ester
Not slacking multitasking
If he continues to be so distressed all of the time and no situation could be found in which he improved, or at least started to improve I think I would consider PTS - ie if he could go and live in a field full time in an established herd with minimal necessary contact and was better that would be fine- if whatever you do he paces fence/stable etc he is either in pain (physical/mental) or making himself ill that cannot be any life for him and I would consider PTS - that isn't from a hho put everything down perspective honest and I would be doing my darndest to help him first (living conditions or behaviouralists, training etc) and obviously it would then be a judgement call. It just seems a long time since the initial veterinary treatment for him to be in the sort of state he is currently.