Coming to terms with neurological diagnosis

[C_L]

my 2006 warmblood was diagnosed last week as neurological. i was expecting arthritis or similar requiring injections but not career ending, so this has taken me by surprise and i’m having a bit of trouble processing it.
in hind sight though, it does make sense. His symptoms:

• neck break at C3 and C4 (x-rays of it) when he was young, details unknown but was started at some point then left unridden from age 7-15
• at 15 a dressage trainer purchased him, put 3 months on him and i bought him to be a low level dressage/pleasure horse
• we’ve run into a lot of challenges, such as ulcers for many months, complete change in riding approach stopped that but have still never gotten past basic w/t in connection, canter varying degrees of unbalanced, despite being in 2+ lessons per week. he often seemed moody/resistant under saddle unless loose rein, safe to ride but required lots of tact to get him to use himself and hard to sustain
• challenging to build muscle. never got a solid topline on him despite riding 5 days/week over 3 years

These symptoms really escalated in the last 4 months.

• started dragging his toes, thought it might be arthritis so put him on previcox, 2 months later and his toes are so worn down its impacting his balance, needs hind shoes even if unridden
• muscle wasting: he has 0 muscle along his back and hind end now. his spine is like a shark fin despite being a healthy weight and getting appropriate supplements. my saddle fits completely different now vs even 6 months ago.
• no longer lays down at all, and will only roll on a slope in his paddock, presumably to make it easier to get up.
• i’ve seen him fall down multiple times, sometimes twice in a day, while dozing in his paddock. has been getting cuts along his front legs i couldn’t figure out until seeing that
• hind legs tripping out while riding, probably once every other ride
• canter has gone backwards, struggling to hold lead, picking up the wrong lead, wanting to ‘trot run’ into canter (totally new), and hard to get him moving smoothly and balanced vs almost hopping in the canter

So all that led to having the vet out. I was expecting arthritis or such, but vet was 100% its neurological and will continue to get worse, and be a quality of life matter.
I guess my question, and what i’m struggling to come to terms with, is do i stop riding him? Stop lessons and trying to work in a frame with expectations etc yes absolutely stopping that. but loose rein, w/t work?
The vet said riding on trails and uneven surfaces is a hard no, stop that right away (we did trails weekly prior to). but that for ring work its based on my own risk tolerance. He will be a fall risk but unknown when.
Speaking to my trainer today, its decided no more lessons with him, and as i’m pregnant she also thought i should stop riding him at all.
saying that, it does seem obvious i need to stop and just let him be a happy pasture puff for as long as he’s content doing so.
I guess i know the answer, but would appreciate hearing from others who had to stop riding their horse, how you came to terms with it. just anything i suppose to help feel ok with this and not like im just giving up.

[stargzng386]

What was the diagnosis for why he is neurological? Did you test for Lyme and epm? Is it confirmed coming from the neck?

Based on your description I would not ride this horse. The fall risk is too high and these types of falls can very easily cause TBIs and head injuries. I would chase a diagnosis and treatment.

[Highflyer1]

I agree that if you haven’t tested for EPM/Lyme you should do that. A lot of what you’re describing sounds like EPM to me.

And definitely stop riding. Realistically I would test and do a couple of rounds of treatment if positive and unless there is a dramatic improvement, euthanize. If he’s not comfortable enough to lie down and is sleep deprived enough to be falling, that’s a safety and a quality of life issue.

[C_L]

No tests for lyme or epm were done, though i can inquire about that. the vet made the diagnosis on physical exam results and x-rays of the neck fracture, believed to be causing spinal compression.

[Festivity]

Hugs, it’s hard to get unexpected bad news. Being pregnant also can cause reactions to swing back and forth, hormones are weird.

I had to retire my gelding who I raised from birth August 2023 with a neurological diagnosis. He hit his hip hard on a stall door and then was a bit stiff and sore as that healed. When out on a trail ride it felt like his caboose was loose and something was odd in his back end. He seemed happy going down the trail and wasn’t tripping, just felt weird. I had the vet check him the next time she was out to check the pregnant mares. The vet watched him move and then did a tail pull to the side while walking and he almost went down when pulled to the left, to the right wasn’t much better. She did a few other neurological tests and it became clear that if he couldn’t see his feet he had no idea where they were. She’s pretty sure he’s been mildly neurological for a long time and has learned to compensate really well. Regardless I was told he was no longer safe to ride and it was unlikely to improve. He was also a bit of a sidewinder which has gotten a lot worse. Oddly enough he hasn’t gone downhill as fast as expected, we figured given everything we had read that we’d be able to keep him comfortable for a month or two at most. Big surprise he’s still happy out with the herd and retired. He runs, bucks, plays with the young colt, and is generally happy. He lots worse standing and walking. We X-rayed his neck, it took 3 vet techs to hold him up, he can’t compensate when sedated so we aren’t going to ever sedate him again. Nothing distinct showed up in the X-rays, epm test was negative, the guess is that there is degradation along his spine and trying to find something to fix would be whack a mole. Vitamin E has helped some. He was given a 4.5/5 on the neuro exam when I pushed for a number. The vet keeps checking his condition, comfort, and muscling every time she’s out and he keeps astounding her that he hasn’t lost muscling, he hasn’t become asymmetric, but he’s very much a sidewinder. He’s 26 this year and I’d guess that we’ll have to put him down this spring, it’s getting harder to trim his feet. Not being able to ride him has been hard for both of us, he doesn’t understand why he doesn’t get to go on adventures anymore but he is absolutely unsafe to ride. Not sure if this info is useful at all, it definitely isn’t giving up to stop riding a horse that may fall at any point. We can’t take care of them if we are injured too.

[RedHorses]

If I’m reading correctly you have had this horse over three years? And had ongoing issues the whole time?

I had a neurological impaired horse for practically his entire life. When he was diagnosed I could confirm that everything the vet pointed out as neurological symptoms were things he’d always done. I had been suspicious about him being neurological for about six months before diagnosis. The vet told me that she couldn’t advise me that a neurological horse was safe to ride.

I did continue riding, because he had always been better, fewer symptoms, when ridden regularly. Knowing the diagnosis gave me the knowledge to not excuse any tripping or increase in clumsiness. He also had a clear signal to tell me he couldn’t carry me on any given day, which I trusted.

A couple of months later he came in very back and body sore. I think he probably fell. He never really recovered from that, and I was considering giving up on riding him. I had neck xrays done and one of the expert reviewer’s diagnosis matched the symptoms we were seeing. That was the end of riding him.

I wasn’t expecting to find anything definitive with the neck xrays, but I wanted to not just give up on him. We found something that explained the symptoms, my horse was telling me he couldn’t carry me, and it was clearly time to give up.

Long term neurological horses learn to compensate for their deficiencies. At some point the age changes come too quickly to permit the horse to adjust their compensation habits. They can go downhill very quickly.

We have cold, snowy, icy winters here that last up to five months. My horse was always less happy in the winter, and needed heavier blankets as he was uncomfortable if he wasn’t warm enough. I knew he fell in turnout as I’d seen him fall at least twice a year. While they never looked like much, just a moment of inattention on a loose or slippy surface during a bit of exuberance, I was afraid he’d go down and seriously injure himself at some point. I chose to let him have the summer, as long as he remained comfortable, and euthanized that fall before the freeze up.

His ability to compensate diminished over the summer, and got noticeably worse when the nights got cooler. I saw him lose his footing and nearly fall twice in the three weeks prior to euthanasia. It was absolutely the right decision for him.

I had trouble with it because he was my fourth horse and we were supposed to have another ten years together after we said goodbye to my third horse (who is still with me at almost 27). I had dreams of what we were going to now that years of work and figuring out the puzzle of what he needed was finally coming together. All that was gone. All of that lost future required grieving, even before I actually lost the horse.

Remember that. Honour it, accept it, and allow it. Grief for lost dreams is real. Grief for the lost life will come later.

I scratched out one tiny shred of good out of the last summer. I asked my vet to come and talk to my riding club about neurological issues in horses, and use my horse to demonstrate a basic neurological exam so the club members could see what neurological issues can look like. Knowing what I was looking at might have saved me years of heartbreak and struggle. Knowing what they’re looking at might let someone else get their horse treated for a viral infection early enough to prevent permanent neurological damage, or get a diagnosis before a catastrophic accident.

It’s a hard diagnosis to come to terms with. (((Hugs)))

[2DogsFarm]

OP, I have no experience with a neurological DX.
But you have to put your safety first.
Especially now that you’re pregnant.
Can you handwalk your horse?
If yes, you can take him on walks, like an XL dog.
He gets out, you get to spend time with him.

Wishing you Peace on your newest journeys.
Life sometimes hands us Stuff

[Renn_aissance]

OP, I’m sorry that your horse’s condition has escalated so severely.

You say he can no longer lie down to sleep and has fallen down while dozing. This is beyond the issue of whether the horse is safe to ride. He is not. If he cannot get adequate sleep, then the compounding effects of sleep deprivation will worsen his overall neurological state. This is an issue of whether the horse is safe inside of his own body.

If your vet is not optimistic about being able to restore his ability to sleep comfortably, then I think you need to be having a conversation with the vet about euthanasia, because his condition has declined so significantly and he is unable to enjoy the basic functions of being inside a body.

I’m sorry you’re going through this.

[fordtraktor]

This horse is sadly not safe to ride or even be around. He could fall on you, OP! I have seen it happen. Especially given you are pregnant.

I would euthanize a horse that falls down. They are flight animals, if they are falling they are in very bad shape.

[fivestrideline]

First, I’m sorry OP.

Second: this is WAY beyond ‘slightly questionable neuro, might be able to ride on perfect footing at a walk’ and WELL into ‘need to seriously start considering euth’. This horse is NOT safe to ride in any way, and might not be safe to handle either if he’s falling.

The sleep deprivation is likely a result/reaction to the neuro issues. I might titer and treat for EPM/Lyme just to check that box (if he improves, great, but if not…), but it would not be out of line to talk to the vet about euth as it stands right now. This horse is suffering.

Again, I’m sorry OP. It’s not easy.

[FjordBCRF]

@Renn_aissance

You say he can no longer lie down to sleep and has fallen down while dozing. This is beyond the issue of whether the horse is safe to ride. He is not. If he cannot get adequate sleep, then the compounding effects of sleep deprivation will worsen his overall neurological state. This is an issue of whether the horse is safe inside of his own body.

100% this. Short of your own safety, this is not fair to your horse either.

I’ll echo testing for EPM and lyme. Both can be treated, but with EPM in particular it’s not a one and done…or a guarantee it won’t flare in the future. The more advanced the disease is, the harder it seems to manage and additional complications can manifest like polyneuritis.

Very sorry you are going through this.

[Grey_Pony]

OP-I’m so sorry this is happening but I echo what others have said-Please do not ride. As a matter of fact, do not get into enclosed spaces with your boy. Last May my 25 yo mare all of a sudden started to scramble with her hind end and fell down-just walking in the pasture.She had no previous symptoms like your horse. Vet came immediately, did tail pulls and suggested she had Sidewinder syndrome. Cautioned me not to be in the stall with her. Two days later she fell in the stall just turning around. Had I been in there she would have fallen on me. After both episodes she seemed terrified at what was happening to her. At her age, along with other medical issues, we had her put down. I had never heard of Sidewinder before and it sounds like it might fit your situation. Please stay safe. Sending hugs.

[NaturallyHappy]

@C_L

No tests for lyme or epm were done, though i can inquire about that. the vet made the diagnosis on physical exam results and x-rays of the neck fracture, believed to be causing spinal compression.

I’m really sad for both you and your beloved horse. I wonder if there is any merit to sending those neck radiographs (and perhaps an ultrasound) to Dr. Steve Reed at Rood and Riddle. Even if surgery is not an option, perhaps something else could be recommended. He’s a superb veterinarian and an even better human.

[C_L]

RedHorses, You are correct, i’ve had him for over 3 years and ridden work has been a struggle throughout, so the diagnosis, while not welcome, does explain a lot. Plus makes more sense why an otherwise healthy, sound 16.2hh warmblood was in a field from age 7-15. Thank you all or sharing your experience, and your advice. It does help.

[C_L]

Funny you mention the XL dog walks, thats exactly what i’ve started doing with him. He’s a total gentleman so the perfect walking partner. I won’t be riding, but I will be enjoying time with him that way, for now at least

[C_L]

Thank you everyone for your feedback and thoughts, I appreciate it all. I will discuss quality of life further with my vet. I’d love for him to have at least 1 more spring/summer to enjoy and be loved on, but obviously needs to be what’s best for him.

[2DogsFarm]

Still be mindful of where he is in relation to you on your walks.

My Driving Club had a presentation from a local FD Large Animal Rescue Team & they identified The Kill Zone as anywhere near a horse’s hooves, said always stay on the dorsal side if they’re down.
For you, keep a good length of lead between you so if he even hints at collapsing you are out of range.

[Renn_aissance]

@2DogsFarm

Still be mindful of where he is in relation to you on your walks.

I realize that this might seem like overkill to the OP, who was still thinking that her horse might be comfortable under saddle, but it bears repeating.

Leaving the neurological issues aside (and it’s a big aside,) this poor guy hasn’t gotten a good night’s rest in some time. Think about how you would feel trying to drive a car if you hadn’t gotten more than an hour of continuous sleep for weeks. And he’s trying to operate a 1200lb body… and on top of that, his motor signals aren’t working.

Don’t ask too much of your good guy, walks included, until you get the vet on the phone and have a forthright conversation about what he ought and ought not do. If he really isn’t sleeping, he needs to marshal his energy for his daily life, not going on strolls. But I bet he would enjoy hanging out in the sunshine and hand grazing.

[IPEsq]

Horses need to lay down for some period of time daily to get REM sleep. No matter the reason for not lying down (there are many reasons this can happen), this would be a big quality of life concern for me. That is why he is falling down and getting the sores. His body is trying to go into REM sleep while he is standing. I’ve seen horses deal with this for years (including one horse where I made a few bucks on the side tending to and bandaging her sores after turnout because the boots didn’t help and they would get open and infected), and it’s very hard on them mentally and physically.

[BITSA]

My heart horse had something similar. I spent six months and got three opinions trying to find something that would tell me a different result. I then agonized over what to do. Bring him home and let him be in a field or opt for euthanasia.

A good friend who had a similar situation told me she waited too long. She said you may feel bad euthanizing him to early, but you will never forgive yourself if you do it too late. She saw her horse go down and hurt himself and be unable to get up.

I took her advice and euthanized my horse. He was happy and not in pain, and I was there with him. Losing him still hurts be heat almost 5 years later. But I do not regret my choice to euthanize him before things got really bad. It hurt me but I have never doubted it was the right thing to do by him.