment


                            #14
                            Well, I sure did a lot for my guy who is also 61/2 and finally just said- enough, and retired him to my daughter in law's family farm. He's got several acres to roam with their old quarter horse, and they pull him out occasionally for a little ride around the farm and love him up. He's in heaven.

                            Gabapentin is a great medicine with few side effects, and worth a try. I guess if you want to keep going with stuff, certainly do so, but I really second the idea of a different job which may mean different barn- more turnout, easy going pleasure riding, and some retraining for a discipline he is happy in. I am really sorry, but this horse just doesn't sound happy and it doesn't seem he will be able to perform like you would want. I like the idea of him being a trail horse or something low key. Not sure how you feel about that though. It's really tough to let go of what we were hoping to accomplish with our horse.

                            Sometimes, really truly- LESS is more. Less treatment, less meds and supplements and getting back to the roots of what he really needs which at 61/2 isn't much. My guy was extremely high maintenance too, until I decided he wasn't.

                            Comment


                              #15
                              Originally posted by TWH Girl View Post
                              Well, I sure did a lot for my guy who is also 61/2 and finally just said- enough, and retired him to my daughter in law's family farm. He's got several acres to roam with their old quarter horse, and they pull him out occasionally for a little ride around the farm and love him up. He's in heaven.

                              Gabapentin is a great medicine with few side effects, and worth a try. I guess if you want to keep going with stuff, certainly do so, but I really second the idea of a different job which may mean different barn- more turnout, easy going pleasure riding, and some retraining for a discipline he is happy in. I am really sorry, but this horse just doesn't sound happy and it doesn't seem he will be able to perform like you would want. I like the idea of him being a trail horse or something low key. Not sure how you feel about that though. It's really tough to let go of what we were hoping to accomplish with our horse.

                              Sometimes, really truly- LESS is more. Less treatment, less meds and supplements and getting back to the roots of what he really needs which at 61/2 isn't much. My guy was extremely high maintenance too, until I decided he wasn't.
                              I agree with the sentiment that less is more, or at least can be. However, I don't get the impression that OP's horse is one that I'd like to take a trail ride on.

                              OP, which saddle brands have you tried on your horse? If the've all been of a similar type, maybe a departure from that would give you more info? Like if you've used French, try British or vice versa. Other than that, I have no idea on the medical, other than to say that behavioral problems can stem from medical issues and then hang around if the horse learns that the evasion works. So maybe you can involve the person who helped with the ground work?

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                                #16
                                At this point my gut says there is more than one thing going on, quite possibly related, and that one of things could be a zebra (reference - Occam's Razor). I also wonder if this is one of those horses that remembers previous pain better than the typical horse does, especially the typical gelding.

                                I have huge amounts of respect for your diligence and persistence. As you know I have been there, done that, got the t-shirt on neck issues and know what a roller coaster it can be.
                                The Evil Chem Prof

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                                  Original Poster

                                  #17
                                  Right now, I am asking him to walk forward under saddle. If I can get a forward walk, then some days I ask him to trot. If that goes really well, then I ask for a canter but do not really push my luck with canter depending on the day. So, to be retrained in something other than a driving discipline at this point seems limited. If he needs extended time off from riding, I can take him to a friend's trail obstacle clinics which she runs both mounted and in-hand, to give him some experience and life skills. He seems to like playing with tarps and things, so he might like the pool noodles and bridges and such. Of all the horses I've had, he's way down on the list of ones I'd want to take out on an open trail. Maybe one day, if he ever mentally grows up. He reminds me a lot of a relative of his I knew who did international grand prix jumping and all the quirks that tend to come with those kinds of horses. And his relative was especially mentally quirky--and I knew him after he'd grown up and BTDT.

                                  After the back injections, the first ride back was rough. We had a CTJ style discussion to get him to try to go forward. Once he gave it a go, he seemed to realize things weren't as bad as he was expecting, and so each ride over the next week and a half was an improvement from the ride before. Much less back talk about going forward. Able to ride at all gaits. I did not ask him for anything hard at this time and kept the rides generally under 30 mins to reward the good behavior.

                                  After the face injury, the behavior slid backwards just as fast, with each ride becoming more resistant. I don't think it has anything to do with his face hurting, though. I tried riding outdoors in an arena we hadn't been in in a while because we got rain and the ground finally softened (they don't use the sprinklers till summer). Thought this might be a good change for his brain. That was good one day. Horrible the next time I took him out there, which is when the spinning and backing into corners thing started. I thought it was because there's grass in the corners of that arena and the only spring grass he's getting is on hand walks, but he's since started doing it in the far corners of the indoor where there's nothing appealing.

                                  I do think he remembers pain and is affected by it more than average. It is possible to break the behavior when he feels good, as I've done many times so far with varied time periods of good before the next thing bothers him.


                                  Last night I was thinking more about this. Tell me if any of this sounds plausible (back story first)--

                                  When I moved to CO, I'd been going through over a year of some significant pain. I had a pinched nerve from my lower back causing pain/tingling/numbness in my left thigh. 3 MRIs later, all structures look fine. No disc disease or hip problem. I get temporary relief from PT and massage, but most of the home exercises are too difficult and bring the pain back rather than fixing the problem. I go to a chiropractor who can't get anything in my lumbo-sacral area to move. I move to CO and find a new chiropractor who subscribes to a certain method of functional fitness training for back problems. But rather than "exercises", it's more like poses. He's able to get things aligned better in my lower back and helps me learn to fix muscle imbalances. Certain muscles were completely shut down, as I couldn't resist against pressure in certain directions. This was fixing the pinched nerve but OMG my back hurt. Add to the fact that I'd been doing road cycling instead of riding horses for many years and had changed my upper body composition and was now getting back into catch riding green and rank horses. I was getting my back dry needled as much as 2x a week to cope with the muscle pain. Using topical analgesics, epsom salts, heating pads.

                                  I'm a lot lower maintenance now though still have some SI issues (which I've always had). I wonder if the injections and shockwave have only just continued to peel back layers of the onion with my horse and there are more layers to go. I got him a FES treatment (functional e-stim), and for the first time, he actually had movement in his lumbo-sacral area while wearing the device. It wasn't bothering him at all. Going on his thoracic spine, he didn't get movement but he was able to wear the device for the full 30 mins. The first time we had tried it there, he melted down (bucking in the cross ties) after 10-15 and we had to take it off. Maybe we've unlocked something and now he's like OMG my whole back hurts because we've disrupted his compensatory pattern. I can certainly relate to that. I just don't know what to do. He needs to regain strength in the correct way and learn correct movement patterns again, and to do that, he needs to move his feet.

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                                    #18
                                    OP, you have my utmost respect and sympathy for everything you have been through here.

                                    It is obviously no coincidence that the bad behavior arose after the pasture accident. It seems to me that there are three possibilities: 1. Horse re-injured original back problem 2. Horse has new undiagnosed injury 3. The special, extra fun combo of 1 and 2.

                                    I might be inclined to take a closer look at the neck, head injury and whatnot. I might also get new eyes on him. Maybe just another vet in the area. Sometimes when a horse has been worked up a lot, history confounds the present.

                                    I've seen some discussion about EPM, what about Lyme?

                                    Good luck to you and your horse. You both deserve some!
                                    Show me your horse and I will tell you who you are.

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                                      #19
                                      Just wondering if it might be time to just find a place where he can live mostly outside and possibly realign himself without all the poking, prodding, testing and meds? Extended turn out (like a year) can work , have seen it work, with banged up, brain fried race horses, a few GP Jumpers in similar shape and a couple of hothouse flower WB Imports that had never even seen turn out until they got off the plane. All these defined high maintainance and baffled vets and trainers. But they did come back very much better, less dependent and returned to useful lives...even if not in the prior job or level. It cleans their brains out too, possibly he's been in pain over such a long period he's got that stuck in his brain and is reacting to that memory instead of current condition. Might explain why he has not wanted to go forward since shortly after you got him, either he hurts now or remembers hurting so he won't go.

                                      Might be time to drop back and punt. Nothing else seems to be working and there's still not a concrete diagnosis at the two year point. More hasn't been working for you, maybe it s time to try less???? But no, I wouldn't want to trail ride him...he'd probably spook and trip over something creating a new problem. Doesn't seem to have a great sense of self preservation.

                                      I still wonder if there might something going on around that injured area from when he, apparently, flipped or fell over as a very young horse? I'm thinking like spinal chord impingement thats too slight or too deep within the disc to show up on any imaging tests or maybe some tiny fragments in there. He hasn't ever been right for you, maybe that accident did more harm then they think?

                                      Not dissing your vets but sometimes I wonder if they recommend what generates income for them over changing course to something less invasive that reduces their involvement? That's one side effect of MM coverage I sometimes don't care for, JMO. But at some point, backing off might be in the best interests of the horse.
                                      When opportunity knocks it's wearing overalls and looks like work.

                                      The horse world. Two people. Three opinions.

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                                        #20
                                        Originally posted by findeight View Post
                                        Just wondering if it might be time to just find a place where he can live mostly outside and possibly realign himself without all the poking, prodding, testing and meds? Extended turn out (like a year) can work , have seen it work, with banged up, brain fried race horses, a few GP Jumpers in similar shape and a couple of hothouse flower WB Imports that had never even seen turn out until they got off the plane. All these defined high maintainance and baffled vets and trainers. But they did come back very much better, less dependent and returned to useful lives...even if not in the prior job or level. It cleans their brains out too, possibly he's been in pain over such a long period he's got that stuck in his brain and is reacting to that memory instead of current condition. Might explain why he never has wanted to go forward, either he hurts now or remembers hurting so he won't go.

                                        Might be time to drop back and punt. Nothing else seems to be working and there's still not a concrete diagnosis at the two year point. More hasn't been working for you, maybe it s time to try less???? But no, I wouldn't want to trail ride him...he'd probably spook and trip over something creating a new problem.

                                        I still wonder if there might something going on around that injured area from when he, apoarently, flipped or fell over as a very young horse? I'm thinking like spinal chord impingement thats too slight or too deep within the disc to show up on any imaging tests or maybe some tiny fragments in there. He hasn't ever been right for you, maybe that accident did more harm then they think?

                                        Not dissing your vets but sometimes I wonder if they recommend what generates income for them over changing course to something less invasive that reduces their involvement? That's one side effect of MM coverage I sometimes don't care for, JMO. But at some point, backing off might be in the best interests of the horse.
                                        I have been thinking this for a while... glad someone was thinking it as well.

                                        It may be time to forget the $$ tests, voodoo witch doctors and expensive therapy and just put him outside - seriously. 24/7, with friends (yes, you read that right).

                                        Sometimes I think being even more vigilant makes a horse more likely to hurt itself - I really do.. We get so hyperinvolved in their management that I think it creates more avenues for destructive behavior in the horse. JMHO. Benign neglect with Dr Green has made an INCREDIBLE transformation out of those "but-he's-too-accident-prone-he'll-kill-himself!!" horses. Really. Boarders swear up and down their horse is the type to kill himself with too much turnout but what I really think it is, is that they see how hyped up the horse is when he is first turned out after being in a stall for 20 hours that they think that is how the horse would behave if he was out 24/7 - the reality of the situation is that he would not. If they didn't spend the majority of their time in a stall, like some odd 15 hours, they wouldn't gallop around first thing in the morning when they get out, letting loose massive bucks, etc.

                                        I know so many boarders and clients that (not saying this is you OP, just remarking in general) hover/helicopter over their horses to the point where they restrict management of the horse in a way that directly causes the unwanted behaviors in the horse.

                                        Example 1: they think horse is too hyper to be with another horse, so they insist on solitary confinement: result, horse gets ulcery and reactive because he doesn't have herd-mades to burn steam with/play with -- alternative, horse plays over the fence because he's starved for equine attention and hurts himself/breaks the fence.

                                        Example 2: they think Dobbin is too likely to hurt himself on T/O so they restrict it from 12+ hours to 8, then eventually to 5, then eventually to 3. Horse acts out during riding because he's spending too much time standing still, not burning off energy. Boarder wonders why horse acts like a nitwit in work.

                                        This is just two of many examples but I have seen it time and time again.

                                        IME, a horse on 24/7 turnout really burns them out in a good way, takes the edge off of them. It also keeps them moving, which keeps inflammation at bay, keeps their muscles and bodies conditioned, etc. I keep all of mine outside for that reason.. and they are happier and healthy.. and I have, in the past, kept quite a few in stalled situations and there is a huge difference in their mentality when they go back to being stalled 12 hours out of the day.. not in a good way. They definitely prefer being out.. though I did have one that loved his snuggle-time in freshly dumped shavings..
                                        AETERNUM VALE, INVICTUS - 7/10/2012

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