Didn’t light up on bone scan (I’ve had two with suspensories that were found via bone scan).
Update: we injected his hocks and stifles 3 weeks ago. Stifle fluid looked healthy but hocks did not. Also started another course of Adequan. So far, no improvement. Ordered omeprazole and sucralfate to see if that does anything. I’m running out of hope and considering pulling his shoes and putting him out with the retirees.
Bone scans don’t always pick up soft tissue injuries. Ultrasounds are much cheaper in comparison and if you’re running out of hope at least rule it out before accepting that everything was done to find the issue. It might not be the end!
Vet watched recent footage of him and thinks the hind end looks better but now bilaterally lame on front feet (again). Will redo X-rays next week and probably inject navicular bursas and/or coffin joints. As someone who has shown multiple horses into teens without ever needing a joint injection, this is so disheartening. My first homebred from my heart horse 
I just want to put this out here again, I think it might be a time to step back and give his body some time to heal. Two sets of injections a month apart is a lot for any horse, especially a young horse. Whatever is going on with him, his body is a mess right now and continuing to pay for treatments and chase mystery lamenesses is probably not going to get you where you want to be. If this was my young horse, I would give him at least 6 months, more likely a year to just be a horse. Trail ride him, turn him out, do fun stuff with him. Don’t stress too much if he’s not perfect every day, just focus on fitness and keeping his mind happy. If you come back a year from now and there are still problems then maybe continue down this road, but I think you are just throwing good money after bad at this point.
Bumping thread up to see how the OPs horse is doing. Hoping for a good report. 
His SI ended up being the culprit afterall. We injected it with ProStride and shockwaved it. It took about 4 weeks to see results, but he’s 100% sound now. We did not treat his front feet — they ended up not being an issue. I’m so happy to have identified the source of his pain rather than depending on OSPHOS.
What was causing the SI pain?
https://www.tiktok.com/t/ZT84vEtN2/
Is this what your horse was doing?? Because this is the first time anyone has put words and understands what my horse is doing. My rehab with the suspensory doesn’t seem to be addressing the SI pain he probably has. Going back to the vet on Friday to insist about his SI again. 
:dash:
Thanks for the update and very glad your horse is improved. I think it’s really important to hear the follow up and outcome if something was identified so it can help others 
Some vets can be positively recalcitrant about investigating SI pain. Which, as a sufferer myself, seems completely whacked.
Well in the lameness exam once he blocked on the suspensory they just stopped and gave me the diagnosis. They didn’t keep going up. I personally did not see much difference after the nerve blocking, they said he improved when it was blocked but he looked pretty much the same to me so I’m not sure what they were looking at to judge the improvement.
Pretty certain that if we don’t treat the root cause which is probably higher up, SI, Gelding scars??? Then his suspensory issues are going to keep manifesting!
I wound up firing a vet practice over this. Their answer was to send horse to a cowboy instead. I did share the necropsy findings with them, though, in case it could help another horse.
No, that’s different than what my horse was doing. On the take off (when they push off to leave the ground) he was swapping his hind legs to avoid pushing off one of his hind legs.
Summer of 2022 when all of his issues started, my vet thought his SI was the problem. He ultrasounded it (rectally) and saw arthritis. I never got to see if it helped his hind end because he was lame on his RF the next time I rode him. I didn’t think it did anything (but couldn’t really tell either) so I didn’t want to go back to that before trying something else (and the symptoms were different this time).
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