Vent: got a quote in for keratoma surgery and I can’t afford it

[khalswitz]

Feeling absolutely sick right now and waiting to hear back from a bunch of people so having a bit of a vent here.

I got my first horse after a 9 year gap back in April. She’s 17 and a happy hack so insurance was crazy expensive - and as I’d never put a horse that age through eg colic surgery I was quite happy just putting money aside to cover emergencies. But start of June, she’d gone lame - intermittently she’d look abscess-lame and then for days only be slightly lame in trot before going lame again. No sign of anything on poultices and farrier could find nothing. After the recommended rest etc vet Xrayed and found what he thought was evidence of a keratoma. By this point I’ve spent over £1100 on vet bills in six weeks.

It got referred for surgery to remove it, but the quote I’ve got is more than twice the top end of what I was expecting. And on top of this, my car broke down this week and is either going to be an expensive repair or a new car job, the washing machine died, we’ve got an upcoming holiday and a wedding down south, plus we’ve just shelled out for a present for hubby’s mum’s big birthday. My husband is also in the middle of selling his old flat, and we’re a more than worried about the finances of it all - I can’t afford this surgery.

I’m just sat here after getting that quote feeling sick to the stomach. I’ve called my vet to discuss what other options we have and waiting to hear back. My understanding is that it’s not a life or death surgery although she’s obviously intermittently lame on it so she’s sore, which makes it harder - if it was a horrendous injury we’d just have put her down.

Literally not even four months back into horse ownership. And not a chance after this my husband will let me get another one.

Urgh. Sorry. Needed to be able to vent to someone because my husband is incredibly stressed as it is right now and this is just another major stressor for him.

 

[TPO]

Can you shop around for quotes? Is there a university/teaching hospital near you? They tend to be cheaper.

A griends horse had it done ~2017 and it was less than the £1100 you've already paid. I know prices have rocketed since covid.

Could you look at a 0% credit card? Martins Money Tips lists the ones with the longest 0% period.

I'm far from an expert on keratomas but it's my understanding that their removal is essential.

I'm sorry this has happened and at such a difficult time. The joy of owning horses... I hope you find a resolution.

 

[Landcruiser]

This is the chance you take with self insurance, sadly, especially with older horses. It's really bad luck for this so have shown up so early in your ownership, and I truly feel your pain and anxiety - I've been there more than once. Horse ownership is a massively chancy business, and if you don't have deep pockets, a financially stressful one too. There's no easy answer, and the vet should be able to advise on non surgical options and prognosis. I do feel for you OP. I stopped insuring my older horses once they passed 15 ish, although I kept an "accidental injury" policy going for my remaining old boy (now 25ish) until a couple of years ago. Even youngster insurance is crazy expensive, but I bite the bullet for now because my youngster has a self destructive tendency. Good luck and I hope you can find a resolution

 

[khalswitz]

Can you shop around for quotes? Is there a university/teaching hospital near you? They tend to be cheaper.

A griends horse had it done ~2017 and it was less than the £1100 you've already paid. I know prices have rocketed since covid.

Could you look at a 0% credit card? Martins Money Tips lists the ones with the longest 0% period.

I'm far from an expert on keratomas but it's my understanding that their removal is essential.

I'm sorry this has happened and at such a difficult time. The joy of owning horses... I hope you find a resolution.

I’m going to have to try. It was a university hospital quoting me £3k though so that doesn’t bode well. Although they said she’d need to be in for a week where my own vet had said it would probably be day surgery - partly why I hadn’t expected that kind of cost.

I know it’s horses and it happens. Just couldn’t have come at a worse time.

 

[khalswitz]

This is the chance you take with self insurance, sadly, especially with older horses. It's really bad luck for this so have shown up so early in your ownership, and I truly feel your pain and anxiety - I've been there more than once. Horse ownership is a massively chancy business, and if you don't have deep pockets, a financially stressful one too. There's no easy answer, and the vet should be able to advise on non surgical options and prognosis. I do feel for you OP. I stopped insuring my older horses once they passed 15 ish, although I kept an "accidental injury" policy going for my remaining old boy (now 25ish) until a couple of years ago. Even youngster insurance is crazy expensive, but I bite the bullet for now because my youngster has a self destructive tendency. Good luck and I hope you can find a resolution

Yeah I know it is. And tbh I know I still wouldn’t have done anything differently because the cost of insuring her would have been over £1.5k a year and I wasn’t spending that on an older horse.

It’s easy to say if if if but if all these other things weren’t cropping up at the same time we could have managed a payment plan over a couple of months. Or if it had been 6-12 months into ownership, I’d have had enough put away. I just don’t know how we’re going to manage this right now.

 

[Pearlsasinger]

I’m going to have to try. It was a university hospital quoting me £3k though so that doesn’t bode well. Although they said she’d need to be in for a week where my own vet had said it would probably be day surgery - partly why I hadn’t expected that kind of cost.

I know it’s horses and it happens. Just couldn’t have come at a worse time.

I would ask why she would need to be in for a week. It might be that it's not really necessary.

Slightly different but our small animal vet always used to want spayed bitches to stay overnight after the op, even though there was no-one routinely at the practice overnight. We had more than one disagreement over the policy. Now the policy, despite having night staff in their new hospital, is to discharge to home unless there appears to be a problem.

 

[The Fuzzy Furry]

I’m going to have to try. It was a university hospital quoting me £3k though so that doesn’t bode well. Although they said she’d need to be in for a week where my own vet had said it would probably be day surgery - partly why I hadn’t expected that kind of cost.

I know it’s horses and it happens. Just couldn’t have come at a worse time.

I hate to pile on you, but there will be a period of box rest after, often a surgical shoe may be used. Follow up post OP vet visits will add more cost.
You'll need to factor in additional costs of bedding, fodder etc and potentially care too - if you haven't already.

I got quoted 2 months ago for an op, the additional costs would have added another 1.2 to 1.5k. I'm fortunate (???) in that mine is now turned away without shoes and unless hopping lame, will be on field rest for another 3 to 6 months (she is sound at walk and 2/10 off in trot). There was no guarantee that the issue would be the only thing that the operation would throw up once they opened up. Field rest in my own yard was one of the 3 offerings that specialist vet suggested.

Good luck, hope you can come to a suitable decision that you can work with x

 

[TPO]

I’m going to have to try. It was a university hospital quoting me £3k though so that doesn’t bode well. Although they said she’d need to be in for a week where my own vet had said it would probably be day surgery - partly why I hadn’t expected that kind of cost.

I know it’s horses and it happens. Just couldn’t have come at a worse time.

I think it depends on the keratoma. If a week in hospital is needed thst may indicate that's on the more serious side.

Iirc a poster on here (is Shoestring Eventing but can't remember user name. SJ something?) had a horse with a keratoma. It was on the more serious side so it might be helpful to search for her posts.

I've previously insured and don't anymore for various reasons. It's not usually the "main event" that costs, its all the repeat visits/check ups/bandage changes/extra costs of box rest that adds up.

I had an ex racer with an undiagnosable hoof issue. He had chronic abcessing and two surgeries to try to remove "something". The bulk of my cost was the very regular vet visits and dressing material.

You've taken the first step contacting the vet for a breakdown. Might be worth contacting the hospital and telling them you're not insured, that often makes a difference to the price. Try some other equine clinics for prices.

I guess then you have to do the maths. Is a loan or 0% card an option eg. Would selling the flat free up cash for the car and horse? If the cost is truly beyond your reach then you might need to consider other options.

My horse was never a welfare issue so I kept trying to fix him. Ultimately none of it worked and he was pts 2yrs later due to unrelated issues. With the benefit of hindsight I wish I'd pts sooner for both our sakes. He was almost 6yrs of vet bills and current horse is year 3 of ongoing stuff. There's no wrong decision, it's a tough situation to be in.

Based on the experience of others on here I wouldn't broadcast any of your plans on your yard. A few on here had a really hard time with others judging them.

 

[AmyMay]

If it’s any consolation OP, if it were my horse I’d turn away under veterinary supervision. It’s not a surgery I’d have done.

 

[SEL]

When I had one in for surgery the overnight livery costs weren't a huge part of the bill - the majority was related to the surgery (tie-back in her case)

I have more recently got a lot firmer with vets as regards treatment options and will now tell them if a course of action isn't 'financially feasible' and see what response I get. My most recent conversation went 'I know gold standard is to blood test monthly, but that isn't financially feasible for this horse and if her liver becomes a problem then she'll be put down anyway, so let's try blood testing at 2 months'. Vet went quiet and then said OK.

It is worth saying to your vet that the quote is unaffordable and are there other options / hospitals etc

 

[SEL]

FWIW I'd also just keep sticking a poultice on in case its a deep abscess - I've seen too many now that bubble away for months with on / off lameness issues and then suddenly track out through a weak spot and the horse is instantly sound.

 

[Pinkvboots]

I'm not I would do the op its alot of money for an older horse if you don't have insurance.

I've only known one case of keratoma in the hoof he was a 12 year old ex racer he had the operation all was fine but within months was lame again and it had come back.

If she is field comfortable why don't you turn out for a bit then see if your situation is better at the end summer.

 

[Patterdale]

I would turn out and reassess when I had more money.

Sorry all this is happening in your life now! Things will get better

 

[khalswitz]

Thanks everyone for the input I appreciate the sympathy and suggestions for ways forward. I’m going to contact the hospital again, and am waiting for my vet to get back to me on other options although as some have said he did say the only treatment option really is surgery. (And yes it’s probably a fairly serious case as it showed basically a gap in her pedal bone from pressure from the keratoma and even on her best days right now she’s lame in trot in the field).

I’m also going to look into 0% cards and also ask the hospital about payment plans. And frank conversation about whether it’s doable to leave her turned out til the autumn.

I know the ongoing costs are going to be a big too, but it’s easier in some ways paying manageable amounts regularly over time than finding a big wad of cash like this. Paying another 1-1.5k over 3-4 months of recovery would be manageable, finding £3k in one go at the moment isn’t.

On another note, she is insured for accident/illness as someone mentioned, it just doesn’t apply for this.

 

[ycbm]

I would contact a peripatetic vet who is used to dealing with stuff at the horse's home, and ask them to look at the x rays and see if the believe a standing sedated operation could remove it. Hospitals always go belt and braces on things for safety and it's not always necessary.

I'm so sorry your re-entry into horse ownership has thrown this at you and that your husband isn't in a position to support you. I think my husband would ask for a divorce or book me in for psychiatry if I ever told him I wanted to buy another.
.

 

[Birker2020]

Sorry if this has been mentioned, would you consider a % credit card and pay it on that? If used with care, a 0% credit card can be a useful way to buy bigger items and pay for them over a longer period. I am assuming you could pay the vets bill on this, I know I've bought a number of items on mine, mainly tubs of expensive Myoplast and other supplements and I'm sure I've paid a couple of bills too.

You have to make interest free payments every month and normally can choose from a number of credit card companies (if you go down this route make sure you get as longer fixed term to repay as possible).

 

[criso]

If it was absolutely necessary I would go for a 0% credit card over at least 24 months. Think of the monthly payments as what you might have paid for insurance which you said would have been over 1.5k a year. So financially you'd be in the same place. Virgin money do a good one.

However I would also have a tough conversation with the vet about outcomes. Do you put yourself through this if there's only a 20% chance it will work.

 

[khalswitz]

FWIW I'd also just keep sticking a poultice on in case its a deep abscess - I've seen too many now that bubble away for months with on / off lameness issues and then suddenly track out through a weak spot and the horse is instantly sound.

Might be worth noting that the vet said keratomas lead to multiple repeat abscesses. So that could well be part of it but it’s likely still linked to the keratoma.

 

[khalswitz]

If it was absolutely necessary I would go for a 0% credit card over at least 24 months. Think of the monthly payments as what you might have paid for insurance which you said would have been over 1.5k a year. So financially you'd be in the same place. Virgin money do a good one.

However I would also have a tough conversation with the vet about outcomes. Do you put yourself through this if there's only a 20% chance it will work.

Actually, over 24 months or something that could work to be fair, that’s manageable.

The frustrating thing is that they’ve told me the outcomes are usually good. Apparently reoccurrence is rare, and most horses come sound again afterwards. If anything, it’s a more straightforward and solvable issue than navicular or arthritis or one of the many other things I was worrying about. It’s just an expensive op with a lot of bandaging and a potentially decent period of box rest.

 

[Sanversera]

FWIW I'd also just keep sticking a poultice on in case its a deep abscess - I've seen too many now that bubble away for months with on / off lameness issues and then suddenly track out through a weak spot and the horse is instantly sound.

This. My horse was like this for months,we just turned away. He's sound now

 

[criso]

The frustrating thing is that they’ve told me the outcomes are usually good.

That's a positive thing. If the outcome was poor you might have to make a heartbreaking decision.

 

[khalswitz]

That's a positive thing. If the outcome was poor you might have to make a heartbreaking decision.

Maybe this sounds daft, but if the outcome was poor it would be an easier decision not to do it, and then decide on whether she can be field happy or not. I’ve gone through that before with a horse with a stifle issue that needed surgery to be sound for riding and he stayed a field ornament. It’s worse when it’s a surgery she needs in order to get better, that she’s likely to slowly get worse over time without it (so it’s not a permanent pause we can put on this), has good outcomes, but I can’t afford to do it. Then it’s all my fault.

 

[AandK]

My horse had a keratoma op in Nov '20, he had his done under GA as vet wanted to be thorough and he stayed at the vets for a week post op. My first bill including the op and several visits to change the bandage (done every 3 days by vet to start, I took over once he had the hospital plate shoe on 3 weeks post op) was £4.3k. He was on box rest for about 11 weeks after the op and was allowed in hand walking once the shoe was on, bandage changes every other day until the defect keratinised and then he went back out in the field. It was tough on both of us but the op was the only option, as the tumour was already damaging his pedal bone so I had to take the chance of removal otherwise it would have been PTS. However, he was only 7 at the time and also insured.
Join the Equine Keratoma Support Group on FB if you are on there, lots of stories to read and you can ask for advice etc. I have seen people on there with horses who have had the op under standing sedation, which would keep the cost down.

 

[Surbie]

My stable neighbour's insured horse had a keratoma op in autumn 2022 and was in Liphook for 2 weeks iirc, with the complication that the foot also abcessed, plus had to return to Liphook for remedial farriery. She was 12 I think at the time. The tumour was large, and when we watched the dressing being changed you could see her pedal bone. She was in on box rest for longer than if it had been summer, but fortunately coped with that and in-hand grazing around the yard.

The changes of dressings over the box rest time added up too, as well as the extra hay/bedding etc and that might be something to consider if you are budgeting.

If you can have standing sedation that would be a lot cheaper.

The horse is now fine, and while my friend naturally watches her like a hawk for any misstep, she hasn't had any abcesses or recurrence so far.

 

[Rowreach]

Did your vet xray all four feet or just the one your horse is showing lameness in? I ask because one of mine was lame in only one foot and kept pushing up abscesses but on investigation there were things going on in three feet that we could find, and then she started having abscesses in those feet and I called it a day.

Yours of course might not be as bad as this, but there's little point spending £3k plus all the rest on top if the problem is going to appear somewhere else.

 

[khalswitz]

My horse had a keratoma op in Nov '20, he had his done under GA as vet wanted to be thorough and he stayed at the vets for a week post op. My first bill including the op and several visits to change the bandage (done every 3 days by vet to start, I took over once he had the hospital plate shoe on 3 weeks post op) was £4.3k. He was on box rest for about 11 weeks after the op and was allowed in hand walking once the shoe was on, bandage changes every other day until the defect keratinised and then he went back out in the field. It was tough on both of us but the op was the only option, as the tumour was already damaging his pedal bone so I had to take the chance of removal otherwise it would have been PTS. However, he was only 7 at the time and also insured.
Join the Equine Keratoma Support Group on FB if you are on there, lots of stories to read and you can ask for advice etc. I have seen people on there with horses who have had the op under standing sedation, which would keep the cost down.

Oh my god that sounds like such a major surgery. My vet had my under the impression it was standing surgery, I wonder if the price is because they’re thinking full GA? I’m not sure I’d put a 17 year old through GA tbh even without money considerations, so that’s a whole different question I need to be asking. Thanks for sharing this I really appreciate it - did your lad come right after it?

My stable neighbour's insured horse had a keratoma op in autumn 2022 and was in Liphook for 2 weeks iirc, with the complication that the foot also abcessed, plus had to return to Liphook for remedial farriery. She was 12 I think at the time. The tumour was large, and when we watched the dressing being changed you could see her pedal bone. She was in on box rest for longer than if it had been summer, but fortunately coped with that and in-hand grazing around the yard.

The changes of dressings over the box rest time added up too, as well as the extra hay/bedding etc and that might be something to consider if you are budgeting.

If you can have standing sedation that would be a lot cheaper.

The horse is now fine, and while my friend naturally watches her like a hawk for any misstep, she hasn't had any abcesses or recurrence so far.

That’s really encouraging to hear a positive story.

Yes, I’m prepared for box rest costs and have a few methods of mitigation - for example, when my last horse had a five month box rest spell, I got the local libraries to let me take their daily newspapers once they were done with them, and used my old shredder to add shredded newspaper to bulk out my shavings. Hay isn’t so bad because it’s included in my livery. And very luckily, via my work I can get ⅓ off bandaging materials - it’ll just be special dressings/meds etc that I’ll need to buy full price from the vet. So all together whilst I know it will cost, I’m hopeful.

 

[khalswitz]

Did your vet xray all four feet or just the one your horse is showing lameness in? I ask because one of mine was lame in only one foot and kept pushing up abscesses but on investigation there were things going on in three feet that we could find, and then she started having abscesses in those feet and I called it a day.

Yours of course might not be as bad as this, but there's little point spending £3k plus all the rest on top if the problem is going to appear somewhere else.

Yes they xrayed all four. For her age, she’s got fab feet - no signs of any degeneration in any of them, and although her hinds are a little unbalanced there’s no sign of anything abnormal other than the keratoma, which is in the foot she’s lame on.

 

[Slightlyconfused]

I’m going to have to try. It was a university hospital quoting me £3k though so that doesn’t bode well. Although they said she’d need to be in for a week where my own vet had said it would probably be day surgery - partly why I hadn’t expected that kind of cost.

I know it’s horses and it happens. Just couldn’t have come at a worse time.

See if you can speak to Brian O'Mera, he did my ones surgery and it wasnt that much. Granted he had his investigations done under insurance which came to about £3K of £4k insurance as he had a MRI to confirm, from memory the op was about £1200 but it was done standing sedation. If he had to go under GA it would be double. At least.

There is a lovely Keratoma Support group on FB that offer a lot of help and advice.

 

[Pearlsasinger]

If it’s any consolation OP, if it were my horse I’d turn away under veterinary supervision. It’s not a surgery I’d have done.

I know someone who co-paid for an MRI that found a keratosis, then for various reasons decided against operating and turned away, then decided to retire the horse, which never was ridden again but appeared to be field sound.

 

[Beausmate]

I would contact a peripatetic vet who is used to dealing with stuff at the horse's home, and ask them to look at the x rays and see if the believe a standing sedated operation could remove it. Hospitals always go belt and braces on things for safety and it's not always necessary.

I'm so sorry your re-entry into horse ownership has thrown this at you and that your husband isn't in a position to support you. I think my husband would ask for a divorce or book me in for psychiatry if I ever told him I wanted to buy another.
.

Your farrier may know of a vet who would be prepared to consider doing it at home.