Atrial fibrillation, lame WWYD

[gregory123]

Really need some advice - struggling to make some tough decisions.

My 17hh 10 year old ISH went lame about 3 weeks ago - intermittent right forelimb, no heat, no swelling or hoof problem so took to the vet today for full lameness work up. He was only lame in trot and on a tight circle but I’d been finding him a bit doddery down hills.

They found him to be lame in both front feet on nerve blocking. They blocked the problem right foot only to have the other go lame. X-rays showed large side bones but no reactive changes. The vet was about to sedate for an MRI, suspecting navicular, when she found an irregular heartbeat.

An ECG followed and lo and behold he’s in atrial fibrillation. I have no idea how long for, but he seemed to really really struggle in the recent hot weather.

The vet wouldn’t sedate him for the MRI considering his heart rhythm and now thinks he should have an echocardiogram and medical cardioversion with quinidine.
We discussed the side effects and tbh it sounds awful. I really don’t want to put him through it, if he’s never going to be sound again but I can’t find out what’s causing the lameness without correcting the heart rhythm.

It’s so hard to know what to do. Friends have suggested PTS as he’ll not hunt or jump if not fixed and the prognosis for the two conditions is so poor. He’s quite a bolshy, stressy beast so quite an unsuitable field companion I would say.

Any suggestions, advice, experiences welcome.

 

[Meowy Catkin]

What an awful shock finding out that he has AF. Can you get a second opinion before opting for euthanasia? I think that I would definitely need to talk things through again and look at all the options.

 

[ycbm]

The foot problem is likely curable, especially if you can go for a barefoot rehab. I've no idea about the AF, but if the prognosis is poor there's no shame in calling it a day.
.

 

[splashgirl45]

my first horse who i had owned for 13 years and competed regularly fell and somersaulted while cantering on a smooth track out hacking , luckily i was thrown clear and was only bruised. i got the vet the next day as he had a couple of nasty looking wounds and vet said he had an irregular heartbeat and that could have been why he fell. he said either PTS or retire but def no riding. i retired him and PTS after 3 years for something else. i suffered with AF some years ago and it was sorted out with medication, not sure if that is an option for a horse..

 

[Mule]

A famiy member had an eventer with atrial fibrillation and like your own horse he wasn't medically fit to event. The horse would only be able for light hacking. He ended up getting another horse to event. He has land so was able to keep the horse with the heart problem as a companion horse.

The vet gave the option of quinidine treatment but said that it's not always effective. I can't remember why my relative chose not to get the treatment for his horse, but the impression i got was it's something people will try with a valuable horse but might cut their losses with a more everyday horse. There was an olympic dressage horse (Parzival) who had successful quinidine treatment, but you'd take the risk with a horse like that.

I've no advice really, i just thought I'd tell you about my experience with it. Pts wouldn't be the worst option if you decide against the treatment (you don't know that the treatment will work anyway) you could also sell as a light hack. If the horse is insured you could try the treatment and if it doesn't work then make a decision about his future. There's no harm in asking the vet what they would recomend, if they were in your position. I've always found the answer helpful. Take a bit of time to think over your options anyway.

 

[Britestar]

Friend has a horse who was diagnosed with AF at a lameness work up too.
She chose not to treat the AF. He's retired and barefoot, and his lameness improved significantly. Hes happy pottering around the field.

 

[Elf On A Shelf]

Denman, Sprinter Sacre, One For Arthur and Big River have all had AF. Arthur's corrected itself. Denman and SS were both electric shocked back into the correct heart beat. Big River was tried with Quinine and colicked badly before treatment could finish so he was then electric shocked a few weeks later.

All of these horses went on to race at the highest level again.

The quinine route is not one which I would take. It's a horrible process but cheaper than electric shocking them and would suit some horses better.

If your horse has had this for a while - and you say they haven't been quite right since the heat wave, then they are very unlikely to sort it out themselves. If they are going to it's usually within 24-48 hours.

There is no reason why your horse couldn't go on to hunt and jump again with treatment for the AF. But there is also no guarantee that the heart won't flip again. And that's before you get to the lameness issues.

 

[Pearlsacarolsinger]

We had an elderly retired cob who one recently qualified vet told us had AF, when she came to do vaccs, then the vet qualified dentist said she didn't think so. I got another opinion from the senior vet and cob was found to be absolutely fine. I have no idea whether the first vet was mistaken, or the heart righted itself spontaneously but I would certainly advise that you get a 2nd opinion before making any decisions.