PSSM can cause somewhat localized pain/discomfort in the back and hindquarter muscles, which would line up pretty well with his saddle issues.
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We haven’t done a myelogram to completely rule out ECVM…but he did have extensive imaging of the neck. Maybe a slightly enlarged facet at C6. Nothing overly worrisome on imaging. They did inject that but it didn’t seem to change anything. And he is not a horse that is stiff in the neck (he can totally contort himself to pull down a blanket or bucket from the aisle or to reach over and tag another horse). He doesn’t feel neuro to ride (and doesn’t trip/or loose balance)…it really does feel more pain mediated.
@Fancy_Free I totally agree with you…it’s not off my list of things we’ve ruled out, even if the vets have been dismissing it. Though we have overhauled his diet, which would align with being what you want for PSSM.
Time for an update…well, mostly because we’ve found some more stuff and I thought it might not hurt to add an update for those who are having similar issues.
So we had gotten the second round of ulcers all healed up…my boy was still pretty fussy and very spooky. Took him to a very top sports med vet in the area…who decided there was no lameness or musculoskeletal cause for the behavior. So that didn’t leave us with much, though it did make the trainer feel more comfortable that we had him checked out again. She has been going super slow - basically treating him as if he was an unstarted baby horse. But, things just weren’t clicking and he still wasn’t happy.
So, I had her vet pull blood this week and test for Lyme and EPM. We had done Lyme tests last year and he was negative for all the titers, so it was a good baseline to compare to.
Drumroll…yup, my special horse decides that he wants to come back very positive to BOTH Lyme and EPM!! Ugh…this horse!!
So the Lyme came back as 1:1206 (over 1000 is considered diagnostic on that test) for acute infection.
EPM came back as 1:8000 (4000 is considered the high level).
Vet agrees that even though they often see horses testing with a higher level for EPM, that his is significant and warrants treatment (we had asked about testing before but vets said no…this vet thankfully was willing to test). And, we know the Lyme titer is significant as he has tested negative previously.
So, I am actually a bit glad…as we have things that match and would definitely cause his current issues. I was starting to think we were going to have to go back for an neuro eval with EDM as the differential. So he is going on meds for both and he will get a bit more time to recover before we pressure him under saddle.
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Happy for you that this vet was willing to test! Sorry both came back positive. Hope the meds kick in quickly and he’s on the mend for you.
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Sorry about the diagnosis but happy that you know. Hope he responds well to treatment and comes back ready, willing and able to start back under saddle.
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Sorry to hear this, but glad you have something to treat. Hope he responds well to the meds!
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Wow!! You are one of the best horse moms ever. I have been through the ringer chasing the nqr horse a few times. It’s tough.
So glad you found a diagnosis that actually makes sense even though I’m sure that’s pretty dang expensive. But at least it’s pretty treatable. Thank you so much for updating as we all can learn from it.
It’s hardly ever behavioral. We all must listen to our horses always.
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I’m glad you finally have a diagnosis! A lot of people would have thrown in the towel or retired him as a pasture pet. I really hope this is the end of all his health issues. Do they think maybe his immune system doesn’t work as well as it should? Or perhaps the anaplasmosis/Lyme is what started everything? Could he have EPM to begin with and that could have caused the accident with his fractured ribs?
It seems highly unusual for one horse to have so many things go wrong. But how amazing that you were able to finally find a diagnosis.
I was pretty darn close to throwing in the towel! If these hadn’t come back I was going to give him another month allowing the trainer to press him a bit…and then set up a full neuro eval at Rood & Riddle and that would be the final work up I was going to do. Really glad we may not need to do that!
I do also wonder if this is an EPM relapse…and that we never caught it last year. Why else would a very fit athletic young horse run into a tree/fall hard enough to break two ribs?? And he was grade 1+/5 neuro at that eval a year ago…just that they did not feel it was EPM and didn’t want to test. But it would make a certain amount of sense. We know he didn’t have Lyme as we did test for that.
I was also wondering about the immune system component too…or if all the bute/exceed/meds he got for the laceration and then traveling a few weeks after was just enough to start a cascade of events?
I am sure I can double guess and spend a lot of time doing the “what if”…but not much that I can change with what has happened. Just hoping that this is the fix and we can get him feeling back to himself. The trainer did say that he already seems to be a bit less anxious and his appetite is better. Fingers crossed:)
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I’m late to the party, and I see you have some additional diagnoses that seem promising.
Having cracked a couple Ribs in Feb 2022 that still bothered me this year, I thought I’d suggest asking if a vet can laser his ribs for a series of treatments. Can’t hurt might help if he has residual pain. Mine would itch when I worked and breathed hard. I felt like I could feel the scar tissue in there. Class 4 laser could help with that if he is in pain.
Best of luck. Sounds like you are doing all the right things. I hope he gets better.
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OP, kudos to you for going the extra mile. Your boy sounds like a sensitive fellow who’s been trying to work through many issues.
Here’s what I’m seeing, as a complete outsider. He got hurt at the trainers (freak laceration under his chest). Was this when he hurt his ribs? Because you didn’t know his ribs were hurt, he was asked to carry a big western saddle with broken ribs, which I’m guessing added to his pain, anxiety, ulcers. He’s been through a lot of diagnostics, a lot of poking/prodding & stress/anxiety. In trying to treat his anaplasmosis, it may have flared his ulcers.
Bottom line, we don’t know when he hurt his ribs. Were there fireworks Memorial Day Wknd? He was great one day, but bad the next. I’ve seen horses do some incredibly stupid things behind the owner’s back - can’t watch them 24/7.
He was much better after 6 months off & then backslid at the trainers. Maybe he was still in pain? Maybe he had anxiety from freak injury. Maybe he has too much baggage at the trainers. PTSD is no one’s fault.
We’ve gone from your original post of March to showing some diagnostic problems in June.
My concern is that the treatment for Lyme will flare his ulcers. Why not bring him home & let him get healthy? Id wait more than a little more time to recover before you pressure him under saddle. You’ve exhausted guite a bit of $ trying to understand why your horse is telling you that he doesn’t feel well. You get a blue ribbon for that. He has some very legitimate reasons …freak injury, broken ribs, anaplasmosis going back & forth to vets, trainers & now 2 serious diseases a long the way. I’d just bring him home & let your wallet recover & let him tell you when he feels good. I don’t think he’s a drama king. He’s young enough that you have time.
Best of luck & keep listening to him. It sound like you have a nice horse in there & he’s lucky to have you.
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The laceration was Feb/March 2022…came home April 2022…rode great for 2 months (did get spooky but that was probably the start of the ulcers). Then broke his ribs Mem Day weekend 2022. He never had a western saddle on with the rib fractures…he was riding great when he came home from the trainers and for several weeks. Then the rib fractures happened. So there was no PTSD or baggage from the trainers…whatever he did, he did at home. And he was better before going back to the trainers because he wasn’t in work.
As for bringing him home right now…that would be a 12 hour plus trailer ride and a cost of 2-3k. I do think the 12 hour trailer ride with everything he has going on right now would not be in his best interest. If he were a few hours, then yes, absolutely. But that’s a long haul that he doesn’t need to be put through at the moment. And I did switch him to just regular board/turnout with no training for a bit so that he’s just chilling in the field with friends and not being pressured. He is staying on ulcergard while we are doing the Lyme and EPM treatment, because I don’t want to chance his ulcers flaring again. Also doing some massage/body work as well.
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Just something else to consider… could the long trailer ride to/from the trainer be stressing him enough to trigger the ulcers? I know you said you had started him on ulcer meds before the trip, but maybe the trip really stresses him?
Yes, I wondered the same thing…if the trip out there was a trigger for the ulcers and EPM. I did ship him in a box stall, but still. That’s why I would rather leave him out there right now until he fully recovers, as I think the trip would just make him worse. At some point he will need to come home though! And then I may just have to plan for another EPM/ulcer relapse.
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@Critter, Does he regularly do 12 hours of confinement in a box stall? Is that a norm for him? I know you stated that he’s normally out 24/7 except for bad weather. When he is in training, does he have 12 hours of confinement? That could be another cause for stress exacerbating the ulcers.
Yes, he is used to a mix of turnout/stall time depending on the season. Spring/fall at he is generally out all the time. Winter they are in overnight/out for the day and summer they are in for the day/out overnight. He doesn’t seem to be that stressed about being in…and depending on the weather, there are definitely times he wants to be in! But he is overall happier when we are doing more turnout. The turnout is the same at home or the trainers (he gets friends at the trainers, but not at home because he is too rough and will play fight with my old gelding). He has been trailered a lot when he was at the trainers being started (they did short field trips to different places multiple times a week and trail rode from different parks). But he definitely was more stressed about trailering after he returned home…now was that connected to the ulcers, rib pain, balance issues? Or associating it with a trip to the vet every time? Not sure.
