Chronic snotty nose

[Jo]

My elderly TB has had a snotty nose for a few months. It was initially diagnosed as a bad tooth; tooth was pulled and AB given. Snotty nose cleared up for a while but came back about 6 weeks ago. She’s had several rounds of varying AB, each with varying success, but the snot returns after the ABs have ceased. Two weeks ago, she had face Xrays done to determine if there was another bad tooth brewing. Nothing showed up there, teeth were again checked. IV AB and additional oral AB prescribed for 10 days.

Snot still gotten better - it’s no longer thick and yellow. Vet wants to wait and see another week or so without any AB. Next step would be drilling a hole in her sinus and flushing daily for three days straight. I’m concerned about such a major procedure and am wondering if anyone has any experience or thoughts on alternative treatments that may work for her.

I also hope that since our weather is not so wishy-washy this week, that it might help…?

Basically crossing my fingers that she’s miraculously better when I go out tonight and all of this will be “moo.”

[Simkie]

Can you scope her head holes before knocking a hole in the sinus? It might be helpful to take a looksee in there first.

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[2tempe]

Agree w/ Simkie - had a mare years ago with sinus issue unresponsive to antibiotics (several types). Took her to Ohio State, they scoped and then did the sinus flap surgery. It went fine, though I was told I wouldn’t want to watch…

[Xanthoria]

I went through this last year and ended up having the sinuses drilled and teeth removed 2 times, at a teaching hospital, costing over $6000 and 3 weeks total in rehab. During which time horse managed to mysteriously blow his cruciate which required euthanasia

https://www.chronofhorse.com/forum/forum/discussion-forums/horse-care/9729037-tell-me-about-sinus-issues-in-horses

My advice to you: skip the oral or injectable antibiotics - they won’t touch a sinus infection. If teeth are bad, remove them right away - and ask if all other teeth associated with sinuses can be removed at the same time (first 2-3 upper molars each side). Test for Cushings - this can be the thing that lowers their immune so they keep getting infections. But end of day a low grade sinus infection (with no painful teeth) is something they can live with (yes the hospital told me this after they fleeced me) and I so wish I had taken a different route. But I did what the vets said.

[DarkBayUnicorn]

Also investigate guttural pouch infection.

[skyy]

We just had a horse with a chronic, 1 sided snotty nose. AB didn’t clear it up, so a hole was drilled and it was flushed and that procedure was no big deal. Very undramatic. This didn’t clear up the problem though. I just wanted to comment on the lack of excitement with the drilling and flushing.

[Jo]

@Xanthoria

But end of day a low grade sinus infection (with no painful teeth) is something they can live with (yes the hospital told me this after they fleeced me) and I so wish I had taken a different route. But I did what the vets said.

Thank you for all of the ideas and suggestions. This, in particular, was what I was wondering about. She has no other symptoms - eating fine, normal attitude, etc. Luckily my vet is not pushing to do the drilling so now we’re on a “wait and see” for another week.

[drafting_dots]

@Xanthoria

But end of day a low grade sinus infection (with no painful teeth) is something they can live with (yes the hospital told me this after they fleeced me) and I so wish I had taken a different route. But I did what the vets said.

I’m pretty sure I live with a low grade sinus infection. Might be an unpopular opinion here, but as long as there is no serious underlying issue and the horse is behaving normally, I don’t think I would do any kind of head drilling.

[candyappy]

@Jo

Thank you for all of the ideas and suggestions. This, in particular, was what I was wondering about. She has no other symptoms - eating fine, normal attitude, etc. Luckily my vet is not pushing to do the drilling so now we’re on a “wait and see” for another week.

Could she have an allergy? If she is acting good and has no fever and eating why not just watch her and do nothing for a while??

[TBMaggie]

Are you anywhere near an equine dental specialist? I would definitely have someone who sees these problems daily, take a good look at your horse. A chronic snotty nose isn’t something to take a ‘wait and see’ stance on - something is going on, and it could destroy the sinus walls or bone if left unchecked.
I had a horse with a non-stinky snotty nose for over 2 years (vets kept telling me that if it was a tooth, it would stink) - so kept treating with abx over and over. My horse ate fine, acted fine. No fever. He had a chipped tooth that was finally removed - but now has almost no walls left in his sinus cavity, and lost a good deal of bone over the tooth, leaving a hole that may never fill.
Sinus infections are the worst. There may be a bone chip that is still up there on your horse, that isn’t showing up on the films, or a possible cyst that formed and has calcified as in the case of my horse. Something like that would only be found by drilling the hole - really isn’t that big of a deal apparently to the horse, only to us horse owners. I freaked too, but it was all ok.
So, long story short, find a dental specialist. Don’t wait.

[kiwichick]

I have experience with this too, like Xanthoria.
Antibiotics will never get rid of a sinus infection, not if you feed them until the day the horse dies.
The only route to clear it is to drill and lavage, and in my case this did not clear it. He went on to reinfect and require bone flap surgery, which was completed in August.
My horse since then has bouts of snot, they range from day to day, and from clear to green. Once they go green I run him through a course of Potassium Iodide/ammonium chloride, and that seems to settle things for a couple months.

My only options going forward are to re-drill and lavage, or open the flap again, and neither will be happening. My horse is young, he is 6, and didnt do well with all the medical intervention.
Hindsight is a wonderful thing and like Xanthoria knowing what I know now, the way I handled it would be different. My total vet bills were 8k and my insurance has written my horse off for further sinus issues.
If you have Xrayed and no teeth are involved then drilling may be an option, but if it comes back after that, I would be rethinking next steps.

I also had my horse scoped what felt like a million times, and loads of xrays, the xrays were indefinitely more helpful than a scope, and the reason they scoped was purely to check gutteral pouch. Basically they scope and go ‘Ah yup its sinus’ and they need to xray then anyway.

My horse had a cyst which was missed by the initial vet hospital, they stuck a camera in through the drill hole and entirely missed it. MRI would have picked that up at the time, and saved me having 2 surgeries and long drawn out recovery where by my horse started hating me. But MRI is $$$ too.
The chances of his cyst returning arent low, hence I will do what I can for mine, but we will not operate again.

[kiwichick]

Sorry other things I didnt comment on

My horse presented with difficulty breathing (no discharge) he was found to have complete blockage of one sinus and over 4ltrs pus removed.
He had no fever at all, I was checking him daily and all vitals were checked by hospital when we arrived.
There was no smell, to this day there never is.
He was fine, eating, galloping around. I had stopped riding him as his breathing sounded bad. I expected an asthma diagnosis and thats what the hospital actually started checking for.

He began violently spooking and im convinced the pressure in there caused this, unfortunately these behavioural issues remain. I also need to speak to the vet about wether there is any possibility it could have damaged his sight, as im convinced he has an eyesight issue these days.

His tear drains are ruined so his eye on and off weeps, Vet said that will probably heal either.