Letting nature take its course?

My heart goes out to you it really does. I have been following your story willing buzz to get better. Your love and affection for him shines through in each of your posts.
On paper it's easy for everyone to say pts but we all, as dedicated owners know our horses well enough to see when they are giving up or recognise when they are suffering. In my opinion as long as you stay true and close to that, then as someone else said- when there is life there is hope. Good luck, he is so lucky to have you and I for one respect your dedication and strength. We are all rooting for you's
 
Another who has followed your story and had hoped for the best for Buzz and you. I tend to agree with Gamebird ( I am ITU trained and have seen far too many humans suffer) but will add that in my personal experience with horses they can let you know when they are ready to leave their eye changes almost asking you to do the last and kindest thing for them . So hard thoughts are with you
 
Am I right that in your previous pics they didn't manage to get the whole tumour out during surgery? I do think if his jaw/ability to eat doesn't improve quite rapidly and that the chances of the cancer returning may not be eliminated I would be serious consideration to his future. I do think it is different with animals than people when you can't explain to them what is going on.
 
I am so very, very sorry - you've done so much for your much-loved horse. There's no harm in just giving him one more chance with the grazing. As others have said, you'll know when it's not right and he'll let you know that enough is enough. Huge hugs and I know that you'll make the right decision when it's the right time to make it! Be brave.
 
googol said:
My heart goes out to you it really does. I have been following your story willing buzz to get better. Your love and affection for him shines through in each of your posts.
On paper it's easy for everyone to say pts but we all, as dedicated owners know our horses well enough to see when they are giving up or recognise when they are suffering. In my opinion as long as you stay true and close to that, then as someone else said- when there is life there is hope. Good luck, he is so lucky to have you and I for one respect your dedication and strength. We are all rooting for you's
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Unfortunately I have seen to much of people's desire to hang on to a beloved pet, to the point where one dog was hairless, blind, incontinent and falling down steps. I'll be bluntly honest, if this were my horse I would have him PTS. The quality of his life has gone, he is only able to suck soaked cubes, if he can't chew those, how is he able to chew grass? His jaw can only open 4 cms, how can he graze the grass. He is in pain.

Give him what he deserves from you, a chance to leave this world with dignity and still carrying weight. If you let him go now you will remember him as the plump shiny horse that you have loved so much. If you let him go on and he loses weight how are you going to remember him, thin and distressed.

The decision is yours and I don't envy you, I will one day be in the same boat with my beloved Serenity, but I know I couldn't let her linger if I knew she was in pain. I love her too much to let her suffer.

(((((HUGS))))))
 
I have nothing to add except ***hugs*** and sympathy for you - it's a very difficult decision and I think everyone on HHO has been willing Buzz to get better. Good luck, you have both been so brave through all of this.
 
I have been following your story and rooting for you and buzz. What an awful situation to be in when you've come so far but he's your horse and you know him best. He actually looks really good considering but as others have said, they are designed not to show weakness until they really can't go on so bear this in mind with the decision you make.
If he were mine I think I would give the injections a try, they will either work or not, but if not I wouldn't be keeping a horse that was unable/found it painful to eat. Massive good luck wishes coming your way that the spasms are fixed and that you get good news in 5 months time.
 
I am so sorry to read this latest update Twiglet.

I too would probably give him one last chance with the muscle relaxant....if no improvement though I know what my decision would be.

Big hugs. x
 
ester said:
Am I right that in your previous pics they didn't manage to get the whole tumour out during surgery? I do think if his jaw/ability to eat doesn't improve quite rapidly and that the chances of the cancer returning may not be eliminated I would be serious consideration to his future. I do think it is different with animals than people when you can't explain to them what is going on.
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The main treatment was the radiotherapy - the surgery was about debulking the mass of tumour visible in the mouth, and making it more comfortable for him (which it did do, it reduced the size in his mouth enormously).

The cancer itself is a bone cancer, so grows and lives in the bone itself, and surgery isn't an option there as it would involve removing the affected bone - commonly in dogs, it's the hind leg that's affected, so amputation is the first port of call - which isn't an option with the mandible, as would remove his whole lower jaw.

So the treatment plan was always around surgery to improve what was outside the bone, and then a specific course of radiotherapy, guided by a huge number of CT images showing the jaw from every conceivable angle, to zap the tumour inside the bone. This type of radiotherapy is very much a slow process - from my very limited knowledge, and I stand to be corrected by more scientifically minded people! - it involves killing the malignant element of the tumour, and preventing the cells from multiplying, which takes place gradually, after the course has finished, hence why we can't CT again until August.

Prior to this jaw spasm, the last mouth exam showed a reduction in the size of the visible tumour, and an improvement in the surface quality - which previously had been a horror show of decaying dying flesh (hence the smell that first alerted us to an issue) - to healthy pink flesh, all of which points to the radiotherapy starting to do its job.

Whilst it's a rare and somewhat pioneering treatment for this kind of cancer (in this country anyway), the best case scenario is a 'full cure'. In theory this treatment can cure this cancer, and enable him to have a normal life, and that's what I'm aiming for by continuing with treating him - not keeping him alive to remain in pain and unable to eat. I am hoping against hope that these are short term issues - if they weren't, there wouldn't be a question. The spasm is unexplained, and could be a result of the treatment, or the cancer, but it is the main factor in his current troubles.

If these injections work, and the jaw is released, then he will in theory be able to eat again, and the pain will be significantly less.
 
Thank you again for all your replies, I do really appreciate people taking the time to share their experiences.

The vet was out last night to administer the third dose of the muscle relaxant (which can cause depression and lethargy - I think I'm getting the side effects on his behalf!!) - at the time he was being hand grazed by a friend - and the vet was pleased with his ability to get to the grass, which is positive. He also threw a bit of a tantrum - although Buzz style tantrum involving some mild squealing and standing still - at being taken back to the stable.
 
Reading your post above brought up a few more thoughts, the jaw spasm is an unexpected complication, could it relate to the fact that he cribs, is he cribbing more due to being in, having the drugs etc, has he had gastrogard or any other supplement recently to help prevent ulcers which may in turn help reduce the cribbing? turning him out may stop the cribbing and allow the jaw to relax.
The prognosis and results so far sound encouraging, I can see why you really want to continue having come this far.
 
Twiglet said:
Thank you again for all your replies, I do really appreciate people taking the time to share their experiences.

The vet was out last night to administer the third dose of the muscle relaxant (which can cause depression and lethargy - I think I'm getting the side effects on his behalf!!) - at the time he was being hand grazed by a friend - and the vet was pleased with his ability to get to the grass, which is positive. He also threw a bit of a tantrum - although Buzz style tantrum involving some mild squealing and standing still - at being taken back to the stable.
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Crossing all fingers - and making Apollo doing some half pass as well for luck - God, I hope he comes right!
 
amymay said:
So ultimately, there will be no successful outcome.
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What makes you say that? The best case scenario outcome of this treatment would be a non-recurring benign tumour, causing no discomfort or effect on him on a day to day basis. If it works - and admittedly it's a big if - he could return to a normal life, able to eat, work and compete. His Cambridge vet has always said her aim is to see him eventing.

I know you're trying to help, but you're not a vet, and you're not treating this horse, so statements like that are actually not particularly useful - and are contradictory of the oncologists and surgeons treating him.
 
be positive said:
Reading your post above brought up a few more thoughts, the jaw spasm is an unexpected complication, could it relate to the fact that he cribs, is he cribbing more due to being in, having the drugs etc, has he had gastrogard or any other supplement recently to help prevent ulcers which may in turn help reduce the cribbing? turning him out may stop the cribbing and allow the jaw to relax.
The prognosis and results so far sound encouraging, I can see why you really want to continue having come this far.
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I have no doubt that the cribbing doesn't help - the stress it puts on the jaw (and his door!) must be pretty extreme. But prior to all this he was scoped and found to be totally clear of ulcers, and have no visible digestive issues that could be a factor in the windsucking. He didn't do it prior to his 4 yr old year, and only then on moving to a dressage yard with no turn out, so I'm inclined to think it's behavioural.
 
OK so the cribbing was possibly a reasonably big chunk of info missing at the beginning! And I do agree his coat looks good in the recent photo.

That said I do think you need to be very clear in you own mind how far you are prepared to go in what could ultimately be a series of expensive and invasive veterinary interventions that ultimately could just prolonge the pain but don't change the outcome.

With the cribbing aspect I can see why you are considering the current option of injections and turnout. In your shoes my gut feeling is that I would try that. BUT with the big caveat that if there was no significant improvement in 'X' amount of time then the horrible alternative should be done.

I am not an ARC equine supporter. But should this be something your vet suggests (which I doubt) then I have one sat here at home not in use that you are welcome to.
 
ihatework said:
OK so the cribbing was possibly a reasonably big chunk of info missing at the beginning! And I do agree his coat looks good in the recent photo.

That said I do think you need to be very clear in you own mind how far you are prepared to go in what could ultimately be a series of expensive and invasive veterinary interventions that ultimately could just prolonge the pain but don't change the outcome.

With the cribbing aspect I can see why you are considering the current option of injections and turnout. In your shoes my gut feeling is that I would try that. BUT with the big caveat that if there was no significant improvement in 'X' amount of time then the horrible alternative should be done.

I am not an ARC equine supporter. But should this be something your vet suggests (which I doubt) then I have one sat here at home not in use that you are welcome to.
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Ah yes, sorry - massive windsucker, mainly around feedtimes (which was what pointed to ulcers, but he was totally clear), and will do it on anything in the vicinity - water drinker being his favourite. Has tried windsucking on my head in the past. Never got to the bottom of why, but it does appear to be his favourite thing (interestingly, far less so in the field). It definitely doesn't help the jaw.
 
Leg_end said:
You know Buzz better than any of us on here and you will know when it's time. There is usually a subtle shift in behaviour that probably only you would notice, but it happens, and that is the moment to make a decision. Trust your gut - if you are thinking about it seriously then its time - and whoever said 'better a day too early than a day too late' is spot on.

You are both in my thoughts x
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Absolutely this. It's really hard to remember that you know your horse better than anyone else and you find yourself wanting validation of your decision from others.

This is a horrible situation to be in - there is hope maybe and you don't want to give up on that. If he still seems happy and bright in himself then I agree. FWIW though - in the vids of him tanking about I didn't see a particularly happy care-free horse - I saw a horse being shoo-ed around the arena and kicking out towards the person and avoiding the poles nearest the camera. But I don't know him...
 
AshTay said:
Absolutely this. It's really hard to remember that you know your horse better than anyone else and you find yourself wanting validation of your decision from others.

This is a horrible situation to be in - there is hope maybe and you don't want to give up on that. If he still seems happy and bright in himself then I agree. FWIW though - in the vids of him tanking about I didn't see a particularly happy care-free horse - I saw a horse being shoo-ed around the arena and kicking out towards the person and avoiding the poles nearest the camera. But I don't know him...
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Ha. Not quite...this is the previous vid - I'm on the other side of the school with my back to him - he puts himself into trot and trots over the poles (which were out in the school when we got there, I didn't ask him to go anywhere near them). Before turning round and doing it on the other rein. Not exactly being chased or shooed around is he?!
https://www.youtube.com/watch?v=1saRCEt02P8

This horse has a minimal work ethic - his attitude to jumping is 'if in doubt, run out'. If he doesn't want to go over something, nothing will make him do it. Yes he bucks and kicks out, but then he had just landed on the poles - and squealing! This was a good display of attitude and energy from him, it was refreshing to see him being cheeky.
 
ihatework said:
With the cribbing aspect I can see why you are considering the current option of injections and turnout. In your shoes my gut feeling is that I would try that. BUT with the big caveat that if there was no significant improvement in 'X' amount of time then the horrible alternative should be done.
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That's how I would feel I think, I wouldn't want to leave him too long with a jaw in spasm limiting his eating beyond that of the original problem.

Thank you for the fuller description of what went on treatment wise twiglet.
 
Twiglet said:
Ha. Not quite...this is the previous vid - I'm on the other side of the school with my back to him - he puts himself into trot and trots over the poles (which were out in the school when we got there, I didn't ask him to go anywhere near them). Before turning round and doing it on the other rein. Not exactly being chased or shooed around is he?!
https://www.youtube.com/watch?v=1saRCEt02P8

This horse has a minimal work ethic - his attitude to jumping is 'if in doubt, run out'. If he doesn't want to go over something, nothing will make him do it. Yes he bucks and kicks out, but then he had just landed on the poles - and squealing! This was a good display of attitude and energy from him, it was refreshing to see him being cheeky.
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Proves my point - you know him best, better than the vets, better than others on your yard and certainly better than anyone on here :)
 
Twiglet said:
Was a good chance to go back through old vids though....turns out the kicking out isn't cancer related, it's just his attitude :p Although maybe my dodgy placement of the headcollar could have caused the tumour - not quite sure what I was thinking!

https://www.youtube.com/watch?v=yuBs1DGGv7s
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What a beautiful horse!! (shame about the headcollar, lol). He was showing off to the mirrors - he then properly checked himself out in the mirrors the next time round.
 
The very best of luck with him, he's beautiful and deserves a chance. Considering what he's been through he's looking very well. I do hope he comes right.
 
AshTay said:
What a beautiful horse!! (shame about the headcollar, lol). He was showing off to the mirrors - he then properly checked himself out in the mirrors the next time round.
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He remains a total tart in that sense....if he was a person I think he'd be on Made In Chelsea....or more likely The Only Way Is Essex :p
 
This must be so hard for you. It's always difficult in these situations to know how long to carry on for but if the vets can offer you a realistic hope of cure then you just need to do everything you can to keep him comfy in the mean time. If he'll find it easier to eat longer grass then that would be best but if he'll struggle then he's best off carrying on as he is. If his good days start to be outweighed by the bad ones then it might be that things need to be reassessed.
 
In the end you are the one who knows Buzz best and from everything you have posted you are aware of what may be the eventual outcome. I am a great believer in gut instinct, and if your gut is telling you to give him this chance then I would go with it, because you obviously are not blinded by unrealistic expectations.

I really hope it works, but if it doesn't I have no doubt that you will make the right decision for Buzz, and will do it sooner rather than later.
 
I hope the muscle relaxant works well and he can be turned out to enjoy the grass.

To be fair to amymay bone cancer is usually (in humans and dogs as far as I know) a really invasive, really fast growing cancer that is managed only palliatively and there is no treatment for, but it may be different with this particular type of equine bone cancer. Have the vets given you a statistical probability of a complete cure, i.e. no recurrence of the tumour, similar numbers for the chance the tumour will return and within what time frame and the chances it will spread to other organs despite the treatment?
 
Booboos said:
I hope the muscle relaxant works well and he can be turned out to enjoy the grass.

To be fair to amymay bone cancer is usually (in humans and dogs as far as I know) a really invasive, really fast growing cancer that is managed only palliatively and there is no treatment for, but it may be different with this particular type of equine bone cancer. Have the vets given you a statistical probability of a complete cure, i.e. no recurrence of the tumour, similar numbers for the chance the tumour will return and within what time frame and the chances it will spread to other organs despite the treatment?
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Statistically it's very hard to say - the cancer itself is incredibly rare, and this form of treatment even rarer. Cambridge are the only place able to treat horses with linear beam radiation in Europe (I think) and only of only a handful in the world. So the number of horses suffering from this cancer AND able to access this treatment is tiny, and every case is very different, so it's not a question of being able to access hundreds of case studies to assess the chances. The surgeon I spoke to in the States (the leading surgeon of this kind of treatment) said "it's the only option but it's a good option". He - and the guys at Cambridge - have had success with this cancer in different places and this treatment.
In terms of metastising (sp) - there has never been a high chance of this with this cancer. It is likely to grow locally (without treatment) but it is not a cancer that spreads to other organs or systems.
With regards to how the radiation works - when it works, it reduces the chances of recurrence to virtually zero (again - based on minimal case studies, but it is a "cure" in that sense).
 
Nothing to suggest as I'm neither a vet or an oncologist but as before I am sending you and Buzz lots of hugs and best wishes. He is looking very well and I hope he continues to flourish; if he doesn't you will do the right thing by him I'm sure x
 
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