Blood Clot in a vein?!? (thrombophlebitis)

Char89

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Hi I'm wondering if anyone can help me 😓
My 4 year old mare has a blood clot on the inside of her upper hind leg. We suspect she was bitten or stung by an insect originally which caused inflammation and infection - treated with antibiotics, painkillers and steroids.
Pain - swelling and lameness came back after initial treatment, we took bloods, X-Ray's and scanned the area. X-rays fine, bloods slightly low indicating infection and scan showed the blood still moving but sludging through part of the vein (forming a clot) she went onto a higher dose of antibiotics, steroids and started her on asprin to try and thin the blood. This treatment went on for just over 3 weeks and she seemed to be recovering great so we started to gradually reduce the steroids and asprin (completely finished antibiotics). Once I got her to the stage of half dose of steroids and no asprin the swelling and lameness came back so the vet re-scanned the vein and it has clotted 😓 we have put her back up onto a high dose of steroids again (95 per day) and back on the asprin (1200mg per day) as well as applying Compagel directly onto the area twice a day (contains heparin and is absorbed through the skin) my vet has told me this almost never happens and is waiting to see what treatment is available for horses (medicine wise) as if she was human she would be givin heparin and warfarin but would be kept in hospital at first and if she was to bump herself she could bleed internally due to stopping the body from clotting. Not easy telling a 4 year old horse to take it easy and try not to bump herself! 😳 one specialist vet has come back with the suggestion of surgery under general anesthetic to strip the vein but I don't really want to put her through surgery unnecessarily if there is another option.

Has anyone had this before? If so what was the treatment and outcome for your horse? 🙏🏻
 
For humans the recommendation is to stay on aspirin for at least 3 months, sometimes 6 and is most cases they are put on proper anticoagulants (aspirin really doesn't work that well).

If she has a persisting/recurring clot they really need to be managing it more aggressively - if it breaks off and travels to the heart/lungs/brain it can be fatal. I don't want to scare you but you really need to get a second opinion from a specialist.

ETA - just seen that you have had specialist advice. If the specialist has said that the only option is to strip the vein then you do need to consider it... Have they considered inserting a clot filter and long term aspirin?

Eta2 - I dose warfarin for humans. I'd love to get involved in establishing and maintaining a therapeutic dose for horses.

Also consider a diet that is low in vitamin K - vitamin K helps with clotting and by lowering the levels you can impede clotting. In humans vitamin K is found in high levels in sprouts and other green veg.
 
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Thank you for your response EQUIDAE! Yes I am seriously considering the surgery as I need to weigh up my risks. I'm not sure how safe it would be to administer a horse with warfarin?? What would you think? I've also asked my vet if we can get another specialist opinion as I want as much information as possible before we go ahead. She has only just been broken this year and is going amazing, I have real high hopes for her career going forward and don't want to jeopardise that 😩. Also diet if there is anything I can do in that way that would be great. Where do I start searching for feed low in vitamin K? X
 
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