Fast forward to present-day.
In June of 2015, I moved to Washington from Arizona. Before I left, I had Grimm checked over by his faithful and knowledgeable vet. Grimm was pronounced (still) pain-free, and ready for the trip. I took every precaution: I fed him up. I started him on ulcer medication, electrolytes, stress and calming supplements. We stopped frequently on the trip and unloaded at night. I took three days instead of pushing for two so he wouldn't be stressed in the trailer. Nevertheless, by the time we got to Washington, Grimm's poor back was a mess.
Thanks to all of our earlier work, I knew how to manage it, and I brought him back slowly, carefully, correctly, but about the time he started to come back around and I had him back under saddle, he got a stone bruise. I laid him up and had the farrier and the vet on it. It took forever for him to get over it, and I started him again, but he didn't feel quite right. I had the farrier investigate, found an abscess, and put him in pads. More lay-up. Started him again. And he didn't feel quite right. The vet had me test him for insulin resistance and Cushing's, just to rule them out. The results were normal. It went on and on.
To make a months-long story short, every time I tried to put him back to work, he seemed just mildly off, and I could always attribute it to something different. He had several tiny abscesses, sometimes he seemed sore in his back, sometimes he just didn't seem to want to go forward, or he just didn't look like himself on the longe. Sometimes he was crabby and bronc-ish under saddle. I convinced myself it was his back ... except he didn't show ANY of the other symptoms, and to everyone who didn't know him, he looked fine. But I knew something wasn't right. He was trying to tell me there was a problem, and I heard him. I just couldn't understand what it was.
Finally, after months of frustration, he started limping in earnest, in his right front, and I couldn't attribute it to anything else. Finally, I had something we could investigate. I called the vet out again.
We blocked him and isolated the pain to his hoof and over the course of weeks, we started working to solve the mystery. His x-rays were essentially clean. There were some things that are normal for a horse his age with his history, but nothing that should indicate the lameness. The ultrasound found some hints of inflammation, though. So we tried Prevacox and more lay-up. Back to light work for a week, and he was off again. Hoof injection and lay-up ... and he actually came up lamer than before. Things were not looking good.
The problem is that Grimm is not a retirement candidate. Because of his back issues, he needs to be in work to be pain-free. Without work, his back will lose flexibility and the degeneration will accelerate; he can not be a stall ornament. In addition, mentally, he MUST have a job. Without one, he is miserable. He beats the ever-loving tar out of his stall, fights with his neighbors, becomes depressed, quits eating .... And he can't be retired to pasture, either. Alone, he frets and frets. He trots the fence line until he is coated in a froth of nervous sweat, and then he keeps going. He will run himself almost to death, throwing shoes like frisbees, and injuring himself right and left. If other horses are in the pasture next to him, he tears down the fence trying to get at them, and with company in the same pasture, he can't really be trusted. I'm not sure what happened since he was out with the other geldings at the rescue, but when I put him in pasture with company now, he goes into full stallion mode. I've watched him go after a mare with blood-lust in his eyes -- he nearly ran her through the fence before I could get in and get them separated -- and he's literally gone after other geldings with the intent to kill. Worse, even if I COULD find a pasture-mate for him (and risk that horse's life to test it out), Grimm's hooves won't handle being outside here in Washington with the mud and the wet. He'd be crippled in a week.
So, with this weight bearing heavily on my heart and soul, in March, I took him to Portland for a standing MRI. Either, I'd know for sure that I had some very, very hard decisions to make, or we'd find something we could treat.
Thankfully, it was the latter.
The report came back with a reason to hope:
"Mild fluid, navicular bone and distal phalanx, right fore
Mild navicular bursitis, right fore
Mild deep digital flexor tendinopathy, right fore
Focal mild to moderate sclerosis, third metacarpal bone proximal phalanx, right fore
Mild to moderate arthrosis, metacarpophalangeal joint, right fore"
Basically, lots of related inflammation, all mild or mild to moderate, probably caused by contusion or a mild degenerative injury. Dr. Haberman, Grimm's vet, assured me that she has brought several horses back to soundness and full work with this same diagnosis. It's not a guarantee, but it's something ... and that's where we are today.
Grimm's diet has been changed to a modified (read as not QUITE so strict) insulin resistant feeding regimen, just in case. The tests aren't 100% reliable, and there is some evidence that cutting out sugars and carbs and upping the amount (or at least making sure to feed the recommended daily allowance) of iodine, copper, zinc, chromium, magnesium (very important), vitamin E, and calcium can help control inflammation, even in horses that do not test positive for IR.
He gets a mixture of timothy and alfalfa, heavy on the timothy, and Renew Gold (a low sugar, low carb feed) to keep his weight on. He gets prebiotics and probiotics to help ensure hindgut health, which is also indicated for horses with IR. As a supplement, he gets LamineX, by MVP., which is formulated to 'support healthy joint function, blood sugar levels and hoof growth in horses recovering from founder and laminitis.'
Dr. Haberman has treated him with three shockwave therapy sessions, an injection of Osphos, and a navicular bursa injection. We will be doing a fetlock injection, too, later this month.
The farrier has him in a reverse shoe to keep support under the heel, but to allow the hoof to break over sooner when he walks. This is to keep the pressure off the tendons that must extend at the end of the stride. He may need to be shod this way for life. I can live with that; it's super fun to ask an unsuspecting student to pick his feet ....
Most days, he gets hand-walked in side-reins or turned out to walk in the arena right behind the barn with me to keep him company. As long as he isn't left out too long, he stays quiet. He also has a stall with toys and a very large paddock -- when it's dry enough that it doesn't turn to mud, which will soften his feet. He gets groomed regularly, but he's impatient about it -- probably because his back hurts. He fidgets and threatens to kick, which isn't like him. He has trouble reaching around to scratch an itch on his flank; his back just won't bend enough anymore. If he pulls through, the rehab on his back will start all over again.
Last week he learned to play fetch with his Jolly Ball, but this week, the novelty has worn off and he refuses to play. I can tell he's getting sick of not working. He nickers and comes eagerly to his stall door whenever he sees me and keeps nickering as I put on his halter. He seems a bit disappointed, though, when all we do is walk around the arena, and he's starting to screw around when he's supposed to be walking quietly. I'm hoping this is a sign that he's feeling better and ready to work. He still has three more weeks off. I'm going to have to come up with some new games to entertain him until then.
At the end of the month, we find out if all of the treatments and the time off worked. At the end of the month, I'll have my answer. For now though ... for now, I just hope.