Yes, xrays have been done three times. When it first came back, and then again I think when he went in for the flushes, but the vet didn’t think he needed them, and then in the hospital getting the flushes this time. At least the vet said he was sending something to the equine dentist. I believe he said he was sending xrays, because he said he didn’t see anything wrong with the teeth - just some cloudiness from the mucous, but I don’t see them on my bill so not completely sure on that. But I’ll get clarification. I did give the Excede yesterday, but snot in his nose again this morning. He acts like he feels ok, is eating and grazing on what little bit of green grass he can find. I am hoping we can find something that works because I just don’t see putting him through that bone flap surgery. I had said when I started this that I would do anything barring surgery other than tooth extraction - I’ll do that again. But that wasn’t a piece of cake either - he worked and worked and was talking about having to go in from the outside to get the tooth, but was able to get it by removing the neighboring tooth. My head still tells me that is the reasonable thing to do, but my heart is breaking.
I went through this with one of mine- 2 CT scans, multiple surgeries including the bone flap, the whole thing. The surgery was actually not nearly as hard on him as the sequestrum surgery afterward or tooth surgeries I have been around- it looked gross but he handled it like a champ, I think in large part due to the techniques they used at UF. I will also say the CT was very useful and cost less than 3 farm calls trying to chase around what was going on, so if you have a vet school close enough I would consider that. I even did next generation sequencing thinking there was an infection that we just couldn’t get to grow in culture but it was just a gnarly strep zoo infection the whole time. The sinuses just don’t get great perfusion for antibiotics and sometimes it’s as simple as that. I think it ended up being 3 months of doxy that finally got my boy straight and no problems since.
Well guys…things are not working out so well for Tonka. Monday, I talked to the vet who did the flushings. He said he was not concerned with his face still being swollen. Tuesday his regular vet came out and took a culture. She looked at his face, and the assistant said she had seen Tonka when he was in the clinic and his face had gone down. I didn’t think so, but attributed this to me looking at it every day so maybe I didn’t see it. Today, I was supposed to go out of town for a much needed vacation for the weekend, meeting some friends from PA. But after giving Tonka his Omeprazole I went out to feed him, and he had blood and pus pouring out of the entry site where they did the sinus flushing. The owner of the vet practice is coming to see him tonight but it will not be until he has finished his rounds at the training tracks. So, I wait. I feel so bad for my boy. He was so much better before I took him in.
I’m so sorry…I forget. Could guttural pouch infection be a problem here?
Jingling for both you and your Tonka!
You are doing what you think is best for him. Do not get down on yourself for giving him medical care.
Sending prayers. It does sound like he has a nasty infection in there.
@Sarah_R …yes …my mare had several sinusitis …it seemed to coincide when I stabled at away shows after she was on shavings bedding (she normally was on dust extracted chopped straw ) we did antibiotics which would help, but then it would return …vet did a trocar procedure at my farm -which I was not prepared for …it was awful …they basically hammered through her skull under her eye but above the nostril to make a hole im assuming for the drainage to come out …nothing really came out and it resulted in a big swelling /lumps on her face …that continued to flair up and swell each time the sinusitis returned…I ended up taking her to a nearby University Specialist hospital to X-ray her skull because I was afraid they caused damage …luckily it wasn’t but they did say that procedure should really only be done in a clinic setting and was un necessary….anyhow …we did more testing …serum allergy testing which revealed alot of sensitivities…so she started on immunotherapy shots and we now try to avoid shavings-alsi because they’re dusty which aggravates her asthma which we also discovered she has as well.
I had a beloved Hackney pony with recurring sinus infections. We’d do a round of antibiotics, he’d get better and the discharge would stop, and then it would come back. We did this for three or four rounds of antibiotics. My vet said the only way to be sure of what was going on was to scope him, but he thought it was probably a sinus tumor. The pony was 29 and not doing well in general, so I opted to euthanize when his breathing became impaired.
I hope you can get to the bottom of this and get your horse back to health. It sure ain’t easy.
Rebecca
Was he xrayed and if so, would a tumor not show up on an xray?
He wasn’t X-rayed. This was in 2010, and back then my vet didn’t recommend it when I said I would only pursue non invasive treatment. I think he didn’t recommend it because it would not have shown a tumor, since X-rays show bones but do not show soft tissues.
Rebecca
I went through much the same with my horse 6 years ago…My best advice is you is to seek advice from a board certified equine dentist ASAP. Really, I can’t say that enough. ASAP
Well, Monday night I was told that four vets had consulted about Tonka - including the quine dentist who removed his two teeth on the same side of his face back in May of last year. The concluded that he had pus in all of his sinuses and that would have to be flushed again and he would be scoped as well. I did not want to take him back to the clinic. He was at least happy here, and acting normal, eating, etc.
But I was told it was the only option at this point. The call I got after the procedure was anything but good. He aid that the divisions between Tonka’s sinuses had been eaten away. They drilled another hole in his head at the top between the eys and a little above. They said that when he went in for the first flushing the push was pushed out of that sinus and into all the other sinues on that side of the face. Seems wierd to me - why wouldn’t that happen to any horse getting this procedure? But he opened a spot lower down that looked like it was about to burst, and he had lost his hair. The reason he had lost his hair there is because the tissue is dying. There is no winning this game, and I haven’t even gotten the culture and sensitivity test back yet. Tonka will be put to sleep on Thursday when he comes back home.
What sad news, I am so sorry 
I am so very sorry!
I am so sorry. {{{{Sarah R}}}}.
I’m so sorry. You did all the things you could.
My horse doesn’t have any sinus walls either - he has just one big open area in his head. A tooth that was cracked (uppper) became infected, and by the time it was finally addressed properly (almost 2 years later, lots and lots of pus draining, 2 flaps cut, etc), it had eaten a lot of bone and all the walls in his sinuses away. I was lucky that I lived within 5 hours of one of the country’s best board certified equine dentists, and shipped him as a last resort. My horse remained with that dentist for the next 5 months. It took that long for the flaps to heal, and I was comfortable enough to bring him back home. I’m so sorry that it sounds like you’ve gotten nothing but terrible advice, and your horse has paid the price. PM me if you’d like the name of the equine dentist I used - a phone consult wouldn’t hurt at this point, but I totally understand if you’re ‘done’. It’s an exhausting battle, and I’m so sorry.
This is heartbreaking and Im so sorry you and Tonka are facing this after everything.
As @NaturallyHappy suggested, i also thought of a guttural pouch issue.
I am so sorry. Just remember you are doing right by him. You’ve made every effort to help him, and if he can’t be helped, it definitely is time to let him go.
Hugs.
Rebecca
I am so very sorry to hear this sad news. 
