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View Full Version : He GOT a neurectomy.... w/ Updates to the Story.



Ozone
Jul. 15, 2010, 11:22 AM
Vet is coming to block my horse at the nerve where his nerves will be cut so I can get a generalization of how he is going to move, soundness wise afterwards. Is this the general to-do's prior to the surgery?

Vet seems to want to try more "in between" treatments such as injecting the navicular bone with a chance of him being sound or not. Which I do not want to do. I am tired of all the in betweens and want this horse to be comfortable.

I have read good and bad about neurectomy's and I am willing to take the risk. He is not old and his choice is either be sore (even with the right shoeing and bute) and do nothing to rest of his days or cut the nerves and let him go on at least pain free for a while (hopefully a long while). I am aware of the nerves growing back. I know he will not be able to feel the heal of his feet but he will be able to feel his toe... so, there is feeling there to some degree.

You who has had this procedure done could you talk to me about the surgery a bit and the after care? Time on rehab, what was your end result etc?

I know some of you are going to say that you would not do this to your horses and that is fine, that is your choice. This is my choice for my horse. He is in pain so why not fix that to the best I can for him?

Thanks!!!

tidy rabbit
Jul. 15, 2010, 11:34 AM
I have a mare who I did this with. Looking back now, I would have pulled her shoes, thrown her out into a big pasture for a year or two with regular trimming by a different farrier, and then looked at her again.

tidy rabbit
Jul. 15, 2010, 11:36 AM
The recovery was not a problem. She went back into modified work, but the root problem still wasnt addressed so she continued to have issues throughout her body. :( I would not approach this type of situation the same way I did before; knowing what I know now.

I hope you are able to make a decision that you feel comfortable with for you and your horse. Best of luck with whatever you decide.

Ozone
Jul. 15, 2010, 11:50 AM
Tidy,

Other issues throughout her body that were found to be an issue after the neurectomy?

I would love to do the in the field situation with him but I would have to board him elsewhere to do that, which is not an option for me.

What can go wrong with the surgery? I am aware of ner-(something) that could happen at the nerve ends? Was it performed at the barn or at the clinic?

ASB Stars
Jul. 15, 2010, 11:59 AM
The horse can develop neuromas, which are truly painful, in and of themselves.

I would never to a surgical neurotomy. I had a horse we did chemical neurotomies on-- and it was a real eye opener. He was so much better, because he had been compensating everywhere else in his body, forever. We got about a month out of each treatment, and, eventually, his heels opened up, and he was so much more sound, all around, you could stop the things.

Try something that is not irreversible- your Vet is on the right track.

tidy rabbit
Jul. 15, 2010, 12:07 PM
Ozone,

You misunderstood me. Or I didn't communicate correctly...

ABS stars makes a great point about the chemical blocks.

Ozone
Jul. 15, 2010, 12:13 PM
Re: chemical blocks, that is what he suggested but said we could see a difference or could not see a difference... ????

What is the sucess rate of chemical blocks?

Really tired of all the drugs and shoeing with no results... It stinks!!!

HiddenAcres
Jul. 15, 2010, 12:18 PM
Although my old gelding had a surgical neurectomy before I knew him, I had
14 wonderful years with him and it just was not an issue. He had some arthritis issues that kept him on the "riding horse" program instead of the "show horse" program. No more stumbling than any other horse. His surgery was just a snip because it was done 20 years ago - I would imagine it has greatly improved. He rarely required bute and was barefoot and out 24/7 except for weather the last 7 years of his life. We rode and jumped field type small jumps until the week he twisted his intestine and didn't make it through surgery. He was 25.

Are you near a vet school or orthopedic surgeon? Maybe your vet has seen some go badly and thus the hesitation.

Good luck and let us know how it goes.

Ozone
Jul. 15, 2010, 03:17 PM
Hidden: Did you know your horse was nerved before you purchased him?

Thanks for your post. I need to hear positive outcomes with this. Really not what can go wrong afterwards. Sounds like your guy lived a fine life (late sorrys on your loss), that's what I want for my horse. He no longer is required to be the superstar he once was, just a comfy horse to plod around on when he's feeling up to it :)

I feel like maaaaybe my vet has never done one before and that what brings out the hesitate, not sure though. Vet comes right out of the clinic that performs these kind of surgeries... maybe he has see some with no good results. I will know next week. Will be asking a ton of questions!!!

saddleup
Jul. 15, 2010, 05:24 PM
My 8 year old horse had a neurectomy in January. I would not have a vet do the procedure who was not VERY experienced. My horse went to the clinic for a week; they put him under with general anesthesia, then kept him there to make sure everything was okay. He was on stall rest for six weeks, then I brought him back very slowly, three months of easy arena riding. He's now back to being my primary trail riding horse, and he doesn't take a wrong step. And he's pain free.

I spent a year with him turned out, while I tried everything my vets and I could think of to figure out what was wrong. No navicular changes showed up on the x-rays, I spent thousands of dollars in treatments and shoeing, repeated vet consultations, and general trial-and-error. He just limped around back there, no matter what I tried, and I finally decided to go for the surgery.

My trainer has had quite a few horses over the years who were nerved, and she encouraged me to do it, as a last resort. I'm very happy with how it's working out. We were just up in the mountains on Tuesday, over some very harrowing stretches of trail, and he never took a wrong step.

Just make sure you do your homework, and weigh the risks against the possible good outcome.

vbunny
Jul. 15, 2010, 07:26 PM
See a difference or not see a difference means it may help your horse or the pain may not be coming from where a block, chemical or otherwise, would help. Just because your horse has pain in his navicular area does not mean nerving him will fix it. Some horses it helps, some it does nothing for.

HiddenAcres
Jul. 15, 2010, 08:29 PM
Ozone -

He was the horse I took weekly lessons on when I became a re-rider at 34. I asked to lease him after he chased a pony around a very large indoor and both little kids came off. It was clear to me that Fred needed a mental health break :yes:. That's when I found out about the neurectomy - not from the barn manager or on-site vet - but from several boarders who came up and told me all about it. When a job transfer came, I bought him.

Would I consider buying one again? You bet.

Because of how well my horse did, I guess I am more inclined to try it than some of the others on the board. Talk to the most senior leg vet you can find and ask your farrier who he'd use and what he thinks.

Marshfield
Jul. 15, 2010, 10:10 PM
My gelding is 5 years out from a unilateral neurectomy. Recovery was 2 weeks stall rest, 2 weeks hand-walking, and 2 weeks small paddock turnout. my only regret was waiting as long as I did. He was able to teach me through third level once recovered.

AKB
Jul. 15, 2010, 11:51 PM
We have two horses who have been considered for a neurectomy. The first horse is now age 24, and sound (other than some arthritic stiffness). We discovered that with injections every 6months-5 years, he stays sound. I'm glad we didn't do the neurectomy.

The second horse is aged 22, and can be kept sound with multiple other treatments (injections, IRAP, Tildren). My plan is to do a standing neurectomy if we cannot manage his navicular with the other treatments. However, now he has a suspensory injury and a splint bone fracture, as well as heaves and Cushings. I think the other problems will kill him before he needs his neurectomy.

A neurectomy is not reversible. I was told that it lasts an average of 2 years. I would not do it unless you have done corrective shoeing, coffin joint injections, navicular bursa injections, or whatever else a referral hospital/board certified surgeon recommends trying before the neurectomy.

Fharoah
Jul. 16, 2010, 02:30 AM
I think one of the risks would be to the deep digital flexor tendon, my boarded surgeon perfers an MRI before denerving.

nicbarker
Jul. 16, 2010, 04:50 AM
I think one of the risks would be to the deep digital flexor tendon, my boarded surgeon perfers an MRI before denerving.

Most "navicular" horses actually have soft tissue damage before they have bone damage, and DDFT lesions are commonly found on MRI. My worry with de-nerving is that, without pain as a warning, there is a risk the horse will suffer more severe ligament and tendon damage. Its not just a case of taking away pain - after all the reason vets don't normally recommend that you bute a horse with tendon damage and carry on riding it is because you are likely to do more damage that way.:(

Happy_Hooves
Jul. 16, 2010, 06:46 AM
Most "navicular" horses actually have soft tissue damage before they have bone damage, and DDFT lesions are commonly found on MRI. My worry with de-nerving is that, without pain as a warning, there is a risk the horse will suffer more severe ligament and tendon damage. Its not just a case of taking away pain - after all the reason vets don't normally recommend that you bute a horse with tendon damage and carry on riding it is because you are likely to do more damage that way.:(

I agree but do not feel that all riding should be stopped horses enjoy doing things with their owners and its part of their quality of life with many horses. The horse owner needs to become the "sensory apparatus" that protects the hoof that know cannot be felt by the horse. Horses should generally be retired from any competitive athletic endeavors following nerving but many seem to do well as light trail riding horses if the owner watches out for any rocks or sticks in the trail that they may not feel and trip over or can work in well groomed arenas as theraputic horses that work with special needs patients mostly at a walk, where the horse and client have 2 coaches walk along. Easy kind of jobs that do not put the horse and rider at risk once the horse cannot feel his feet and the ground underneath.

Ozone
Jul. 16, 2010, 10:18 AM
WOW thanks everyone for positive and informational insight, I really appreciate it!

His deep digital flexor tendon was inflammed, but it was to be expected and has since calmed down with bute. I guess after he is blocked next week I will be able to tell where the DFT is at huh?

I have druged up, injected hocks, numerous chiro visits, Xrays up the ying yang, adequan/legend/supplements for this horse... I would HOPE (positive thinking) that he comes up sound blocked.

With coffin/bursa/navicular bone injections did I hear some where that eventually the injection breaks the bone down and long term use is not recommended? I am open to hear about these injections however, I feel they are only short term help, no?

Once he has the surgery I don't expect him to jump or do any rocky mountain climbing :D just hacking in a flat ring, same thing he has been doing this past year. Here's the thing, this horse needs to work, likes to work, likes to do anything but hang out in the pasture or in a stall. He was not made it sit. If he was then perhaps I would consider other options. He will become depressed if not in some kind of work.

People who have no pro's for this surgery I think to compare it to any other maintence that you would do on your horse. Many of us go through great lengths for the comfort of our horses, yes, this is a surgery but so many have had surgery for good reason.

I will be his "feeling" for his feet, I already do all hands on with him daily, and thankfully he is not an abcess horse, pretty low maintence foot health wise.

My farrier thinks it is a great idea. He's been working on his feet for 9 years now so he knows him, his history and he and the vet work well together so I feel I am in good hands. I have a another top vet in the area that I will use should my "general practitioner" per say :lol: does not feel comfortable doing it.

Overwhelming? Yes, but thankful for your stories and knowledge. I will let everyone what happens next!

FindersKeepers
Jul. 16, 2010, 05:20 PM
I have a friend that has a horse that had navicular. She struggled for years and years to get him comfortable. Trimming, shoes, no shoes, turnout, no turnout, riding, no riding, and a pharmacy full of medications. She finally decided to do the neurectomy. I went with her to the clinic, as my mare needed to go up for something else. The doctor had it done in about 20 minutes. He hung out for a few hours at the clinic, then we loaded up and drove home.

That was 7 years ago, and he is a new horse. She ended up having the second front foot done about 3 years ago. He is happier than ever and is still ridden daily. He just does flat work/dressage now, but he loves his life and his job. He had no complications healing and she has never regretted the decision for a second.

Does it address the problem? No. But the vet at the clinic had been in consult with her for a year and reviewing x-rays and felt the rotation was done. He recommended she continue with the corrective shoeing and continue with x-rays every 6 months to keep an eye on things, but hes had not a single problem.

GiGi Larkin
Jul. 16, 2010, 09:32 PM
Beware, the horse will have no feeling in that foot.
Your horse will not feel an injury or infection and that can lead to serious problems.

saddleup
Jul. 16, 2010, 09:52 PM
My horse has feeling in the front of his feet, just not the heels, following his neurectomy.

AKB
Jul. 16, 2010, 09:53 PM
I know you said you are concerned about injections not lasting and doing harm long term. Coffin joint injections and navicular bursa injections can be done for years. It isn't good to do them too frequently, but for our horses, they last 3 months to a number of years. The one horse had his first injections by our vet at age 8, and is now 24. He probably won't need to be injected too many more times. The other horse had his first injections about 5 years ago. He is 22.

If the navicular disease is more of a bursitis than a bone disease, the injections may make him sound for quite a while. Some horses benefit from Tildren, if they have bone involvement. We had had the regional perfusions of Tildren on several occasions. For us, it is a lot cheaper than IV Tildren.

My understanding is that doing a neurectomy is not technically difficult. The hard part is knowing if it is time to do the neurectomy, and knowing if you have exhausted the other options. Do you have a board certified surgeon/vet school near you?

Calvincrowe
Jul. 16, 2010, 09:59 PM
I know two local horses who show up to 3' at A shows who have been nerved. No change in their abilities from prior to surgery to after, except they are no longer in pain and needing extensive drug/shoeing therapies. I do not know why they were nerved, mind you, just that they have been done. Both are in excellent barns, with excellent vet care/follow-up.

And, Gigi--they CAN feel their feet...nerving only affects the heel, thus can only be used for heel pain. The toe remains connected to the nervous system, thus can feel. Advances in surgical know-how have made nerving a less risky procedure and it does allow horses to continue productive or at least pain free lives.

AndNirina
Jul. 17, 2010, 12:54 AM
After exhausting other avenues, my mare is going up to the clinic tomorrow for a neurectomy on Monday morning. My vet is one of the best on the West Coast and I trust his opinion implicitly. We have a few 3' and under hunters at our barn that have gone onto successful and useful careers after being nerved.

For my mare, it's time. At this point I would just like her to be comfortable. She's been lame since Oct of last year and this will be her second (non-related) procedure since January, so I feel as though I'm making the right choice for her ongoing comfort.

Watermark Farm
Jul. 18, 2010, 11:29 PM
My gelding had a bi-lateral neurectomy done at a surgical facility. It was the absolute last-ditch after 2 years of trying to get him even pasture sound. He was 1/5 lame even with the nerve block, so in my case, we knew we would not get him more than pasture sound even with the neurectomy.

Your vet is 100% right --- you want to exhaust other options before you do a neurectomy.

Neurectomy numbs the heels and the rear portion of the sole. As nerves regenerate, the horse develops some sensation in his skin again.

The cost was $1500 for a bi-lateral neurectomy done under general anesthesia at a clinic. There is fairly intensive bandaging for the first week or two. Aftercare was 30 days stall rest, followed by 30 days stall/paddock rest, then out to pasture after that. My horse was stumbling and didn't seem to know where his feet were the first few days, then his whole demeanor changed once he realized he was out of pain.

Keep in mind that neurectomy is usually not a permanent thing. I was told to expect 2-5 years on average until it needed to be done again.

The risk of neuromas is lowered by having the procedure done in a hospital setting under a general, by a REALLY experienced surgeon who has done tons of neurectomies. Also aftercare (bandaging, clean wounds, and keeping the horse on stall rest as specified) helps negate the risk of neuromas.

Good luck, and feel free to PM me with other questions.

PS, My very first horse was nerved, too. He was ridden in dressage and also evented and did Pony Club. Nerving was a wonderful option for him. He was 8 when nerved and stayed sound until the day he died at 28.

Ozone
Jul. 19, 2010, 04:51 PM
Beware, the horse will have no feeling in that foot.
Your horse will not feel an injury or infection and that can lead to serious problems.

He will have no feeling in the heal but will feel his toe. I am daily with his care and know his pasture in and out and will be on top of him should injury occur.

Tomorrow is block day and will know what happens next. I really appreciate all the positve information you all have posted, thanks for that. This is the best decision for my horse, if I felt like he was a candidate for other options I would go that route.

Wish us luck!!!

Ozone
Jul. 19, 2010, 04:53 PM
PS, My very first horse was nerved, too. He was ridden in dressage and also evented and did Pony Club. Nerving was a wonderful option for him. He was 8 when nerved and stayed sound until the day he died at 28.

This does my heart good... and I am sure it was a blessing for you to have the option at that time. Thanks for offering your voice through PM. Just a for warning after tomorrow you may be hearing a lot from me with my long list of questions
:D

Guin
Jul. 19, 2010, 07:22 PM
I feel like maaaaybe my vet has never done one before and that what brings out the hesitate, not sure though.

Uh - is there a reason you haven't ASKED? Like, Dr. Vet, HAVE YOU PERFORMED THIS OPERATION BEFORE?

JA
Jul. 19, 2010, 09:02 PM
I agree with Guin..... Why in the world haven't you asked your vet if they have ever done this surgery! If it were my horse I would get the opinion of several surgeons from a well known and respected clinic or vet school.

And I would definitely try injections first.

Ozone
Jul. 21, 2010, 10:18 AM
Uh - is there a reason you haven't ASKED? Like, Dr. Vet, HAVE YOU PERFORMED THIS OPERATION BEFORE?

When I made the statement of "maybe he has not done them before" that was because I talked to him on the phone prior, not in person like I did yesterday. I like face to face conversations with folk. ;)

He was hesitant because as he has done many neurectomies he stresses to people the safey precautions afterwards for humans to abide by and said he sees SO many people get neurectomys and go out and jump their horses like they were before the surgery. He knows me well enough to know I know better :)

He is going to the clinic next week for surgery. He blocked sound with only doing the more progressed foot. I am having them both done. I am nervous and excited.

Once again I spoke in lengths about injections. It is not something worth it for my horse.

Wheel Whip
Aug. 8, 2010, 12:42 PM
Ozone how did your horse's neurectomy go? I was following with great interest, because we have an otherwise fabulous QH/Paint that just had a DPN. When they did the proceedure the vet discovered excess nerve bundles in the foot that was bothersome. He is on five days of stall rest, then stitches out and return to light exercize. He is already a happy camper after four days.

Ozone
Aug. 9, 2010, 12:11 PM
Ozone how did your horse's neurectomy go? I was following with great interest, because we have an otherwise fabulous QH/Paint that just had a DPN. When they did the proceedure the vet discovered excess nerve bundles in the foot that was bothersome. He is on five days of stall rest, then stitches out and return to light exercize. He is already a happy camper after four days.

Hi Wheel Whip - everyone. On Wednesday 8/4 we had the neurectomy done. He came home from the clinic on Thursday. Thursday night I walked him for 10 minutes, changed his bandages and ice wrapped him for an hour. The clinic did a fab. job. The incision site is clean, the stitches looks great. No heat - no swelling - nothing - THANK GOD.

Since Thursday I've been doing the same after care just increasing the walking time. I am up to 35 minutes now. At first he was stubbing his toe but besides the surgery I chalk that up to he is shoeless at the moment. Now when we walk he gets a stub here and there but for the most part knows where his feet should be. On his discharge papers it said to go for short walks however, since his whole circulatory systems is interrupted I would rather him walk his heart off and get the blood flowing then be on complete stall rest.

He is doing better then I could have ever expected! His spirts are high (literally :D) and he will get some turn out towards the end of the week. Stitches come out and shoes back on!! From there I will do a slow start back undersaddle.

This was the best deicison I have ever made and it's something I owed to my horse. He has given me ALOT over the years. It was the least I could do for him!

Thank you COTH for your positives!

Wheel Whip
Aug. 9, 2010, 08:54 PM
Excellent! Pirate is enjoying his first evening turnout and he seems secure with his footing. Stitches out on Weds and shoes on Thurs. He is a terrific horse, and if I can give him a comfortable life, YAY! Both the vet and the farrier were a little reluctant to broach the subject because of the reputation the "back alley" neurectomies have. When I mentioned it, they both said he would be a perfect candidate.
Let's keep in touch.

saddleup
Aug. 9, 2010, 11:40 PM
That's great news! My guy is 7 months post-neurectomy, and I don't even think about it anymore. He seems perfectly sound and happy. I watch him zipping around out back, and think of last year when he was hobbling around.

It's not right for everyone, but it sure worked out for my horse. Sounds promising for yours, as well.

fordtraktor
Aug. 10, 2010, 10:10 AM
Great news, so glad he is doing well.

It is also one of the hidden secrets of upper-level horses that many have been nerved (at least back in the 90's when I competed more). I know of at least half a dozen grand prix horses that were nerved and went on to perform well at those levels afterwards. It is one of those subjects that is generally not talked about, but it is there. Don't let people scare you. Everyone does the best they can for their horses.

I've never nerved one but if nerving worked for ringbone I would nerve my old retired horse. I hate to see him limping around, but he's happy and I can't put him down yet either.

Ozone
Aug. 10, 2010, 11:42 AM
Excellent! Pirate is enjoying his first evening turnout and he seems secure with his footing. Stitches out on Weds and shoes on Thurs. He is a terrific horse, and if I can give him a comfortable life, YAY! Both the vet and the farrier were a little reluctant to broach the subject because of the reputation the "back alley" neurectomies have. When I mentioned it, they both said he would be a perfect candidate.
Let's keep in touch.

Awe Great to hear Pirate is at the next stage and onto turnout! Tomorrow when his stitches come out can you let me know how that goes? If you still have to wrap the incision for a few days etc. Can he turn out daily for short periods now? Are you planning on riding him? Did he walk on his toes at first?

Phone is no longer walking on his toe. He gets a stub here and there but he truly know where his feet are at now. The vet just called and is coming Friday to remove his stitches. Tomorrow will be 8 days. I think tonight he is ready for some short period turn out and of course I will keep him wrapped and ice - everything I have been doing.

I am very pleased the way his surgery went. Going in I had tremendous anxiety of "what if's" but that has subsided and his after care is going as planned. I am excited for the days to come seeing my horse off bute for good and knowing he is not in pain any longer! :yes:


There is controversy about this surgery but I think its lack of knowing, negative results/horror stories that turn people away from it. There are many good results but like anything risks are risks. First person I called was my farrier. He's been doing my horses for 20 something years and knows my horse better than anyone. He was all on board. He's seen so many horse continue on riding from where they left off. My vet's big concern was safety of horse and rider afterwards - which I can understand and will abide by. Other than that everyone was all on board for this. Like Pirate he was a candidate for it.

Saddleup - Does my heart well knowing 7 months later your horse is out "doing him". I wish many many more years for him of pain free happiness!

Ford - ;) Agree. I deal with some top people on the farrier/vet/old schooler horse people end and neurectomy was being performed left and right "behind the scene" since there was so much friction about it. Those horses did alright :) I could only wish ringbone could be nerved. I would have done it 3x's over now for my beloved horses.


This has been such a successful "journey" and I could not be happier ..... for my horse! :)

espridham
Aug. 10, 2010, 11:52 AM
My horse had the exact same problems. He actually had his navicular bursa injected, which helped temporarily but did nothing in the long run. We ended up nerving him which was the BEST thing we could have ever done for him. My horse was also fairly young and loved his job. Our vet did block him prior to the surgery to make sure the surgery would effectively block all lameness.
We are now 2 years out from nerving and my guy is still going great. He has been able to continue competing at the upper levels and I noticed absolutely zero performance loss. I would highly recommend the treatment, as it has allowed my horse and I to keep doing what we love.

Ozone
Aug. 10, 2010, 12:34 PM
espridham - I was almost talked into injections but did my own extensive studying on it and felt like I would see no change in him. I am more than happy with my decision.

When I started this thread and read others in the past there would be more cons on the subject than pros but now I find it comforting that there really are so many of us that did this for our horses with great results.

I wonder if it is the "what ifs" (neuromas etc.) that turn people off to this surgery...

Ozone
Aug. 11, 2010, 10:32 AM
Up date today :( Last night I found a "veiny bump" on the right side of the foot. Close to the stitches but far enough away, worried so vet is coming later today. Wish me luck!

Wheel Whip
Aug. 11, 2010, 10:35 PM
Fingers crossed that the bump is nothing! Pirate has been turned out since Monday. He is wrapped because he tried to scratch out his stitches with his teeth. Other than that he is just iced(with gel packs) for 20 minutes a day. Farrier reset his shoes and said there was no heel reaction.

AndNirina
Aug. 12, 2010, 01:19 AM
Glad to hear about your great outcomes, and fingers crossed for your horse's "veiny bump", Ozone. I had posted earlier in this thread about my mare getting done a few weeks ago, but due to scheduling conflicts (mostly on our assistant trainer being able to get the mare to the clinic) we put it off for a few weeks.

She actually got her neurectomy done this morning, and will be coming home on Friday. I talked to my vet this morning and all went well. Can't wait to get her home. I'm confident that I made the right decision for her and think that injections would have just put off the inevitable. I've been anxiously following this thread and hope to hear more of your good updates.

Ozone
Aug. 16, 2010, 10:44 AM
AndNirina: Please let me know how all works out with your girl when she gets home!


With my horse the veiny thing (LOL) was nothing but vet wrap folding in the spot so we thought. Vet left. Next day I unwrap my horse and his leg is blowed up from knee all the way down. Called vet in a panic. SMZ's were dropped off, hosed his leg for 20 minutes, re-wrapped. I have never felt a leg so hot on any horse until now. It fevered right through the wraps. Just then did I start second guessing my decision. :(

Vet came early morning, injected the tendon sheath with antibiotics and steriod in the heel. Left wrap on for two days. Last night I went to change the wrap afraid of what I was going to see his leg/heel/foot was cold, tight and back to normal. Pheww! :)

That veiny bump was the start of infection ;)

He is ok now but what a roller coaster ride it's been. His feet never hit a spot of dirt through this all but still infection arose internally. If it was still stocked last night then it would have been neuroma and my horse would have had to do surgery to correct it.

Tonight he gets stitches out. Hopefully on both legs!

Keep me updated on Pirate :) and AndNirina's girl too :)

Portia
Aug. 17, 2010, 08:47 PM
(Now that I read the rest of the thread, I see you already had it done, so I revised the post.) A horse in our barn that I know very well is in the same position, just a bit further alone. He got his stitches out a few days ago and is doing great. Excellent feeling in his toes, moving perfectly normally -- except now he's happy and sound. Here's hoping yours are both the same very soon.

Our vet/surgeon is very, very experienced with neurectomy. He's done neurectomy studies, written papers, handles frequent referrals from other vets, gets asked to travel around the country to do the surgery, and has done more of the surgeries than the vast majority of veterinary surgeons -- not because he likes to do them, but because it was his study speciality and he is known for his knowledge and skill in the area. He always wants to do the block first to find out how the horse reacts and moves under saddle and, if he jumps, see how he does jumping. Quoting him, if you don't like how the horse goes when he's blocked, you won't like him nerved.

He always makes the point that theoretically, the modern low neurectomy should only deaden sensation to the heel area; however, the nerves are kind of like a tree root and every horse can be different. In some cases, the loss of sensation extends to the toe.

Our vet's practice is to first try steroid injections, and if that doesn't work, then Tildren coupled with injections. If that is not successful in making the horse sound, then he'll consider surgery, in appropriate cases after evaluation. He always does the temporary block first. The surgical protocol is surgery under general anasthesia at the surgical hospital, come home the next day if no complications, 10-12 days stall rest (with hand walking) until the stitches come out, then go back to light work and get the horse's fitness back. If all goes well, return to normal work. Then X-ray every year to monitor the status of the foot and particularly the navicular bone. If the bone becomes too ragged, it can cut the tendon without the horse feeling it, and that's the end. Our vet will not operate on a horse whose navicular bone is too badly degenerated. So, if needed, yearly Tildren treatments to help keep the bone in good condition. In the unusual situation that a neuroma develops, it can be removed with further surgery.

The fact is, there are plenty of GP jumpers, dressage horses, reiners, and barrel horses out there who've been nerved -- but its not exactly something people announce to the world.

Wheel Whip
Aug. 17, 2010, 10:19 PM
Ozone, my heart was in my throat when I started to read your latest post, Whew! Hopefully all goes well from here on. Pirate has permission to start walking out under saddle. We have been going out on short trail rides and now he is much more willing to walk forward. No issues with tripping or stumbles, in fact, he is starting to get impatient and wants to go faster. The plan is to walk out for two weeks then start trot sets.

Ozone
Aug. 18, 2010, 12:58 PM
WW- I am SO Jealous of you and Pirate righ now! :yes: but VERY happy with your results thus far!

My guy is still in wraps. :no: All the swelling went down in his one leg but he is still tender by the nerve ending. Vet is coming Friday to inject that area again. If we do not see a change then he will go in and take that peice of nerve out.

I feel like I should be were Pirate is at right now but mine may be a late-healing-bloomer! Can you see I am staying overly positive? My farrier is coming today to clean up his feet but no shoes on incase vet needs to go back in he will just end up pulling them anyway.

It takes me about 2 hours per night to unwrap, ice, gauze, re-wrap him. He is stall bound with no walking or anything. I was a bit sad last night seeing all the riders, riding... seeing the horses out in the pasture and here is my boy - just waiting. :cry:

If anything it's been a journey of ups and downs. I know he will be ok I guess I just expected sooner.


Portia - I just revised the header :) Exactly what you wrote is how my vet handled and went about the exams leading to the surgery, surgery and aftercare. However, It was my choice not to try injections before. His one foot (the problem foot now) has moderate navicular that is why I went right to the neurectomy.

I know there are many that had this done and many are hush hush about it but from my end, with my horse, I figure if I can share my own personal experiences of the good & bad to people who only know hearsay on the surgery maybe my experience can help their decision :)

I just am at a bump in the road at the moment.

Wheel Whip
Aug. 18, 2010, 05:04 PM
Big hugs, Ozone! This is just a bump on the road to recovery. Just think if you had to wade thru all of the other injections, MRIs, bla bla bla. I wish I was there to help you with the wrapping etc. Maybe some helpful Pony Clubber in the area can give you a break. I will follow some of the other vets proticol(sp?) about yearly radiographs but I still am not sold on Tildren. I had a long talk with the vet about the neurectomy stigma. He said they will only perform the proceedure for owners who really know their horse and will watch the effected areas daily and have appropriate expectations for the future (proper shoeing, possible decrease in performance level). I feel that by being open and willing to discuss the proceedure with others, the stigma can be demystified.

meaty ogre
Aug. 20, 2010, 12:09 PM
I've been thinking about chiming in on this thread. I had a bilateral neurectomy done on my TB several years ago (4-5? Can't remember exactly...I've had kids and the loss of brain cells that goes with it!). For years we did various things to try to get him sound...special shoeing, wedges, pads, injections, blocks, supplements, drugs, voodoo shaman, fairy dust, you get the picture. I was over it, and had a horse who was not sound walking in his pasture. I had the neurectomy done by a very experienced, highly regarded specialist vet. He laid it all out on the table. Explained about the neuromas, which he said he has had very few issues with. I think a lot of that depends on technique, but that's just my uneducated opinion. They can and do happen. Bigger issue is that it can be a contributing factor to a total DDFT blowout which is a death sentence. If a horse has structural issues where the DDFT is being torn by a jagged navicular bone it can get shredded, and if the horse has lost feeling to that area, he will be much more likely to move around and do so than if he is in pain. And apparently it can happen even if that pathology isn't there. So that can be scary.

It was great for my horse because it allowed me to transition him to a healthier hoof and to soundness. He had severely contracted heels and frogs from the shoeing attempts to help him. Yes, that could have been fixed without the neurectomy but the blocks were wearing off more and more quickly and he was not comfortable with any combo of boots and pads that I had tried. I was really at the end of the rope. He sufferred from chronic heel pain that just didn't have a cause that we could point to on his x-rays, and I realized that his hoof structure needed help but buting him daily for however long it took to come up with some magical fix wasn't going to work. I used his stall rest time to pull his shoes and bed him very deep, so he had minimal sole bruising of his paper thin soles. Packing his hooves helped stimulate the circulation needed to grow out his frogs. The neurectomy allowed him to go through this transition without being crippled.

I never really planned on doing much with him, but I had a recent scare with him (vet misdiagosed an abcess as a femur fracture. Yeah.) and I have had a little free time lately so I'm putting him back to work and he's the soundest he's been since I bought him. I do realize that by typing that I have angered the horse soundness gods and brought their collective wrath upon me. ;) Anyway, I ride him in a nice sand ring and he's happy. He's perfectly sound in his pasture, and has been so, barefoot, for years. If I do progress back to any real work with him I may need to put something on his hooves (I'm reading the epona thread with great interest). I just wanted to share my story. While plenty of horses return to relatively heavy workloads after a neurectomy, I think it helps to limit your expectations, but it can be a really good option for lots of horses, especially if you are using it while you address any other issues that are keeping the horse from being sound.

Ozone
Aug. 20, 2010, 12:51 PM
I've been thinking about chiming in on this thread.


I do realize that by typing that I have angered the horse soundness gods and brought their collective wrath upon me. ;) Anyway, I ride him in a nice sand ring and he's happy. He's perfectly sound in his pasture, and has been so, barefoot, for years. If I do progress back to any real work with him I may need to put something on his hooves (I'm reading the epona thread with great interest). I just wanted to share my story. .


Hi! Thanks for chiming in here. I find everyone's story as another piece of information learned about neurectomies. :yes: and I am happy that your horse did turn out ok after what seemed like an extensive process just trying to find him some comfort. Some people would not go through all that you have but you know you tried every avenue before having the neurectomy done.

As far as the soundness Gods go I would rather see my horse in the pasture "looking sound" than seeing him in the pasture crippled. JMO.

Many, many horses are ridden after neurectomies. Just like many horses are ridden with ringbone, arthritic hocks, suspensory issues, chipped knees, oslets, pins etc. Just because my horse's nerves are gone and he cannot feel it doesn't mean that he is less sound then the horses with the above mentioned that are visably unsound ;)

I think that riding is alot of our intentions for our horses after the surgery. Some folk do it for their old horse when the other option is putting them down but when you have a younger horse that needs to have a job you go through the surgery to get back what you had before - a riding horse.

I understand my horse is limited but I will be riding him again.

Vet comes today hopefully for the last time. He is doing great.... finally!! Wishing he had some turn out :eek: he is becoming a beast :lol:

Portia
Aug. 20, 2010, 05:59 PM
He laid it all out on the table. Explained about the neuromas, which he said he has had very few issues with. I think a lot of that depends on technique, but that's just my uneducated opinion. They can and do happen. Bigger issue is that it can be a contributing factor to a total DDFT blowout which is a death sentence. If a horse has structural issues where the DDFT is being torn by a jagged navicular bone it can get shredded, and if the horse has lost feeling to that area, he will be much more likely to move around and do so than if he is in pain. And apparently it can happen even if that pathology isn't there. So that can be scary.

Exactly what our vet says. He wants x-rays and ultrasounds done at least yearly to keep an eye on the bone and tendon. Tildren will hopefully help with this, since it helps to repair the bone.

As far as riding and performance go, our very experienced specialist vet says that a high percentage of the horses on which he performs neurectomies are high-end performance horses, in a wide variety of disciplines. The owners eventually turn to neurectomy precisely because the horses are talented and valuable -- too talented and valuable to easily replace.

AndNirina
Aug. 26, 2010, 01:59 AM
My mare has been back home for a few weeks now, and just had her stitches removed yesterday. Her incisions look fantastic and I was surprised at how tiny they actually were. She seems to be doing very well, and aside from the occasional stumble right after she got home from the clinic, she seems to be able to move just fine.

I'm interested to hear what your return to work rehab protocols look like. So far, she is being handwalked twice a day for 15 minutes. We will be able to put her back undersaddle in September and my vet recommended walking for the first week. During the second week, after a long walk warmup, he asked that we canter her immediately for a lap each way to stretch out her pastern muscles. (I don't have the protocol in front of me.. I'm paraphrasing here!)

My mare had stifle arthroscopy in January to repair a torn medial meniscus ligament so her undersaddle work will be rehabbing both the recent neurectomy and her older stifle surgery. So, after the two canter laps then we are to follow her stifle rehab protocol which consists of one lap of trot then one lap of walk repeated 5x and building in duration over a period of months. This has been quite the year of surgeries for her and I joke that I've erected a shrine to the Soundness of her Right Hind (the only one that hasn't been operated on yet in 2010, but sadly it's only August, right?!?)

I hope your horses are doing well and I'm hopeful that mine can return to at least 75% of what she was in the past few years competitively. At least I know that she's comfortable now regardless of the outcome.

Ozone
Aug. 26, 2010, 10:13 AM
Here to send well wishers to everyone horse who's been through this lately and an update on my guy!

Its been 23 days now since his surgery and he is doing GREAT! He is on turn out now, he knows exactly where his feet are, you cannot even tell he has stitch marks and he is sounder than he has ever been.......... that is with NO shoes too!!! :eek: :D I cannot express my feelings when I called him over to the fence. He came trotting over with this bright look in his eye, ears up with a floaty trot! Made my day.

Vet wants to look at him one more time next week after that he will have his shoes back and a riding we go!


AndNirina: After the surgery I walked my guy 10 minutes the first day home and increased by 5 minutes every day following that. That was for a week and a 1/2. The following week he was allowed turn out in a small pasture. (we had a bump in the road along the way so I had to do stall rest) but he would have been turned out with wraps on until the stitches came out. I re-dressed, re-wrapped and ice wrapped his legs for 1 hour every night.


Riding wise once I get shoes on I will start out more walk, less trot than increase more trot. My horse was a worker before this lay up so 23 days without work is a toll taker on the constant scheduled horse so I will take it slow and do about two weeks of walk trot every other day and incorporate the canter in from there.

Sounds like you are on the good road to recovery!!

Madison
Aug. 26, 2010, 06:13 PM
espridham I wonder if it is the "what ifs" (neuromas etc.) that turn people off to this surgery...

That is part of it, but mostly it is the stories that stem from inappropriate use of the surgery (and in some instances the misperception that the horse can't feel their foot). Neurectomies can be very helpful for horses with a chronic heel pain condition that is not going to get better, not going to get worse. But, if it is used to prop up a horse that has a degenerative condition, then it can mask deterioration of the horse's condition, and the horse can cause further injury. So, IMO a lot of the pro/con analysis can come down to whether the horse is truly an appropriate case for a neurectomy.

Ozone
Aug. 27, 2010, 09:51 AM
Hi Madison. I can see where you are coming from. For now my plan is to ride him however nothing in the way that he was ridden before. I will be conscience of his every move for his own sake and safety reason. I am totally aware of what his feet feel and don't feel.

My plan of action for the future is to continue to Xray him yearly to make sure all is ok. Come a time when the disease has progressed and it would not be wise to ride any longer then my horse will be retired.

AndNirina
Sep. 3, 2010, 01:43 AM
So, the mare got her nerve endings injected today and she should be cleared to go undersaddle by next week. So far, although only at the walk, she looks great and seems very happy. We shall see.... She has also dropped some weight over the last month, too, which can only help her soundness.

Ozone
Sep. 9, 2010, 10:11 AM
Just a quick update. It has been a month and a few days. I rode my horse on Tuesday walk trot! It was like the first day I bought him home ... years ago! I am thrilled with his movement. Sound as can be, happy, floating trot... he knows where his kickers are! :)

This was the best thing I have ever done for him.

I wish everyone the same success with thier horses!

One question, AndNirina, why did the vet inject the nerve endings? Just curious.

Portia
Sep. 9, 2010, 12:34 PM
That's great Ozone. :) The horse in our barn that had the bilateral neurectomy surgery at the beginning of August is back to doing everything he did before, only better and much, much happier. He's jumping again and by all appearances loving it.

AndNirina
Sep. 9, 2010, 09:39 PM
Ozone, it was part of the mare's post-op care to inject steroids into the nerve endings. So, she was injected last Thursday and then I was able to ride her last Saturday. She's been in layup for the better part of 9 months (stifle and neurectomy), so of course she was kind of all over the place. By yesterday, though, her trot felt lovely and floaty and very sound. She seems very happy as well and I'm thrilled at my decision, too. Glad that all is going well for your guy and the horse from Portia's barn.

HiddenAcres
Nov. 22, 2010, 05:48 PM
Ozone & others -

How are your horses doing now? Are they friskier in the cool weather now that their feet don't hurt?

Hope they're doing great!

doublesstable
Apr. 12, 2011, 08:16 PM
I know this thread was from August and November of 2010 ---- read the entire thread after finding out a horse I have had for three years was nerved before I got him - I had no idea. I did notice the white hairs developing around the surgery site but thought it might have been due to old age...

I read that the nerves can regenerate? To date, my horse still has no feeling in the heel bulbs....

I have surfed the net looking for answers and actually this thread was the best thing I found so that's the reason for bringing it up out of the past.

I know NOTHING about nerving and never been around a horse that has been nerved. He seems normal and I "was" jumping him... but now I have some guilt I guess... I don't want to hurt him.... :(

kiwifruit
Aug. 23, 2013, 03:20 PM
Just curious if anyone who had the neurectomy could update the thread on their horse's soundness? And if they returned to work? I'm at a crossroads with my guy and whether or not I should do the procedure. Thanks!