So my best riding gelding (who I just started jumping finally) was diagnosed last week with a keratoma. He is sound, no abscess in over a year but the hoof wall has been split since he blew a huge abscess a few years ago at the coronet band...it would almost grow out and then split again. Hence the x-rays.
My vet thought it could be done standing given how small it is, it isn't infected, its in a good location, etc. Two surgeons have looked at it and both agree that it is one of the more minor cases they have seen but one surgeon said they absolutely will never take out any keratoma standing up. The other wanted pics of the hoof, which I sent, and am waiting to hear.
I am petrified of general anesthesia. Just lost a beloved cat to it in the early spring (I know, apples to oranges but still...) and I know of several horses that had terrible reactions to the anesthesia itself or injured themselves waking up/getting up. Does anyone have any reassurances/insights? Am I being silly to be so worried about it?
I've had mostly "good" general anesthesia experiences, with three horses undergoing surgery and one requiring GA for an MRI. All handled it fine, got up okay, but I knew the risks and was worried the whole time. I think that is normal. The only one I regret is the MRI Horse as I was very hesitant, knowing him, and he did have some weird after effects (discussed in a previous thread).
Now I also had my vet perform a standing surgery on a leg for a horse and it didn't go so well...I should have known as this horse had been difficult to work on in the past with standing sedation for minor treatments. Should have sent him to a clinic for GA, but my vet (then, not anymore!) was a little over confident, I think.
If it were me, and two out of three vets are suggesting GA I would probably opt for it. You know your horse, so that might influence things...I was really worried when my huge one (big warmblood tipped the scale at 1500+ ... His surgery was 8 or 9 years ago and I just talked to the surgeon for the first time in years and the thing he remembered was that BIG horse I had!) ... With all his bulk, I thought the recovery would be terrible, but he did really well. The clinic was super careful and used meds to control him so he got up at the right time, not too soon.
I'm going to have to go look up keratoma as it isn't something I've dealt with (how rare! I've had about everything...). Best of luck with your horse, no matter which way you decide to go.
I was just having this very conversation with my vet this week. What I was told was that while (of course) no surgery is 100% complication proof, that usually the ones that have trouble with the anesthesia or getting up are the ones that are already sick and/or have to be down for a long time--like complicated colics. Best of luck to you with whatever you decide.
If it makes you feel any better I've had three that required general anesthesia over the years--all recovered like champs. One was an easy colic (impaction/gravel), one had a splint bone removed and the other a fetlock chip removed.
Actually, I just heard back from the third surgeon after she viewed the x-rays. She isn't convinced there is a keratoma. Could just be dirt that has worked up through the white line and needs to be debrided. That is what my farrier friend (who lives in MD) thought when he saw the x-rays as well. When I pressed one of the other surgeons, they said "well, we saw a little remodeling of the coffin bone on the x-ray so wanted to investigate surgically-we won't know until we get in there why that remodeling happened-it COULD be a keratoma". :eek::eek::eek: Really scary that the other two surgeons were willing to cut off a portion of his foot for a potential pocket of dirt.
So, no general anesthesia for this guy (who is half draft and therefore already at increased risk) to remove dirt. A VERY unnecessary risk. This is why I got several opinions. :no:
Re: the anesthesia question:
Being a board certified veteriary anesthesiologist (and there is another one of us around here too, if she cares to chime in)....
1) Anesthesia does not = ansthesia does not = ansthesia
Meaning there are million and 1 ways to do the same thing.
Some of it is drugs.
A lot of it is monitoring.
And even more of it is doing something in response to what the monitoring is telling you.
2) There is ALWAYS risk with anestheisa
But we should always be proactive and minimize that risk (too often that is not that case however)
God put a leg on each corner of a horse for a reason. Meaning recovery is the riskiest portion of the anesthetistic period for a horse. 99.999% of recoveries go just fine. It is the 0.001% that suck. And we can't predict.
Having said that, glad you got second opinions and are getting new films, etc.
I agree with Meghan....
I wouldn't hesitate to put a Draft/Draft Cross under GA if it *needed* a procedure with some precautions. If you can't get consensus on if the procedure needs to be done, I would do more diagnostics/treatment until you are reasonably sure.
If general anesthesia needs to be done, I like to check the muscle enzymes prior to anesthesia and try and determine if any therapeutic diet (like for PSSM) needs to be done prior to GA. After that, make sure you have someone with experience anesthetizing these guys and lots of padding, and good monitoring and a trained anesthetist.
These guys actually tend to recover pretty well since they are large and the recovery stall is small - they can't get up as much speed in the little padded room as a smaller horse can! Also their temperament tends to be calmer and less reactive (as compared to oh, say a racing TB) and so they usually get up well.