After the last visit with my vet, his recommendation was to give the TWH 2 weeks off until we could get him in for an ultrasound. The first vet recommendation for the ultrasound wasn't available until at least this coming Friday so I called the second vet recommendation and was able to schedule the visit for this past Friday AND was able to have my vet there at the same time. Success! While the vets are colleagues, it was important to me to have my vet there when the ultrasound was being done. I trust his opinion and believe that he will recommend what is needed to for testing and won't go overboard just because or to bill me more. When talking to the ultrasound vet on the phone, he was making me nervous when he said the ultrasound was just a starting point in our visit, ugh.
On Friday I washed the TWH all up so he would be clean(ish) and threw both him and the App in the trailer to make the hour long trek to the equine hospital that my vet, Dr A, works with. It was a pretty nice facility, there was a nice drive-thru space so we could unload out of the mist that was coming down. The TWH had a nice fluffy stall of straw waiting on him and he was content to snack on straw as we waited for Dr A to arrive. Dr A and the ultrasound vet, Dr K, had a fairly long discussion of what was going to be done, Dr A was telling him what he had seen last week and that we didn't need to do a full lameness exam with blocks before the ultrasound, he just wanted the suspensory checked first and to proceed from there. This was the exact reason I wanted Dr A there, love Dr A! We don't need to start from scratch, we already have a pretty good idea of what is going on. Dr K tranq'd TWH and got him shaved for the ultrasound. It was so funny, TWH is a lightweight with his drugs. He kept having a hard time keeping his hind legs still because his head kept falling so far forward he was having to move his hind legs to rebalance and not fall on his nose. Hahaha! Finally the vet assistant held the TWH's head in their arms in a big hug to hold his head up and that seemed to be enough to have the TWH hold still.
The ultrasound was actually kinda cool to watch and I could (eventually, after some pointing and explaining) see the issue. His left mid-suspensory is slightly inflamed and swollen, instead of a straight line like his right, it bulges. Interesting. Thankfully that was the only issue found in both of his hind legs, no torn ligaments, no frayed ligaments, nothing else abnormal. I then agreed to a nerve block of his mid-suspensory to see if he was sore in his suspensory, his hocks or both. The treatment options are different and we might as well know what the root of the issue is so after a quick 10 minute wait, we put the TWH on the lunge line. The difference was amazing. He went from a 2.5 lame going to the right to a maybe .5, if that. Dr K said if he didn't know the horse was lame, he would have diagnosed the TWH as sound. Yay!! We successfully pinpointed the cause of his pain!
The treatment we are going is injecting his left mid-suspensory with some steroids and an anti-inflammatory to reduce the swelling. He has 2 more weeks off of work and then Dr A will come out to re-evaluate him. If it doesn't work, however, I will need to decide if I want to spend $600-1k to fix him or if I want to retire him as sound to a non-jumping job and spend the $600-1k on a more suitable-to-eventing replacement. Ugh the decisions.
We then took a final look at the App, he was just coming along for a follow up appointment to see how sound he was after his polyglycan injection/rest/salve application. A quick lunge showed him moving awesomely, the vet agreed he is sound, sound, sound! We are going to give him bi-weekly injections of pentosan and if he goes south again we will switch over to polyglycan. Soundness success!