What do the vets think? They know the most about recovery and how his age will affect that.
Anesthesia is always a risk with older animals, but I would feel pretty safe doing it at the university. They should be the most up to date on the best anesthetic protocols to use for an elderly animal and advanced monitoring equipment. Definitely a risk, but if the vets think it's your best course of action then I would go for it. Much better than a permanently lame horse.
If it was my horse, I would exhaust every conservative method before putting them under General. Especially since this is not a life saving procedure like a colic surgery or something. And it sounds like you would not be devastated if he was a pasture pet. It would be different if he absolutely HAD to return to riding.
At least, since you are so undecided, you might want to just take him home and think on it a little longer.
Everyone agrees it's a risk since the horse is so unfit due to stall rest.
I should add that this horse is the beloved buddy of my 14 year old daughter, who would be absolutely devastated if we lost him. Less devastated if he was lame and permanently retired...
To decide I'd
1) Ask myself how smart and self-preserving this horse is. Can he figure out his limits while waking up from anesthesia? There's no certain answer, of course, but don't overlook the horse's contribution to his own safety (or his lack of that).
2) Is your kid mentally/emotionally ready to participate in the cost/benefit analysis and the decision? The key is to taking risks like this is making sure we don't do something we'll regret. If she understands the risks and wants to go with that (apart from your opinion), I'd be more inclined to go ahead.
3) This is a lot of risk-- to life and wallet-- just for a diagnosis of a problem that hasn't been fixed via stall rest. So what are you getting from this next picture? Is it likely to be anything you can or would treat? If not, why bother?
Pre-anesthesia blood work should let you know if your horse can handle anesthesia reasonably. With horses of course, it's the coming OUT of anesthesia that can be most dangerous but these are professionals. If your horse isn't normally a nutjob, you should be okay.
I personally would put my faith in the professionals. If they think this is necessary and reasonable, do it.
22 isn't OLD. Your horse likely has lots of life left! (my mare is 22 so I get to say that!)
Jingles in whatever you choose.
A good horseman doesn't have to tell anyone...the horse already knows.
Thank you everyone for your incredibly helpful input. I had an hour yesterday to make a decision, and I decided NOT to risk the recovery from general anesthesia.
And boy was I glad I made that decision!
Long long story short, this is a 10 month long lameness odyssey involving several vets and opinions. I opted to have UCD do yet another lameness evaluation, kind of triangulating the info from my 2 home vets plus my bodyworker and my own observations. There was strong suspicion something was going on inside the knee. We'd already diagnosed a suspensory origin avulsion fracture and check strain, both of which have long healed --- but horse continued to be lame and in fact has gotten worse over the months of rest.
At UCD, we were able to hone in on suspicious areas -- proximal suspensory and the carpus. did various blocks, knee rads, ultrasound of distal limb. Diagnosis is this: "At this time it is strongly suggestive that horse may have suffered a trauma like injury to the carpus and subsequently injured the *medial palmar intercarpal ligament* including a small avulsion like lesion." This is a little ligament between bones at the back of the knee. The radiographs were strongly suggestive, but obviously an MRI or CT would be the gold standard in confirming diagnosis. However, either way treatment (or lack of, unfortunately) would be the same: possible PRP, IRAP, or plain old injecting the joint with steroids/HA to see what happens. UCD vet said that little is known about this type of injury.
I am SO glad I went with my gut instinct and did not do anything involving general anesthesia, because the stress and motions involved in him getting up (ever seen them wake up, when they sit up like a dog with front legs outstretched? yikes that would have torqued this exact ligament of knee!) could easily have made the injury worse. Vet at UCD agreed it was the right call.
Thank you wise COTHers for the input that helped me make a critical decision. I was so grateful to bring our beautiful boy home. He has worked so hard all his life and he will be retired (although I'm going to throw a little more money at some attempts to heal this injury up).
So now I have a working diagnosis which I believe is correct. Anyone have experience with knee ligament injuries like this?
Last edited by Watermark Farm; Oct. 30, 2012 at 05:33 PM.
I had read your query late in the day & wondered which way you'd gone - just couldn't see doing the GA myself (under these conditions).
Ligament injuries take such a long time to heal even with "support" (thinking of humans where you can easily use splints etc) - did vets suggest anything in terms of exersize/stretching that would develop supporting muscles?
(wondering about water work, though no idea if there are any equine facilities near you - I suspect not everyone in California has a conveniant beach - despite the many TV shows implying otherwise )
Yes! He's such a gem and has a great mind but is very body sore/wracked and I'm having my chiro and bodyworker assess him. Will update that thread soon.
Prognosis for intra-articular ligament injuries like this is not great. But I'm going to give this more time and try a few new things. And yes, I have an equine swimming facility 15 minutes away, and that may be something we try.
I would try PRP as I think it's specifically recommended for help in healing ligaments along with requisite rest. We did a round on my 2 year old after he strained the check, etc and after 2 treatments at the last check vet couldn't even find the issue.
My mare had multiple bone chips and inter carpal ligament injuries. She had arthroscopic surgery at Davis and stem cell treatment and has made a full recovery including jumping. I do think you made the right decision on the GA. My mare was only 12 and had an allergic reaction which they dealt with and struggled/ panicked waking up. She is a normally sensible horse! It really took a toll on her and I will not do it again unless it is a life/ death situation. I would try the PRP and see if that helps him out. Who is your lameness specialist at Davis?
There is a lot to be said about following your "gut instinct." I had to make a decision about putting a horse under general. My problem was not age, but size and breed. This was my 18-3 Clydesdale. And Clydes are NOT good about getting back up. If he could have been made pasture sound without surgery, I would have taken that option. But he had a bone chip and due to the size of the chip and where it was, it needed to come out. I did a lot of research, told the vet what my limit was for him being under and I brought a large animal rescue sling with me for them to use. They needed it, and he got up with a lot of help. Then they suggested a second surgery to get some other chips. I tempted fate once, but said no to doing it twice. I watched the surgery and that made me even more aware of the dangers of knocking out a horse and having a machine breath for them while they are upside down. Good to avoid if at all possible.
I'm the "if an expensive picture won't change the treatment we'd do, let's skip it" school of thought.
For me that started long ago when ultrasound was new. I asked the Vet of My Childhood how vets incorporated those into their older tool box. She said, "Look, you block them, know some anatomy and then figure out what could be broken in the section of leg that spoke up."
It makes sense. The horse leg isn't rocket science. Rather, it's elegantly simple mechanics.
Now that we can take these great pictures of joints and feet, however, we can say a whole lot more about which dinky little collagen string in there is frayed.
IME, knowing which ligament is trashed doesn't make a huge difference for the first round of treatment and rehab. If you have a high end horse and for managing the horse with this problem later, then I can see how you'd want to know. But here, you are putting in a lot of time, effort and money to make a small change in the mechanical system.