I talked to the place the horse came from about my options (my vet is certain there's no way to fix it or even stabilize it, and the horse is in constant pain but is tough enough to ignore it). The place says if I send the horse back, they'll have no choice but to euthanize it if it's in chronic pain. Yay.
In this situation I would send the films for another opinion, to a place like Roods and Riddle. I think if the prognoses was that bad they would not have done the surgery in the first place. Some horses have ugly Xrays but are happily doing there job. I would at least get another opinion before putting this horse down.
I worked at a farm that had a colt with 6 pins in one leg and 3 in another. He raced 43 times after the screws and retired sound at age 8. Don't judge I only worked there. He died in a freak accident shortly after retiring so I don't know how he would have held up long term, but his rads were darn scary and he only got the normal 2g of bute per race.
I just got an OTTB. The horse is beautiful with wonderful conformation (if it weren't for the pin firing marks, you'd never guess it was an OTTB), a fantastic mover (my goal was to ride it in the lowest levels of FEI) with a stellar character and smart as a whip; picked up leg yielding on day 1 of riding. The place it came from told me it had pins in its legs, but they didn't do xrays. I got xrays, but was afraid I was wasting my money. This is a tough horse, and it shows no signs of lameness; flexion didn't pick up anything. Just minorly sensitive in the suspensory when vet really tweaked it. Vet looked at these xrays and said they totally didn't see this one coming, but is subtly hinting that I may want to rethink keeping the horse (since vets can't really advise clients whether or not to continue a purchase/ keep a new horse, I guess that's pretty serious). If these were xrays of a new horse you really liked a lot and otherwise seemed perfect, what would you do? Thanks! Xray 1 Xray 2
I "resemble that remark" (if it weren't for the pin firing marks, you'd never guess it was and OTTB"). . . all my OTTB's have been beautiful and most have had wonderful conformation as well. But, be that as it may, I took an OTTB last year with a fractured sesamoid knowing she might not hold up, but took her and planned on finding the right home. With proper work and conditioning she's jumping and sound. Go with what you've got and see where you wind up. You may have to rehome him/her, but give her a chance.
RIP Kelly 1977-2007 "Wither thou goest, so shall I"
"To tilt when you should withdraw is Knightly too."
I have an OTTB with old sesamoid fractures in both hinds (his fronts are flawless...go figure). I never did x-rays, just flexions when I bought him as he had been going sound for me for 6 months under lease. I showed him in the 3' hunters, sometimes schooling 3'6", for several years. He became unsound under saddle over time, but we had a very hard time pinpointing the problem until we finally did films of his hind fetlocks. Turns out the calcification around the old fractures was irritating the suspensory. I retired him at 14 and turned him out per the vet's advice. He's been out to pasture for 18 months now and I believe he is trail sound (he is definitely pasture sound and not in pain).
In your case I would get a second opinion with the proper films. Sesamoid fractures can be a big problem or not too bad depending on the type of fracture. If you have high hopes for the horse it would be worth the extra cost up front. No point in putting all that training in him and then having him go unsound in a couple of years.
There were 2 fractures of the left foreleg. The screws fixed the condylar fracture we already knew about and is a non-issue. The sesamoid fracture was unknown to us until the xrays, and was never treated. The sesamoid fracture is at least nearly 3 years old (the horse last raced in 2-10).
If the sesamoid fracture is that old there's no fixing it now - what you see is what you get. Even acutely, that would be a hard one - it's 50% of the sesamoid so you would have to put a screw in it, you can't just take out the piece.
So, if I'm reading this right, the horse is fine now with light work (you said appropriate for a horse that has been off 2 yrs and recently started back) - I don't think I would call him "chronically painful" if he's sound.
A horse with radiographs like that can be pasture sound and even sound for light work, but is not going to have any significant athletic career IMO.
I have a mare that had a sesamoid fracture when she was a weanling. She is coming 5 y/o and is completely sound and has no problems with flexion tests which we keep up to date with annually.
I would consider her workload to be moderate... Three-four days a week, 45 minute rides, once a week jumping lesson 2'9 and under.
Mind you she does not have pins or screws..... and xrays look clean.
Her sesamoid does look slightly larger than the other leg but vet advised that when injuries calcify the bone typically heals larger and can be stronger.
My advice, since this worried me when I purchased her as a 2 y/o so I know the feeling, have a couple well known trainers come and watch the horse and observe any changes after the ride.
Push the horse just slightly past their current comfort zone to see if any pain or changes pop up. Mind you I wouldn't push too much since the horse is likely out of shape but you will want to get an idea of what you are into.
Note: I did have an OTTB mare for years that had screws in each foreleg, (bad track accident). She was sound for light w/t/c work after 5 years of pasture/mom-hood but it became a problem when she was put into anything more than light work.
Nothing serious but clearly in some pain.
Tread carefully, if it will be your only horse.... I might be leaning to no due to the screws but if you have another horse available to ride, I would definetly consider it.
...This is a tough horse, and it shows no signs of lameness; flexion didn't pick up anything. Just minorly sensitive in the suspensory when vet really tweaked it. Vet looked at these xrays and said they totally didn't see this one coming, but is subtly hinting that I may want to rethink keeping the horse...
Originally Posted by animaldoc
To compare - there are three injuries in a "breakdown" - condylar fracture, bilateral sesamoid fractures and suspensory rupture.
Look at it this way... If there are the above three injuries in a "breakdown", this horse has the condylar fx, the sesamoid fx (untreated), AND is sensitive to palpation over the suspensory. In my mind, he's got 2.5 of the 3 injuries that contribute to a "breakdown".
If your goals are FEI, I don't think the horse would stand up to that level of work, especially given the FEI's extremely strict no-meds rule.
If you have your heart set on the horse, get an ultrasound of the suspensory. You said there was sensitivity when the vet really tweaked it, but that's subjective - one person's version of really tweaking it might be another person's gentle palpation.
Sorry you're put in this situation. It sucks no matter how you look at it.