| Author |
 Topic  |
|
|
|
saddlebred
Platinum Member
United Kingdom
1706 Posts |
 Posted - 14 Jun 2010 : 9:57:35 PM
|
Some of you will remember my post about my 11 month old filly who is lame with a subchrondal bone cyst on the lower pastern. I have just had a call from the specialist who my vet asked to review the x rays and I am completely in a spin.
I had sort of come to terms with the idea and was hoping to leave her to see if the problem will resolve itself before deciding on surgery.
However, the specialist has told me that cysts in the middle of a bone can spontaneously improve. However, Diva's is right at the bottom of the bone and is already interferring with the joint. He advises that if I leave it alone she will definitely develop arthritis. He told me that keeping her as a pet without surgery is not an option as she will be crippled.
He is suggesting putting her forward for two surgical procedures. The first one will be to take a bone graft from her hip and plate it into the hole, and inject it with corticosteroids. This is the best surgery but he is guarded on the prognosis because of the location of the cyst near the joint. This surgery will mean a long journey, a week in hospital and then 2 months box rest.
If after 5 months that surgery hasnt worked he says she will need to go back to have the bone/joint fused with another 2 months box rest and then will obviously have no flexion in the pastern. He says that she would be sound after this procedure and could lead a normal life, which contradicts what my vet said.
Either way she will not be able to be the show horse that I bought her for as she will have an enlarged pastern/scar. I am obviously devastated - particularly as I had bought her because my other youngster has Recurrent Exertional Rhabdomyolosis. It seems I have a talent for buying horses with very rare conditions.
Surgery is clearly the only option open to me but would you just go straight for the fusion rather than risk putting her through it all twice.
I just dont know what to do any more. Please help.
|
Based Bewdley Worcs |
Edited by - saddlebred on 15 Jun 2010 07:48:40 AM
|
|
Report to moderator
|
|
|
Callisto
Platinum Member
6905 Posts |
Posted - 14 Jun 2010 : 10:40:21 PM
|
| I am so sorry that you are in such a difficult position. I can only say that I would probably go with the specialist's advice, after all, if it goes well then she will not need to have the bone/joint fused, whereas if you go straight for that then you have denied her that chance. Very difficult, and I wish you and your poor little girl all the best, what ever you decide. |
  Zahkira (GR Amaretto x Taffetta)
Linda
East Sussex |
Report to Moderator  |
|
|
Gail
Gold Member
993 Posts |
Posted - 14 Jun 2010 : 10:55:34 PM
|
Hi,
I am so sorry to hear you are facing this awful decision. I can't offer any real advice to you without knowing the full picture.
However what I can say is that my TB developed a bone cyst on the medial condyle of his stifle following a kick. He had the bone cyst scraped out by Tim Philips (we flew him up to Glasgow to do the surgery)and it wasnt filled. He was on box rest for about 6 weeks post op but the final 4 weeks had in hand walks on the agenda (most of the time was spent vertical)He recovered enough to be ridden again and was only retired due to his frazzled racehorse brain and not the aftermath of the bone cyst. All the following x rays showed the gradual filling of the cavity the bone cyst left behind naturally.
I know every situation is different but Mouse was so lame that leaving him without surgery was not an option either.
Thinking of you,
Gail x |
| Report to Moderator |
|
|
linda
Platinum Member
United Kingdom
1772 Posts |
Posted - 15 Jun 2010 : 07:41:04 AM
|
Hi Gail,
I am so sorry for you and your filly,
A friend of mine is in a similar situation at the moment, but her mare (x race horse) is 14 yrs old and has cysts on her pastern joint and also arthritis, she has been into the equine hospital who called in a specialist and also a remidial farrier,
Lx
|
     |
Edited by - linda on 15 Jun 2010 07:42:51 AM |
| Report to Moderator |
|
|
pintoarabian
Gold Member
Scotland
1242 Posts |
Posted - 15 Jun 2010 : 12:02:54 PM
|
| Sorry that you are facing such a difficult dilemma. At the end of the day, you are the only one that can make that decision. You mentioned previously that she was insured. Presumably, you have already secured their agreement that they will cover her treatment costs. If you haven't, you should do so without delay. If she was mine, I would follow the advice of the specialist. I wouldn't worry about the long periods of box rest. We have a filly that had enforced box rest for around ten months for a different condition. She was great during all that time. It was either that or lose her. Two years on, she beat the odds, made a full recovery and I spent hours watching her galloping around the field last night, full of the joys with not a sign of the problem that had threatened her life two years ago. You will feel better once you make a decision that you think is right for both of you. Good luck. |
http://www.performancearabians.com
http://performancearabians.blogspot.com/
https://www.facebook.com/PerformanceArabians
      |
| Report to Moderator |
|
|
ella
Gold Member
United Kingdom
786 Posts |
Posted - 15 Jun 2010 : 12:20:16 PM
|
So sorry to read your sad situation. If you are happy to keep her as a pet/brood mare then why not try the surgery(s)? If she can be made pain-free she will still have a good life.
The first surgery if it works might give you an athletic horse that can be ridden, even if restricted to hacking. If she has the joint fused it's unlikely she will be able to be ridden, so worth trying the graft.
Has she had her other joints checked for lesions? I would want to be sure her problem is in only the single cyst & is very unlikely to occur elsewhere, i.e. not OCD.
Whatever you choose, it's your personal beliefs that matter about her future quality of life, thinking of you at this tough time. |
   
"If an 'alternative treatment' has reliable effect it becomes classified simply as MEDICINE" D.B. |
| Report to Moderator |
|
|
proctorclaire
Silver Member
437 Posts |
Posted - 15 Jun 2010 : 12:34:09 PM
|
| I would go with what the specialist has said because all respect to vets they can be wrong. I've heard some shocking horror stories of what vets have told people. Some vets have said the only option for their horse is to be put to sleep and then when they've had a second opion the horse has had whatever procedure is needed and then gone back to full health. Imagine if these people listened to the first vet? They wouldn't have their horse any longer and then would be beside themselves when found out they could after all have been fixed. |
| Report to Moderator |
|
|
pinkvboots
Platinum Member
United Kingdom
3290 Posts |
Posted - 15 Jun 2010 : 2:28:32 PM
|
Oh Debs so sorry about the situation your in, I would have to agree with most on here I think you have to follow the specialists advice I think if you can avoid two lots of surgery I would go with that.
As she is so young I think if you have the chance to give her a normal life you got to try, you know I had a similar situation which scared me half to death but I knew if surgery was the only chance for him to have a normal life I would have to go for it.
My heart really goes out to you I know how you feel Pm me if you feel the need if I can help in anyway let me know. Liz xx |
 |
| Report to Moderator |
|
|
alethea
Platinum Member
United Kingdom
1526 Posts |
Posted - 15 Jun 2010 : 2:45:50 PM
|
So sorry to hear about your horse and situation. Must be a very tough time for you. I would go with the specialists advise. She is young so will hopefully heal quickly.
All the best with your decision and keep us updated!
Alethea
Aristotle Arabians
********** |
| Report to Moderator |
|
|
Theo
Silver Member
England
368 Posts |
Posted - 15 Jun 2010 : 3:51:12 PM
|
So, so, so sorry to hear of the bad news.
In my humble opinion...
dependant of the size of the cyst, I would first opt for the cyst scrape BUT without the bone implant and allow the bone marrow to do the job... To me, this would be the only chance to minimise the possibility of an arthritic condition later on in life. (As per Gail's situation above)
Fusing the joint seem soooo terminal and irreversible!
That would be my 'sensible' approach. 
Will keep everything crossed this end whatever your decision is. Our thoughts are with you hun!
T & J xxx |
    |
| Report to Moderator |
|
|
Vera
Membership Moderator
United Kingdom
8652 Posts |
Posted - 15 Jun 2010 : 4:39:16 PM
|
Having been through this almost exact dilemma I know the turmoil you are in.
Something for you to consider may be that most insurance companies only pay vets fees in the first year so if you wait you may find that not all your expenses are covered. So it really is a good idea to get the expensive things out of the way!
My feeling is to get the scrape done as this is exactly what Dennis had done and then allow the bone to heal itself. Dennis's cyst was massive, the size of a 5p and the vet still comments on how well it has healed. Mind you he also had several injections of Hylartil too. Google it - it is remarkable stuff and expensive so again get it in the first year!
I would still really recommend that you ask about IRAP. Any joint surgery damages cartilage and IRAP actually makes it possible for the body to repair itself, the only treatment that does this.
Gail - Tim Philips was one of the surgeons who operated on Dennis - He is a GOD!!! Him and alongside him was David Lloyd, and another vet from New Zealand who was working on secondment. |
    
Hampshire |
| Report to Moderator |
|
|
MinHe
Platinum Member
England
2927 Posts |
Posted - 15 Jun 2010 : 6:05:19 PM
|
A surgery scar isn't likely to affect her show career - so I shouldn't even take that into consideration. My old girl had BIG scars down one cannon, but it didn't stop her qualifying for Europe!
Keren |
| Report to Moderator |
|
|
saddlebred
Platinum Member
United Kingdom
1706 Posts |
Posted - 15 Jun 2010 : 9:59:06 PM
|
Thank you guys. A very mixed bag of opinions but that actually is reassuring in a strange way. I dont like to think that there is absolutely no choice.
I have asked my vet to do some more research around stem cell treatment which I have read about at Newmarket and Liverpool. I would like any surgery to be minimally invasive because I will beat myself up about it if it doesnt work.
All my horses are with me for life so keeping her pain free for a very long time is my main aim. I do want to ride her and I was hoping to show her in Saddlebred shows and palomino shows. Some of these only have one or two entries so an enlarged pastern wouldnt make much difference provided she's sound.
I have also mentioned IRAP and Hyartil to my vet (thanks Vera for that tip) and once I hear back from him I will push this further. I am going to google the names that you have all mentioned here to see where the best place is for her to have surgery.
I really appreciate all your help. The specialist told me that this condition is very rare at the end of a bone and that I will not find anyone in the country who has done lots of these operations. They tend to be more experienced with cysts in the stifle or shoulder.
I was in shock yesterday because I had decided to leave her for 6 months and see if it repaired itself. Realistically though I can see that her action is already changing to compensate for the lameness and I know that we need to intervene surgically in some way sooner rather than later.
You are all such a comfort. I dont know what I would do without you. THANK YOU. Debs |
Based Bewdley Worcs |
| Report to Moderator |
|
|
ella
Gold Member
United Kingdom
786 Posts |
Posted - 16 Jun 2010 : 5:53:33 PM
|
IRAP is out of favour now due to studies showing minimal benefit over other treatments vs the cost. Ask the specialist what medical treatments he thinks are effective.
|
"If an 'alternative treatment' has reliable effect it becomes classified simply as MEDICINE" D.B. |
| Report to Moderator |
|
|
Gail
Gold Member
993 Posts |
Posted - 17 Jun 2010 : 07:46:17 AM
|
Hi Debs,
Would Tim Phillips not be the best option for your filly? He is at Liphook ( or was) and operated on Dennis and Mouse. Mouse had a huge cyst too which was about the size of a pond coin and nobody would have been able to do the surgery in Scotland which is why we flew him up so he could come to you.
Its so difficult dealing with situations like this.
Vera, Tim Phillips was absolutely fantastic with Mouse too.
Gail x |
| Report to Moderator |
|
|
Theo
Silver Member
England
368 Posts |
Posted - 17 Jun 2010 : 3:57:56 PM
|
Debs, we're 45 mins from Liphook so a stop over point for horse and or people would not be a prob!
T  x |
|
| Report to Moderator |
|
|
saddlebred
Platinum Member
United Kingdom
1706 Posts |
Posted - 17 Jun 2010 : 7:55:33 PM
|
Aaah. Thanks Theo and Jo. I might take you up on that very kind offer. I am thinking of leaving Diva in livery at whichever practice she ends up at though, because I think she will handle the box rest better with 24 hour attention.
I have asked my vet to research stem cell treatment at Newmarket (a guy called Matt Smith) and I have researched Liphook as well as there seem to be 3 experts there - Tim Phillips, David Lloyd and John Walmsley.
My vet has referred me to Nigel Woodford who is at Endell in Salisbury but previously at Bristol Equine Hospital. They speak very highly of him but it is such a leap of faith when you dont know the surgeon or anyone else who has used him.
The only problem with Diva's surgery is that it is at the end of the pastern bone and is already showing signs of collapsing into the joint. It is not as easy (!) as dealing with a cyst in the stifle or the shoulder. I am waiting to hear back but I am expecting them to say that it cant be scraped out without filling because of its proximity to the joint.
The specialist said that I wont find anyone in the country who has done more than 1 of this type of surgery  as it is so rare.
I think I would go mad if I didnt have you guys to sound off to. I have had 5 horses in 30 years and only 2 of them got to the stage of being ridden without having a serious condition. I have had it all:
1. Dandy - 2 year old who I "rescued" died horrific death after 6 weeks with redworm (despite me worming him twice in that time)
2. Maverick - 5 year old developed high and low ringbone and vets advice was PTS. He did go on to live to 30 but obviously mostly as an expensive pet.
3. Fayre - was ? navicular within months of buying her but was "cured" with a warfarin type treatment. She has had a few near death experiences including an arthroscopy at 18 due to a kick at livery which left her with 6 joint mice on her fetlock. She has been fine since though and is now 27.
4. Jazz - diagnosed with Recurrent Excertional Rhabdomolysis at 5 so is fine in the summer but "ties up" a few times each winter. We are learning to cope with this but Diva was meant to replace her.
5. Diva - nuff said!!
I think I've done my fair share of keeping horses as pets. It seems so unfair that people who dont look after them well, and use them as a commodity before selling them on, dont seem to have any problems.
Rant over - sorry - its part of the grieving process me thinks!!
|
Based Bewdley Worcs |
| Report to Moderator |
|
| |
Topic |
|
decision time - please help :(
