Updated: time and bodywork have given us hope! Bone scan vs neck X-rays vs retire vs?

[fivestrideline]

Okay, I think I just need to see all this written out, but maybe y’all will have some insight.

I have an 11 YO OTTB gelding, my Mr NQR from previous threads. I’ve had him for about 8 years. Semi-recently (last year) he popped a front suspensory, but the diagnostic tests to find that injury opened a massive can of worms. I’ve semi-retired him now, more from an emotional burnout standpoint, but shopping for another riding horse is almost worse. I’m starting to wonder the value of trying to get Mr NQR at least flatwork sound (so I can save and shop for the horse I want) but that may require some more digging. I also would just love to get him more comfortable in his body, at the least.

While finding the suspensory we found:

• extreme back soreness, run a finger down his back or haunches and he almost collapses
• extremely tight hamstrings and back muscles. Robaxin doesn’t really seem to make a difference
• NPA all around, worst on hinds. This has been a whole debacle trying to fix (farriers making it worse, moving horse too far from good one, etc), I’ve pulled his shoes and found another farrier to try. We were about flat/0, but may have regressed slightly due to poor trims.
• kissing spine, from withers to lower lumbar. Not exactly overlapping, but remodeling.
• hock arthritis??? Maybe?? Injected, no improvement, later vets have seen the rads and don’t see any signs of arthritis
• he’s just increasingly… weird. Stands and cow kicks at the air. Terrified of wind. Scared of the big grassy paddock, won’t go out there with his buddies (that he’s very happy to chill with in the dry lot). Backs into his shelter by choice, BO hasn’t ever seen him walk in head first. Other just mildly quirky things that make you go hmmmm. He is, by nature, a big goof.
• Moves like a WP horse on lunge and U/S and will have random explosions - BO did the lunging and riding and said it’s almost like he gets a “twinge” and the hind end falls out from under him a bit or he trips in front. Then he gets mad. The tripping went away for a bit when we put wedge pads on the first time, but then it got worse again. It has remained the same with pads vs barefoot vs open shoes.
• He doesn’t hoof test sore but his feet are pretty bad.

I’m just starting to see years and years of retirement down the road, and I’m wondering if there’s Just One More Thing I could do to get him flat sound or trail sound enough to be useful. I’ve debated bone scan, or just having my home vet X-ray his neck. At the moment, we are rasping his toes and hoping the new farrier can get his feet back on track, have turned him out with friends and are letting him chill. Or, I may just need to give up and let him be a rather expensive (but could be more) pasture ornament.

[Dbliron]

He’s at that age…I would put him on the PSSM2 diet and exercise regimen, give it a month, and see if things change. He sounds so much like the 9 y.o. Appendix gelding a client of mine bought, and when the sports med specialist worked him up this was the conclusion. The specialist was dead set against possible PSSM2 when we started, but utterly convinced by the time we finished. A total diet and exercise re-work changed the horse completely.

[fivestrideline]

Hmm I’ll have to go look at the diet. He’s on grass hay, TC30, salt, 4000 E, Cu and Zn. I think alfalfa pellets as a carrier.

[CindyCRNA]

Has his back been injected?

[fivestrideline]

@CindyCRNA

Has his back been injected?

No. I have not done shockwave or back injections as of yet.

[lenapesadie]

Bute? Frog support pads?

He sounds pretty uncomfortable just in his own skin? I’d put a deadline on that. Horse needs to be comfortable in retirement by X date or I’ll give him his final peace.

[fivestrideline]

@lenapesadie

Bute? Frog support pads?

Done both. No real change. We had frog support pads on but the trim got BAD so I pulled the shoes. No difference in comfort even directly out of pour ins and pads

[Obsidian_Fire]

I feel for you, that’s for sure.

If this were mine, I’d go ahead and spring for the bone scan. You can continue the ‘maybe this, maybe that’ diagnostics and in the end spend just as much money. Or more.

I have used Osphos for KS, to help slow down the remodeling. Mine are not overlapping, still have space, but appear that they occasionally touch/rub, which is causing the remodeling. Our last injections were a combination of steroid + mesotherapy which really helped.
I’ve had my mare 5 1/2 years now and have spent the last 4 1/2 trying to alleviate the NPA. We can get her positive on trim, but 4 weeks later she’s 0. At least now she is more comfortable in her hind end.
I’ve also had her SI injected, some relief was found there too.
The tripping and explosion U/S, mine has been the same way. And you’re right, it’s like there’s a sudden twinge and then either the back end gives way or there’s an explosion. All neurological tests have been negative and we did test for EPM.
Anyway, the tripping in front, mine has one front that wants to run NPA and it’s also the foot with some navicular changes. So that is one of our considerations. Aside from that, I did have her neck filmed and found nothing of note. BUT. I personally don’t rule out that there may be something subclinical. My gut has been right in regards to this horse, every time.
She has vetted ‘sound’ every time too; hocks, etc. nothing comes up. I’ve tried injecting them (once) just to see, nada.

All this said, I vote for the bone scan at this point.

[CindyCRNA]

Bone scan AND back injections. Of course I can be willy nilly with your money!

[Ghazzu]

I might be inclined to go with the bone scan to see where you want to radiograph.
In a case like this, if you’re looking at throwing $$ at the horse to try and make him comfortable, it’s worth finding out if that is possible sooner rather than later.
You may find what needs to be “fixed”, or you may find that there is something going on that is not successfully treatable.
At least you’ll have an answer.

I also agree that the PSSM diet trial is worthwhile.
Maybe give that a go first.

[Pepsy]

Hi,
Based on my own last decade of heartbreaking horse experiences, if you feel you have a vet that can get good neck xrays and read them well, I would start there. It is true that an X-ray may miss a problem, but if there is a big problem with neck, all of the other issues you described can be linked to this.
A bone scan will only light up with active inflammation, is my understanding. You may end up going there. It will be far more costly.
Good Luck. I feel for your situation.

[IPEsq]

I think I would do neck X-rays first. With so many issues, a bone scan could show you a lot of what you already know—he’s got a lot of issues. It can be difficult to interpret what is primary and what is secondary. Back, neck, SI can all cause the behaviors you describe. And the foot issues are not helping any of it.

There is enough weirdness where I’d say, ok if he’s got junk in his neck too, it’s time to retire fully or maybe euthanize if he’s uncomfortable in this already retirement type setup. This is much cheaper than a bone scan. If there isn’t anything in the neck on X-rays, that doesn’t totally rule things out, but maybe at that point a bone scan would make sense, but so would trying some more treatment on the things you already know are there. A bone scan won’t show you if there’s soft tissue problems in the feet or things like that.

[CindyCRNA]

I have a sneaking suspicion this horses entire back is going to light up though. OP said the whole back shows remodeling. To me, I bet this is this horses main problem.

[LCDR]

Is this horse boarded, so you have no control over diet? While what you have described almost certainly is associated with a medical problem, at least look at diet for possible exacerbation of signs.

An example is MSM. It was recently discussed here, and as a side effect it has caused extreme anxiety and related behavioral problems in a very small percentage of horses receiving it. And MSM is an ingredient in some ration balancers.

[greywithchrome]

Im not sure I would do a bone scan … you’ve already xrayed the “big things” (feet, hocks, back) so I don’t know that you would find anything remarkable on a bone scan unless it was in fact neck. In which case you couldve just xrayed the neck from the start.

I’ve seen in your other threads that you’ve treated him for ulcers but I think that may be something worth exploring further … could be the link between the weird behaviours and the whole body soreness. I know when my gut’s not doing well my whole body compensates for it. And the cow kicking the air is telling to me. The lunging bit sounds to me like perhaps a horse that’s just out of shape.

I think I have commented on every one of your threads because I also have a “Just One More Thing” back sore horse lol. She even ended up going for the KS surgery after years of injections, shockwave, etc, and as far as I can tell it didn’t help at all. I am out of money so my new approach is to try and get her whole body to just CHILL. She is a hot horse and can be very tense which causes so much trouble in her body. We do a ton of slow and controlled natural horsemanship style groundwork to get her comfortable in her own skin. For example, I’ll make her back up 10 feet from me and just stand there for a few mins. She starts off wanting to come back to me but if I stay firm she slowly lowers her head, licks and chews, does a big sigh. It’s hard for ME lol as I am pretty impatient but I can definitely see a change in her. More and more her default state is starting to become “relaxed” rather than be on high alert, and as a result she is more confident, her posture is improving, and she is less tense and sore through her body. It sounds like your horse has been through a lot over the last year in an attempt to make him feel better, he may just need to take a step back and breathe. Spend a few months hand walking on trails. If he’s possibly heading towards retirement anyways there’s not much to lose!

[beowulf]

I think you have gotten a lot of good advice here.

All I can say as a fellow owner of a Mr NQR who also had KS and funkiness in his feet – the moment his feet weren’t perfect was the moment the cup brimmed over with diagnostic complaints all over his body. His best days were when his feet were aggressively tended - even to the point I’d pull out a rasp myself. I’m not saying the feet were the root of his issues, but they made everything significantly worse.

[CHT]

If this horse is that body sore, I am not sure he is suitable for retirement. Have you done blood work? He sounds like my broken necked horse, only worse: x-rays would help diagnose that at the issue. With this much pain, I would think a bone scan won’t be definitive enough. Does he do better on Gabapentin?

[Posting_Trot]

I’ve read your other threads about the horse and commented on at least one. But I dont’ remember whether you’d tested the horse for lyme disease or not. If you haven’t, that’s something you might do before dropping the money for a bone scan.

I’m saying that because some of the issues you’re describing sound neuro or like a horse that has some neuro deficits that he’s trying to offset. Lyme disease can have an effect on the nervous system.

Good luck!

[fivestrideline]

Thanks for the replies y’all. I do know I’ve started a lot of topics about him, but I’m at this crossroads of trying to determine what makes sense and his actual comfort level.

To answer some questions:

• tested for Lyme. Negative.
• we pulled shoes and are swiping at his toes because they are clearly long, and with the crushed heels and his fast growth, it makes it look like all he grows is toe. I cannot get a farrier out more often than 4-5 weeks, so we do a little rasping in between
• he is on and off MSM with no notable change
• I have not tried gabapentin but could ask the vet. This horse is “sound” in that he doesn’t head bob or leg move lame, and plenty of people would ride him except for the trip (he fell with his rider earlier this year)
• he has gotten progressively worse during suspensory rehab as the under saddle work began (trotting). We turned him out with friends to see if he would loosen up in the bigger pasture.

@IPEsq

There is enough weirdness where I’d say, ok if he’s got junk in his neck too, it’s time to retire fully or maybe euthanize if he’s uncomfortable in this already retirement type setup. This is much cheaper than a bone scan.

This is kind of where I am at. Wondering if a bone scan would light up anything I didn’t already know about with the exception of neck and/or an SI injury. Neck imaging could maybe give me an idea of what to look at (or rule in, at least), while I pony up cash and logistics to get him scanned if nothing shows up.

[2tempe]

Just wondering if the horse has had a basic neuro exam? My old horse (TB) showed neuro signs when he was diagnosed with cervical arthritis, but he was 21 or so. From the sounds of this horse, and multiple problems, I’d be thinking retirement. Or maybe down time until you can get the feet fixed. Ugh, I feel for you…