Help - ethmoid hematoma

[shadesofbay3]

I apologize in advance for any typos as I am doing talk to text on my phone.

For any context, please see my past thread where I was talking about my mare’s nosebleed.

Well I got the scope and radiographs done today and the vet is about 98% sure that she has an ethmoid hematoma. She is going to examine them more closely in a dark room and also share them with the surgeon for his opinion and get back to me but she was saying the likelihood is that my mare will need surgery

When discussing this with my barn owner, she was cautioning me not necessarily against the surgery but about the problems that I might run into because of the recovery process and the fact that my mare is older (24) And the anesthesia might be hard on her

I haven’t made up my decision either way which way to go but want to do what’s best for her and her quality of life… My vet said that whatever was in there definitely has grown from the scope last year so if I don’t get it removed what’s to say it won’t keep growing? My vet said that there is a potential it could restrict her breathing at some point I guess if it keeps growing

what would you all do in my shoes? Would you undergo surgery or not? What I need to ask my vet is what would happen if I didn’t get it removed. I feel like I would just be waiting for something horrible to happen if I don’t remove it……

[Laurierace]

Not enough info to make a decision yet but I definitely wouldn’t make it based solely on her age and anesthesia possibly being hard on her. Is she still in work or retired?

[Simkie]

I’m so sorry you’ve gotten this stressful news

I agree that there’s just not enough info here to make a call. Do they have to lie her down for this surgery, or can it be done standing & sedated? If your vet isn’t comfortable keeping her standing, is there a larger referral center nearby that could? What is your vet’s prediction about recovery and how it will go? What sort of things can go wrong?

[IPEsq]

I know an older horse that had sinus flap surgery for something (can’t recall if it was for this condition or something else)… and twice due to a secondary infection after the first surgery… who recovered well. Horse was still in low level work and continued on for some time. Now retired for unrelated reasons.

[No1]

Before you get to the point of treatment, you may have to decide if you want to do a CT. A CT can show you the true scope of the problem and how likely treatment is to be successful.

If you can inject it with formalin and shrinks it, go for it. I would not do a sinus flap for a horse of that age. The recovery for a sinus flap can be tedious (for the horse) and long. A sinus flap is not what I would consider a minor surgery.

[shadesofbay3]

Thanks for your response… she is semi-retired. I still get on and put around several times a month but nothing major, just WT, sometimes WTC, mostly bareback

[shadesofbay3]

Thank you for your reply! It doesn’t help that I don’t know much at all about this condition so I don’t even know what to ask really. She told me that it can be done standing up… so I don’t know if that would mean she would only have to be sedated as opposed to fully anesthesed (sp). We would be doing to a larger center near us for a CT and they would be doing the procedure. Vet is calling me tomorrow after she’s had a second look at rad’s and the surgeon has looked at them too

[shadesofbay3]

This is probably a stupid question, but is sinus flap surgery the surgery for this?

[shadesofbay3]

Thank you - vet mentioned a CT as next step but I will definitely see if the CT scan correlates with how successful treatment will be

Thank you

[IPEsq]

That’s my understanding. Basically they have to open up a flap of bone on the front of the horse’s face to access the growth if it needs to be removed surgically. I want to say that it was done standing on my friend’s horse, but as I said, I am not sure it was for the same type of mass. Horse’s owner is a small animal vet and didn’t have any trouble doing the aftercare until systemic antibiotics turned out to not work and he got a secondary infection and had to go through the recovery and rounds of antibiotics a second time.

[shadesofbay3]

Thank you. Yeah, my vet said we could do standing as well. Problem is, I board and am only able to get out to barn 1-2 times a week so on top of it all I might be looking to have to move to layup facility for the short term if my barn doesn’t feel like they can handle the care after the surgery (if I go that route)

I just want her to have a good quality of life

[IPEsq]

I guess one risk of trying to shrink it (as well with surgery if removal isn’t done perfectly) is that it could recur. But I wonder if the timeline and odds for recurrence aren’t so bad considering her age if you go the less invasive route.

[shadesofbay3]

Based on what little I’ve read (and I could be wrong), it could reoccur if it’s removed surgically? And it if it just injected and occurs again, can’t they just reinject? That seems to be a much less invasive method then cutting open her skull

[2tempe]

OP - I posted on the other thread re a mare who had same type of surgery for a sinus problem. She had minimal recovery issues but she was much younger than your horse ( I think maybe 8 at the time). AND hers was done a vet hospital, there is no way that I would do it in other than a surgery setting.
In your situation, I’d be inclined to go with the injection.

[2DogsFarm]

{HUGS}
I have nothing to add re: the condition or the surgery itself.
But, if you are near a good vet teaching facility they can most likely board her through recovery.
The cost, IME, - while not cheap - will be less than a private clinic & they may take payments (Vet college here did that for one of mine) or CareCredit.
JINGLING for your mare & you!