Tell me about sinus issues in horses

[keysfins]

@Xanthoria

Well just in case others go down this road with their horse, here’s another update.

Two weeks of rehab. They called me halfway thru, saying he was lame on LH. Could be an abscess. Can they get the vet out? Yes. Vet goes out, treats as abscess.

I go fetch him and he’s in WORSE shape than when I went up there.

1. He’s on 2g bute, antibiotics, gastrogard and pergolide (the latter two given by the rehab place - their idea vs vets)
2. He’s very lame - and I DON’T think it’s an abscess
3. He has awful thrush in all 4 feet (not causing lameness)
4. He still has a snotty nose!
5. Appetite is awful - has he LOST weight?
6. Very stocked up on all 4 legs

I was really upset, got 2g IV bute in him and loaded him to come home. Spent the next 2 weeks curing the thrush, handwalking, applying standing wraps, 2x a day meds. Told my vet all this. Vet comes out and diagnoses a very much blown stifle (so. not. an. abscess) and he’s annoyed that in 3 vet teaching hospital visits, one specifically for lameness, and with a rehab center’s daily expertise, nobody noticed this.

Had rads done yesterday, awaiting vet’s full dx. I’m down another $3k, and my horse is in the worst shape of his life. I could spit. :mad:

So yeah - sinus infections: not super easy to fix… :no:

What the…??? Stifle!!! How is he doing now he’s back with you with proper treatment? Any idea where/when/how the injury occurred, or is no one willing to 'fess up? Timeline sounds suspiciously like the rehab place. Was he just on handwalks, or turned out at all?

Photos, photos, photos: would be good to document condition if anyone else has a situation like this, needing to send a horse out for short or long term rehab.

Pergolide/Prascend is known to decrease appetite. We have a large WB at the barn who started out on one tablet daily, and he quit eating any hard feed, picked at hay. Tried all sorts of temptations, meh. Refused to take treats, was suspicious of ‘contamination’ by Prascend stuffed into one, so refused any at all! ((Had a buffet of different treats, candy, cookies, etc. to dose him. Resorted to a small 6cc syringe and dissolving the dose in warm water, then squirting into his cheek. He doesn’t like it, but he gets his dose without too much wrangling. At least, until he learns to spit it out after holding it in his cheek!))

Cut dose in half and got him eating again. Each time vets tried to up the dose he would only pick at his hard feed, in spite of many temptation tactics. It is a balancing act, and every few weeks he may decide he wants a different hard feed, or combo. ((Stocking three types of senior at the moment, plus alf pellets, beet pulp, fat supplement, oats, toppings, etc. Feed room is a veritable buffet for the two picky eaters in residence. Good thing the hay is so fabulous.)) Big Guy will now take peppermints from me if I unwrap one in front of him, the smart dude!

Soooo, may want to check with your usual vet/uní vet/specialty vet/ pull blood to see if the pergolide is essential right now. Especially if nutrition for healing trumps Cushings–?

How is the Old Man doing? Prognosis on the stifle? Will he be pasture sound, and do you have space to rehab or stall rest him at home with you? Is he of the temperament to handle stifle rehab and anything needed for sinus flares? Is he still getting abx for sinus crud, or flushing? Any light at the end of the tunnel, or just go with the flow now?

JINGLES!!!

[Xanthoria]

@keysfins

What the…??? Stifle!!! How is he doing now he’s back with you with proper treatment?

He’s a LOT happier - he was v depressed at the rehab place, again, which they commented on. Thrush is fixed. Appetite now that I took him off pergolide is better. Still very lame though. I’ve ordered some APF which a barnmate swears by to help stressed and immune compromised horses, and we have a panoply of tempting foods to eat too.

@keysfins

Any idea where/when/how the injury occurred, or is no one willing to 'fess up? Timeline sounds suspiciously like the rehab place. Was he just on handwalks, or turned out at all?

I am trying to be cool headed about this. He had a suspected on/off abscess a couple months ago in same foot, and vet was focused on treating the nose at that time. I was able to pick up that foot then (can’t now) but perhaps this happened before in pasture, perhaps in rehab. I am not going down the road of anger with that right now… well, trying not to. He came home with scabs on his nose in the region of a chain, which my vet brushed off, but my gut says he did not have happy times there.

@keysfins

Pergolide/Prascend is known to decrease appetite.

Yes! We started on 1 pill/day, then my vet said give 1/2 dose am and pm (I was syringing in with the antibiotics and bute) but we ran out… and his appetite picked up. Another whole issue here is how long it took my vet to come visit a lame horse… but again, I’m focused on the horse right now. And the treatment would have been same - stall rest.

@keysfins

Soooo, may want to check with your usual vet/uní vet/specialty vet/ pull blood to see if the pergolide is essential right now. Especially if nutrition for healing trumps Cushings–?

That was actually the plan - “when sinus is healed, we really need to check for Cushings” as despite not showing clinical signs his immune is low. We did pull blood at the weekend and white cell count pretty normal, fibrinogen at 500 (inflammation… hello…) and the only other thing a bit off was monocytes on high side of normal (chronic inflammation - no surprise). Horse was running a low temp, and we did xrays of the stifle which I am yet to hear the final word on.

@keysfins

How is the Old Man doing? Prognosis on the stifle? Will he be pasture sound, and do you have space to rehab or stall rest him at home with you? Is he of the temperament to handle stifle rehab and anything needed for sinus flares? Is he still getting abx for sinus crud, or flushing? Any light at the end of the tunnel, or just go with the flow now?

Well I board so he’s in a stall with a big fluffy bed for the foreseeable. If he will never be pasture sound then I’d euthanize, as he is a herd guy through and through and hates to be cooped up. He’s thin, so being in over winter to recuperate and eat, eat, eat is FINE with me and he can just deal.

No treatment for the sinus anymore - vet and teaching hospital agree we’ve tried ALL the antibiotics. Flushing was done for 2 weeks and came clear, only to pop up immediately again. So right now my focus is swelling/pain relief, and getting FOOD into him. One day at a time on the rest.

@keysfins

JINGLES!!!

Thanks. We need them

[kiwichick]

Im sorry to hear of your troubles.
And I agree sinus issues are not easy to fix.
My guy has had no further symptoms, but I dont believe is fully healed (flies are attracted to the nostrol and eye on that side of the face) but he is on his own now anyway in terms of surviving or not.
My guy is physically ok, but not at all ok mentally after the trauma, so I have all that to deal with too.

You have my sympathy.

[keysfins]

Oh, Xan! You have done everything you possibly could, and you still are. I’m hopeful for you both that he’ll pick up on his appetite now without the Prascend. And fingers crossed that sinus drainage is better than NOT draining.

Jingles and peppermints!

[Quelah]

Xan I’m so sorry you’re going through this. My significant sinus experience was with my BFFs horse. He got a really bad sinus infection due to trauma, he freaked out in a trailer, bashed his head seriously enough that he had blood in his sinus cavity which eventually because a nasty infection. Multiple rounds of antibiotics didn’t work, in field vet said it was tooth, Dr MacD at PEH said no, straight up sinus infection from trauma. Third opinion from my most trusted vet concurred with Dr MacD. So he had sinus surgery, where they open up the flap of bone on the face and go in and clean it out. This was done as PEH, Dr MacD loves that stuff, that and guttural pouch, area of personal fascination to him.

The biggest trauma of the surgery was to her checkbook, I think it was about $3500 and this was a few years ago. horse came through beautifully. The horse has quite a few happy years, he was retired shortly after that surgery (due to ringbone, the sinus was fine). After about 5 years, he got a sinus infection again, now it really was likely the tooth, he was an aged horse at this point. We could almost clear it up with antibiotics, 72 hours off meds, it would come back. If he could have just lived on metronidazole, he’d likely be here still. But it wouldn’t clear completely, and the option given for extraction was to take it out through his face (upper molar in the back), which at that point she wasn’t going to put him through nor could she justify the money. So after one last round of antibiotics, he hung out here for a week and ate lots and lots of spring grass and we let him go before it came back again.

Oh, DH’s beloved did have a bad tooth, when he was quite elderly. Seemed sinus but tooth involvement was obvious. I said if we can take it out orally, then yes, not putting him through more than that. Fortunately the tooth did come out very easily, and another course of antibiotics and he was fine. Hung around being a pain in my ass until his heart started giving out at 32.

So that’s my experiences, I hope your guy has seen the last of this stuff and his stifle will be ok.

[Xanthoria]

Thanks keys, kiwi and Q… it’s a bugger to deal with a stifle on top of it all. And now that you mention hearts… vet let me have a listen to horse’s heart last week - the sound reminded me of the beach vacation I won’t be able to afford after all this, with all that sandy swishing noise from a proper heart murmur!

I should find out tomorrow how bad the stifle is - really not sure how valuable rads are for this dx and not ultrasound, but my vet doesn’t have an U/S machine… still if horse can recover to pasture sound fine. And he’ll be at pasture with a snotty nose I expect.

The little bugger is Full of Vim and hobbled out of his stall and led me on a low speed chase the other day, as I’d left the stall door open while wrapping his legs, thinking the bucket of food in front of him would be enough. Nope! He wants BACK OUT IN THAT FIELD! So hopefully he can be patched up and get his spring in the sun.

[kiwichick]

Any update Xanthoria?

[Xanthoria]

Aww kiwi it’s bad news… sorry I didn’t update: I thought about doing it but my other thread contains the details. His stifle injury ended up being a cruciate injury, and it suddenly became completely unstable, so the decision was made to put him down as there was no way to fix it. Vet opened up the joint afterwards to confirm the damage. I’ll never know how it happened (…) but it wasn’t repairable.

As for as the sinus thing goes, I would have been happy to just live with that at the end of the day - it wasn’t killing him by any means, but I was pretty unhappy with the results of all the $ I spent on having his sinuses drilled and rehabbed twice. The root cause was bad teeth - if I had a do-over I’d have had more teeth removed prophylactically perhaps?

Poor old man. He was my little old pet - I miss him

[kiwichick]

Oh what a bummer after you came so far
Thats the worst thing about animals/vet issues. If you could see the whole picture at the start it would be so much easier to make decisions, but often as we get down the track its to the point of no return and we end up wading into waters we never would have.

Ive ridden my horse 4 times since his surgery (the last time without crying the whole way through, or after the ride), he is absolutely like a brick wall on the left rein, but so far its ok.
He is having on and off discharge, almost like a kid with a snotty nose, but its draining at least and it doesnt smell at all. I feel sorry for him, he is only just turned 6 and everything was wiped away in one go.

Im just going to keep moving on and see what becomes, I replaced him as a ridden horse (or I was going to give up, it was too hard) so there is no pressure on him to be ridden, but I feel sorry for him now being left in the paddock while I take the other horse out.

I think he is ok for now, but I dont think he will live to a grand old age. I hope im wrong, but such a small thing, has really had such a huge impact on his life (and thats assuming the cyst doesnt grow back)
I guess I should just enjoy the time with him while I have it.

[Xanthoria]

Yes just enjoy him and don’t worry about a little snot. Worse things happen at sea!

[allons-y]

I so sorry for all this Xanthoria. Jingling for the old man

[Xanthoria]

Thanks @allons-y :sadsmile: