I would not waste your money on shockwave. For the kind of issues this horse has, the cost/benefit in my experience is not worth it. Because he seemed to respond to Pred, once you hear back from a specialist, I think if you wanted to do something more, I’d put steroids directly in the neck. It’s not going to fix his back. Maybe it would calm down the neuro stuff. Hard to say because often once they get to this point, you are past the point of injections working. But it might be worth one try. It is ok to say enough, though. You have done a lot already.
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Agree on all your points.
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Just chiming in to say I’m sorry you’re dealing with this, and that it’s okay to call it. I think you know already but if not, I think you also have the collective COTH support if you decide it’s time. He is so, so lucky to have you as his advocate.
There’s a unique heartbreak to euthanizing one so young, but it is also the most immense kindness we can give them when their bodies fail them. You are not a failure. You’ve done so much for this horse and truly left no reasonable, fair-to-him stone unturned. You’ve maintained his comfort and quality of life as the priority. That’s more than many horses get…even ones whose owners have unlimited money to spend. Just because you can doesn’t always mean you should.
Re: family…when I made the decision euthanize an almost 6yo OTTB due to similar untreatable chronic pain and behavioral issues I’d been trying to rehab for 18 months, I knew my father would lose it if I told him the truth. To this day he thinks he had a catastrophic colic that progressed too quickly for us to save. (He did end up in a catastrophic accident a few days before I had planned to euthanize him, the day after the hole was dug, but knowing my father it was the kind of thing he would have blamed me for. And I’d made the decision two weeks before. I still believe Perseus was telling me that he was ready to be done). Obviously I don’t know your relationship or proximity to your mother or how easily she could find out if you tell her something other than the truth. But it’s also okay to protect yourself from that blowback when you’re already making a heartbreaking decision.
Sending hugs.
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Honestly, he sounds like a stereotypical ECVM or EDM horse, which is heartbreaking. My guy was diagnosed with ECVM last year and he didn’t start showing symptoms until he was 13.
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It wouldn’t surprise me in the slightest.
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I only just caught up with this thread @fivestrideline. I’m sorry your boy isn’t doing very well.
I posted this link quite a few times on CotH, but in case you haven’t seen it here it is again. I hope it helps.
My Wobbler was 15, but from everything I read about neurological issues it seems that once they start to decline things get worse fairly rapidly. I know mine went from visible foreleg neuro deficits on specific exam to dragging his front toes in the paddock in less than six months. There were other things I saw deteriorating over his last summer as well. For that matter her went from “there’s something more than ulcers going on”, to neuro diagnosis, to permanent retirement with decision to euthanize before winter in the space of a year.
They learn to compensate until something upsets the apple cart, and then things spiral faster than they can learn to compensate. I suspect arthritic progression can be a major factor.
Maybe it’s time to sit with everything by yourself (or with a safe person - IRL or here) and think through what you’ve done, what effect each has had, what you want to happen, and so on. We can get caught up in the next thing so easily, and add another therapy to the things we do without thinking about it all.
My senior just had his Osphos on Tuesday. His stifle has healed enough for walk with a tiny bit of trot hacks on stable footing, but is uncomfortable on slick or in deeper footing. Had he not gotten to this point with the stifle I don’t think I’d have done Osphos. Exercise is too critical to managing his health, and I don’t think he could be a pasture puff for very long before those health issues caused problems. These are tough decisions, easy to make in the heat of the moment and to forget to think all the way through later. I know my senior is getting very close to his end, and as much as I want him to live forever I find myself questioning every new thing. When it comes time to think about doing another round of Osphos I will be weighing the benefits he got from this one, and how his stifle is doing, and all the other health concerns before saying yes.
My second horse’s gift to me at his end was this “Just because we can, doesn’t mean we should.”
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Update: how likely is it that these symptoms are tied to the weather? Or is that maybe a coincidence?
Since it has dried out a bit and cooled off (mid 80s during the day, 50s at night), my horse is presenting with markedly less back soreness. Like, I can’t get him to react. He’s also uncrossing his front feet when we place them crossed … 
The only other thing that changed is I had the farrier take a TON of toe off. Which could contribute, somewhat, but I wouldn’t think it would make a difference in the front end neuro?
I would pin any improvement on the change to the feet. Getting the feet right is HUGE, for any horse.
Think about it this way…if you’ve got a back problem, what are you going to be more comfortable in: heels, or a good sneaker? Not having the feet right throws everything off.
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I have neurological deficits and major problems in my neck due to radiation for Hodgkin’s disease. The shoes I wear can make an incredible difference in my pain level.
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Good to know. It was a barefoot trim, and while it was a lot of foot I didn’t think it was THAT much.
I’ll be keeping an eye on his feet more closely!
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My Wobbler had back pain issues when it was muddy for long periods - weeks every spring. So much so that I had rads done looking for kissing spine 2-3 years before his neurological diagnosis.
It made sense to me. Mud changes the effort (amount of force) and type of effort (which muscles used) required to move around. If the proprioceptive feedback was lacking it would be easy to use the wrong muscles and strain things.
In my horse’s case there was another horse in the paddock who played rough and I suspected my horse was getting stuck or slipping in the mud when trying to go from relaxed standing snooze/munch to jumping around playing without notice.
So yes, the weather could play a part.
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Interesting. I know mud can change MY mood and stance…
FWIW, the horse was remarkably sound yesterday. None of the tripping or stumbling that has been his MO, he wasn’t crossing his legs to graze, and he really enjoyed a good curry. I have to say that I’m baffled. We have had dry spells before where he’s been backsore, but I haven’t really been paying as close attention to ALL factors.
If it’s the trim - cool. Can do. If it’s mud… that’s harder to remedy. He doesn’t tolerate a stall and there are almost no places here with mud free/dry lots - the usual practice is to keep them inside instead. I’m sure it is a combination of both.
My money would be on getting the toes back and less mud, in that order. The extra strain from a long toe can cause compensation across the body. Even if his feet weren’t sore with the extra toe, which I’d bet they were at least a bit, the additional leverage of a long toe will make it harder for them to move, period. The additional lift needed to account for a delayed breakover can definitely irritate a compromised neck and back.
I also notice my “weird but not always weird” NQR horse does much better when there’s no mud. Two years ago we built out a hard standing and it made a HUGE difference in his overall comfort during a very rainy winter where they lived out 24/7. I think the slipping and sliding around in mud is just really hard on them when they have to compensate. Even a few loads of small gravel/DG might help create somewhere he can stand on that’s not slick…it’s a chunk of change but might help? But I definitely understand not sinking $$ into rocks on a property you don’t own and might not stay at, even assuming BO would let you.
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Luckily, BO definitely would let me. And would likely help with the labor!
I’ve thought about essentially digging out the shelter (open sided), laying railroad ties and fabric, and packing in pea gravel or something. Sand would be nice tbh, so they might lay down, but I have no idea what would be cost effective.
This might be the thing that inspires me to make that happen.
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So… apparently OSPHOS can take up to two months to see the full effects? Because that lines up perfectly with the improvement we have seen - right about 2 months from the appointment he suddenly was significantly more comfortable. Running happily around his turnout, leg crossing seems to have stopped, he’s back to his sassy but happy self. The footing has also improved in that time, but we’ve had dry weather before and he’s been pissy. This is significant improvement.
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I have heard the two month thing for full effect also. But I’ve also heard and seen that it will take effect within a day or so.
But it makes some sense to me that both could be true. The horse has to rewire it’s patterns of behavior and stop guarding itself from pain, and all the pieces and parts have to settle in to a new normal.
That aligns more closely with my experience, almost immediate effect, really good within 2 weeks, and completely worn off in 3 months.
I wonder what the immediate effect is from. Given that Osphos affects the way the horse remodels bone I can’t see that having any sort of immediate effect.
Mine is five weeks out from his Osphos and I’m only just beginning to think I’m seeing him more comfortable moving.
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My vet told me that Osphos has a brief pain killer effect, which lasts maybe a week or two. Then about two months before it is fully effective for the intended purpose.
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It does work on the pain receptors in bone, and so it can have a quick pain relieving effect before the bone metabolism effects are noticeable.
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