Underweight horse?

I can only see one other mention of teeth and the other thing I thought of was worms but you have probably already checked that.
Another idea would be to do a fecal egg count. A few years ago my boy lost a load of weight, even though he was always regularly wormed with the yard programme but due to some other skin problems, I wanted to try a herbal wormer. I was advised to check first as that wouldn't deal with a high burden. So when the result came back high, I was shocked - he was also diagnosed with Cushings about the same time.
Wormers are ok for some horses but there are others that have a low resistance to worms and what with worms getting resistant to wormers, they can end up building up a hefty burden.
So FEC, and I would get a EDT to check teeth, if you haven't already. Vets are ok and are getting better, but I still would rather trust a professional dentist who does nothing but teeth.
O and if he is over 15 years, and the above is already done, I would have an ACTH blood test. My boy looks very much like yours, even though he has cushings so you can't tell by outward signs these days.
 
I have the same problem with my boy, he is sooo hard to keep weight on in winter, he is on C&C, Alfa A and oil with as much haylage as he can eat and the grazing is good even in winter! He was probably about the same weight as your lad in winter and is only now starting to fill out (I think it i more muscle related than anything as he had the winter off). I really wouldn't worry too much about it, he has a lovely shine so just try to block out all those busy bodies - you know your horse!
 
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