Ideas for mystery behavior?

[Emerson]

My horse (10 year old appendix gelding) has been exhibiting the following behavior for 3 months now. I have worked with 3 vets and they are stumped. I would love to hear from anyone who has experienced this behavior in a horse before who could maybe point me in the right direction.

Symptoms:

-Shifting weight behind - He trades weight between his hind legs roughly every ten seconds. Sometimes he lifts the leg up off the ground, sometimes just resting on the toe, but always shifting.
-Most agitated when at rest (in his “resting spot” in his stall on the back wall where he always stands to snooze) - lifting each hind leg high and holding it high before shifting to the other leg. Tail swishing, pawing and stomping with front feet, walking back and forth in place, shaking head, pinning ears. He only does these things if he is trying to rest/sleep. If he is eating hay, awake, cross tied, then the only consistent symptom is the weight shifting.
-General restlessness - circling in stall, moving around in cross ties
-Irritability/grumpiness
-Body soreness
-Weight loss/loss of topline
-Difficulty standing to have hind feet picked or trimmed, as he wants to trade legs after 10 seconds.
-When farrier works on front feet, he brings hind legs forward and under himself.
-When asked to pick up a hind leg, he hovers the leg forward and up.

Horse is located in Ohio. Gets turned out 15 hours per day with a buddy in a huge grassy field, stalled for 9 hours with constant access to hay in stall. He does not shift weight while in the field. Lays down and seems comfortable. Gets up and down with no issue. He is a dressage horse who came out of work at the beginning of December due to winter weather and lack of indoor, started exhibiting these behaviors all of a sudden in beginning of February. Has not returned to ridden work since.

Vet work:

-Regular blood panel
-Lyme test
-Vit E/Selenium test
-Hock and stifle X-rays - NSF
-SI and lower back injections
-Scoped and found grade 4 ulcers - treated with a month of gastrogard and sucralfate. Rescoped and majorly improved, finishing another month of continued treatment/tapering omeprazole. Symptoms did not change with ulcer treatment.

Blood work was all normal. SI injection yielded no change. He is not lame. Not reluctant to move, lunges/long lines like normal. Have trialed bute, banamine, and equioxx for short periods. No change in any symptoms on any nsaids.

If anyone has had a horse who has exhibited these same symptoms, please let me know! I am desperate to help him and get to the bottom of this, although the budget is starting to run thin after the vet work I have already done. Any ideas appreciated. Thank you!

[S1969]

Hmm. I would want to know more about his feet - any changes to the trim schedule, changes to farrier?

I might suggest testing for Cushings just to rule it out - but shifting, body soreness, topline wasting are definitely symptoms.

Was the turnout and feed situation the same prior to December? Is it possible there was spring grass to eat in February? (Not here in NY, but maybe in Ohio?)

I might put him back into light work and see what happens.

[evtrmom]

Has he been tested for EPM?

[fivestrideline]

I would look at the feet next. Any changes? What’s his shoeing setup? Could you do X-rays and/or hoof testers, maybe try pads and magic cushion?

EPM as well, though the serum test isn’t the most accurate and CSF is hard/invasive to get. Worth noting though.

I’d also look at his diet. Depending on where you’re at nutritionally, a PSSM type diet trial might help rule a muscle disorder in/out. IIRC a blood test wouldn’t mark for PSSM

Following as I have a similarly uncomfortable guy, and am curious.

[Feathered_Feet]

Did the horse feel more comfortable after the back injections, even if only for a month or two?

I agree with the others to check for EPM, metabolic issues, neuro exam.

I would radiograph the feet next, looking for NPA, then ultrasound the high (proximal) suspensories in the hind legs, looking for inflammation. If both of those looked perfect, then I would inject the stiffles and see if that helped (even if NSF on radiograph).

If injecting the SI and back didn’t help, then you know you can probably not dig in further there (for now). Next I would look at the neck, after you checked/treated feet, high suspensory, and stifles.

I bet you’re dealing with more than one area of soreness here, which makes it really hard to “pin down” (because there isn’t just one culprit).

[NaturallyHappy]

Do you have access to anyone w a laser or a bemer blanket? I’ve seen both help horses that were body sore everywhere from an unknown cause (perhaps slip in pasture no one saw) and stumped good veterinarians.

[Emerson]

Have not tested for EPM yet. I did bring this up as a possible next path with one of the vets. He suggested that due to the unreliability of interpreting the blood titer (exposure vs infection) and cost/risk of spinal tap, that I could potentially just treat for EPM and see if he gets any better.

Diet has stayed the same as since before all of this, only change is switching to the 2022 cut of hay in January. Same hay fields and cut though, just current year. Barn staff did find some horse nettle plants/berries in this hay, although it’s been a fairly minimal amount and the horses seem to eat around it and leave the berries behind. Local vet was consulted and was not concerned about continuing to feed it. He gets 6lbs of Purina Ultium Gastric and 1 lb of Tribute Essential K per day, split into two feedings. Free choice 2nd cut mixed grass hay, and abundant pasture. Spring grass started coming back in just recently within the last few weeks.

No changes with farrier or shoeing schedule. He was in a full set of shoes, however we had to pull his hinds in March because he can’t hold a hind leg up long enough to be shod. He is now barefoot behind, (pulling the hind shoes did not produce any worsening of his symptoms). He has generically good and straightforward feet, have never had any shoeing or hoof issues with him in the 6 years I’ve owned him, but also have not xrayed feet. Are you suggesting looking for NPA specifically behind? Or xraying all feet?

[NancyM]

Stringhalt? Does he jerk the hind legs up every now and again? Some of what you describe is seen with a stringhalt case, and not all cases exhibit all the same issues… there is some variation in symptoms.

[Posting_Trot]

I was thinking stringhalt too, but EPM would also be a possibility.

A horse in the barn where I board was recently treated for EPM (I think he had a positive blood test, but I’m not sure TBH) because he had occasional issues with picking up his feet while walking and trotting, didn’t like having his hind legs and hooves held up to be trimmed and shod, etc. He also showed some hesitancy about going up and down hills under tack. But there were no symptoms that immediately screamed EPM, and the owner had had a number of other diagnostic tests first.

The EPM treatment and a lot of groundwork during and after (especially work over ground poles) really helped him.

Good luck, I hope you get to the bottom of the problem.

[beowulf]

I have seen undiagnosed bilateral suspensory injuries (sometimes concurrent with DSLD/ESPA) present similarly. Sometimes both can be present or made worse with NPA behind or up front.

Has this horse been flexed?

Do you have a video of him W/T/C, in hand or on a lunge?

As an aside – a question and not a criticism – why was the SI injected? I’m sure the vet had a reason, what was it?

Some of these symptoms can also be early stages of discomfort associated with c-spine issues – the difficulty holding up the back feet would be textbook for this, as well as having to shift or walk forward first before lifting a hoof – but this is more zebra, and later in the diagnostic array after others have been ruled out.

[Emerson]

The back and SI injections didn’t seem to change anything for him. It didn’t lessen any of the symptoms, and he has been consistently back sore since.

[Emerson]

He doesn’t jerk the legs up, it’s more of a slow hover, and never while moving. I have seen several stringhalt horses and this seems different than what I have seen with them. The holding legs up is only when he is stationary and as soon as he takes a step his gait is normal. He seems to be most uncomfortable when standing still, he constantly wants to be moving. I think that’s why he doesn’t shift weight or hover his legs in the field, because he simply walks forward instead.

[Emerson]

He has been flexed by two different vets - no lameness on flexions.

SI/back injection was the first thing done in February when he was newly presenting with the symptoms. At that point the weight shifting was the main symptom, the agitation and accompanying symptoms at rest hadnt been pinpointed yet. The back soreness and palpating sore around the SI was the only thing the vet was clinically finding in the exam, so I believe the thinking was that potentially he had slipped in the pasture or something similar and the SI had gotten inflamed and the injection would calm things down and see if it impacted the weight shifting, which it did not.

I have video of him jogging in hand, as well as video of the behavior in his stall. Can I upload video on here? If so, how?

[beowulf]

Go to whatever device your video is saved on. Hit the Reply button and you will see a Reply Box pop up that looks like the below (note: it may be arranged slightly different if on mobile). Click the Upload icon, which is highlighted in red below. Once you hit that button, a dialogue box will appear - find the file you want to upload, click it, and click upload. It usually takes a few seconds depending on file size and internet speed.

That will attach uploads to your post.

[frugalannie]

He sounds like a good fella who is doing his best to cope with discomfort. And you’re doing your best to try to fix it. That’s a good combo.

Some random questions. Does it improve if he’s on pain meds? (Bute, banamine or Robaxin) Has a good chiro/ acupuncturist seen him? Does he feel different under saddle?

Not to anthropomorphize too much, but it sounds like what I do when my sciatica is flaring: I shift weight and have to lift my legs slo mo if standing still. This is really going to sound weird but taking a relatively low dose of CBD for a few nights stops it. It seems to work on nerve pain quite well. Might I suggest a four day trial for him? I have used it on a horse for trigeminal neuritis, and it worked very well. Please buy good stuff, not the CBD oil they sell in gas stations, and try about 10 mgs* worth, squirt under the tongue once a day for four days. If no improvement, no harm, no foul.

• I can’t tell you how many mls, because I don’t know what the concentration would be of the product you use.

[Emerson]

Ah thank you! I will try to get some videos uploaded later today.

[Feathered_Feet]

@Emerson

He has generically good and straightforward feet, have never had any shoeing or hoof issues with him in the 6 years I’ve owned him, but also have not xrayed feet. Are you suggesting looking for NPA specifically behind? Or xraying all feet?

I would at the very least look at the hinds, but if you can, do fronts also. If nothing else then you have a baseline for future medical mysteries.

The crazy thing about NPA is it can creep up slowly, even after years of “uncomplicated” feet. At the very minimum get some lateral shots of the back feet to rule it out

[fivestrideline]

I agree. Lateral shots of each foot (so 4 X-rays total) can be very helpful and not particularly expensive. I would start at the bottom and work my way up, as funds allow.

Feet, then suspensories (ultrasounds are actually quite cheap, and I’ve seen PSD present similar to this), then EPM meds or a PSSM diet trial.

Hoof issues, like NPA, can be shockingly sneaky and extremely painful all the way through the body. Like working on concrete in bad shoes - moving feels better than standing.

[luvmyhackney]

Sounds like it could be multiple things wrapped up like a fun puzzle.

Without video and hands on, it’s a shot in the dark but I would 100% get X-rays of his feet, blood test for Cushings, neuro exam to start.

Something hurts and probably predated the ulcers.

My guess is low grade laminitis.

[PaddockWood]

@Emerson

lifting each hind leg high and holding it high before shifting to the other leg.

This very peculiar behavior is something my mare does. I took her on as a rehab case years ago. If I gently groom the inside of her legs at all she does it. Lifts one leg and then the other up HIGH just like you say.

She loves having her seat bones leaned on - where you take a hand and lean ALL your body weight on one. She leans back as hard as she can. Both seat bones.

She also has body pain and posture and has since the day I got her. Tell us more about the back pain on your horse? I’ve always suspected my mare has a pelvic soft tissue tear or issue and swear when she dies I will get a dissection and understand what is wrong.

She has always had a tight back on the left right behind the saddle. Never liked being ridden. Bareback, saddle, halter - none of it. Wants to be good but something is wrong.

Never got it sorted out. Spent lots of money trying.