Ok I just got home and it’s a lot to process. I apologize if this is long winded, I spent 6 hours driving and 4 hours at the vet and only had breakfast today.
Let this be confirmation to anyone who has a gut feeling that there is more going on to trust it, and hire a 2nd, 3rd, or 4th opinion.
I knew he had back pain. I was specifically asked not to further investigate his back pain by the vet that diagnosed his PSD. This is after not getting any further diagnostics done because Spankie did not palpate or flex or react like he had back pain during a static physical exam. I acknowledged that he is not reactive at a stand still under no pressure but when he is ridden or worked in any way he presents like he has back pain, like muscle spasms.
Spankie at Brazos Valley
I took him to Brazos today to be evaluated for castration adhesions. He did a very thorough physical exam and Spankie reacted pretty severely to the deep neck palpation which I’m realizing wasn’t done at A&M because otherwise that would have been the only reactive part of his physical exam. Right away the vet today noticed his asymmetry, he even palpated thickening of the muscles running down the right side of his lumbosacral area. The muscling on his left side was not as thick. We know he would cock his right hind forward and that his right pelvis was always pulled forward, likely because of the thicker and contracted musculature on the right side which existed because he was protecting a painful area - his back. When I asked the 2nd vet why he stood like that she said it was because he found it to be more comfortable.
The vet today absolutely saw his back pain, it’s undeniable. He wanted to get X-rays of his neck, back, and ultrasound his SI and his back. They found C6 C7 facet arthritis first. He has beautiful spacing along his entire spine so no kissing spine. The ultrasound of his back was perfect. I asked if he would be able to feel the iliopsoas with the rectal examination and he said he could. He said most of the time he can palpate the iliopsoas and get a reaction from the horse’s pain, when I tell you he didn’t even get all the way there before Spankie reacted in pain. His right iliopsoas is completely atrophied. The left is enlarged. There was muscle spasms here. EXACTLY what I felt was happening. He did not find any castration adhesions. When it came time to ultrasound his SI the left SI was beautiful. The right SI is injured. There is a huge difference and when I get the images I will post them here. He said this kind of injury to his SI was likely from a pasture accident, and he would have presented incredibly lame. And he had never had an accident here where he was incredibly lame in the right hind like he described he would be. He said this could have happened to him as a foal. So when he was started and brought into work, this untreated and unidentified injury was at play the whole time. The symptoms would disappear as I could get the muscling better in the right iliopsoas but it would never stick because it’s injured. He said the shortened cranial phase in his right hind isn’t from the suspensory at all it’s from the SI. He does NOT have primary proximal suspensory desmitis. Just like I had a feeling about all along. He got the desmitis from standing camped under trying to take the pain away from his SI. Because he couldn’t carry himself correctly he was chronically on the forehand and that is what caused the C6 C7 facet arthritis which is what caused the medial lateral imbalance in his left front which the second vet wanted to inject last week.
He received PRP to both SI, and platelet poor plasma to both iliopsoas muscles. He received steroids to both sides of his neck. He is confident this will heal the damaged SI and when his suspensory is healed we can begin to rehab the SI but not until then. I am transferring full care to the third vet and not going back to the second vet. His suspensory would have never healed with the continuing SI pain that was being denied by the second vet. My horse was continuing to get worse and the rehab was putting us both at risk of getting hurt as my horse protested from untreated and undiagnosed SI issues. We are scaling way back on his rehab and going back to hand walking for the next week. I am to do range of motion exercises in his hind legs daily as well as carrot stretches for his neck. I go back in 6 weeks to rescan the suspensory and hey! With the back pain addressed there might be positive changes in his suspensory instead of none! Going to this third vet, being truly heard, where he actually looked at my horse and got him to a point where he may completely heal was half of what I spent at the 2nd vet on the first visit. Considering I got a TON of X-rays, total ultrasound of the back, rectal ultrasound, assessment for adhesions, PRP (4 total injections today) and 2 more injections to the neck.
Knowing my horse has a future again - priceless.
