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lateral metatarsal arterial aneurysm...anyone? Update

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  • lateral metatarsal arterial aneurysm...anyone? Update

    Just got my mare and filly home...yeah! Except I am a nervous wreck watching my mare. After she ate her dinner she looked a little colicky but is now better. This is worse than foal watch!

    The filly has a swelling on her right hock the size of a golf ball. She is not painful on it, it is not warm, she is not lame. They did lots of ultrasounds and consults with the surgeons, radiologists and cardiologists at NC State and they are calling it an aneurysm of the lateral metatarsal artery. They have never seen this before and are not sure if it is developmental or trauma related. They are trying to figure out what to do about it but initial thought is a CT scan with contrast dye to see if there is enough collateral blood supply that they can safely ligate the vessel.

    Anyone ever have this in a foal/ horse of theirs? I have already emailed two friends of mine that are equine surgeons but thought I'd put out as many feelers as possible.

    Thanks!
    Last edited by Blume Farm; May. 28, 2013, 09:27 PM.
    Read about my time at the Hannoveraner Verband Breeders Courses:
    http://blumefarm.com/hannoveranercourse2011.html
    http://blumefarm.com/hannoveranercourse2012.html

  • #2
    ligate the vessel
    What does this mean? Repair it? Can you post pictures?
    Fresh, Frozen & ISO Warmblood Breedings FB Group

    Comment


    • #3
      OMG-- You cannot catch a break! I'm so sorry!
      I have never, knowingly, been in this situation and wish you the best outcome!!

      2 thoughts; how many times have we all seen a swelling that went away with a little benign neglect? I wonder if this is a case of tmi due to technology....

      and, most importantly, is there any chance that an aneurysm in a neonate is any less risky/likely to self-repair?
      Last edited by tucktaway; May. 24, 2013, 09:27 PM.

      Comment

      • Original Poster

        #4
        Originally posted by back in the saddle View Post
        What does this mean? Repair it? Can you post pictures?
        essentially what they are proposing is to tie off the vessel. I took some pics on my phone that I will post tomorrow once it charges.

        Originally posted by tucktaway View Post
        OMG-- You cannot catch a break! I'm so sorry!
        I have never, knowingly, been in this situation and wish you the best outcome!!

        2 thoughts; how many times have we all seen a swelling that went away with a little benign neglect? I wonder if this is a case of tmi due to technology....

        and, most importantly, is there any chance that an aneurysm in a neonate is any less risky/likely to self-repair?
        no sh*t! I have wondered the same thing...sometimes too much information is detrimental! Everyone at the vet school is stumped by this and have no idea if it will self correct over time. But because no one knows we don't know if it will get worse and really cause a problem either. Hence why I am searching for anything!! There aren't even any published papers noting such a thing.

        You never want to have the problem that the vets say "well isn't that interesting"
        Read about my time at the Hannoveraner Verband Breeders Courses:
        http://blumefarm.com/hannoveranercourse2011.html
        http://blumefarm.com/hannoveranercourse2012.html

        Comment


        • #5
          Is this the big vein that goes down the back leg?
          Fresh, Frozen & ISO Warmblood Breedings FB Group

          Comment


          • #6
            Originally posted by back in the saddle View Post
            Is this the big vein that goes down the back leg?
            an artery along the "outside" splint bone

            Comment


            • #7
              Weird.

              Very first question I would ask, far in advance of doing at CT: is there any HARM in not treating this?

              If there is no harm, let it be. There IS potential harm in anesthetizing for the CT.

              I would watch and wait unless the vets gave me a VERY VERY good reason why it needed to be addressed.

              Comment


              • #8
                WOW!! That is totally new to me. What about US (ultrasound)? That's what doctors do on patients for DVT. I work in doctor's office so that's why I mentioned US.

                Comment


                • #9
                  Would be interested in seeing pics as well. It kind of sounds like what one of yearling filly has which has stumped us and vets. Her hock slowly swelled and was pretty massive and odd looking but was never lame and never really hot. Just looked really weird.

                  She got it drained which seems to have helped. ( she was having surgery for something else anyways). Vets poked about her hock but never found anything per say.

                  P.
                  A Wandering Albertan - NEW Africa travel blog!

                  Comment

                  • Original Poster

                    #10
                    http://www.blumefarm.com/images/452_20130524_175827.jpg

                    http://www.blumefarm.com/images/452_20130524_175724.jpg

                    It is difficult to appreciate in the pictures. The swelling/ bulge is on the distal lateral aspect of the hock, but before the cannon bone starts. It is definitely the artery as when you palpate it you can feel her pulse clearly and strong blood flow.

                    The problem with doing a wait and see approach is no one knows if it could be detrimental and possibly rupture. It is much easier and cheaper to do surgery as a foal versus when they are older. She can even be recovered from anesthesia by hand at this size.
                    Read about my time at the Hannoveraner Verband Breeders Courses:
                    http://blumefarm.com/hannoveranercourse2011.html
                    http://blumefarm.com/hannoveranercourse2012.html

                    Comment

                    • Original Poster

                      #11
                      Originally posted by Polydor View Post
                      Would be interested in seeing pics as well. It kind of sounds like what one of yearling filly has which has stumped us and vets. Her hock slowly swelled and was pretty massive and odd looking but was never lame and never really hot. Just looked really weird.

                      She got it drained which seems to have helped. ( she was having surgery for something else anyways). Vets poked about her hock but never found anything per say.

                      P.
                      This can't be drained as it is a outpocketing of the actual artery...not a discrete structure like a hematoma.
                      Read about my time at the Hannoveraner Verband Breeders Courses:
                      http://blumefarm.com/hannoveranercourse2011.html
                      http://blumefarm.com/hannoveranercourse2012.html

                      Comment


                      • #12
                        Originally posted by Blume Farm View Post
                        http://www.blumefarm.com/images/452_20130524_175827.jpg

                        http://www.blumefarm.com/images/452_20130524_175724.jpg

                        It is difficult to appreciate in the pictures. The swelling/ bulge is on the distal lateral aspect of the hock, but before the cannon bone starts. It is definitely the artery as when you palpate it you can feel her pulse clearly and strong blood flow.

                        The problem with doing a wait and see approach is no one knows if it could be detrimental and possibly rupture. It is much easier and cheaper to do surgery as a foal versus when they are older. She can even be recovered from anesthesia by hand at this size.
                        Definitely can see the problem in the picture. I guess you will have to do what you feel is best for the foal. Sending many jingles to you and your filly.

                        Comment


                        • #13
                          Well, I have no experience with something like this, but what you say makes sense regarding doing surgery now. That's an area that often gets scuffed or banged and I'm assuming that a rupture of the aneurysm from such trauma could be very serious.

                          I also think that there is something to be said for addressing things now because this does not sound like something that would resolve on it's own. If you do nothing and it doesn't resolve, what will you do with a three year old with this same problem? The horse won't be saleable and I'm not sure you would want to invest money in breaking and training when the horse wouldn't be saleable and would be at risk for a rupture of the aneurysm with exercise, trauma, etc. The horse would probably be a guaranteed pasture pet.

                          There may be some risk of doing the procedure--I'm not a vet so I couldn't speculate about how much risk there is--but it seems to me that young horses often recover well from odd things. It may be that a young growing horse would have a better chance to develop alternate blood supply as it grows than a more mature horse.

                          Best of luck with your foal and your decision.

                          Comment


                          • #14
                            Wow.
                            Sorry, but that *is* interesting!

                            Maybe they could call in a vascular surgeon (MD) to give a consult?
                            "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                            ...just settin' on the Group W bench.

                            Comment


                            • #15
                              Jingles for your mare and Brilly the filly.

                              Can they do the dye and CT scan without full anesthesia? If you had that additional information re collateral vascular supply or not, it would make the decision about whether or not to ligate a lot easier. As in, yes or no. And if the vets are uncertain after CT, well, jeeze, I assume they would err on the side of NOT ligating.

                              One step/decision at a time can help reduce the tmi/brain racing with possible hypothetical scenarios/decisionmaking stress. But that's a big do as I say, not as I do for sure

                              Good luck!
                              http://www.facebook.com/pages/Easy-K...22998204542511
                              http://www.easykeeperfarm.com

                              I can ride my horses without a sharps container.

                              Comment


                              • #16
                                Ineresting. Do they put vascular grafts in horses? Can't imagine why they couldn't.
                                What I lack in preparedness I make up for in enthusiasm

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                                • #17
                                  I had a yearling filly that had one on the artery that runs down the front of her LH cannon. Because of it we couldn't sell her so we kept her and ran her. We retired/sold her at 4 and up until then it never bothered her. We have no idea what caused it. She just had a squishy bump there. It did seem to get smaller with age.

                                  ETA for her they told us surgery was not an option

                                  Comment

                                  • Original Poster

                                    #18
                                    Well I have been in contact with surgeons at UC Davis (my alma mater) , Cornell, Atlanta Equine and Rood & Riddle. Thus far no one has ever seen such a thing

                                    At the moment some feel that it might not be a true aneurysm as that has never been documented in a horse in this location. So we are probably going to go ahead with the CT to map her vasculature and see if we can determine exactly what is the abnormality. Dr. Hopper felt that it most likely could be ligated as there is enough collateral blood supply to the limb.

                                    This is a keeper filly for me so i don't have to worry about resale issues, but I do want a rideable mare one day Other than this "defect" she is quite nicely put together and has beautiful straight legs. Thus far I have only seen her canter (and buck, and twist, and leap) but boy can those legs stretch out. One day I hope to see her trot!
                                    Read about my time at the Hannoveraner Verband Breeders Courses:
                                    http://blumefarm.com/hannoveranercourse2011.html
                                    http://blumefarm.com/hannoveranercourse2012.html

                                    Comment


                                    • #19
                                      Very interesting! Good luck. I can't see why such a thing couldn't be ligated or coiled, provided it actually is a true aneurysm.
                                      Click here before you buy.

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