Opinions on diagnosis

[Moshposh]

Hi everyone
I could use some thoughts and opinions on my horses recent diagnosis. Here’s a

backstory:

I bought my 2 1/2 year old off the track in November 2021. I gave him eight months of downtime before restarting. Because he was so young I did a lot of hacking and light work for the whole summer. I noticed from the beginning he was pretty weak in his hind end. I had the vet out on three separate occasions to take x-rays, do lameness exams , inject hocks , do a gastroscopy, chiropractic work etc. because I just knew something wasn’t right.

Despite of this, he’s been joy to ride, is happy to do his job, and has advanced quite quickly.

Anyways, those vet visits were a dead end and I was advised to just continue strengthening
his hind end. Fast forward to now. I am down south, and got a second opinion on him. That vet felt all his radiographs were insignificant, but definitely thought he was back sore from this “hole“ in his back. She thought it was a fascial tear; it’s not deep enough to be a ligament tear. She told me I need to lung him an entire month of lunging on the flat ,over poles, and over jumps and then reevaluate after. He’s on a whole lot of Robaxin and will be doing laser therapy. But I’m just not so sure if this diagnosis is correct.

Any advice? Anyone have experience with this? Also, isn’t there a “ ask the vet” equine Facebook page I could share this on?

[beau159]

@Moshposh

I bought my 2 1/2 year old off the track in November 2021. I gave him eight months of downtime before restarting. Because he was so young I did a lot of hacking and light work for the whole summer. I noticed from the beginning he was pretty weak in his hind end. I had the vet out on three separate occasions to take x-rays, do lameness exams , inject hocks , do a gastroscopy, chiropractic work etc. because I just knew something wasn’t right.

Despite of this, he’s been joy to ride, is happy to do his job, and has advanced quite quickly.

Anyways, those vet visits were a dead end and I was advised to just continue strengthening
his hind end. Fast forward to now. I am down south, and got a second opinion on him. That vet felt all his radiographs were insignificant, but definitely thought he was back sore from this “hole“ in his back. She thought it was a fascial tear; it’s not deep enough to be a ligament tear. She told me I need to lung him an entire month of lunging on the flat ,over poles, and over jumps and then reevaluate after. He’s on a whole lot of Robaxin and will be doing laser therapy. But I’m just not so sure if this diagnosis is correct.

Any advice? Anyone have experience with this? Also, isn’t there a “ ask the vet” equine Facebook page I could share this on?

Did the vet ultrasound this spot or anything else? Or just the xray?

Are there any other views? Could it be artifact? (not there?)

I’m not an xray expert, but the purpose of xray is to view bone. I would be looking to other imaging if I wanted to investigate tendons, ligaments, or other soft tissue.

[Tha_Ridge]

All this. I wouldn’t be trusting an X-ray to make a diagnosis of a “hole” in the back.

[StormyDay]

It does look weird but it could be something as simple as a ‘shadow’ on the x-Ray.
(Not an x-Ray expert, but do have some ones with funny looking shadows in the squishy parts of the horse)

[Kyrabee]

Definitely something to follow-up with ultrasound. As others have said. X-rays are for bone.
Fascia is soft tissue. It kind of looks like an artifact (shadow) to me. I little bit too symmetrical?

Susan

[Paint_Party]

Agree that this could just be an artifact and is a case for an ultrasound.

However, if you look closely, there is a lighter area on the xray that follows the underside contours of “the hole.” Could this be inflammation? Scar tissue? Signs of a long ago healed cyst or skin abscess? It is… interesting.

[Moshposh]

I’m going to follow up with my vet to get an ultrasound.

It’s not an artifact- he has an actual thumb size dimple there.
She thinks he may have gone through some sort of trauma on the track. But why didn’t he heal with his 8 months down time when I bought him?

[IPEsq]

I would ultrasound to confirm it is not ligament injury.

[zany1]

I’m no vet, so take this with a grain of salt, but in my experience of SI/vertebral column weaknesses/injuries/issues, lunging should be avoided as much as possible, so as to allow time for the muscles and ligaments to heal correctly whilst still gaining strength. Not that this helps you with the diagnosis issue, but just a thought. Also agree with everyone else that further diagnostics should be done, which it sounds like you’re already doing. Best of luck and sending lots of jingles!!

[beau159]

@Moshposh

I’m going to follow up with my vet to get an ultrasound.

It’s not an artifact- he has an actual thumb size dimple there.
She thinks he may have gone through some sort of trauma on the track. But why didn’t he heal with his 8 months down time when I bought him?

Without seeing your horse, I just wonder if it’s an old injury or old scar. Because right, it’s been a long time.

Does he palpate sore or anything in that area by the dimple?

I mean, I’ve got a permanent “dimple” (or divet) in my shin when I hit a metal barrel one time. Cut DEEP. Probably should have gotten stitches. Left a literal dent in my shin. Ugly scar on it. But doesn’t hurt and doesn’t bother me.

I agree to confirm the diagnosis with other testing such as the ultrasound before you go and lunge him into the ground. (Sorry, for a horse who might be sore in the hind end, the last thing I would want to do is make him go around in small circles that you do while lunging. * shrug * )

@Moshposh

I had the vet out on three separate occasions to take x-rays, do lameness exams , inject hocks , do a gastroscopy, chiropractic work etc. because I just knew something wasn’t right.

Despite of this, he’s been joy to ride, is happy to do his job, and has advanced quite quickly.

More questions from your first post – what they actually find/notice on the lameness evals? Did he flex off?

Is your main concern with him is that he is just weak behind? Have you noticed any hitch in his gait or anything to suggest a lameness problem? Or just the general weakness?

If he’s happy and goes well, could he just maybe need more time to build up muscle and strength, learning to travel correctly?

Just more questions!!

[walktrot]

Do you have a specialist available? My vet suggested an evaluation by a lameness diagnostician/surgeon.for a knee that was deteriorating. We knew what the problems were, but the questions were around whether my aging horse could recover sufficiently to go back to light riding. We also wanted to determine appropriate treatment options, including joint injections, which I wanted to avoid. We had “a shot” at getting back to riding but it didn’t pan out. We were able to do a short Century Ride and he retred to a life of luxury, which he enjoyed until I had to put him down last July.

I looked at plenty of x-rays with my vet. She is terrific, but specialists see more esoteric problems and have experience with a wide variety of treatmemt options. I had an ultrasound done and the specialist spent upwards of an hour with me going over the anatomy of the three joints in the knee with several techs there also. He refused to do an MRI unless it was a life-or-death emergency. There was too much risk that my 27 y.o. gelding wouldn’t wake up from the anesthesia.

I had the my vet continue to take a regular set of x-rays of the knee and both front hooves. She sent them to the farrier which helped him maintain overall balance and alignment. They also went to the specialist to have on file at his facility.