Put yourself in my shoes - WWYD?

B

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OK guys, you could you tell me what you think you would do in the following scenarios?

1) Horse with spinal cord compression in the neck. Causing the horse constant pain and meaning that she has limited control over her hindquarters. Has been known to 'flip out' from the pain. Options are PTS or surgery (bagby basket) which has a 70% chance of improving the horse by 2 neurological grades, making her almost normal in terms of body control and taking away the pain. Downside of surgery is that the other 30% usually can't get up following surgery and are PTS.

2) Horse as above, but also with Kissing Spines throughout the back (thoracic vertebrae, so saddle area). Options for KS are surgery (70% success rate) or steroid injections, both accompanied by intensive physio.

3) Horse with KS, but supposing the neck issue is cleared as being arthritic changes with no bearing on the spinal cord. Options for neck include steroids and physio.

The horse is a 6yo TB who is immensely talented and gives you the feeling that you could take on the world together.

What would you do?!
Don't spare my feelings, be honest.
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I'd go to Sven Kold for a second opinion and do whatever he recommends. If the horse is really talented and Sven thinks the surgery is likely to work, I'd go for the surgery.

Sorry to hear about your horse.

xx
 
What does the vet recommend?

Option 1 I'd have to try the surgery and just see what happens from there.

Option 2 , difficult if I were happy to keep the horse as a pasture pet then all the treatment options I could and see what happend. If weren't in the position to keep as a pasture pet, I'd discuss PTS with the vet.

Opttion 3 , as above.

Really sounds like horse needs to stay with you for life, so are you in a position to be able to do that even if it ends up field happy but unrideable.


ETA - All these assume you have the time and extra money to put into proper after care post surgery as good after care can make such a difference to the result.
Then go from there.

But that's purley what I think I would do based on your post and I know there is always a lot more to it than that. But then I am a softy to.
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Is horse insured for if PTS? cos this would be route i would be looking down for defo 1 & 2 and prob if not insured would prob defo do PTS

and 3 i prob would give a good go to see if horse could come back

Apart from that (((((((((((((((((hug huge)))))))))))))) and total heartbreak for you
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I would always give the horse the chance for surgery - esp at 6yo!
Hope it all works out for the best whichever options you take !
Sx
 
With no emotional ties I would have the horse PTS.

However as someone who has gone through spinal compression and KS with two of our horses I know that in your position you will try anything within reason.

The spinal compression horse was eventually PTS as his condition deteriorated rapidly and the damage was irreversible.

The KS horse was managed with shockwave and physio and did not have surgery as was considered to old at 15.

Goos luck with whatever you decide and feel free to PM about either of the above in more detail.
 
In all honesty, and this is just IMO, I would have it PTS for both 1 + 2 as IMO if the horse is in that much pain and having that many problems at only 6 it will get worse and wouldnt be able to compete at top level anyway. Also for me looking at it from a professional/financial way, it makes more sense to just count your losses (sorry if that sounds cold).
Scenario 3 is more difficult. I would give it a go but would also in the back of my mind worry that if it's already having arthtritic changes in its neck at 6years old and will need physio and treatment its whole life, I would question if it was worth it. 6 is very young for problems to start to arise.
 
Firstly it depends on whether your insurance company will pay for this, or are you wealthy enough to pay for it yourself.

Option 1. If my horse was in so much pain she flipped out, I am afraid I would have her PTS.

Option 2. If my horse had both these scenarios, the kindest thing is to have him PTS.

The figures of 70% success rates, are these for a horse to be able to live as a pet, or a ridden animal ?

I would be asking myself how much distress these operations and treatments would cause my horse. If I felt the operations and treatments would cause her a great deal of pain and misery, even if I thought there was a 70% chance of her being OK. I would not put her through the trauma because horses do not understand what you are doing, they live for the moment.
 
Mm, when you say 'in constant pain' and 'flips out from the pain' ....how do you know that its a horse in pain? what do you mean it flips out?

Ok so this spinal cord compression is wobblers-What grade of wobblers is it exactly?

The bagby basket operation only seems to last for a few years.

Hmm. Dont really know what to say am afraid!
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Thanks for all your comments everyone, keep them coming. I am pretty sure I know what route(s) I will go down, but I need to see the bigger picture from outside perspectives first. It is so easy to become too involved, isn't it, and not be able to see the wood for the trees.

In answer to a few questions -

The 70% success rates are horses returning to a competitive life - racing, SJ, eventing etc. The figure doesn't include paddock ornaments.

The bagby basket op involves 2months box rest, then restricted turnout and beginning an intensive physio regime to re-educate the nervous system - it is the sensory neurons that are affected, so proprioception etc. Noticable improvement by 4/5 months, 'normal' horse within 12.

Insurance - she is insured but they haven't cleared any of this yet. So far she has had several examinations, a full body bone scan, and is having xrays and nerve blocks today. If NFU decline to cover this then I am already in the sh*t financially. I can find the money to do whatever it takes, somehow.

Psychological affect on horse - she loves her stable and would happily be stabled 365, and this isn't just my interpretation, she genuinely loves her stable! I am not worried by box rest for any period of time..

She will be going for a second opinion with Svend at Willesley if there is ANY hint of hesitation from the vet who is currently treating her. She will have to go there for a myelogram anyway, if the xrays show compression.
 
1) If you have insurance to pay and the facilities to keep her pain free as a pet then I'd operate. If not PTS.
2) PTS
3) As per 1)
 
OB - you know your horse is in pain when you 'know' them. She is happy enough in the stable though, where the need to move is limited.
As for 'flipping out', she is OK to handle on the hard, but if you take her onto a soft, slippy surface she doesn't have enough control over herself and freaks out. The movement from the 'freak out' seems to push her over the edge and she rears/bucks/leaps, and then is instantly calm again as though nothing has happened. It is only the last 2 weeks that she has gone so quickly downhill, though I have had a niggling feeling that something has been wrong for sometime, though vets/chiros/physios/farriers/bowen have all told me that she was fine.
We're looking at 3/5 behind.
Tell me more about the longevity of the BB op? Nothing I have read has said that (and I have spent HOURS trawling the scientific databases for veterinary journals!)
 
What a horrible situation to be in, ((((hugs))))) for you and your horse!

I think a lot depends on the attitude of the horse to prolonged box rest and rehabilitation. Since you say that she is likely to remain calm during this period, and if the insurance pays out or you can afford it privately, I would go with treatment for all options, but keep an eye out for deterioration in terms of the horse's physical and mental welbeing.
 
Oh dear
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that does sound bad
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Poor mare...sorry had to ask as I was trying to get more of a understanding about the stituation!

From my distant memory about the BB op ( this is a few years ago, when I looked into it) someone told me about this racehorse stallion that had it done, and for some reason he had to have it done about 3 or 4 times over a span of 10 years or so, to keep him covering. There do seem to be a few incidences of this, but dont think it is the majority...
 
Not sparing you at all.. Id have him PTS.. at 6 years old he is never going to reach what he would without these issues and i just think it would be a hell of a lot kinder on the horse to PTS.

Lou x
 
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She will be going for a second opinion with Svend at Willesley if there is ANY hint of hesitation from the vet who is currently treating her. She will have to go there for a myelogram anyway, if the xrays show compression.

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You poor, poor love
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I second HS re Svend, it is so much his area of expertise and he sees so many with these sort of conditions compared to most vets, he may be able to give you a better indication of her chances as an individual case rather than statistically. Hugs to you whatever you decide.
 
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I think I would cry
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That's the one thing I haven't let myself do yet - if I start I won't be able to stop. I f**king love this horse.

TD - I trust Svend. He did my geldings KS surgery (yes, I have been here before
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, and never intended to be here again). I think I might get him to look at here anyway, regardless of what happens with my own vet today. I just need to make sure I know all the options back to front and inside out before I do anything drastic.
 
Sh1t, what a situation. So sorry.
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Wait for the second opinion, and go from there. If it's the same prognosis, I'd probably go down the PTS route, but that's looking in from the outside. In your shoes, I'd be so unsure what to do. For 2, I'd say no option other than PTS, too much going on, for the other two, if you can afford it, then give it a try if she's a happy bunny on box rest.
 
The thing that is playing on my mind is that around 70% of competition horses have KS without displaying any clinical symptoms - so would the KS even be in the picture if she hadn't had the scan?!
She is most likely having the back nerve blocked anyway this afternoon, so hopefully we might see a bit of a difference which will help answer that question for me.
I am also going to find out what nerves would be affected at C4/5 and see what they can do to test that. She only sweats on the right hand side, which I'm SURE must be a neurological thing.

Gah!!!
 
What an awful situation to be in. I don't think we can ever under-estimate how stressful a major operation is for any horse, so I always think very hard before allowing this in all cases and would want a very good chance of full return to work with no long term effects before I considered it.

I would certainly look for a second opinion, but I think I would be seriously considering PTS in case 1 and 2, I may try 3 but would want to see an improvement in the horses condition very quickly as you say the horse is currently in noticiable pain.
 
I had a horse who went to 2 different vets to be x-rayed and both thought that she clearly had some spinal compression. They also thought she was a potential surgery candidate so she went and had a myelogram, with the view of doing the surgery if appropriate. The result of this was completely clear and they then gave her a clean bill of health, no treatment or anything! My insurance company covered the cost of the myelogram, which was 2k. But I did make sure they had agreed to cover it before she went.
Good Luck
 
honestly though... I would take her to willesley as they dont operate on the C joints but do steroid injections? Also RH sees alot of these and Sven&Ollie are two of the best KS surgeons in the country if it comes to that so they would be able to give you a better prognosis?
 
Thanks again to all who have posted.

You lot have been really helpful in getting me to think rationally about all the options, something which I wanted to do before I was put on the spot at the vets.

LPP - my vet said she would have considerable pain if the spinal cord was being compressed, though yours and Orange Empire's experiences don't fit with that?
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Hopefully the nerve blocks will shed more light on whether the KS is actually causing her pain.

Chatter - thanks for that! Can I just ask though, what made you chase a diagnosis in the first place? How did you move on afterwards, once you were given the all clear?
 
If the insurance was willing to pay, then im sure i would go along with surgery, if not then PTS. Im not convinced from what you have written that surgery is really going to help, there just sounds like to much is going wrong to be able to fix your horse... its really bad luck for you.
 
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