Aaargh, think I might have to PTS my in-foal mare

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scarymare

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Hi all

I posted on here 3 weeks ago with horrific pictures of wire injuries to my broodmare. My vet now advises that it is not healing properly and he would like to try skin grafts or refer her to a horspital for the same. Estimated costs could run close to £7K. He is not optimistic of a positive outcome. If the operation fails, he would try to keep her going until the foaling but doubts if she would sustain the high demands of having/feeding a foal without a significant risk of constant wound opening and risk of septicemia. This vet is already a second opionion as I have sacked my initial vets whose handling was incompetent to say the least and this has made things so much worse. She was inseminated on 14th April so is almost 6 months gone. I'm really in a quandry but could definitely not manage an orphan foal. The market value of youngstock atm is pretty low, even for horses of her calibre (£1000 stud fee too). Sorry to bring this down to numbers but I am not a bottomless pit and bills already close to £2K. Pointless post really - anyone got any ideas (no judgemental ones please as I'm already doing that myself). BTW she is 8 and has a permanent ligament injury.
 
Based on the maths alone
currently
1k stud fees
2 k vets fees
300 squid PTs costs

with treatment [ & as you say no great prognosis]

1 k stud fees
2 k vets fees
7 k additional vets fees

& whatever additional costs for hand rearing foal & all the additional issues linked to hand rearing

i dont know what the sale profit from young stock would be - i suspect not enough to cover your costs [ please forgive me if I am wrong]

& what would you do with the mare afterwards - given a better outcome then current prognosis & is that a real choice for you???

sorry, if this read as blunt, best wishes
 
Apologies if these are tupid questions, but could the poor healing be due to her providing for the development of a foal? If so if there anything you can feed/do to help this?

Other than that - with a permanent injury to her (ligament) and a not so good outlook, I'm think PTS should be a seriously considered option :(
 
Hi, I too had a mare who severed her hock (hitting all structures,) on wire it was absolutely horrific. I havent seen the original photos you posted but am guessing it will be along the same lines. My vet also wanted her to have skin grafts etc. We used Alu Spray to keep the wound covered and it took 18 months for the wound to heal (it always was very weak following healing) and she was never 100% sound again. However, we did manage to pull her through..(without skin grafts)

I dont know if you have an experience of the National Foaling Bank, and Joanna Varden (SP?) but it may be another option if you want to save the foal (and yourself a lot of effort and possibly heartbreak) they should be able to find a mare to "adopt" your foal. Sorry if I am teaching granny to suck eggs and you know all this, I just thought it might be worth mentioning.
 
Silly question but when the vet says its not healing properly is it still healing all be it at a slower rate I am sure as shes in foal and 6 months the foal will be making more demands on her now. I would be feeding her Iron rich foods just to help the healing along could she be aneamic?
 
Thanks for all the replies. Thankfully she is remaining very positive in herself and not objecting to the box rest. I think the problem is the sheer scale of the injury and a smell which is distinctly gangrenous (had a cat RTA with this). If she was down in herself this would be a very easy decision. I just dont want to carry on and on and put here through any more if it all ends in tears anyway. Vet says its my call which of course it is. He says if she were his he would try (but then he's not facing having to get a 5 figure bank loan). Interesting point about the feeding though. She's on ad-lib haylage and D & H pasture mix - I'll look for supplements now.
 
angrovestud said:
Silly question but when the vet says its not healing properly is it still healing all be it at a slower rate I am sure as shes in foal and 6 months the foal will be making more demands on her now. I would be feeding her Iron rich foods just to help the healing along could she be aneamic?
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I was thinking this. When my old horse did a tendon I was told it wasn't healing properly and PTS was presented as the sensible option. It certainly took longer than expected but it got there (or something like) in the end.

But if it's healing so slowly that she's likely to re-injure it during birthing or when the new foal is born then maybe the sad but right thing to do is to let her go.

I know nothing about the success or long term implications of a foal being "adopted" so can't comment on that.
 
I was wondering whether it may be a good idea to post this in the breeding section. They should be able to give you good advice about your mare and what she can and cant have being a broodie. Best of luck, i hope it turns out well in the end. Out of interest did she do any damage to the tendons etc?
 
Allover said:
I was wondering whether it may be a good idea to post this in the breeding section. They should be able to give you good advice about your mare and what she can and cant have being a broodie. Best of luck, i hope it turns out well in the end. Out of interest did she do any damage to the tendons etc?
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No, she didn't which makes it even more gutting.
 
Our mare has taken over a year for hers to heal. It then healed with massive proud flesh so That had to be cut off and we had to start again.its almost healed now. Three weeks is not all That long.good luck. X
 
ok bear in mind i tend to think outside the box,

i have a couple of suggestions

1, just wondering if a swab has been taken from wound, if you can target the antibiotics to the correct bacteria this will help with the infection control better.

2,
also other things to consider are the type of wound dressing, maybe trying something like this

http://global.smith-nephew.com/master/ACTICOAT_27517.htm

3. also maybe the use of medical maggots, http://www.monarchlabs.com/veterinarians.htm

which i know is a usa website but you can get this sort of thing in the uk. they eat the rotton flesh you just have to make sure you count the number on and count the number off


hope you find the correct treatment for this mare :)
 
Are there any signs at all of epithelialization (fresh pink tissue growth) at the wound edges? If there are then it may be worth trying some Vulketan. My mare had an slow healing wound, but once we started using it she was able to be turned out less than a week later.
I have to say I wouldn't go down the skin graft lines. but this decsion is going to be made even more heartrending by the presence of the unborn foal. For the foal to have any chance at all it needs to a minimum of 300 days, & even then it would be very touch and go. I've been present when a premature foal has been cut out of a dead mare & whilst it wasn't a nice thing to have to witness, we did save the foal. It was almost full term though.
I'd be looking at seeing if there was anyway the mare could be kept comfortable enough to continue without the skin grafts. Long term bute could be an option - I foaled a mare who was on two bute a day for the whole of the gestation period due to a really deep overreach that refused to heal & the foal was fine. (The mare was PTS once the foal was weaned though)
Feel free to PM anytime if you just need a sounding board, or someone to chat to who'll understand how hard this must be.
 
hollyandivy123 said:
ok bear in mind i tend to think outside the box,

i have a couple of suggestions

1, just wondering if a swab has been taken from wound, if you can target the antibiotics to the correct bacteria this will help with the infection control better.

2,
also other things to consider are the type of wound dressing, maybe trying something like this

http://global.smith-nephew.com/master/ACTICOAT_27517.htm

3. also maybe the use of medical maggots, http://www.monarchlabs.com/veterinarians.htm

which i know is a usa website but you can get this sort of thing in the uk. they eat the rotton flesh you just have to make sure you count the number on and count the number off


hope you find the correct treatment for this mare :)
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Thanks - I too think out of the box and have invested 100's in various dressings etc, none of which my vet wishes to use. If the snow comes early I could always turn her out I suppose, that's what would happen in countries like Austrailia/Argentina I think
 
following on from hollyandivy ive heard marvellous thing about honey poulticing for wounds then trimming the proud flesh weekly ,its slow but really works. (((big hugs)))
 
Zebedee said:
Are there any signs at all of epithelialization (fresh pink tissue growth) at the wound edges? If there are then it may be worth trying some Vulketan. My mare had an slow healing wound, but once we started using it she was able to be turned out less than a week later.
I have to say I wouldn't go down the skin graft lines. but this decsion is going to be made even more heartrending by the presence of the unborn foal. For the foal to have any chance at all it needs to a minimum of 300 days, & even then it would be very touch and go. I've been present when a premature foal has been cut out of a dead mare & whilst it wasn't a nice thing to have to witness, we did save the foal. It was almost full term though.
I'd be looking at seeing if there was anyway the mare could be kept comfortable enough to continue without the skin grafts. Long term bute could be an option - I foaled a mare who was on two bute a day for the whole of the gestation period due to a really deep overreach that refused to heal & the foal was fine. (The mare was PTS once the foal was weaned though)
Feel free to PM anytime if you just need a sounding board, or someone to chat to who'll understand how hard this must be.
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Thanks - I may just do that - its so frustrating. No sign of significant granulisation/epithelia formation as yet. I suppose the foal wont know anything anway - its already been sedated 6 times.
 
You dont say what treatment is currently being tried, has a swab been taken?
i had a mare that wouldnt heal and she needed a different antibiotic,immediate improvement.
As said three weeks is not long for such an injury,I would think it is way too early for skin grafts , I read on here not long ago,but cannot remember where exactly, about salt water spraying for larger areas could be worth finding out more.Vets tend to have a medical approach to everything and often thinking outside the box brings the solution when other routes are not helping.
The honey treatment is also worth trying, again not all vets will agree,but many do use it with excellent results.
If she is still well in herself it makes sense to continue treatment until either she is not happy or you have to spend silly money,I would not do that it does not make economic sense.
 
I would not go for the skin graft on the other hand I wouldnt shoot her either. Manuka honey is used at East Grinstead burns hospital with great results. I know its not cheap but give it a go. I think you have invested so much that it would be a shame to give up now. Good luck.
 
lionman said:
I would not go for the skin graft on the other hand I wouldnt shoot her either. Manuka honey is used at East Grinstead burns hospital with great results. I know its not cheap but give it a go. I think you have invested so much that it would be a shame to give up now. Good luck.
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I've got 12 tubes of medical grade Manuka Honey in my kitchen. Vet sympathetic but says the injury is just too big. There wasn't enough skin left to heal it. TBH its outside every one's experience. I think my first vets were relieved when I took her away. The fact its on her hock is of course a huge issue. All of the reasons I brought her as a broodie - huge movement, youth etc all seem to be conspiring against her really. Her cup is half full though, and she's trying and its very difficult to shoot them when they are doing that.
 
Well, I'd say if you have already bought the alternative treatments, then you may as well give them a go? And I would really look into a supplement of some kind if you haven't already :)
 
Stencilface said:
Well, I'd say if you have already bought the alternative treatments, then you may as well give them a go? And I would really look into a supplement of some kind if you haven't already :)
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Agreed. However she is a 16.3 WB and isn't that keen on anybody touching her unhock (understandably). Before I changed vets I could manage to wash it with saline without mortal danger but wouldn't have been able to do more than that I'm afraid, and the more sedation she gets, the more chance of damage to the foal. (I'm already calling it Junkie tbh - black humour I know).
 
Try the honey, my Boy had a similar but much smaller loss of skin 2 and a half months ago (also lower down so easier to protect/cover).

This is it after a coupe of weeks of manuka honey dressing:

http://www.flickr.com/photos/redlaura/5978032570/

He had a skin graft a couple of weeks later (punch graft) and is now finally without bandages, the skin is growing and it's covered by a protective white (zinc?) spray. It has healed amazingly and I know it's a lot smaller than yours but the honey/graft/zinc spray might be worth trying esp if you have it already. It does take an awful length of time to heal as it has to heal outside in (hence why the skin graft can help as it also heals inside out and speeds it up).

Good luck in whatever you decide :)
 
I've just had a look at your other post with the photo.

My TB had exactly the same injury to his hock, almost de-gloved himself bar 1 inch of skin, many years ago. Unfortunately it wasn't a good outcome. Vet was excellent patched him up, he healed very slowly, left a huge scar, was never 100% sound.

Lost him almost a year later due to him putting an excessive amount of weight on his front legs, to 'save' his injured hock. He had typical bad flat TB feet. Ended up with chronic pedal ostitis, deteriorated rapidly and never recovered.

Be guided by your vet.
 
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