de-nerving.... your opinions?

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spacefaer

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Short and to the point

Got a horse with arthritis in his coffin joint. The joint medication he's had successfully in the past has ceased to work (injected 3 weeks ago with no improvement in soundness)

The vet came today and recommended denerving him.....

has anyone direct experience of this? Does it work? Do they come sound? What are the implications?

PM me if you'd prefer :)
 
He's 17 and otherwise extremely fit and well (it's only one leg that's crocked) the vet was impressed with how good the rest of him was.

I don't know whether it's an option - I'm trying to find out more about it to begin to be able to make a decision.

He's not currently hacking sound so we have to do something. Otherwise it's take his shoes off and turn him out which seems a shame when the rest of him is so well.
 
This was something that was a possible option with my mare - she had a tear in her DDFT and it was really the last resort. She had pain/inflammation in her navicular bursa and had 2 injections into this. The first one only lasted 2 months and touch wood, the second one was done in April and shes stayed sound so it never came to making the decision. My vet told me she would need an mri scan to be sure nothing else was going on before the de-nerving was done. Dont know whether you would have to go down that road. A pony on our yard had it done in both front feet as it had navicular and the owner told me she never looked back. If your vet is suggesting this to you he must be happy that there is nothing else going on as its a big step. I do know you have to be careful where you ride and be watchful for other things like abcesses. If your horse if fit and healthy in every other way then I see no problem with the procedure so long as its not going to cause another problem in relation to the coffin joint. Another horse on our yard had arthritis in his coffin joint and after various courses of treatment that didnt work he unfortunately was pts. He was hopping lame.

Only you and your vet know whats best for your horse to make the decision. As long as your horse is comfortable and happy thats what is most important. Im not a vet but I would presume your vet is recommending this procedure as the arthritis is not too serious.

Good luck with it. x
 
This was an option for my boy who has a chipped nav but luckly the injection worked. Tbh if id hadnt i dont think i would have went down the de nerving route as vet said that he would only beable to hack and can cause them to trip and mine really does hate hacking!! If you de nerve the foot does it not mean they cant feel there foot??
 
our mare who was 17 was denerved and it was the best thing we did, no more medication and she could return to having a normal life with no box rest or injections. What do you have to lose? we did use it as a last resort after injections etc and we were very happy with the results. We returned to normal work and nearly qualified for Olympia in the veterens coming 2nd. She never tripped or got any of the side effects of it.

The lameness can re-occur though but we got a year and a half out of doing it where she was completely pain free. Well worth it to me. Especially if you say your horse is fit and healthy.
 
De-nerving a foot is quite a biggie. You essentially will have the horse loose the entire feeling in that foot.

Benefits would be you have a horse that is pain free and able to continue a working existance, which lets face it is a huge plus.

Downsides. The minor ones are the costs and the GA risk. The bigger ones are what level of work you expect a horse able to do (certainly these horses are excluded from BE, and I would suspect BSJA too). I really do think that you would be silly to expect a horse to jump. However hacking and dressage should be do-able.
In addition to work load you will need very careful management of the horse after the op, by this I mean footcare and observation. The horse will not be able to feel bruising, pus etc and whilst most things aren't going to be a real problem you will need to keep an eye out. Also bear in mind that by riding a horse with degenerative damage you will just increase the speed at which this degeneration continues.
It has also been known for nerves to re-grow, so you might find yourself with a short term fix but having to PTS down the line.

I'm not for or against specifically. I think it is an option to consider if you would prefer your horse to have a shorter life of higher quality (ie pain free and ridden) and are prepared to pay too!
 
I'm one of those wafty barefoot people, so I suspect I'll be shot down in flames for saying this but....

...why not do (half) of what you mention above - take the shoes off, get a good trimmer, and if you can, gently exercise the horse (using boots if there is any footsoreness). I can't see that it would do harm to try, and presumably you will exhaust any possibility before going down the drastic route of de-nerving.

I have no experience of this type of condition, but there are so many reports of horses showing what could be described as miraculous recoveries once they are in a good barefoot management programme, that it would seem an obvious first route. I did manage post-operative laminitis earlier this year barefoot, which was against the vet's advice - I just read lots about it and went for it and I'm very glad I did as the horse has recovered extremely well without going insane on box rest. The reason for the operation would give me much pause for thought in your situation too - she had developed septic pedal osteitis as a complication of an abscess. There are several old posts on here about it, but basically by the time she showed any pain, the bone was already infected and she had to have a chunk of her pedal bone removed. She is now back in full work, but if she hadn't shown the pain I dread to think what would have happened inside her foot. The abscess track wasn't at all obvious either, the vet couldn't find it on her first visit and it took quite a lot of searching with a hoof knife before we eventually did find it.
 
Against it, dont know the whole ins and outs of the horse sorignal condition but a horse my friend was riding for someone had been denerved not sure why but obviously then the horse never showed and problems being lame and was given the all clear to be ridden etc, eventually the coffin joint totally disconnted from the horses leg and the horse had to be destroyed anyway after what was a pretty traumatic time for the owner apparently its entire foot and lower half of its leg just started to disconnect and some of the pedal bone started to come through the base of the horses hoof
 
ihatework said:
De-nerving a foot is quite a biggie. You essentially will have the horse loose the entire feeling in that foot.
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To be fair, that's not quite accurate. Perhaps there are still people out there "high" and "low" nerving as in the days of yore, but the only operation I've seen/heard of in the last couple of decades affects only the back portion of the foot, so there is still feeling in the toe. Also, the real horror stories, of horses losing feet to infection etc. seem to be mostly hold overs from those old practices. Not that that makes modern de-nerving any less of a difficult decision, just to clarify.

I'm not for or against specifically. I think it is an option to consider if you would prefer your horse to have a shorter life of higher quality (ie pain free and ridden) and are prepared to pay too!
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Very true. The other consideration, in my book anyway, is a horse retired/turned away in pain is still a horse in pain, regardless of whether or not it's as obvious to the people around it when it's not being ridden. (No idea if this is pertinent in this case, it's just one of my pet peeves when people turn away crippled horses even if it's not the work causing the problem and/or likely to heal with rest.)

Also, there are quite a few indication for neurectomies and similarly invasive surgical techniques for other degenerative conditions, such as PSD, these days, which people seem much more likely to consider favourably. I'm not saying this is good or bad, just that foot de-nerving seems to carry more "baggage" than other procedures, perhaps because of its long and sometimes gruesome history.
 
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I think it's very much a matter or personal opinion. My horse had neurectomy for PSD, and came sound (eventually!) for nearly a year, but has now gone lame again and is having to be PTS because the ligaments have deteriorated badly to breaking point but he can't feel them being so bad so there's nothing telling him he should be taking it easy.

I was discussing it with my OH and said I don't think I would de-nerve again, as of the 3 horses I know who've had it, 2 were put down within 18 months. But, as my OH said, it comes down to money and quality of life. If you can afford the op, and if quality of life will improve for a short while then maybe trading QoL with longevity in less comfort, is a sensible option.

Good luck whatever you decide. I wish horses could just tell us what they'd prefer. It's so much responsibility making these decisions for them.
 
I considererd this re. Tiggy, before I realised how bad her condition was and it wasn't an option anyway.

Anyhoo, having given it much thought, and researching a great deal, I decided against it.

Pros: she could be worked, rather than be a field ornament.

Cons: likely to grow back and we'd be back to where we were, with all the attendent issues and stress, etc.

I could not balance risking her life, with those attendent risks and issues, just so as I could ride her. She had a nerve there for a reason. Stopping the pain wasn't going to solve the issue but merely mask it. If, however, cutting the nerve would have cured her and there weren't any other complications, i.e. no chance of it growing back or of the original condition getting worse, then yes, I would have gone for it.

She was a young, beautiful, fit and lovely horse. I would have happily kept her as a field ornament, just to go and talk to and spend time with. Losing her was devastating.
 
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