Rear Leg Lameness

Question
Hello,  I have a 20 yr old QH Gelding that was shown and used for Cutting/Reining most of his life.  He is in very good condition and has only had 1 injury in his life as a 4 yr old - stone bruised after an extending packing trip in the mountains.  5 weeks ago I watched him walking through the pasture and he would stop and rest his rear right leg for a few minutes then continue on. I brought him in and checked him but could find no heat or swelling, nor was he limping at all.  He progressively got worse over the next couple of days to the point that he was switching his weight from foot to foot every 10 seconds. Not to mention the stress this was placing on his neck and shoulders from trying to balance his weight on his front end. I took him to my vet who advised stall rest and bute for 10 days, he didn't believe there was anything broken, or chipped, and thought the injury was up high in his hip and most likely had tore something from slipping on the ice or had gotten up from a laying down position and hurt himself.  I have had him stall rested for 5 weeks and on bute twice a day for the whole time until 8 days ago when he showed that he was recovering from this injury. (no switching of his weight and standing square without any discomfort.  I starting taking him out for 10-15 minute intervals and just walking him short distances.  He was fine until 2 days ago when I went to feed he was in worse shape than the beginning of this injury.  He is reluctant to keep weight on this leg and appears to be in worse pain. He is laying flat out quite often which tells me he is in a lot of pain, otherwise he just lays down for the majority of the day and night. I have never dealt with this type of injury and am very concerned that I may not be treating it correctly.  Should he not have any exercise if he is showing improvement?  He is loosing muscle tone at an alarming rate and dropping weight. Should I keep him on bute for an extending amount of time even considering how harmful this can be?  Any advice would be appreciated.
Thank you for your time.
Corrie

Answer
Corrie:

It is difficult to answer your question this way because you have no diagnosis. there is no specific diagnosis made in this case- ony a working presumption. You need a diagnosis- not a presumption. It could be a muscle thing, but it could also be a laundry list of other things and there have been absolutely no diagnostics run on this horse. You need a good lameness vet to 1) identify the SPECIFIC location of the injury or problem and then to do whatever appropriate diagnostic imaging is necessary. That may include ultrasound, radiographs and/or scintigraphy if necessary. There is absolutely no way to prescribe an effective therapy without knowing what the diagnosis is- thats why you are where you are. Rest and bute are very non-specific treatments that will improve nearly anything, but to HEAL and return this to the best condition it can be, you must have a diagnosis to know what the problem is so you can know what specific therapies are necessary to treat it effectively. Your horse could have several problems, but a pelvic fracture or injury, torn muscle, neurological problem, stress fracture, muscle and neurological problem such as motor neuron disease, systemic disease - are all possible- among other things. The examination and the diagnostics must be performed in order to try to focus in on exactly what the problem is. If you have exhausted the capabilities of your local vet, I suggest you get with him/her and discuss referral of the horse to a hospital for full evaluation. i cant tell you if exercise would help or hurt without a diagnosis- there are conditions that might benefit from exercise and others that could be the problem too that would be worsened by exercise- im sorry i cant help more but Ive never seen the horse to evaluate it and you do not have enough diagnostic results to help me narrow this down yet. Please consider my suggestions... I wish you the best of luck, I know this is frightening and frustrating. good luck to you.