Another neck thread, time to call it?

[clburnham11]

Long saga ahead, lol. Mulling over continued diagnostics or retirement. Hoping you all can offer me some wisdom. Newbie to neck issues but I think that’s what we’re dealing with!

6 year old track trained but unraced tb I’ve had for 2 years now. Purchased as a 4 year old with 1.5 years under saddle training after the track. Great ppe with back hock and feet x rays. Planned to do local hunters or eventing.

From the start he didn’t love being groomed or tacked, and was rushy and tense under saddle. The first winter I had him we discovered ulcers and treated, and saw improvement in his demeanor. He was progressing in training but would have tense days. After almost a year as the weather started to get cold again, he started to deteriorate. Attitude was back, very tense again under saddle, seemed angry all the time, was out 24-7 but would just stand there and wood chew. Was either explosive or downright angry under saddle, refusing to go forward or biting at my leg. At this time he was on individual turnout. Just seemed so unhappy. I had a lot of things done- Lyme test, chiro, acupuncture, redid back x rays, neck x rays, (unfortunately I wasn’t well versed in this yet and only got left side, static view which radiologist and vet said were fine) saddle fit, teeth, several lameness exams, robaxin trial, gabapentin trial, scoped again (clear), equioxx, nothing helped. I was in between trainers at the time as mine had passed away, and my vet and I agreed the best course of action would be to send him off to training with group turnout and regroup in a few months.

He moved to training in a warmer climate and started group turnout, and immediately started improving. Happy, gained weight, muscle, looked great. Threw some challenges under saddle in the beginning but nothing like before, had hocks injected at new vets recommendation (mild changes) and continued progressing. Would always take some time to relax under saddle but was happy go lucky and had a great work ethic. As trainer started asking him to use himself more with dressage, noticed some back and si soreness and got mesotherapy on back and si injected. He was doing great and we decided it was time to bring him home at a new barn I found with a great trainer. He had spent 6 months at the training barn.

He arrives and he has an explosive episode under saddle. Have new vet out who suspects my saddle actually doesn’t fit (not the saddle he used in 6 months with trainer), he flexes and lunges totally sound. Vet reports he shows chronic misuse of his body particularly in the thoracic sling, and she thinks with proper saddle fit and training on the ground then under saddle he will progress. He’s a bit tight and sore all over, good ROM in neck and back. She suspects npa, and we find it in all 4, worse in the hinds.

Fast forward about a month, we have a new saddle on trial and rocker shoes on all four with frog support pads on the hinds and he’s like a new horse! Incredible improvement in posture and relaxation both on the ground and under saddle. We start basics at the walk and trot, slowly add in canter, he’s never been so relaxed and rhythmic I am thrilled. He’s chronically stiffer going and bending right, but works through it. Once in a while I feel an odd step in the right front, like he stepped on a rock, but it goes away as he continues to get more balanced and use himself correctly. We reflex and ultrasound the right front just in case and it looks great.

We start FES to help with muscle memory, starting in the lumbar sacral area. 3 treatments, getting better each time- more symmetrical and willing. By now it’s getting cold again, and we have another huge setback. His turnout decreases from about 20 hours to 8, he gets grumpy and more sensitive again, seems sore all over, looks awful going right on the lunge line but not “lame” per se. Starts getting a bit resistant with more work asking him to lift his back. We get him back out 24-7 with some adjustments and resume FES, now on the thoracic region. He responded awfully to this, which my vet says means we are missing something pain wise. Current symptoms which all were at their worst the day after thoracic FES

-cranky and anxious on the ground and in work (under saddle or ground)
-intermittent doesn’t want to hold up the right front for hoof picking
-intermittent odd steps on the right front
-resistant to back, veers hindquarters off to the right
-excessively mouthy, like he needs something to chew on all the time
-tripping in the front- this only happened after the fes. Got better each day subsequent
-braced in back and thoracic sling
-hates being blanketed and messed with in the neck/chest/back area

My vet says next steps are to image the neck and inject, and possibly inject the back as well. I brought up ecvm and cord compression, she doesn’t think we’re at that point yet. She doesn’t think he has any neuro signs but agrees we may find an issue in the right neck. She mentioned nerve root compression?

My questions are, anyone else have experience with neck issues like this getting so much worse in the winter? Anything else I should be looking at that correlates with cold weather like this and is so one sided? Since his back x rays are clean, should I ultrasound the back? Should I ultrasound AND x ray the right neck? Haul him to the clinic to get the ecvm films?

My vet can’t get back out to image for 3 weeks so my plan is to give him a vacation and just do some light groundwork until then. I’m torn between continuing to investigate/treat this and just retiring him before he turns 7. My worst nightmare is spending years and tens of thousands on treatments and diagnostics only to still end up with an unrideable horse. I guess I’m basically already living that. Lucky me, I got him after losing my last young tb prospect to ks and really thought I was doing everything right this time This community has taught me so much, thanks for any insight you all have!

[Simkie]

I’d at least radiograph the neck, with someone who really knows what they’re looking at. Those images can be challenging to interpret. I don’t understand why your vet wants to image the neck but doesn’t think you should consider ECVM.

I don’t think it’s unusual for stuff like this to get worse through winter. You mentioned you moved to a warmer climate and he improved. Are you still in a warmer climate? How warm? Is it cold there at all? How is the footing in turnout? Being cold can really make everything hurt–blanketing him heavier than you’d expect to need to might help, but it’s a little bit of a balancing act because heavy layers may also cause stress on structures. Having to work through mud, or frozen ground, can also impact function and pain levels. Since this also coincides with a lot less turnout, is there any option at all to move him back to more?

Have you ever tried him on gabapentin? It could be worth a shot, and often works great on horses with nerve pain. If it helps, then that’s also a good sign that something nervy is going on.

Checking his vit e and selenium levels might also be a good box to check.

[clburnham11]

@Simkie Hi there! Thank you for your response. I agree, worth imaging the neck more. I will also push to talk more about EVCM.

Yes, I am in the northeast and last March I sent him down to VA for training and he did do better. It was hard to say if it was the temp, training, or group turnout that helped, or all 3! We are back in the northeast now and its full blown winter. Footing in turnout and indoor is quite good thankfully. I may try the heavier blanketing, I agree a balancing act! Him worsening did seem to coincide with a lot less turnout, but we did move him back to 24/7 out and it didn’t change anything

We did do a trial of gabapentin last Feb, no change. We tested for vitamin E a couple months ago and it was normal levels. I have him on maintenance elevate for the winter. I’m stumped!

[Simkie]

@clburnham11

Footing in turnout and indoor is quite good thankfully.

But hard and unforgiving outside, if it’s frozen, or sticky and squishy, if it’s warm enough to melt.

A Tylenol trial could be worth a go. It won’t hammer his belly like bute or banamine or whatever, but provides good pain coverage.

Maybe one of the warming tech fabrics, like back on track, could be worth a shot, to add warmth while keeping weight to a minimum?

[fanfayre]

Was just going to suggest a warmer layer of blanketing, but you and @Simkie beat me to it. I especially agree with a BoT blanket or sheet/liner under a blanket, and perhaps the back pad pre-ride as you’re grooming, etc.
Good luck and hope you find something that works, as he sounds lovely!

[TWH_Girl]

My young gelding is the same age and has many of the same traits. I saw so much of him as you went down the list. He does have mild changes at c5-6 as well. Trainer and vet do not see anything neurological or a true lameness. Had him worked up by sports medicine vet and my vet is at same practice and is aware of his condition. I’ve definitely noted him to be more tense November to around April. I use neck covers or Wugs to try to preserve neck warmth. Thinking about a red light pad to help as well.

He’s improved quite a bit with correct work and strengthening. I use a lot of poles and isometric exercises, as well as Sure Foot pads. I recently used Alpha 2 Eq for his neck and feel like it helped significantly. He gets Exceed 6 Way for a supplement and 4,000- 5,000 iu Natural Vitamin E. The Exceed has stomach health ingredients but we’ve not treated or scoped for ulcers. He is a bit of a worrier though.

He steps wrong occasionally but not regularly. It’s usually when I’m not riding him every step and he’s not paying attention. I just do light riding for fun and hope to get him on some easy trails this next year. Without having a competitive focus on a higher end sport, I can live with some of his issues a bit easier.

I wouldn’t throw in the towel in this horse but that’s me. Not sure what your goals are. It sounds like you’re managing him well. I would stick with it and maybe ease up or readjust your goals with him if you’re able to.

[clburnham11]

You’re 100% right, haha. No crazy mud and the pastures are very well maintained but it’s winter! Thanks for the idea about trying bot, I think that is a great suggestion! I will see about getting one. Tylenol, interesting thought. I’ll think on it!

[clburnham11]

@fanfayre definitely a good idea, maybe he’ll live in a bot. Ugh he is SO nice when he’s nice! A few more things to try before giving up. Thanks for the well wishes

[crthunder]

My OTTB has an awful time with cold. He has to get clothes under 60 and has more outfits than my previous two horses combined. He had similar symptoms as your boy when the weather changed (I’m in IL) until I figured out a blanket routine. He gets a neck cover for turn out and added BOT layer under his 220 when it gets under 15. I also use quarter sheets that go under the saddle for riding starting at 35 and we increase our warm walk time to 20-25 minutes.

I never did biopsy tests but when he was young (he is 22 now) my vets and I suspected he is RER based on many symptoms when under stress and in cold. It may be worth talking to your vet about the muscle disorders?

[dmveventer]

Is he on individual turnout now? If he’s in a smaller paddock without friends that’s a big difference from 24/7 out in a herd, even if he can see other horses nearby. Not all horses are suited to living in that environment, and a young TB is one I would definitely want out in a herd if possible.

I would get images of the neck before you throw in the towel, at least then you know what you’re dealing with, and run down some of the lingering management questions like blanketing and turnout to see what works.

[LovieBird]

I wonder if nuclear scintigraphy might show something. I don’t have experience with this issue, but it might even be more cost effective in the long run to take him to a university to have a thorough work up.

[LadyLawyer]

Yes, this! I am in NE Wisconsin and my gelding would get so tight, sore, cranky, bucky, resistant, and looked lame in the winter until I figured out his blanketing preferences and oh boy did it make such a huge difference. All of his issues stemmed from being outside in the winter without a heavy enough neck cover. He would shrink his neck into his shoulders to protect himself resulting in tension and soreness along his neck/spine that manifested as all sorts of problems, including SI.

[Pezanos]

Every horse is different but I have a horse with severe enough neck issues that he had surgery and his behavior in winter (cold climate) was no different than any other season. Also x-rays didn’t show anything. Positive neuro test, bone scan, ultrasound, and ultimately CT myelogram were needed for proper diagnosis. If we had gone only on x-rays the neck issues never would have been diagnosed.

The big personality change in winter for your guy makes me wonder about muscle issues as well.