3-month update…horse still isn’t sleeping and I’m a bit frustrated/confused. Long story short, two different vets have examined him since then and they disagree about musculoskeletal pain. The internal med vet with interest in neurology says he has significant neck pain and gait abnormalities, most likely caused by cervical arthritis. The sports med vet who did a full lameness exam (flexions, longeing on hard/soft ground, ridden exam) says he looks great and he wouldn’t do further diagnostics. Eyes, Lyme test, and EPM test were all normal. As far as sleep he said I could try trazadone, a bute trial, or powdered omeprazole, which he said wouldn’t be enough to cure ulcers if he has them but might make them feel better enough to indicate a scope.
Neck X-rays were blessedly clean but to be sure I asked for an ultrasound also, and he said they literally never see such clean necks—to the point that he asked if the vet student could spend some extra time looking at a normal neck ultrasound. I was obviously VERY relieved because the first vet had made it sound like my horse is crippled. Then the first vet looked at the X-rays and says they aren’t sufficient to rule out her concerns.
Both vets agreed on consulting an equine behaviorist at New Bolton, Dr Sue McDonnell, who does “sleep studies” by analyzing video of the horse in a stall and looking for environmental causes vs pain indicators. I kept the boys in overnight and mailed her 24 hours of video on a flash drive. It cost $275, for anyone who might be interested. You can also do it at New Bolton but she said the home environment is preferred.
Her report says he seems generally at ease in his stall and in sync with his neighbor, and that his behavior patterns are generally normal other than shorter standing rest periods (and of course, sleep crashing). The only sign of physical discomfort was of the RF leg (pointing/off-loading, nuzzling, and some “visible muscle fasciculations over that elbow and shoulder area”). A week before the video he had violently yanked his RF shoe off by hooking it on a lip in the rear stall door and then pulling back (also caught on video). He was a bit bruised in the heel/frog area from that, to the point that we had to change from frog pads to leather, and the pulling back may have caused some body soreness.
I read the report as generally positive (seems comfortable in his environment and doesn’t show signs of major discomfort), though ultimately not very enlightening as to why he won’t lie down. I talked to vet #1 again and she read it as supportive of her theory that he has neck issues that need further investigation and might be manifesting in RF discomfort. She believes I should take him to New Bolton for another neuro exam, another lameness eval, and a neck CT.
My insurance company won’t reimburse any of these expenses yet because there’s no diagnosis. Meanwhile, my policy is up for renewal next month and they’re proposing an exclusion for “issues involving the cervical spine and/or neurological deficits, subject to full diagnosis pending additional results.” So basically they want it both ways: no coverage AND an exclusion! My agent and the adjuster are both very supportive, but they do need a vet to say there’s something specific wrong with him.
I’m at a loss here. I have one good vet saying he looks great and the other saying he’s practically crippled. Through all this he’s been sound in work, competing at Modified and schooling Prelim. He loves jumping and I have a hard time believing he would be so enthusiastic about it if he were in pain? I could be wrong though.
Clearly something is not right if he won’t lie down, but I’m not yet convinced it’s physical vs “emotional,” even if his hypervigilance didn’t happen to manifest during that 24-hour period. Sigh. I’m not sure where to go next.
What no one at New Bolton noted - believed? - understood? - was that he has shivers in the front (which is, admittedly, unusual). I can only guess that no one at NBC could recognize that he had shivers because the pain in his left front was so bad that it was hard to separate out the behavior. I told them repeatedly that he has shivers but I note that it was not included anywhere in his discharge report, so I think it is safe to say that was as disregarded as well.
) I’ll go with the shivers diagnosis from two of our area’s top sports med/lameness vets. Anyway, in the case of my guy, there is nothing I can do about shivers. I can’t stop him from sleep crashing, so I just try to make it as “safe” (lol) as possible for him, and keep his legs wrapped quite often so he doesn’t bang them up when he goes down. The shivers is extra pronounced actually when he does lie down to roll - it can be disturbing to watch because his front legs shake so badly.
You’ve certainly been down a LOT of other paths.