My horse has been diagnosed with a sinus infection (thick smelly discharge from 1 nostril, vet came out, checked teeth for infection, etc.) He is almost done with his week of oral antibiotics (Tucoprim) and showing no improvement.
Next step, per my vet, is a sinus flush in which they will drill a hole through the sinus cavity and then I will flush fluids daily through it.
The horse in question has a real nose/face issue, is older, retired, difficult. I fear I won't be able to catch him and hold him down for this.
Has anyone gotten to this point and tried something else? Stronger antibiotics? He is not a performance horse so I'd be ok with a slower method if it meant a happier treatment.
We had a horse this summer that we drilled a hole into his sinus for flushing. He can be difficult at times but it went surprisingly well. I just dreaded the idea but it really wasn't that bad. We eventually had to remove two teeth and thought it would solve the problem however it did not. I hope you have better luck then we did at getting his infection resolved.
Given the horse's age, I'd be wondering if the had a cracked tooth and that is what's causing the infection. The roots go up into the sinus cavity and can abscess - producing the vile goo.
A friend's horse had a similar problem but the vet couldn't find out what was causing the infection - horse got worse and I think an xray? revealed the crack and mass. Removed the tooth, drilled the hole - and the rather contrary old mare did just fine and lived happily for several more years.
We went through this almost exactly a year ago... first round of sulfa antibiotics helped, but the infection came back. Local vet thought she saw a pocket of infection near a tooth root on an xray, so we headed to the vet school for surgery - and in the time it took to get the appt. and actually get there after a snowstorm, repeat xrays showed the pocket of infection was gone! He went home with a drain in his face and several more weeks of sulfa at a pretty high dose, and hasn't looked back since. The drain wasn't a big deal at all (admittedly, he's a good boy about almost everything) and healed up without even a tiny knot.
Years ago a friend's horse had a bone chip from a kick to his face, and the chipped site got infected and ended up infecting the sinus as well. He also got a drain, tolerated it pretty well (we were such beginners at the time, I'm surprised one of us didn't end up getting hurt) and healed up beautifully once the bone chip migrated to the surface and out.
Did you culture the discharge? My event horse just got over a sinus infection--he had to have tetracycline for a week, but he did respond to it, thankfully. My vet said that often sinus infections respond well to tetracycline or doxycycline. She did warn me that drilling was the next step, and that sometimes there can be a tumor, but that she'd never seen one in a horse younger than mid-twenties.
My old guy got an infection following a suspected choke episode. We had him on oral smz, IV gentocin and IM penicillin and he still wasn't getting any better. As a last resort before the drilling a hole he mixed me up a solution he called killer red and had me use that in the nebuliser. It did the trick almost immediately.