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A slew of neurectomy questions. Please post if you've had experience!

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  • #21
    Check out the blog dressage mom http://dressagemom.blogspot.com/

    I think her dressage horse had a neurectonmy done, she has kept showing and training and now recently she had a newer experimental procedure done to deal with neuromas. She writes about it and there is lots of info regarding her experiences.

    ETA - I think you will find this an interesting post

    http://dressagemom.blogspot.com/2010...after-weg.html

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    • #22
      If the navicular bone/DDFT pathology is present, doing a neurectomy will rapidly accelerate the deterioration and basically put the horse on the fast lane to breakdown. Yes, if the pathology is present, it's bad news anyway, but a horse whose navicular bone is so jagged that it is shredding the DDFT will load weight differently on the foot and will be more reluctant to move. A horse who is not feeling that pain will load the foot normally and move more, thus increasing the wear on the tendon to the point of failure. Like scraping a knife against some bailing twine slowly, or sawing across it faster and with more force. Both will eventually result in rupture, just one much faster than the other. Unfortunately if a horse has this issue, options are limited. I guess you could try tildren or something. But no, neurectomy would not "buy" a horse like that some time. Just the opposite.

      And, like I said, the vet told me that a DDFT blowout can happen post-neurectomy without that pathology present, so be aware of that.

      http://www.ivis.org/proceedings/aaep/1997/Dabarein.pdf
      Here is an article comparing techniques and outcomes. Guillotine method actually is best, and the surgeon I chose uses the guillotine method in conjunction with something else (I think it may have been liquid nitrogen, but don't quote me on that...I just know he cut and also did something else).

      I asked a lot of questions about neuromas and regrowth. The vet that did the procedure told me that the nerve would not reconnect, but that a branch above the cut could allow feeling to return. (I have heard others say that the nerve can regrow and/or reconnect, but this vet said no. You'll have to research that and draw your own conclusions I guess). He said the concern with regrowth would be that a bundle could form (neuroma) which is painful. He told me that the neurectomy should not have to be performed again unless he made the cut too low, thus allowing feeling, which would be apparent once the chemical block wore off. His goal is to deaden the back 1/3 of the foot. So your horse will still feel an abscess or a nail or stone, etc. He told me that in his experience, he had extremely low occurance of neuromas. He explained that with the guillotine method, he stretches the nerve, makes the incision and then the nerve retracts into the sheath, and the 2nd step which I think was the freezing further discouraged the regrowth. I think that this is why the technique/experience level of the vet is of the utmost importance. The vet needs to have done a ton of these surgeries to have a good feel for where to make the cut, and how to minimize the chance of neuroma formation. Aftercare was a few weeks of stall rest and painting the incisions with DMSO/Cortisone 2x a day. He felt this was an important step.

      As far as clinic vs. individual vet, I would go with the vet who has the most experience, and who stays as up to date on techniques as possible.

      Not only was this a "last resort" for me, I still continued to work aggressively with a specialist farrier to correct some flaws in his hoof structure as well.

      The nerve blocks were the only thing that worked to keep my horse sound. You've probably been doing them already (or you should before you resort to a neurectomy). So if you've already tried all the special shoeing (bars, wedges, pads, eponas, etc.) and you've done the x-rays, MRI, and isoxuprine, bute, etc. are not working, and the nerve block is the only thing that relieves the pain, then I'd say you're in about as good a place to make this decision as any horse owner can be.

      Good luck with whatever you decide, and I hope it all works out best for your horse.

      Comment


      • #23
        I've done it with 2 horses.

        1. Did you experience regrowth of the nerves/did the horse regain feeling in his foot and experience pain?

        a. No, not in 20 years post surgery
        b. No, not in 2 years post surgery (died of unrelated cause)

        2. How quickly did that happen?

        Both horses regained skin sensation, which surgeon said was normal. Horse a was numb for the rest of his life.

        3. What was the reason for the neurectomy (what diagnosis of disease for the horse)?

        a. ringbone and navicular (I question this as it was the late 70s and we knew nothing)
        b. severe sidebone and possible navicular changes in draft horse

        4. How old was the horse when the neurectomy was performed?

        a. 7 years old
        b. 6 years old

        5. Did the horse return to work? If so, was it the same level as before/after the neurectomy?

        a. Yes, horse was ridden and shown in dressage and low eventing for 20 years and was never lame again.
        b. No. We knew nerving would only make this horse as sound as he was with a nerve block, which was still 1/5 lame. But he could be pasture sound (was facing euthing him due to not being even pasture sound).

        6. Did your horse experience any complications?

        a. no
        b. no

        7. Did you have the standing or fully sedated version of the surgery?

        a. standing
        b. fully under a general in a surgery clinic

        8. Where did you get it done?

        a. at my barn
        b. hospital

        9. Did you do a second (or third or fourth) neurectomy following regrowth, and did you have success with that surgery?

        n/a

        10. Roughly, what was the cost for the surgery.

        More recent horse B was done 3 years ago and it was $1500 out the door for a bi-lateral neurectomy done under a general with 2 days in hospital at Pioneer Equine in Oakdale.

        Surgeon told me best outcome is from horses who adhere strictly to the stall rest schedule. My horse did 30 days stall rest followed by 30 days stall/paddock. Stall rest and good management help reduce risk of neuromas. They showed me the 4" of nerve removed from my horse.

        I should say that this surgery is only to be done when you have exhausted all other options. With horse "a" I did not as neurectomy was the 'procedure du jour' at the time and I was a kid. With horse "b" I had spent 2 years and thousands trying to help him get sound. Finally did the neurectomy so he could enjoy a few years in pasture, knowing I'd euth him once it regrew.

        The surgeon (Dr. McDonald at Pioneer Equine in Oakdale, CA --- good guy to discuss neurectomy with!!!) told me that most neurectomies last 2-5 years. He had done hundreds of them and several horses repeatedly. It was a good thing for both my horses. I think it's a much more common procedure that you might guess.

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