How many times are you going to berate the OP for coulda-shoulda-woulda? Especially after it came out that some of the lack of cooperation was after the purchase.
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Any time there are weird lameness issues, I always look at/suggest looking at the feet first. You can track down all kinds of things in the body that light up as red flags, but if they are symptoms of long-term hoof imbalances, you’ll never resolve them (well)
Meaning - I think it’s a very good idea to get to the feet. Negative palmar/plantar angles can make the entire body REALLY cranky. Old coffin bone fractures can be nasty to heal. Collateral ligament issues (need ultrasound or mri) can cause all kinds of problems, and are very hard to heal in the foot. You may find ringbone. Or major navicular changes, r pedal osteitis, or who knows what else
So yes, that is where I would definitely go next.
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I wonder if you could put a bit of lidocaine / carbocaine around that spot in the withers since the abnormality is very dorsal and see if that blocks out?
Have you tried different saddles? My horse has one bone in the withers that is crooked at the dorsal spinous process. Doesn’t look like it was broken or anything, just leans a bit to the right. He is exceptionally sensitive to saddle fit in that area, and while he’s a good boy and so will try to work, when I was testing out new saddles for him, some of them made him head bobbing lame on the right front.
Hind end / SI pain could also cause some of the behavior you are seeing. Could be coming from the feet or not. My last horse had normal images of the pelvis for everything that we could see. And normal bone scan. But he had significant SI issues and they looked shocking on necropsy. He did tend to respond somewhat favorably to injections, but it came down to us doing injections as diagnostics. He would also respond somewhat favorably to systemic steroid, but not Bute/NSAIDs. If he had any gut or hind gut things going on, it would kind of snowball with the SI. I think there’s some nerve input overlap and/or discomfort on one of those exacerbated the discomfort of the other.
He also tended to respond well to Gastrogard behaviorally, but my vet said that it can have a behavioral/personality effect apart from the gut treatment effect. Succeed was a game changer for my horse.
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If it were me (and it isn’t) but I’d be tempted to pull the shoes, stop riding and training and give the horse a couple of months off, then start putting back one thing at a time to narrow down if it is something you can fix or not. I know you said the shoes and pads were needed for a stifle problem but perhaps they help the stifle problem at the expense of causing other issues. I’d also do a 60 day course of Succeed, can’t hurt, considering having him scoped if you think it’s helpful. I’d start back riding outside of the arena and just some nice leisure walks etc. and keep him on a loose rein if possible. With the wither issue, you might look at saddles that are more open in that area maybe a cut back pommel?? I agree at having additional blood work done to eliminate EPM, Lyme disease etc. I’m glad you are taking the time and effort to get to the cause of his problem(s)!
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Yes, I definitely agree. Might just try and schedule that for next week, to tie up that loose end.
That’s what my trainer was thinking of doing, it’s not very expensive and would eliminate that issue. I was blessed to receive a custom saddle for Christmas, and it is totally tailored for him and his high withers/ short back. It has plenty of room up front without making the twist too wide for me. My old saddle definitely wasn’t made for him and could have caused discomfort. I had him on Equiox, and it had no change either…Sounds like we both have a similar situation. Someone else told me about Succeed, so might give that a try as well. Gastroguard made his back tenderness go away completely, which made me SUPER excited (gave me hope as well), but after a week and a half everything got bad again. I had no clue about the behavioral effects as well.
Was he scoped or did you just treat?
Pyloric ulcers won’t really respond to Gastroguard — they might improve for a few days at first just because of the reduction in acid — and can cause some really gnarly behavioral issues.
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Is your horse a Warmblood or Arabian? My previous BO had a horse with Myofibrillar Myopathy (MFM) which was first diagnosed as ulcers. He showed some similar symptoms to your horse. Hopefully it isn’t MFM because it’s a progressive disease.
What a frustrating situation!
But, really, you don’t have to “throw in the towel” permanently. Could you give him a year off - which might well happen all by itself if you’re off to college soon - and then reevaluate? Sometimes rest does wonders.
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It’s not uncommon for a ‘cheaper’ (for me, cheaper is 10k or less) horse here to change hands with zero medical records included. I’ve only had one horse in that price bracket come with a set of medical records, and chances are if you are buying in that price range, you are buying from connections that probably don’t have the wealth pool for extensive medical records anyway.
OP, I don’t find that wither finding to be overly alarming, especially if the horse is not showing symptoms when you put something over their back like a saddle, saddle pad, or blanket. While every horse is an individual, the horses I’ve known that have had something pathological in their withers have demonstrated obvious defensive behavior when anything approached their withers (from brush to blanket).
I’d start with the feet in your shoes. Poor trim or angles can lead to persistent pain, which then cause secondary issues because of posture changes and pain compensation. You can spend a long time treating the pain symptoms with therapeutic approaches like shockwave and pain medication, without changing their reoccurrence unless you address the root of the issue. In my circle I see a bit of tail chasing when it comes to diagnostics, with clients treating the pain symptoms (sore SI, sore back, sore hocks, sore stifles) and then having a new issue occur while therapeutically addressing the hotspot before. I’ve had it likened to a pain ouroboros - it keeps coming back in one form or another because the clients never realize the source of the problem might be the trim. And why would you suspect that, when you’re paying a professional to do an assumed good job?
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We just treated. We don’t have a scoping option around here, and I heard it can be quite expensive. I might do some research, but the problem is do I look into other options such as bad angles, or do I drive three hours to have him scoped. 
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He’s warmblood…What are the symptoms? Is it detectable by a test? Curious as i’ve never heard of it before.
I might be able to, he is such a sweet guy and loves just being loved on. He’s not going anywhere, even if I end up getting a new horse. So maybe by next summer or during breaks I could try and re-evaluate after getting his angles fixed etc. Just let him be a horse for awhile.
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Well, thank you for the reassurance…I was feeling as though I had made a poor choice even though this horse has taught me sooooo much, that its been worth the difficulties (But i’ve learned that it’s people’s opinions on the internet, and I should take them all with a grain of salt). He isn’t defensive about being brushed in that area, but he does flinch when I brush his lower back. My vet was concerned about the SI and wanted to maybe inject it, but some of the symptoms apply and some don’t, which makes me more inclined to fix his feet first then maybe explore less likely options.
Hmmmm…If fixing his feet don’t work then maybe i’ll test for that.
Knowing if MFM is a possibility is a quick thing to learn. Fixing feet (even if they are the/an issue) can take months. Just something to think about. You do need the results read by someone who truly understands what to look for, which is all explained in that article.
I see what you’re saying, and I agree…But I bet my vet wouldn’t do it, because I would want it correctly done…So I would probably have to haul him to the university vet.
Most vets would send the biopsy sample off to be read by someone who knows how to do it.
Gastroscope isn’t super expensive. Much less than the treatment.
It sounds like withers, SI, stomach, and feet are all very likely possibilities, and you could easily have more than one going on. It’s so hard when the biggest symptoms are behavioral. I know this extremely well unfortunately. I think sometimes it’s not that you are chasing outer layers of the onion before you get to the center sometimes but rather sometimes when you treat something, horse does in fact feel better and so behaviors subside enough for a bit to think you’ve “found it” but really you just have found a more easy to diagnose minor complaint. Some horses are just more sensitive and have not hit the jackpot on their bodies and so they get into chronic pain cycles and negative associations that can really affect them mentally. And their issues may only be so fixable (or not). Been there. You have my sympathies.
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