PTS or opt for surgery? What would you do?

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Tamski

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My mare has got severe arthritis in her OF pastern. Vet has said that the only treatment left is surgery to fuse the joint. This involves her being in a cast for 6-12 weeks and on box rest for 6 months gradually progressing to being back out in the field. This will make her field sound and still retired.

She's also got some arthritis in the other front leg which may worsen as she relies more on that leg whilst the other fuses.

She's 19 and a heavyweight girl. I think she'd cope with the box rest but really not sure whether I should put her through it. My husband is very attached to her and wants to do everything but I'm not sure its fair to put her through so much.

What would you do?
 
What will the surgery involve?

Can she be retired happily to the field on a mainenance dose of bute?

I have to be honest, at 19 the surgery is not something I would put my horse through.
 
Hi Tamski.. my horse had this operation on one of his hind legs.. Is it arthrodesis of the pastern where they remove the pastern joint & hold the bone together with a metal plate & pins until the bone fuses?? If it is this operation I have lots of info for you..
 
I personally wouldn't put a horse of that age through any surgery at all but each to their own.

TBH, with arthritis anyway I think the box rest will be very uncomfortable for her, I wouldn't want to put her through it even if it wasn't due to surgery, sorry.

You are going to get a lot of differing views ranging from those that are realistic and practical to those that see horses as their pets/children who will hang on no matter what the horse has to go through to get to the other side. As long as you always do something with the horse's best interests and quality of life at heart first and foremost above your own desires, you won't go far wrong and it's all they can ask of us but it's never easy at times like this, tough call.
 
I've seen friends spend thousands on ageing horses, only to have them put down in the end. It's easy for people to make you feel guilty for making finances part of your consideration, but reality dictates it has to be a factor.

As others have mentioned, I'd have reservations about putting an already arthritic horse on 6 months of box rest.

I don't envy you this decision one bit - it's heartbreaking.
 
Our heavyweight girl has just been diagnosed with arthritis in her coffin joints and pasterns. She has had steroid injections into the joints. She is sound at the moment and happy enough, I wouldn't put her through surgery and don't think it would be fair for her to be on a long period of box rest.
 
I take the view with my 2 elderly arthritics that they've had a good life with me for a long long time, they've had a good retirement too, anything that happens now that involves them having invasive medical/surgical intervention and/or extensive box rest is the time to say goodbye as it would not be in their best interests to put them through it.
 
Tamski, I wouldn't put her through this surgery and the following long period of box rest, it's too much to ask of her. Box rest and arthritic horses do not go together, she will be very uncomfortable. My biggest concern would be that she would get laminitis in the NF as a result of that foot taking all the weight. Her quality of life is paramount.

It's hard to let a beloved horse go, but if it's the right thing to do for her, then it has to be done.
 
I have put a 21 year old through surgery and I would do it again. I don't think you can say just because a horse is x years old I wouldn't put it through surgery - I used to think that, then the vet told me my horse needed an operation which would make her better and I looked at my horse who is still bright, happy and full of herself.

Actually, the surgery itself was not that big a deal. I got really worked up about it and then horse went off to horsepital, went under for half an hour, they woke her up and she was fine to come home two days later and off bute and antibiotics within a week. Anaesthetics and technology has improved a lot in recent years.

To be honest, my decision would be based on box rest and prognosis. If I thought I could get my horse through the box rest without an ill-effects, mental or physical, then I'd consider it. If I thought my horse would be happy as a field ornament (and mine probably wouldn't) then I might consider it too.

At the end of the day, you know your horse best. We've never met her. You are the one that sees her every day and knows if she's happy and enjoying life or if she's tired so be guided by her. Good luck.
 
Thanks everyone for the messages. It is a very hard decision to make.

Ginger Bear- yes this is the op. Any info appreciated please. Where did your horse go for the op?
 
i had my 20yr old operated on - he had his annular ligaments cut in both back legs. he went from crippled and facing PTS to still being here aged 25. Last year he went back out on the veteran show circuit and stood Champion Veteran 4 times out of 6 outings.

having said that, i dont think i'd be very inclined to go for arthrodesis at 19 - casts can cause a lot of problems and it's still gonna leave her just a field ornament whereas mine has come sound enough to still be in regular work.
 
We've got a week to make a decision. Vet has upped her danilon to 4 a day to see if that makes her more comfortable but there's no guarantee that it will or that she'll cope with that level for any period of time.

She's currently out 24 hours a day so will be a big shock for her to have to stay in but is it worth a go to give her more retirement.

Hubby wants to go for surgery but I'm really not sure. What I don't want is to watch her fade away in the box and then have to make the decision to have her PTS anyway. Much better to have a lovely sunny day in the field, buckets of treats and a nice groom but I can't make the call it has to be a joint decision.
 
It so depends on the horse. My mare is on box rest at 23 with lami in one foot she has some arthritis but on flexijoint she is sound.
My mare has been boxed coming up 5 weeks she is as clam as anything, has hay 4 times from morning to evening she is happy .


If it were my mare I would look at all pros and cons.. Your mare is only 19 and could live another 15 years . So If i knew she would cope with box rest and new EVERY thing involved . Then I would give it a try I have seen many horses with fused joints live many years after surgery.

Like with my first mare and pony I knew I did EVERYTHING possible . I would hate to think of the what if i had tried she could still be with me.

Only you and your hubby can make that decision all we can do is give our opinions. :)

if you have the surgery you could poss breed from her if vet said it was ok.

http://www.youtube.com/watch?v=gnm4YzD9p_0
 
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Tamski said:
We've got a week to make a decision. Vet has upped her danilon to 4 a day to see if that makes her more comfortable but there's no guarantee that it will or that she'll cope with that level for any period of time.

She's currently out 24 hours a day so will be a big shock for her to have to stay in but is it worth a go to give her more retirement.

Hubby wants to go for surgery but I'm really not sure. What I don't want is to watch her fade away in the box and then have to make the decision to have her PTS anyway. Much better to have a lovely sunny day in the field, buckets of treats and a nice groom but I can't make the call it has to be a joint decision.
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What are your Hubbies plans for her if the surgery is successful?
 
He was operated on at Newmarket Equine Hospital. He had all his other legs scanned to check for any arthritic changes in his other legs but was clear so they put his ringbone down to an injury. He was given a 95% chance of making a full recovery & being able to do whatever discipline I wanted him to. He was at Newmarket for a month with his leg in a cast. He then came home after the month away with his leg in a massive bandage & that's when the hell began. We then had to get through the 4 plus months box rest with a usually calm horse that turned into a box rest hating monster & the worst thing was that he only had a thin piece of alluminium plating holding his joint together. He was so stressed that he lost all his weight & looked awful. After we got through the nightmare box rest stage he had his bandage off to reveal awful deep holes on the back of his hoof where the cast had rubbed..they were awful - but heeled really quickly being soaked in iodine. He then had to be walked in hand working from 5 mins a day to an hour twice per week, which wasn’t good either but only because he was hyper.
I probably would never put him through another operation again but only because of the way he was with the box rest. If he was 19 & only sound enough to retire like your situation I would probably bute him until he needed to be put down..is this an option for you?? How much pain do the vets think your horse is in? I was lucky because my boy was back being ridden within 6-7 months when usually recovery time is 9 months to a year – he recovered really quickly, the vets were amazed. The weight bearing on the other leg can be a problem for a horse with a normal other leg let alone one with arthritis in her good leg. The other thing to consider is that there is a much lower success rate of recovery in a front leg than a hind. If you need any further info or have any questions let me know..
 
My girl did 3 months box rest aged 22 for a damaged DDFT and it absolutely did her knee arthritis no good at all. I did ride her again after the tendon was healed, but only for a few months before she would go lame on hard ground (and most of our hacking was done on a hard trail, or on the lanes to get to it) so I retired her. Bear in mind that your mare will almost certainly have arthritis in other joints. Mine has it in her hips and neck. My old vet told me to remember that horses have no concept of tomorrow. They live entirely in the present and the next few minutes because they've seen you bringing their food bucket! At 19 your horse is no youngster and what will you actually achieve by the operation, apart from depleting your bank account? I would try the anti-inflammatories and see what happens. My girl costs me in the region of £4000 per year for drugs for another condition, plus her anti-inflammatories, so you could say I'm a fine one to talk, but I am happy that her quality of life is still pretty good, but I monitor her very very closely. The day the bad times outweigh the good ones I will stop.
 
In that case I would probably source every available alternative treatment & probably wouln not go for surgery. On the other hand you know your horse & if you think she will get through the surgery & recovery period then why not give it a go... my vet bill came to 7,000 ish in total.
 
Ive had my boys hocks fused about 8 weeks ago. Hes 13 and struggled to make the decision at that age but I think much older I wouldnt and especially on 4 bute a day I would probably pts. I wouldnt put an older horse through all the risks of surgery and a VERY long box rest with no movement for them just to be a field ornament. Horses live for the day and wont think for 6 months that its ok I can put up with these 4 walls as I can go out in x many days
 
I can't see the point of operating at all for her to be a field ornament. I would bute/danilon her to the eyeballs until she can't take the bute any more, or gets to a natural old age.The bute would cost far less than an op and require no box rest or casts and not risk worsening the other leg. It's also possible that the extra strain on the other foot will cause it to fail with laminitis. I would not take those risks, I would give her a peaceful painless end when the pain relief no longer works.
 
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Ginger Bear said:
In that case I would probably source every available alternative treatment & probably wouln not go for surgery.
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If her future is to only be a field ornament for you to look at for possibly another two years I too would feel even more strongly about not doing the surgery. At the end of the day it's being done for you (your hubby), and not particularly for the benefit of the horse.

Tough, tough decisions. But it's a hell of a thing to put her through just because you can.
 
i personally wouldn't go for the surgery if it was my old boy, i know for a fact he could/would handle box rest mentally, in fact he'd love it BUT it would put too much pressure on his other legs/joints and that would cause other complications.

you say you want to do it because you want to give your horse a couple more years in retirement but how would you feel if you operated and then still had to pts, either from the operation or other problems afterwards?

sorry don't mean to sound callous or rude, i'm so soft i can't bear to make the decision on my old boy when he's having bad times but i do know i wouldn't put him through any operations at his age (he's only 18yrs) and if bute couldn't keep him pain free for a few months then the time would come for me to make the decision.
 
I would PTS without hesitation - maybe after a few days dosed up with painkillers being spoilt.

So sorry for you, I have been here very recently myself.
 
Im in the same situation as u only, my pony is only 5 and half with the same diagnosis and only two option as it is quite severe. Cant stop crying and every day doesnt get easier in making the right decision for him :(
 
Please don't do it. I would not be overly worried about a GA, but the risk of her getting laminitis in her other front foot is very real, if that happens, her life (and yours) is complete misery. Make the right decision for your mare.
 
Thanks All.

The vet is back out tomorrow to have another look at her feet with the farrier to see if we can amend her shoeing again. Hopefully we can move her breakover point to put less strain on the calcifications that she has on that leg which alongside the danilon will at least make her more comfortable.

Fingers crossed!
 
My arthritis horse is MASSIVELY IMPROVED after a period of box rest and only retains any semblance of soundness if she is stabled at night all year. Don't ask me why cos I don't know!! So why don't you try a couple of days in then gradually increase her turnout and see what that does for her. Also if your horse is.over 700kg then 4 danilon a day is like 2 to a tb!!
 
Tamski said:
This involves her being in a cast for 6-12 weeks and on box rest for 6 months gradually progressing to being back out in the field.

What would you do?
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Hi Tamski,

Sorry to hear about the dreadful decision you are faced with.

The first thing that jumped out at me was the mention of your horse having to wear a cast. I take it the cast will go completely underneath her foot and up her leg to her hock? I had a horse who gashed open his entire fetlock on his near hind to the extent that he severed two tendons and opened up the joint capsule. They managed to prevent infection of the capsule and put fake joint fluid back into it and the tendons themselves I was told were of no consequence but the problems my horse encountered during the three weeks before he was PTS at the hospital were continual heel rubs due to the cast. Apparently it is very hard (or was in 1997 anyway) to prevent rubbing of the cast and to set it in the right position. Despite him having to have three GA (at the age of 14) to take off the cast and reset it (changing the positions of the dressing underneath the cast to allow more support and thus try to prevent the heel rubs) they could not save him. He was so uncomfortable with the heel rubs despite copious amounts of painkillers that the fourth time they took off the cast to see the damage (this time under local anaethetic he stretched his leg right back and opened up any healing of the joint capsule that had taken place and the decision to pts my dear friend Biggles was then the only option. :(

If I were you I'd be asking my vet about what happened with my horse and the heel rubs and just how effective casts are these days. Here is a useful site about plaster casts: http://www.dclahdvm.com/Articles/CastCare.htm and this one: http://www.equinehospital.net/leg_casts.htm

As for what would I do in your situation - if the plaster cast scenario wasn't likely to happen with my horse it would depend on how long the box rest was, what type of temperment my horse had and I would also take into account his age. I don't think I would with my current horse who is rising 15, especially if the outcome is still retired. But I am a one horse owner and so therefore my priorities might be different to yours, I need to compete every weekend in order to keep my sanity! BUT THEN AGAIN ....I always said I would never keep a horse if I were told I couldn't ride it again and yet when I was actually faced with this decision back in 2004 with my horse Rommy who had severe wobblers syndrome I was told I would never ride him again and practically begged the consultant to let me keep him for the rest of his days as a field ornament. However he wasn't safe (severely ataxic) and was PTS under the consultants advice. :(
 
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applecart14 said:
Hi Tamski,

The first thing that jumped out at me was the mention of your horse having to wear a cast. I take it the cast will go completely underneath her foot and up her leg to her hock?

My horse had this op in 2010 & yes the cast completly covers the foot & there is nothing they can do to prevent cast sores.. my boy was left with deep holes where the cast rubbed. But they did heal quite quickly.
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