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Tie back surgery vs. Laser Surgery

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  • Tie back surgery vs. Laser Surgery

    My horse has develop a roar and I've been researching surgery options.
    From what I've been told, there's a type of laser surgery that can correct the roaring problem.
    I'm just looking for feedback, from anyone that has had the laser surgery done.
    Did it work, how invasive is it, lay up time and any complications?
    TIA,
    GiGi

  • #2
    I'd like to hear answers to this too. There is a WONDERFUL horse, available cheaply, but DH won't let me go there with the roaring problem. How expensive is the treatment??
    www.crosscreeksporthorses.com
    Breeders of Painted Thoroughbreds and Uniquely Painted Irish Sport Horses in Northeast Oklahoma

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    • #3
      Originally posted by GiGi Larkin View Post
      My horse has develop a roar and I've been researching surgery options.
      From what I've been told, there's a type of laser surgery that can correct the roaring problem.
      I'm just looking for feedback, from anyone that has had the laser surgery done.
      Did it work, how invasive is it, lay up time and any complications?
      TIA,
      GiGi
      Have you had the horse scoped under exercise conditions? This is the best way to assess what surgery he needs. There are a number of surgical choices and which surgery you need depends on the level of paralysis in your horse and whether or not you want to just get rid of the noise or provide a better airway. There are risks and benefits associated with all of them.....
      Turn off the computer and go ride!

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      • #4
        Id have him scoped first, then its easier to choose an option.

        My horse is a roarer and I had him scoped last month...he is only at 60% and my vet said its not worth the surgery at this point....long recovery, expensive, and it may not hold.

        Since at this point it is not affecting his quality of life, I'm not risking it. I take precautions to help keep him comfortable, like not riding in the heat of the day, trying to keep him as fit as I can, long warm ups and long cool downs (which you should do anyway).

        While I have gotten dirty looks from people who dont know what the sound is, and I can no longer show hunters...I wouldnt trade my horse for the world...roaring or not.
        Never Ride Faster Than Your Guardian Angel Can Fly
        Way Back Texas~04/20/90-09/17/08
        Green Alligator "Captain"

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        • #5
          The "laser" just replaces the scalpel blade...every other aspect of the surgery is the same. Sounds all big and fancy, but to be honest its a lot of hooplah. Either method are the same as far as invasiveness, neither are more/less painful or faster/slower. It just sounds more impressive to say it was done with a laaaazer.

          If you really want to get a laryngeal tieback done, make sure its done properly. Ive known 2 horses to have the surgery end up being hospitalized for aspiration pnemonia afterwards. Not always worth the risk if its for an "elective" surgery.

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          • Original Poster

            #6
            I thought Tie Back surgery involved stitching the flap back, not cutting it?
            The horse has been scoped and is a candidate for surgery. The flap is completely paralyzed, but his roar is not that loud.
            At this time, I decided not to have the surgery, but I'm looking for info in case he needs surgery down the road.

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            • #7
              The arytenoid lateralization surgery (aka "tie back") is done under general anesthesia and a large suture is placed to hold the arytenoid (the flap) open so that the airway opens like it should. Of course, then it cannot close, and so rarely there are complications with aspiration etc. That is uncommon. More common is failure of the suture which is reported in as many as 50-70% of cases. Often these failures are not complete, there may just be "sagging" that is seen at the 30 day recheck scope. You can redo these cases, or change their job to something less strenuous where the airway problem won't matter as much (move them from racing to light pleasure riding etc.).

              The laser arytenoidectomy can be done standing and takes out the entire flap. The complication rate is higher, because you have 1/2 of the airway open all of the time.....

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              • #8
                I have had two horses complete tie-back surgery. The first was a Grade 4 roarer (worst level), the second was a mild Grade 3, almost down graded to Grade 2 and was a candidate for the laser option. Animaldoc gave a good synopsis of the two.

                Actual surgery cost was about $2000-$2500. Laser was more expensive, with less downtime. The vet who was going to do the laser surgery had a VERY short recovery time, and I ended up feeling that by choosing that vet and that surgery option, the aftercare I was hoping for wouldn't be what I wanted based from my first experience with a roarer: conservative reconditiong.

                That said, both horses made full recoveries. The first was completly fixed. The second still roars occasionally, but his tieback stitch was not done as tightly considering the moderateness of his roar and that we wanted to reduce complications for the future. I took 3 months to bring them each back to full use (3'6" hunters).

                To reduce aspiration a few lifestyle changes have been made for these horses:
                (1) No hay in haynets
                (2) In fact, they only eat from grazing level.
                (3) Only get fed treats if someone stays to watch them swallow
                (4) I avoid dust at all costs - I won't stable them in barns with the stable rows open to the indoor, I'll skip summer group lessons if the ring is dry/dusty, etc
                (5) Avoid high humidity riding

                I'm sure it's really not as big of a lifestyle change as I made for my guys, but I would rather be safe than sorry. I love them too much =] Also, being an asthmatic myself, I know how much exercise sucks when you can't breathe properly. I wanted my boys to enjoy their jobs, so surgery it was in order to make them comfortable & happy!
                CLIPclop Bodyclipping by Morgan
                Serving North GA with high quality clips.
                --> Just Press Start // '99 Oldenburg
                --> Always The Optimist (reg. Simply Stylin) // '02 Thoroughbred

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                • #9
                  I am not sure if it is still done, but about 8 years ago when it looked like my 2 year old filly needed this surgery, one surgeon at Texas A&M told me about a new procedure they were doing at Cornel that involved taking a small piece of muscle from elsewhere on the horse and implanting it to help the flap close when it should. They were going to fly the guy in from Cornell to teach them how to do it on my horse- but she was borderline for needing it, and since she was only 2, I decided to wait and see. She's 11 now, doing third level dressage and no problem at all in that area. Really glad I didn't do it.

                  I was concerned about the side effects, and also as someone mentioned that it does not have a great success rate.

                  I can't remember the name of the procedure, but they were excited about it because it was looking to be a better option than traditional tie-back surgery.
                  Donerail Farm
                  www.donerailfarm.com
                  http://donerailfarm.wordpress.com/

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                  • #10
                    Originally posted by cyndi View Post
                    I can't remember the name of the procedure, but they were excited about it because it was looking to be a better option than traditional tie-back surgery.
                    About that time, Cornell developed a "tie-forward" procedure - but it's for Dorsal Displacement of the Soft Palate (DDSP) and not Paralyzed Arytenoids (aka "roarers"). They still do it and it works nicely in some horses, but it's for a different problem, despite the similar name for the procedures.

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                    • #11
                      My horse had the laser surgery at New Bolton before I bought him. I feel so badly for him, he coughs all the time when he eats, he can't eat a meal without coughing. He always has stuff coming out of his nose, including water when he drinks. It's horrible. One of the reasons I gave up riding him is due to the coughing. I was in touch with the vet that performed the surgery and I had him examined at Mid Atlantic, there is nothing that can be done.

                      Unless a horse can't breath at all, I would never have this surgery done.

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                      • #12
                        Originally posted by harr754 View Post
                        My horse had the laser surgery at New Bolton before I bought him. I feel so badly for him, he coughs all the time when he eats, he can't eat a meal without coughing. He always has stuff coming out of his nose, including water when he drinks. It's horrible. One of the reasons I gave up riding him is due to the coughing. I was in touch with the vet that performed the surgery and I had him examined at Mid Atlantic, there is nothing that can be done.

                        Unless a horse can't breath at all, I would never have this surgery done.
                        harr754- Do you feed, hay, and water on the ground?

                        I have a horse that had the aritnoidectomy and as long as everything that goes into his mouth is from ground level, he is totally fine.

                        As far as riding, he doesn't make a sound and breaths great. We do tease him though that his whiny sounds like a 40 yr smoker.

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