shoulder lameness

Question
I have a 4 yr old QH gelding.  He came up lame Labor Day weekend, presented like a abscess.  So that's how I treated him... had the vet out and everything... he got better.  The suddenly worse again so I called out a different vet he came out and used hoof testers on him, no response.  He also did a few other lower limb tests, no response.  We sedated him slightly to nerve him (pastern down) under sedation he was better.  Once the sedation wore off he was worse again.  Moving his shoulder caused pain so we put him on bute and I called the chiropractor out.  His scapula was "out" she adjusted his neck and part of his shoulder, he was in a good deal of pain.  Went to load him up to take him to her house for more one on one care and he couldn't seem to get his shoulder up to get in the trailer.  Finally he loaded... he finished his 1 week dose of 2 grams of bute daily Sunday and we switched him to methocarbomol Monday to hopefully help with the adjustments.  Tues he is badly lame again... doesn't want to move his shoulder at all.  Has his butt tucked up under him and is more likely to move in reverse.  The vet is of course coming tomorrow... but I don't know what to think about his problem anymore.  Do you have any insight or possible help or suggestions???

Answer
Hi Katrina - I am so sorry that you are dealing with this issue.  It's obvious that you have been working very hard to find a solution and an effective treatment program.  The shoulder of a horse is such a big area and I can't help but feel that a good digital x-ray would be very helpful.  As painful as he is, I'm wondering if he was able to fracture it somehow.  I'm sure that he is tucking his back end up under himself in an effort to help support the 60% of weight that his front end has to carry.  It sounds like his pain is really deep.  

In addition to everything else that you are doing Katrina, be sure to watch his supporting front foot.  Let your vet know that you are concerned about developing founder in that foot and ask him/her to show you how to monitor the digital pulses in it.  Sometimes the stress of supporting additional weight during an injury like this can cause the good foot to founder.  Unfortunately, it's just about impossible to prevent it from happening as we all saw with Barbaro several years ago.

I wish I had a sure fire answer for you but you have done such a great job of stepping through the options and eliminating possibilities.  You are very persistent and focused Katrina ... surely you will be able to narrow this down even further tomorrow.  I can't think of one thing that I would do different in your same situation.  Please let me know how it goes tomorrow okay?

God Bless your heart and hang in there!

Judi