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Temporohyoid osteoarthropathy AKA "THO"

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  • Temporohyoid osteoarthropathy AKA "THO"

    Long time (years) lurker - first time poster. Going to jump right in:

    At the end of February my 20 y.o. QH gelding went completely off his hay. Still ate his "mush" (LMF Sr). Presented with 101.8 fever, head tilt up and to the right, nasal discharge from left nasal, apparently painful swallowing and a very slight "paralysis" of the left side of his face - noticeable only because left nostril was slightly lower than right nostril.

    Vet came out, took blood, and during exam of my horse's head, touched the area just next to his left temple which caused my horse to throw up his head in what seemed to be pain. He then started backing very quickly, hit the fence of his paddock and could not regain control of his back end, subsequently flipping over a very large boulder in his paddock. He was able to stand and came to me looking very confused/scared. (I was terrified - he has never exhibited ataxia symptoms in the entire time I've known/owned him - 15+ years).

    Based on my horse's reaction, the ataxia, and his slight facial paralysis, the vet tentatively DX'd THO aka temporohyoid osteoarthropathy. He prescribed antibiotics (9 days) & banamine (3 days). He recommended we haul to UC Davis and see the specialist there. Trailering to & from UC Davis is cost-prohibitive for me, and treatment @ UC Davis is also. The surgery required for treatment of a positive THO DX is not an option for us unfortunately.

    I got a 2nd opinion from another vet. He said teeth definitely needed floating, it could be TMJ, or it could be THO. I decided to go w/ the float even though that can be risky w/ THO. The float went well, and there were some ulcers in the mouth and other issues. 2nd vet said if it were his horse, he would take a wait and see approach.

    Since the tooth float 2 weeks ago, my gelding is eating every scrap of his hay, all his mush (of course) and seems very happy/content. The slight facial paralysis is gone. No nasal discharge. No fever.

    A few nights ago, after a really unusually warm/sunny day for this area and time of year, his ears got attacked and bitten by either mosquitoes or biting gnats. He had rubbed the heck out of both ears all night and was a mess in the AM when I went to the barn. Both ears were hot and full of crusty crap. This isn't our first rodeo w/ the bug bite reactions, so I knew how to take care of it, BUT when I went to touch his more painful ear (the right ear) he threw his head up and his back end dropped about 5 inches and he started shifting back feet very quickly. It looked exactly like he did before he lost control when the first vet examined him. I got him to drop his head immediately and he calmed down, let me check & treat the ears and has gotten better since then.

    ***This gelding is my BFF, my heart horse, and has been my main grief counselor since the death of my only child, my son, 6 1/2 years ago. I've owned this horse since he was 5 years old but knew him as a colt. He was (is) my dream horse, most expensive horse I bought, and he broke his right front P2 at 6 years old. We rehabbed from that and went on to ride for many years. He now has navicular in the front left and is front end dead lame. On daily Equioxx, no riding, still my BFF and grief counselor. I do not want to lose him.

    All of this on and on dialogue to say, in my heart, I know there is still something going on. Funds are limited and I'm just trying to pay down the credit card (there were 4 vet visits total in 1 and half weeks) before I start up new bills. I do need to get him scoped or a CT done on the left side of his head, but will probably do that at Loomis (much closer, less expensive & more doable).

    I searched the forum and saw a couple of posts regarding this disease, and I just wanted to reach out & see if anyone else has gone through this. Or if the two posters who have, could give me any updates regarding their horses.

    And if you've made it all the way to the end of this lengthy novel, thank you for sticking with me!

  • #2
    I have no knowledge on this subject nor any words of wisdom but I do want to say that my heart goes out to you. Like most of us here, I know how stressful it is when your heart horse is not quite right and the struggle of juggling funds to get answers. In your case, the loss of your son makes the possibility of another loss even more painful. I hope you are able to get some answers and will keep us posted on updates. We are all here for you. Hugs.


    • #3
      Disclaimer that I know absolutely zero about this condition-- but I would think xrays of his skull would be the next step?


      • #4
        I'm so sorry for your loss. A horse who is dead lame and on equioxx with no real hope of improving (navicular) is the real issue here. It may not be fair to keep him going.


        • #5
          Welcome lurker. Sorry to meet under such grim circumstances.

          I knew a former COTH poster who had an appendix QH mare with it. Mare at that time had produced two healthy foals and owner started her going again when the weird head-tilt thing and uncharacteristic behavior issues began.
          Brought her to Davis and did not opt for surgery because of her age and a definite lack of resources, and ran a course of antibiotics. Mare remained pasture "sound" (i.e. free from neuro issues) for about 8 years.

          Until. On a dark and stormy night she went down, and stayed down. It was awful, and this was the heart horse who made her name, lying down in the mud, unable to rise. Owner, head in sand, ignored the little stumbles, quidding, etc. It is grand that summer is coming but you may wish to prepare for whatever is necessary for your gelding's comfort, and to prepare for your own further grief. Man, does grief do a pile-on.

          Loomis improves more every year and does plenty of consults w/UCD (which is, as you know, world-class expensive). There is absolutely no shame or guilt in using Loomis.

          Jingling that you will soon have the comfort of a conclusive diagnosis.


          • Original Poster

            Thank you all for your responses, I really appreciate it. He is doing much better since the float. No quidding, eating all his hay, bright eyed and solid footed. I watch him closely - I clean his paddock in the morning and evening (he's boarded), so I notice every little thing. Once I pay off the 2nd vet visits (getting there) I will go ahead with the next step, which would be scoping him. Again, thank you all for your responses. It helps to "talk" it out.