Thoughts please. More surgery?

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doodle

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I could cry, throw myself on the ground and howl. Vet has just been to robins teeth. Looked at his elbow. We are 24 weeks in. There is still a wound. It is now forming as crack along it. Below it is thick hairless inflexible scar. Vet is suggesting more surgery to cut it out and start again. I really really don't thjnk either of us can stand that. I was told it would be 2 weeks stitches in then a further 2 weeks and back to normal. All I can see is he had a lump with scar tissue in it. 6 months of having a wound, a very stressed horse, £3500 of vet bills, 2 hospital stays and all that has happened is he has a larger area of scar tissue and a wound where there was not one. Insurance runs out beginning of Dec so we have 2.5more months and £1500 more vets fees (bear in mind just the op and that hospital stay was £1000). It is not bothering him BUT he still has a wound. I am concerned to take him to a show and people point it out.

I just can't put him through more box rest. He could go in a pen in the field but although our fields are remarkable dry a pen will get muddy instantly. And being selfish I am enjoying riding him after almost a year off.

I wish we had left the stupid thing alone. Vet has taken pictures to show head vet and get his opinion but I need to get my head straight before speaking to him

he has also damaged the tendon sheath when he fell. 😢
 
Oh no! :( You've both been through the wringer with this. I really hope that the Vets come up with a good plan and that he's properly on the mend soon.
 
Really sorry to read this, I know you've been through a lot with him and what it's like to have a Perpetually Off Work Horse. I don't blame you for not wanting to put him through more surgery.
 
Fiona said:
Have you any pics??

Fiona
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21762101_10154972498599290_8569258148894288718_n.jpg


that hoefully shows you. You can see how thickened it is around it
 
Yes he is sound and rideable. Work/lack of work dosnt seem to affect it either way. My concern is the crack getting deeper. There is more scar tissue now it has been done. I am not putting him trough surgery again. I just can't do it. However I am concerned atull has an open wound, infection etc.
 
I wouldn't do more surgery. I would consider if unlikely to get infected at this stage.
I'd crack on and give it a few months to settle. If it doesn't - I'd get a second very experienced opinon.
 
Hehe! Yes he has had manuka honey on it. He loved the taste and ate it!! After us going noooooo he couldn't reach it he showed us that yes he can. He had some hugely expensive gel on it that was meant to increase healing. I then settled on sudocrem to keep the flies off. I tried bio oil but he reacted to it. So I have gone back to sudocrem to try and soften it.

The problem with leaving it another few months is that this will take us out of the year for insurance purposes. So if we do anything it has be be finished by beginning of December as that is when the problem first arrived.
 
What about lasering it instead?
I know there are some lasers out there that can help break down scar tissue and promote healing without breaking the skin.
 
Did they ever have an explanation as to why it has been so resistant to healing/why it has scarred so much. If not I think I would be really reluctant to believe their 4 weeks and it would be back to normal suggestion.

I would be really tempted to get a second opinion before your insurance runs out.
 
he has had laser treatment earlier on but it did nothing. We persevered with it twice a day for 3 weeks. I have the physio coming back but vets have not agreed treatment so insurance won't pay (despite me chasing and then agreeing) However I am happy to pay this myself once physio has seen it again.

I have repeatedly asked for an explanation as to why it is so slow to heal and so badly scarred. I feel I just get fobbed off. Essentially they don't know but head vet said he has healed in the wrong way rather than wound contracting it has healed from edges in. We have taken bloods to see if anything underlying and nothing found. The issue is that the stitches failed and the wound broke down causing it to open up. They tried opening, cleaning out, reattaching a drain and reatitching then he was in hospital for a further week on iv and im antibiotics. The wound initially was long but very neatly stitched. If it had stayed like that we wouldn't be having this issue. I was assured it was a surgical wound and no skin was removed so wound was "loose" and so would heal easily and quickly. The vets opinion today was that if he had been better on box rest and stayed in it would have healed better. However head vet said after 7 weeks of hell it probably wasn't healing due to him being so stressed out and so we put him out.
 
Wow what a horrible situation. I think after all of that I would leave it be. Is he a show horse? As in will it effect his marks in the ring? Even in these circumstances, mine and the horse's mental welfare would trump the show ring
 
Kamikaze said:
Yes he is sound and rideable. Work/lack of work dosnt seem to affect it either way. My concern is the crack getting deeper. There is more scar tissue now it has been done. I am not putting him trough surgery again. I just can't do it. However I am concerned atull has an open wound, infection etc.
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I am still of the opinion to leave it unless it affects his ridden work, and treat it as one would a sarcoid over the summer with fly rug/fly repellant creams etc to stop it getting locally irritated.

In saying that, give the insurance situation, if you wanted to get an expert second opinion before time limit runs out then I can quite see the logic in that too. You would need lots of pics I imagine to show referral vet how it did/didn't heal at different stages.

I personally think you've been very unlucky, as I'm sure I've said before I had a pony with a 4 inch long 1 inch deep slice on the side of his thigh, right down into the muscle, and the stitches broke down quite quickly, meaning it had to heal naturally from the inside out. This was many years ago (I was a teenager) and with no suggestion of box rest he was turned out in the field for three months with a dollop of over the counter fly repellent wound ointment applied every time I could get near enough. It healed with no proud flesh, and just a small black line on the skin...

FIona
 
I hesitate to suggest this but has anyone mentioned using copper sulphate to remove the excess scar tissue?....it would have to be very carefully done to avoid the open wound. With hard scar tissue pulling on that crack every time he moves it's not really being given a chance to heal.
 
I have questioned if something in it several times. It was arranged for him tonne scanned but head vet came out and said it wasn't needed at 100% sure nothing in it. It would be impossible to poultice. I have tried bandaging and it dosnt stay.

No he is not a show horse so that is not an issue.

I have spoken to another vet practise and the very good vet there (who I always used to use until I moved to this shiney new practice) and he is going to ring me for a chat. I have about 3 million pictures of it from day one!
 
Can they ultrasound to see what's in there? can they blood test to find out why it's not healed?

I wouldn't chop and hope but I'd probably spend the rest of the £1,500 on investigations (maybe with another vet) to find out what is causing it.
 
What a frustrating situation for you and your horse. Why not get a second opininion from a specialist vet/hospital while he's still insured? Good luck, you must be tearing your hair out.
 
Kamikaze said:
I have questioned if something in it several times. It was arranged for him tonne scanned but head vet came out and said it wasn't needed at 100% sure nothing in it. It would be impossible to poultice. I have tried bandaging and it dosnt stay.

No he is not a show horse so that is not an issue.

I have spoken to another vet practise and the very good vet there (who I always used to use until I moved to this shiney new practice) and he is going to ring me for a chat. I have about 3 million pictures of it from day one!
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I think that is a good idea, can you email him some of the pics prior to chatting?
 
Polos Mum said:
Can they ultrasound to see what's in there? can they blood test to find out why it's not healed?

I wouldn't chop and hope but I'd probably spend the rest of the £1,500 on investigations (maybe with another vet) to find out what is causing it.
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Yes I think I said before he was booked for an ultra sound and the head vet came and said there was no point as he was 100% sure there was nothing in it. We also took bloods which showed up nothing.
 
Summer pudding said:
What a frustrating situation for you and your horse. Why not get a second opininion from a specialist vet/hospital while he's still insured? Good luck, you must be tearing your hair out.
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This is the specialist vet hospital. I have contacted the other vets who are also good for a second opinion.
 
Kamikaze said:
Yes I think I said before he was booked for an ultra sound and the head vet came and said there was no point as he was 100% sure there was nothing in it. We also took bloods which showed up nothing.
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I think you'd just as well spend the Insurance money on an ultrasound. If you have that much left on the claim it won't hurt and you may as well get your money's worth. I don't think any vet could be 100% just by looking at it.
 
I have a horse with similar scar tissue from sarcoid removal. It took months to heal and produced scar tissue that kept splitting. Flamazine in the wound helped with the healing but for the scar tissue I used dermatix, which you can get online, followed by simple aqueous cream now we have a healed wound that has not split in months. This has kept the scarring really soft and it is no longer causing an issue. The vets suggested cutting the scar tissue out and starting again but Professor Knottenbelt said it would be a vicious circle and the new wound would create more scar tissue.
 
Second opinion booked. He will contact current vet out of curtesy and to get the records. I will then switch to this practice (I always used them and vet was amazing with Minto but I was swayed with a lovely new practice with a hospital).
 
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