Should it stay or should it go???? Bone chip???

[merlinsquest]

Merlins xrays were done today on his hind fetlock. The locum vet said there was a bone chip which he would like to take out. To me it looked fairly small.... on the xray it was about 2-3mm across (not sure how big a problem size is as apposed to situation)

Now my problem is that....

a. I have just under 2k left of my insurance money and the arthroscope would devour all of this and some.

b. I am still left with the reality of the joint being severly affected by arthritis, which would be helped by removing the chip but obviously not cured.

So would you think it wise to risk all and have it removed, or treat the joint for the arthritis and hope the chip isnt making it much worse. Its situated outside the actual joint on the inside of the hind fetlock.

I am worried about the risk of the GA, the recovery risks of broken legs etc and the risk of infection... with no hope of the joint being back to normal afterwards.

 

[Tia]

Personally? Having had good experience of this happening.....I'd say leave well alone. The cases I have had dealings with, and 3 were operated on, turned out not well and serious complications arose with one horse.

Depending on where the bone chip is and how big it is, it should become encapsulated by new tissue and shouldn't cause any further problems with luck.

*Edited to say* I did read where it was and the size of it on your post - just needs to be more specific and perhaps you might want to have another vet look at the x-rays and give you a second opinion.

 

[merlinsquest]

Well that was my view really Tia,

Without doubt the chip has been there for over the three years that I have owned him and with all probability since he was two (as previous owner said his fetlock was enlarge when he was a youngster)

The vets have both concluded that his arthritis is not caused by wear and tear, and that he must have had either a septic joint or traumatic injury at some point in the past.

Now bearing in mind that up till one year ago I was eventing at riding club level with no lameness issues at all, I would say if it was that bad it would have caused significant probs before now.

As mentioned before its not necessarily the op I am worried about but he could be ruined by complications and to be honest he will never be right again anyway as the joint is too far gone with the arthritis.

 

[Panther]

Merlinsquest - we have had our differences but both you and Tia are right.. and leave well alone... he will not be improved the stats are poor... you will spend all your insurance and probably be worse off for it.. most i have known have be encapsulated very quickly and happy enough... the risk of opp... is actually higher!!
good luck!

 

[merlinsquest]

Thanks Panther..... now you know why he is a bit short on topline.... and why I am a bit sore on criticism (sp)

!!! We have had issues since he hurt his back last sept and the vet did nothing for the back (he slipped in field) and homed in on the fetlock. It has always been (since 2yrs old and he is now 9) slightly enlarged.. but he has passed 5stage vettings obviously with full flexions with it!!

Basically as I said before, I have done everything with him in the first two of the last three years (if that makes sense). ODE in concrete like ground (nearly anyway) and in wet and sludgy conditions.... SJ and Dressage (the latter not so well)!! and hacked for miles and miles and miles. Not once has he gone lame..... he passes flexion tests, at worst is 1/10th lame (and thats with the vet trying his hardest) and that was only the once.

I am sooo worried that I will go from a horse that so far has been a star, and a sound star at that, to perhaps a lame or dead horse if it all goes wrong. But the locum vet says he would like to remove it. Strangely enough the normal vet has seen the original xrays (but not todays) and the chip was on there, but no mention of surgery was made.

I want to do the best for merlin and feel that I am doing so by refusing surgery. I think after so long it would be hard to remove as would be surrounded by scar tissue.

Anyway, no grudges held here!!! Thanks for the reply

 

[AmyMay]

I would want it removed personally. As if it's left in it could cause problems in the future.

 

[ihatework]

Personally I would request a second opinion from an orthopedic surgeon before making a decision. My gut instinct is to leave it alone but I would follow the advice of a specialist.

 

[LusoLover]

I had my horses bone chip removed, but he was 5 and I have high hopes for a future dressage career. They did advise me though that we could have left it and it would potentially have encapsulated. I'm afraid I don't know your horses history, but from the above, as he seemed to cope with it previously I would probably leave it for now.

If you are considering it, a second opinion would be worthwhile. I always think that whilst we may not be vets, we know our horses, so go with your gut instinct.

 

[Happy Horse]

I'd prefer to have it removed. My horse had a bone chip in his fetlock which was not discovered until it was too late to operate and he was never 100% on it.

 

[merlinsquest]

Thanks guys for the advice....

The thing is he will never be good on the fetlock as its arthritic already.... so I will be risking alot for a little chip. The damage is already done and its probably already surrounded by scar tissue.

Strange thing is the original vet didnt mention much about it and the second vet (locum) has said take it out, so sort of a second opinion without asking???

 

[Panther]

Yes ... see what you mean merlins..

you know my thoughts... and certainly if... you had it done i'd ship him off to the best facility you could find... keeping a horse after any opp is a risky business.. it is very difficult to keep a horse as sterile as poss to prevent infection..

and if already affected by arthritis ... what's the point of potentially making it worse..especially since he has had it sooo very long??

also what some fall to consider is his nature... think of him... his nature... his routine.... would he appreciate being shipped off and couped up for soo long... would he fret... chew off his bandages.... drop weight... you know him best.. would he mentally cope???

 

[merlinsquest]

To be honest for all those reasons I have already said no..... the joint will never be any better..... and would probably be worse after, knowing my luck!! If he were a valuable competition animal then yes, but my best friend, then no. He has had it for long enough, it can stay

I'm not sure how he would cope to be honest... he is different when I am around (but not paying him attention) and does not really like being on full box rest, but i dont think he would be difficult as he is a nice chappy!!

 

[merlinsquest]

Update,

Merlins locum vet has spoken to the normal vet and both have decided that it would be pointless to remove the chip!!

He is now waiting for Tildren and Irap therapy, and a jab of something steroidy for good measure!!

Wish him luck for next week!!

Must say, having spent the winter with a big shaven patch on his neck, would rather not have one for the summer as well!!

 

[Louby]

Sorry havent read your original post but just wanted to tell you my experience. My boy fractured his radius last November and had a large bone chip as well as fragments in the area. Leahurst said leave the bone chip in but my vet said he expected it to cause problems and if so it would have to come out due to it being near his carpal sheath and that there was risks involved taking it out. We left it in and it abcessed about a month later and then abcessed again. Vet xrayed and the fragments had almost dissolved but the chip was still there and so he took it out under heavy sedation. Touch wood he has not looked back. Saying that he would have left well alone if it hadnt caused any problems.
Good luck for next week, I hope it all goes well.