OCD diagnosis, difficult decision to make

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MissyMew

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My 4 year old mare has OCD in both stifle joints. She has been x-rayed, scanned, nerve blocked and had steroid injections. It's now 8 weeks after her injections and today the vet came out to see her. She's unfortunately no better (this I already knew). She looks like she's in quite a lot of discomfort and is quite sensitive type. I have enough insurance cover left to cover an arthroscopy operation and a bit more after care but I think the "pot" will run out quite quickly. I don't think she will cope to well with a long period of box rest which may be required but this is an unknown until the operation. I am in a real dilemma as how to proceed, she is barley backed only 6 weeks ridden work. has anyone else got any experience of this operation and aftercare requirements. I am not on livery so all the post op care would come down to me.
 
MissyMew said:
My 4 year old mare has OCD in both stifle joints. She has been x-rayed, scanned, nerve blocked and had steroid injections. It's now 8 weeks after her injections and today the vet came out to see her. She's unfortunately no better (this I already knew). She looks like she's in quite a lot of discomfort and is quite sensitive type. I have enough insurance cover left to cover an arthroscopy operation and a bit more after care but I think the "pot" will run out quite quickly. I don't think she will cope to well with a long period of box rest which may be required but this is an unknown until the operation. I am in a real dilemma as how to proceed, she is barley backed only 6 weeks ridden work. has anyone else got any experience of this operation and aftercare requirements. I am not on livery so all the post op care would come down to me.
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Two horses at our yard has had the op one very successful and is back fully loving life jumping ect one was put to sleep on operating table too bad once they opened them up ;( but whilst listening to a vet about the rehab he said u can get a surgeon who will do two
Weeks box rest then out in the field! So u may not have long to rehab if u ask about this?
 
Thank you for the reply. I have asked the vets to ask the surgeon for more information on the rehab side, average times on box rest. My vets said that surgery has about a 70% success rate. But there are risks with the surgery itself. I know the surgery is a long shot but do I try? I don't think leaving her in the field is a viable long term option as she is becoming harder to handle/aggressive which I am putting down to her pain.
 
MissyMew said:
Thank you for the reply. I have asked the vets to ask the surgeon for more information on the rehab side, average times on box rest. My vets said that surgery has about a 70% success rate. But there are risks with the surgery itself. I know the surgery is a long shot but do I try? I don't think leaving her in the field is a viable long term option as she is becoming harder to handle/aggressive which I am putting down to her pain.
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If the insurance will cover it id try you've nothing to loose x
 
My mare had it when she was 2 years old. It affected both her hocks. It's now round 20 years ago and so the diagnostics where not as good as we have now. She was X-rayed (by Red Rum's vet). It was thought that she had grown too quickly and so he recommended turning her out for the winter, no rugs, no hard feed, and only shelter and hay. It was difficult because at the time a friend was looking after her as I was going through a divorce and had sold my land and stables.

A year later, having survived the winter very well, I had her x-rayed again, and there was no sign of OCD, so much so that my insurance company removed the exclusion for hind leg lameness from my policy. My new vet (who went on to become her vet throughout her life) told me to treat her as if there had never been a problem. I backed her, and she went on to become an Advanced dressage horse. I did lose her at 18 to suspensory ligament problems, but there was still no problems with her hocks.

And so, as your mare is young she may improve all by herself, although I note that she is become temperamental, which is an added problem for you. I believe that the modern treatment for OCD can be very successful, and as Maza says, if you have the insurance cover for the operation, you have little to lose.

Good luck whatever your decision.
 
I am no expert, but I would think think that a two year old's growth pattern is very different from a four year old.
I know this is very difficult: in your case, I would want to ask for a discussion with a senior vet who is a specialist in the op, it helps a lot to feel that one has as much information as is available.
Then make the decision to operate or to pts [which seems too extreme], I think I would have to give her a chance.
Plan the rest period carefully eg have a companion in another box [almost any large animal can be a pal], provide a stimulating environment, a few hens, a dog, some sheep, lots of tiny hay nets over 24 hours, grooming etc.
Turnout as soon as practical, and give as much time off as possible, if she does not come sound and is in pain then do the deed, which will be just as difficult for you.
 
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I agree that you need to talk to a older specialist vet for advice.
When I was you young the treatment for issues like this was as mentained above turnout in a bare field and left a year .
The problem with insurance is the rush to treat I think it can cause over treatment of conditions that might have managed themselves given the right management .
I would be spending time now preparing the horse for box rest much better get her settled better now when it does not matter if she jumps about .
There's lots of threads on handling box rest do a search , doing box rest properly is labour intensive and hard work you may need to get help daily if you are working alll day , luckily you have time to plan it all .
I think given your insured I would go for the surgery on balance but it's very very bad luck but that's horses for you .
 
My old horse had this-it didnt present itself until he was 9yo. Arthroscopy was carried out but they just did the one stifle and apart from tidying it up, there wasn't much they could do. He then had iRAP treatment in both stifles. He had 4 months box rest (it was during that bad winter in 2010-2011 which really didnt help!) which he was a good candidate for-very easy to keep him on box rest from a behavioural pov, very expensive and hard work for me though. He then went through months of field rest, rehab and bought back into work in 2012-he came back pretty sound, sound enough for hacking. I had him PTS in 2013 due to aggressive melanomas.

If it were to happen again I would make a case (for my own horse) to just have the iRAP which is not that expensive but which definitely helped him, field rest (which I can do at home). Part of the problem with my horse is that they didnt know it was OCD until they went in as it presented like a meniscal tear. The prognosis may well be much better for a younger horse, I know of one that went on to event after the op on both stifles-it really depends on what they find. It also depends on you tbh, if you want a competition horse your plans might be different which noone could blame you for-I am more of a happy hacker.
 
Thank you for sharing your experiences. I haven't yet made any decisions but did check how much I have left on my insurance, it does not leave much for post operative care and physio! She has very little ridden experience, so has spent the majority of the last two years doing very little. Even though rest has been suggested as an option, I don't really see how this will improve a horse with cartilage damage? My horses are kept at my own yard but not next to my home. I work, have family commitments and my other horses. Box rest is a real worry just because it comes down to me. Rightly or wrongly I am worried that this maybe a commitment too far.
 
a lot of bodywork you can learn yourself-getting your horse to activate her core etc will all help massively if her prognosis is ok for ridden work. I was dubious about rest for something degenerative too-but the iRAP helped stop the cycle, rest/field turn out helped him relax and move but obviously I don't know what would have happened long term and he only ever hacked afterwards. tbh I was scared of breaking him, iRAP has/had a rep of not being so effective second time around. I was also completely DIY on my own yard and it was tough. fwiw iRAP made the difference to him being non-weight bearing lame to 2/10th lame in trot on a circle afterwards. He'd gone through two cycles of 3 week box rest before that, the last after steroid injection which did nothing.

I really loved that horse, had him since he was almost 4. Even if he'd just have come paddock sound I'd have been happy-and so would he, he had pals and a nice life I think. I wouldn't expect anyone else to go through it if they didn't want to and not sure I would do it again although that probably doesn't help you :/ good luck, whatever you decide
 
My horse had arthroscopy for bone cyst on stifle, no box rest but small area rest outside which increased over time then we started riding in walk, all went well and horse appeared sound until he hoolied round when I wasn't there (3 days away from full turnout) on the bit of arena he had and tore meniscus (sigh). As far as the op, it all went smoothly and I would do same again.
 
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