Julz
Member
Hi, I am wondering if anyone has personal or knowledge of the sucess of surgical removal of an infected right jugular vein. My 7 yr old mare has been ill since Jul 07. I bought her in Apr 07 from a friend so her history for the year prior was known and she was absolutely fine. 2 weeks later she broke my arm which meant she was roughed off for 9wks. When i brought her back into work in Jun 07 she was nappy and difficult to ride, but as she was a new ride to me, and had moved yards several times, i put it down to her challenging me (she is definitely a mare!). In Jul 07 she became unwell - she was obviously in pain, had a nasal discharge, was depressed and looked as if she had a blinding headache. no specific diagnosis was made by the vet; antibiotics and an iron suppl were prescribed. She was slow to recover, lacked energy and enthusiasm and never seemed 100%. She continued to be difficult to ride although she was much better with more talented and stronger riders (I am v weak down my left side which she took full advantage of) although slow progress was being made. I was convinced that she was particularly uncordinated in canter but even experienced trainers could not put their finger on what was wrong with her. In Feb 08 she developed a nasal discharge from the right hand side and exhibited a further episode of lethargy and dullness. This time, the problem was quickly identified by radiographs as fluid buildup within one or several sinus cavities. Antibiotics were prescribed which cleared up the discharge temporarily. When the discharge returned, I requested further investigation of the problem, convinced that this had been the problem in Jul 07. Fortunately she is covered for vets fees and her insurers have been superb - I'm not sure if i can mention who my insurers are in this forum - they deserve a mention though. Surgery in Apr 08 revealed a sinus cyst, which was removed. The nasal discharge continued, vets were continually consulted, the area re-radiographed but veterinary advice was to give her more time. Mid Aug 08 the area under the bone flap abcessed so the vets re-opened, redrained and created a fistula (hole) to promote drainage. The horse returned home, still dull and thin after having looked well the previous month, although still not 100% right in my eyes. 2nd week of Sep 08 she suffered an impaction colic (considered the result of eating a fresh straw bed when stabled because of bad weather). She had to be re-admitted to the clinic when it failed to clear and she was in pain and becoming dehydrated. She returned home very thin and poor, still with her trademark nasal discharge. Then she came in from the field with a swollen fetlock and in pain - thought to have been a twist. She was then on box rest for 3 wks while I stuffed food into her to try and build her up for the winter. I called the vet out last wed as I was convinced that the horse was unwell, she had an intermittant nasal discharge from her left nostril in addition to her usual RH disharge and a slight cough and her fetlock was still slightly swollen & warm. He looked at her nasal discharge and told me to give her more time. Unfortunately, he did not take her pulse, temp or take a blood sample. The following day she was poorer, but the symptoms were similar to the usual sinus episodes that she has been suffering so i did not suspect another issue developing and gave her bute to ease the pain. Over the weekend, her neck & jaw started to swell, to a greater extent than had previously been seen. By tue the horse was clearly very unwell and in considerable pain so i phoned the vet stating that he would have to investigate further as the horse was clearly in considerable pain; I arranged to drop her off the following day. By wed, an abcess was forming on the right hand underside of her neck. She was admitted on wed am, and quickly diagnosed with an abcess which had infected and blocked the right jugular vein. We do not know whether the infection has spread further at this stage. Strong antibiotics and painkillers have eased her pain slightly so she is fairly comfortable at the moment. Options are to try and get her strong enough to operate on to remove the jugular vein (leaving it in-situ can result in reduced fluid drainage on that side and fluid build up around the head), or euthanasia. This is major surgery, required to save her life unless by some miracle the antibiotics alone clears up the infection (but given the horse's history, one wonders). The vet seems in favour of euthanasia given what the horse has been through already this year, and her prognosis for a full return to good health is 50/50 at best, with a large question mark over what work she could be expected to do in the future. I am not that attached to this horse given the trouble she has been (although i have shed a bathfull of tears for her), she is still my horse and i ought to do the right thing for her. I don't need a useless horse / hack/ broodmare as my other horse may be about to join the later category, and i am not in the ideal position to keep 2 field ornaments. If we euthanase her, i am better off financially than trying to save her and then give her away. i don't feel that i can take much more of the stress of trying to look after a constantly sick horse. I am also accutely aware of owner's responsbilities to make difficult decisions rather than leave it to other people to look after other people's cast-offs and field ornaments. But, it is still difficult to accept that we should give up on this horse. I do feel we are losing a constant battle with this horse's health, and that the sinus problem has not been fully resolved. Has anyone had experince or knowledge of surgical removal of jugular veins, the side-effects and the after-care? or recoccurent sinusitis? grafteful for any thoughts and advice during this difficult time.
