Efficacy of / experience w/ tie forward?

[johnnysauntie]

My 13 yr old OTTB has been scoped and diagnosed with DDSP. He has some abnormalities (including a really flaccid epiglottis) and a failed tie-back.

Until today his airway has been clean, but today’s scoping revealed that he’s aspirating feed. :no: My vet is recommending tie-forward, but noted that both she and the surgeon she recommends have seen little success with the procedure, despite the papers and studies which indicate otherwise. The surgeon isn’t a hack, he is with one of the best clinics in the area, and they do a lot od sport horse/race horse work.

I’m leaning toward doing it, thinking along the lines of “probably won’t hurt, and might very well help.”

For those with experience with tie-forward, I’d love to hear about outcomes.

Horse is now a low level dressage horse (and loved pet.)

[Bacchus]

Before I got him, my horse was in race training, but he was a roarer. They had the tie-back and it didn’t work. Then, maybe when he was a hunter, they had the tie-forward, and it didn’t work:( That’s why I got him for free for my husband:)

Wish I had more details, but I know it didn’t work for this horse.

I’d probably go for it, but maybe get a second opinion (diff. vet/surgeon) first. Why do they think it won’t work? Is it just your horse’s situation or the surgery in general?

[johnnysauntie]

The issue is that my vet and the surgeon haven’t seen much success at all with this surgery. I have no idea whether or not it would work (hence my lobbing this question out to COTH) and am trying to determine if it’s worth the $$ to give it a shot. My guy doesn’t roar. He just displaces - all the time, and is now aspirating food, which was my greatest fear.

[Bacchus]

Is there an alternative for this horse?

[jbonifas]

What is the tie forward going to do or fix or prevent?

[johnnysauntie]

The alternative, according to my vet, is pretty much nothing. He has some wonky airway abnormalities. The surgery would be intended to reduce the frequency of displacement.

[Bacchus]

I guess you have to weigh doing nothing against the surgery. Is it harming the horse? Could it get worse?

I think this the way I would lean, too: “probably won’t hurt, and might very well help.”

[judybigredpony]

2 tie backs and a tie forward same horse…tie forward had to be undone, failed as well…pasture pet now…:(…displaces terribly does not aspirate but panics when he displaces thinks he can’t breath. Happy doing nothing but grazing…

[SonnysMom]

Friend’s horse was a roarer and when they went in to do the tie back realized his was not a classic case and they just lasered off the flap altogether. Obviously that is not reversible but it solved his particular problem. I believe he had scar tissue around the flap.
Not sure if that would be a possibility instead of the tie forward. I don’t know anything about displacement.

[Laurierace]

I would think the tie forward would increase the chances of aspiration so if that is your main reason for doing it I would skip it. My only experience is with racing horses so not sure how that would translate to your horse but I always go for the Llewelyn procedure first then the tie forward if necessary. Neither works for very long as far as racing goes though. If you are lucky you get a year but that includes the recovery time.

[Calamber]

Tie back or tie forward, it is not an answer for a problem that has it roots in nutritional deficiencies, blood lines, drug overuse, chronic infections and poor conditioning. Not necessarily in that order. Sorry, I would not put the horse through it.

[brightskyfarm]

I dont know your location, but, good things have been said about the vet clinic at Charlestown – maybe Laurierace can fill in the blanks on the who/contact for them.

I know one trainer at PN had great success with a tie-back on his horse – (“best $275 Ive ever spent”) however, I believe the general consensus is that either the tie-back or tie-forward surgery might get a horse through 1-3 more races and thats about it – the majority eventually fail.

I would keep gathering opinions/ espeically those from vets working on track horses, as it puts the greatest strain on this procedure, and they seem to be making the greatest advances in research on this subject.

Heres an article that explains specifically on ddsp/aspiration
http://www.equinews.com/article/roaring-and-choking-down-in-horses
The Cornell Collar may help temporarily until you find a final solution
http://www.rwwa.com.au/home/thoroughbredpolicy42.pdf

Go to 32:17min shows normal, 37:08 shows the abnormalities.
http://www.youtube.com/watch?v=QsvS6gEBJuE&feature=share

[Calamber]

Brightsky, I am glad you have come on and commented. Remind or link to the story of your Money horse because this situation reminded me of you and that horse.

[brightskyfarm]

Hi Calamber! … Ah, horses are our teachers.! Thats how I came to the above informaton… the link to the horse autopsy is great! I saw the larynx in a scoping, but to see it hands on like that is amazing.

Turns out the mare now is a h/j -- in a private show home.

Changing barns was the first remedy – the old barn had a lot of mold, causing the initial respiratory distress. Tri-hist and standard anti’s relieved the initial symptoms. Turn out for the summer took care of the residual – some scarring had taken place leaving a touch of roar when highly stressed (such as heavy-foxhunting or upper level eventing, lower level work/shes fine). She could have a lasering to removed those noduals but I and her new owner opted not at this time – rather to see if they interfer, or at all.

However, OP, initially the vets wanted to simply put her down, the 2nd round of vets recommended all kinds of surgeries, the 3rd round of vets found the root and resolved the problem.
It was simply my own intuition, and for knowing the horse that I kept looking for solutions until the right one was found.

[Calamber]

[QUOTE=brightskyfarm;6583445]
Hi Calamber! … Ah, horses are our teachers.! Thats how I came to the above informaton… the link to the horse autopsy is great! I saw the larynx in a scoping, but to see it hands on like that is amazing.

Turns out the mare now is a h/j -- in a private show home.

Changing barns was the first remedy – the old barn had a lot of mold, causing the initial respiratory distress. Tri-hist and standard anti’s relieved the initial symptoms. Turn out for the summer took care of the residual – some scarring had taken place leaving a touch of roar when highly stressed (such as heavy-foxhunting or upper level eventing, lower level work/shes fine). She could have a lasering to removed those noduals but I and her new owner opted not at this time – rather to see if they interfer, or at all.

However, OP, initially the vets wanted to simply put her down, the 2nd round of vets recommended all kinds of surgeries, the 3rd round of vets found the root and resolved the problem.
It was simply my own intuition, and for knowing the horse that I kept looking for solutions until the right one was found.[/QUOTE]

And the kicker was that she was scoped and they determined that she was infected, and that she needed a tieback, and it turned out it was her vocal chords if I am remembering right? Which was why she had the really weird whinny? The funny thing was that I was having the same symptons and I knew it was mold poisoning (except my whinny was not affected, but I had a gravelly voice). I got detoxed for mold, now I am getting chelation therapy for mercury and lead toxicity. So, dig deeper and go outside of commonly accepted hypothesis is what did the trick.

[brightskyfarm]

Yes, yes,…between the two of us we’ll get the story out!
I was simply so tramatized, knowing it was something else.
Im asthmatic, mold being one of the allergens – and I was having difficulty for being in this barn – the vets kept ignorning me when I compared the symptoms.!

Her first major attack looked asthmatic, the side heaving, the limp body for trying to breath and extend the ribs – finally dex was given and that offered relief until I found another vet, a trailer and got her moved. (you saw the size of the throat in the video, right?)

In about 3 days,; she was stable again… and a a scoping did reveal the injury to the vocal chords – wow, she had the size of a pencil to breath through.

So, yes, keep going with diagnositics, especially if your inner vioce is saying something isnt quite right…it most likely isnt.

[Calamber]

[QUOTE=brightskyfarm;6584731]
Yes, yes,…between the two of us we’ll get the story out!
I was simply so tramatized, knowing it was something else.
Im asthmatic, mold being one of the allergens – and I was having difficulty for being in this barn – the vets kept ignorning me when I compared the symptoms.!

Her first major attack looked asthmatic, the side heaving, the limp body for trying to breath and extend the ribs – finally dex was given and that offered relief until I found another vet, a trailer and got her moved. (you saw the size of the throat in the video, right?)

In about 3 days,; she was stable again… and a a scoping did reveal the injury to the vocal chords – wow, she had the size of a pencil to breath through.

So, yes, keep going with diagnositics, especially if your inner vioce is saying something isnt quite right…it most likely isnt.[/QUOTE]

You were a champion for fighting for this mare, something just did not add up, once you sent me that video of her as she started to stabilize outside of the moldy barn and that strange whinny. No, I did not see that video, at the time I could not have watched anyone else with a pencil thin airway! Anyway, I am so glad you came on here and so happy to hear of Moneys’ success, I hope the OP can get some other help for this horse. Full circle, hope the horse can recover.

[MintHillFarm]

I had a tie forward procedure done at Cornell on my Paint gelding, Alex at age 7, last September.

He was diagnosed as your mare was, with a flaccid epiglottis. He had trouble breathing when ridden.
He was not aspirating feed at all… They put him on the treadmill and scoped while trotting. They could not get him to canter on the treadmill…

I was told that the best success generally for this surgery is with a horse that is not asked to go in a round frame. My guy goes with his nose poked out and I never ask him to change that head carraige.

He has some improvement. I would say 35% better. Some days are good, and some days he labors with his breathing still. To be fair, he is a VERY QUIET horse anyway! I am looking forward to riding him as it gets cooler, the heat doesn’t help him…

I would not return with him for any more surgery. I do what I can with him. Some days we trot a couple times around my arena each way and canter a few with maybe a couple of transitions mixed in. We jump some, maybe up to 10 jumps in one ride. When I jump him, I do even a little less on the flat and maybe work in the fences as we hack.

I have also had another horse, Fred, that had a vocalcordectomy as another poster mentioned. The surgery was very successful and gave him much more air. I would say he was 75% better after this procedure. The 2 diagnosis were different though. Fred was to have a tie back, but showed a bit of COPD when scoped again at Cornell, so the vocalcordectomy was the only choice.

As an FYI, my insurance covered both surgeries…

[Laurierace]

There are times I would have liked to replace my kids with cats as well but it get better.