Crossposted: WWYD?? Fractured dreams...

I don’t know why I’m posting here—maybe for some kind of catharsis or, like, commiseration. This is mostly just a rant about bad luck and possibly bad choices on my part.

Here’s some background info: I’ve had DG (dear gelding) for one year. He was purchased as a 3yo from my local track, I did a good vetting which he passed easily, but I did not do rads. In hindsight I should have, but whatevs. Too late now. Lesson learned. He’s beautiful, flashy, an excellent mover, three lovely-to-ride gaits, funny, quirky, pretty well-behaved for a baby, etc., etc., etc. You know, the unicorn.

Anyway, I worked all year to get him going and we successfully debuted at the beginner novice level in August. Everything was golden. No lameness, no training issues (other than being a now 4yo), and he has a good mind. Then, I bring him out of his stall one morning with a mystery swelling in a hind fetlock. I posed here about it. It sort of resolved, but due to the extensive diagnostics I ran, the vet also found some pretty concerning issues in both his hocks. We treated with Osphos, IRAP,and PRP, rest, time, and rehab. I was bringing him back to walk and trot work and he blew an abcess, resulting in a quarter crack that my farrier has patched and is keeping an eye on. So, a few set-backs but, horses… am I right?

Finally, I’m getting him back into semi-consistent work and am making plans for our eventing schedule next year. We’ve just started doing canter work again and a friend comes over for a trail ride at my place. We do a little fun ride, get home, I chuck him out in the field, she loads her horse, and my guy freaks out a bit because the other horse is leaving. He runs back over to the gate, slips in the mud, falls on his side and stands up, holding his left hind up. I panic. Grab the halter, grabs him, lead him out expecting to see exposed bone or immediate swelling from some horrible soft tissue injury. Nothing. He walks it off, he’s fine. Thank goodness.

10 hours later, I’m coming in from work at 1am. I see him standing at the gate waiting for his dinner. He isn’t moving much. He’s holding his leg weird. I have to drag him out of the pasture. His hock is hot and swollen. Get him to the vet as soon as they open and rads reveals he has an “acute fracture of the lateral mallelous of the tibia.” FML. Luckily, it’s fairly common, and it’s a piece of bone he can live without.

So… here we are. He’s on stall rest, obvs. Waiting for consult from surgeon to recommend surgery or conservative management. Vet feels he’ll recover 100% and get back to work in a relatively short amount of time. But here’s where I’m at: how many of you would just cut your losses now? He wasn’t exactly cheap, at least not on a cop’s salary, and I’ve spent a small fortune on vet bills already. I have more to spend, so that isn’t entirely the issue, but he’ll never be saleable with his hocks, at least not to someone who doesn’t want to do maintenance, and now, after reading everything about Osphos and its tendency to inhibit the healing process, I’m not sure he’ll recover from this fracture. I’m just lost.

Am I throwing good money after bad? How do you decide what to do, for the horse, for yourself? A good friend who is vastly more pragmatic than I says she would put him in the ground and start over. Another good friend says to do the surgery, see what happens, and WCS—sell him as a low level dressage horse because he’s flashy and a better than average mover, for an OTTB.

A short good life is a good life.

If I was inside your friends circle and knew you and all the nuances, I could live with whichever decision you make. I’d be supportive of either so long as the horse wasn’t suffering.

It’s very possible that he’s having a run of amazing bad luck, to be followed by years of soundness and no problems. But there is no knowing what the future holds. And every owner has their limits of what time and money they can invest.

If you were to decide to let him go to the pastures above the clouds I would strongly advise that you not talk it up in your world. It’s not a secret, but don’t invite people into the decision. You will end up running a gauntlet of misery with the amount of pressure people will put on you from every direction imaginable. Much based on their own values and emotions, with little or no consideration of yours. Friendships will be tested in unnecessary ways, and it could be surprising which ones. It’s just one of those questions that does that to people. I’d tell them that you did all you could but unfortunately you couldn’t get him permanently sound. Don’t discuss it, and especially you should decline to get into the details. Just say that you just want to move on and not dwell on it, it’s too hard. Because there are also people who will want to micro-dissect every medical detail. What people say about these things isn’t bad or even really wrong, it’s just not necessarily where you are with your feelings and thoughts, and in their own curiosity they are not likely to be considerate of you.

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OTTB’s are accident prone, and baby horses are accident prone, so a baby OTTB means double trouble for sure.

Did you buy him as a resale project? Why are you concerned about not being able to sell him? Are you concerned about him not working out as a good match for you and your goals? Because you would have to find a new home for him in that case. Finding a good home for a sound horse with a good brain but ugly rads is certainly possible. You just won’t get a ton (if any) money.

If he doesn’t stay sound, euthanasia is certainly justified. However, you will get A LOT of flack and judgement for putting this horse down right now. Not that that is a reason to not do it, but goodness gracious! I don’t think most people would come to this decision so quickly and it is apt to be mistaken for you taking the decision lightly. So as Overandonward said, prepare yourself for hate from anyone and everyone, including people you never expected it from.

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There are some questions that need to be asked. The primary one is whether the fracture is displaced or non-displaced. In humans this is a very common ankle break which, if not displaced, is treated with rest and ibuprofen. It’s a walking fracture in humans. Surgery is contraindicated if not displaced. [URL=“https://www.verywellhealth.com/lateral-malleolus-fracture-2549417”]https://www.verywellhealth.com/later...acture-2549417

Basically he has broken a bump off the bone.

I found this paper on the internet on a young Arabian filly with two fractures there. She had surgery with screws and went on to a racing career. https://www.tnequinehospitalmemphis…bian_filly.pdf

The Merck Vet Manual says this:

Lateral malleolar fractures are usually traumatic. Small, well-rounded fragments are occasionally seen; they are considered likely to be a form of OCD and are usually asymptomatic. Small or minimally displaced fractures may be managed conservatively. Surgical removal of fragments may result in a quicker recovery. Some fragments may be removed arthroscopically, although some require an open approach through the lateral collateral ligament of the tarsocrural joint. Larger fragments may be successfully repaired by lag screw fixation.

I also found this British dissertation in Equine Orthopedics that contains a chapter on surgery for this fracture:
https://knowledge.rcvs.org.uk/docume…ith-deo111.pdf I haven’t read Chapter 6, but it talks about 26 horses and their outcomes.

A pubmed abstract: https://www.ncbi.nlm.nih.gov/pubmed/1459054 And another:https://www.ncbi.nlm.nih.gov/pubmed/1459054 Both are about the surgery.
And another: https://www.ncbi.nlm.nih.gov/pubmed/7084181 This one covers 5 malleoli fractures; all five completely recovered and returned to work.

Apparently this is a very minor fracture that shouldn’t affect the long term usefulness of the horse, DV, but each horse is an individual. If I were you, I’d read everything I could find before making any decision. It might be treatable with Dr. Green; it might need surgery, but it isn’t much different from OCD surgery unless the break is in a bad place. You need more knowledge.

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Can’tFindMyWhip: Thank you for your input. The assumption that I’m concerned about his not meeting my needs and goals is correct, and I am worried about the potential he has for re-sale, though he wasn’t purchased with re-sale in mind. It’s comforting to hear that I could find him a good home if needed, even with poor rads.

Believe me, I’m not taking it lightly, and “this decision” has not been made. What I am doing is feeling rather downtrodden and sorry for myself, and especially for him. I’m feeling guilty for turning him out in a grassy pasture that has mud by the gate, which is ridiculous. I’ve had horses for years, all who have done dumb sh*t and none of them have broken a bone, until this one.

I have every confidence I will see him through the surgery and rehab, and then re-assess. More than anything, I’m here asking these questions because I’m wondering what the limit is, or what it was for someone else.

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Wow, vineyridge! Thanks! The vet read me the Merck manual page about the fracture, and said there would be no screws. I didn’t ask why no screws, but she seemed confident the piece would be removed. But… we’re waiting for the official word from the surgeon. Re: the fragment being displaced, I’m not sure. I did see the rads, and the fracture is all the way through, but it didn’t look (to my untrained eye) to be anything other than slightly separated, and not to one side or the other.

I’ll commiserate! I agree- either decision I’d support. I bred a fantastic warmblood. Last breeding of my mare. She degloved her leg on a fence as a weanling, stick her foot through a stall guard as a 3 year old (after 20 seconds in a stall for the farrier), ripped her eyelid open at 4. At 5- her bad leg (which healed but is ugly) fetlock almost hits the ground when she walks. Vet supports any decision but doesn’t feel she’ll hold up under saddle. Sigh

So she sits in my field. If I boarded- I’d have euthanized her by now. I say…

nothing but sympathy from me.

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Look up past posts by Acme Eventer, and her OTTB, Cottonpickingwabbit. Her posts could give you hope.

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Given the time of year, go ahead and plan your season and let him heal up over the winter. He won’t forget what he learned. I know it probably feels like an endless string of stuff, but if you didn’t know about the hocks, you wouldn’t be worried about them. Carry on as if you didn’t know. This recent injury sounds like it will heal pretty well.

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And speak with your vet about Osphos and healing the fracture. At least that way you won’t lose sleep on that one issue.

Plenty of great advice here. Hilary said what I would have said if she hadn’t already!

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I agree with Hilary, especially about the hocks. Unless they start actually causing problems, my vet would advise me to carry on training as if nothing were wrong. It is amazing what will show up in rads but never show up as unsoundness or discomfort. My OTTB is a “war horse” who ran his best races in the wet so he saw lots of wear and tear, and while I didn’t do a proper PPE, he has always been sound without maintenance despite lots of lumps and bumps on his legs. I’m certain if I x-ray’d his legs tomorrow, I’d spook myself out of ever riding him again. BUT because he is going well and willing and seems to love his job, I’m not going to look for a problem. Though maybe I’ll do it when he is feeling his age and ready to retire, for science.

So, since you found the hock problem while searching for a fetlock problem, I would not factor that into my decision making process. If this were my horse, I’d treat it like a routine little bone chip, and disregard the hock problems.

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I thought Osphos was not recommended for young horses? I forget the potential risks, but that might be something to look into.

But horses can be frustrating, and expensive. What are you thinking your option is with this guy? If your goal upper level, maybe finding him a lighter use home is wise (once sound), but maybe he will be fine after this. I guess I would wait until you are a little less raw about the bad luck and can be more objective. He sounds like a lovely horse overall.

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Hilary said it so well. I will just repost.

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Just stumbled upon this.

First off, OandO’s post is really good. No one here knows the minutia of decision making stresses of your particular situation like you do. These things are a gamble. Some times you fast forward and can’t believe you ever considered euthanasia, sometimes you fast forward and the wallet hemorrhage has led to nothing but more heartache and less riding.

The people in in your life that really matter will support you either way, whether they understand your decision or not. My heart goes out to you. It is so frustrating when it’s one thing after another. One of my boarders just had to euthanize her horse after a horrible rolller coaster ride of emotions from a trailering accident. Ultimately, his injuries were never going to allow him a sound, pain free life and she made the tough (but kind) call. I held him for her in that last moment.

I, truly, got lucky with Cotton. I asked my vet three times to euth. I never thought we’d see the end of the road. And he hadn’t even proved himself as a sport horse yet when it all started. We still have our struggles, and I’ve always been an open book with our successes and (many) failures. But I can’t imagine life without him. The story is here:
http://buildingthegrove.blogspot.com/2017/04/cottons-story-three-to-third.html?m=1

feel free to pm me if you want to talk privately. All my best to you.
Fb - Jennifer Shattuck
insta - Thegroveatfivepoints

best wishes to you

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Since this is at the end of the season, I’d ask the vet to explain in words of one syllable why she recommends surgery, if the fracture isn’t severe enough to need the piece screwed back in, and not simply letting Dr. Green do his work over the winter, ie, letting the fracture heal naturally. It may be that the distance between the chip and the bone is too great to allow healing without screwing, and she feels that simple removal would be easier on the horse and cheaper for you. But you should have a complete explanation of all your options. That’s only right.

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Hi, all, thanks for responding. Word right now is that the surgeon thinks a pin or screw is necessary, but needs another set of rads to determine. So, we wait. I’m taking all of your advice/comfort to heart and will proceed with cautious optimism until something else derails us. He is a special guy, and I have a lot pinned on him, but I know well enough that if he gets healed up from this and makes it as far as novice, he’ll make someone very happy.

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Here’s the latest article about OSPHOS that @CHT is referring to:

https://www.chronofhorse.com/forum/forum/discussion-forums/hunter-jumper/10044062-newer-article-about-tildren-osphos-side-effects

Em

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Call me crazy but you need a second horse if that’s attainable. Not necessarily another youngster but something to ride, possibly compete etc so you can go to the barn without your complete focus being on your rehabbing patient. It will make the time go faster, it will keep you sane and of course it never is a bad thing to ride something else. Just don’t buy another project, borrow something, lease something etc. I think it will give you perspective as you deal with your TBs injury and rehab.

I’d say you still need more information. The operation will be a lot more expensive if the surgeon has to insert a screw than if the fragment were simply removed. I’m cynical, but my experience is that surgeons like to do more expensive operations. You might get a second opinion before proceeding; you should sit down with your primary vet and go over everything in detail. If he needs the fragment and/or it won’t heal naturally, then he needs the screw. Otherwise not.

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I’ve been there this year, but with a foal. She was born with contracted tendons but a really good IgG. We gave her IV tetracycline which usually works, except not in this case. We did short splits, then casts, then long splints. Along the way she got pressure sores form the splints and casts. She was stall bound for the first 6 weeks of her life; she had to bee seen by the vet every day. IF Jr. knew what I was thinking when we weren’t getting promising results. He said, “Mom, you can’t put her down. We have put too much effort in this and she wants to live.” My response was, “Okay, but she may make it another 30 years and I will not, so she is your horse.” I paid the $XXXXX vet bill but she is now on his payroll, And she is doing well although one fetlock is straighter and larger than the other. She is ornery, too and that probably saved her.

If you can give it time, great but if you can’t, I think your horse is very young to have too many problems. Sometimes letting them go is the better part of valor.

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