The Undiagnosable

This is the story of Dexter, a sweet six year old who has stumped us all (so far)

Dexter initially presented with a hesitancy to move forward under saddle. As a young, energetic warmblood, this behavior was definitely out of character. While he has a baseline roach back, further assessment on the ground revealed a new onset of back pain with a scissoring pattern in the hind end. Under saddle, Dexter was tense and moved with an increased side to side motion, as if it was difficult to stay balanced.

"..hesitancy to move forward...was definitely out of character..."

So, we went back to the ground. A brief neurological screen revealed abnormal signs across the board. At that time, our DVM was officially consulted. A full evaluation was completed with confirmation of abnormal neurological presentation. So, it was off to Purdue University Large Animal Hospital.

Que all of the testing - radiographs, blood work, spinal tap, neurological exams, lameness exams, myleogram and a 5 day hospital stay. The conclusion - was inconclusive.

While radiographs showed arthritis throughout the spine, and the myelogram was positive for *some* dynamic compression, nothing was significant enough to explain Dexter's symptoms. Bloodwork and spinal tap were negative for systemic disease and showed all vitamin and mineral levels to be well within a normal limit.

We know what it isn't, we just don't know what it is.

So, we set out to do the only thing we could do. We treated the symptoms in front of us.

• Back Pain - a combination of core strengthening and range of motion stretching the length of the spine

• Hind End Weakness - core strengthening, cavaletti work, side rein, Equiband System

• Hind End Incoordination - hill work, bridge work, balance pads, and cavaletti work

• Left Hind Lameness - consult with DVM for appropriate diagnosis and joint injection

Dexter standing on balance pads to help address hind end deficits.

After 90 days of inpatient rehabilitation, working 5 days/week, we were able to see improvements in Dexter's strength as well as his neurological symptoms. His overall quality of movement is improved and he is able to run and play freely in turnout.

Unfortunately, not all stories have a quick fix fairy tale happy ending. Despite his improvements, this has not translated to improved comfort under saddle. So, we try again! Under the guidance of our DVM, we will be adjusting our interventions and attempting to address the pain management piece of Dexter's rehab.

Check out the video of Dexter's progress to date. And make sure to follow up for our next 90 day report around Thanksgiving! If you have any questions about how Perkins Equine Therapy could help your equine partner - please reach out!