Thrombosed jugular vein treatment options?

My new to me 5yo appendix mare had a horrible colic in April and during her in-patient stay she developed a “thrombosed” juglular vein (aka thrombophlebitis). The vet treated her for that with local steroid injections, IV DMSO, and banamine at the equine hospital (she was already on antibiotics, probiotics, and a whole slew of other medications for her colic). It’s been 6 weeks and it still becomes very swollen if let out to graze for any length of time over 30-45 minutes.

Does anyone have experience with this or other treatment options? I’m at my wits end, this girl was supposed to be my next big performance horse! The vet has told me to just “watch and wait” but I’m not very good about that.

For clarification: is her jugular vein swelling or her head swelling? Do you have pictures?

I’m just curious, does the vet think it will affect her performance career? From my experience working in an equine hospital, they usually perform fine despite a thrombosed vein. Thrombosis rarely even affects racing performance, which is about as strenuous as you can get!

My first course of action has always been DMSO and hot packing, which I would probably continue if is still actively swelling… although after 6 weeks, I’m not sure how much it would help.

Very rarely, vets will surgically correct a thrombosed vein, or remove the vein entirely. But that’s usually because of complications from associated septicemia.

Good luck!

I don’t think you have any options this far after the initial inflammatory response.

The beauty about collateral circulation is that the blood from the head will find another route back to the heart, likely in the contralateral jugular.

Like Texarkana said, I’m not sure why this horse can’t be an athlete. You may not be going to the Rolex, but certainly horses that survive with both jugulars thrombosed are just fine, and your horse still has one. Again, the blood finds another way back. Usually the head swells for a few days but otherwise it works itself out.
I have a horse with a thrombosed jugular from a hospital stay and the only wrinkle it has put in his/my life is that I have to remember to tell new vets/students/techs to use the right side for Coggins.

Second hand account so not sure of the details, but know of a mare who damaged the jugular after a colic/long hospital stay. I believe some sort of hematoma developed which was supposed to be closely monitored and treated, but owner got lax and the mare threw a clot, had a stroke, and had to be euthanized. Just think you should be sure what exactly has occurred. Hope it is not as serious as what happened to this mare.

My older mare had a compromised jugular. IT ultrasounded like bone, so vet went in to see what the heck it was and found that a portion of her jugular had been encased in calcium deposits and was necked down to less than and 1.8 th in diameter. He jus tcut that portion out and sutured closed the ends of the vein. he said her drainage would be fine through her other side jugular. And it was. Have no idea how she got a rock on her vein, best guess was previous trauma, like a fall, and the calcium deposits built up over the years.

Your horse should be fine

My friend has a horse who had a terrible reaction to an IV in his jugular and ended up having to get that vein resected (as above, essentially the necrotic portion removed and vein tied off on either side). Since they have jugulars on both sides this is OK if not ideal. He’s now 29 and doing just fine with one jugular.

I had a racehorse whose vein was thrombosed, he had grown a spider web of collateral veins by the time I got him. He ran very well for me and retired to be an event horse. He is still going strong at 18 years old.

If it is 6 weeks out then you should be fine. Most complications would have started by now, but if scar tissue grows there are options but the wait and see approach is most likely because the swelling can take awhile to go down, especially on the head and neck that are constantly moving. Best to just take a deep breath and keep an eye on it. If it gets very hard then your vet will likely do more because it may be scar tissue. Your horse’s career is not over because of this.

I realize this post is years old, but this is my situation. How did your mare end up faring?

My guy is recovering from a horrible salmonellosis colitis during which he nearly died. IV site thrombosed. Discharged and I’m solely handling his care while we wait to test negative.
Meanwhile, he started being unable to graze down to the ground, and developed some edema (which I was thinking was just because he wasn’t getting out much but even with going it it wouldn’t subside.) Initial diagnosis is a thrombophlebitis but no one can coordinate to ultrasound it and even if they can, they aren’t sure what to do. This is working with OSU Equine hospital, one of the top vet schools!

We’ve got him on bute which seemed to help him graze down and the edema has disappeared. But I tried to discontinue it and within 24 hours he could graze again.
So They just keep saying we’re doing watchful waiting. And I want to know how yours went.

I had posted recently about clots…my gelding developed a thrombus in his hind leg in the groin area. We did get it ultrasounded a few days ago at one of the large vet clinics. There is still some blood flow around the thrombus…but it is about 6-8 inches in length.

They put my gelding on Plavix for 2 weeks. They are doing a more conservative option (another choice was to inject the area with tPA)…since he isn’t lame anymore and has blood flow, we are doing the medication option first. They didn’t have a lot of info for me…it’s apparently quite rare to have in the leg (we think trauma running in turnout??).

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My horse stayed on aspirin for several weeks, maybe over a month. She was also on antibiotics for two weeks because she abscessed at the IV catheter site. The first few weeks after diagnosis were a little up and down, it would seem better but then swelling at the site and edema through her throatlatch and jaw would reappear. It took a while for her system to re-route blood flow around the vein. You’d never know it now as she’s completely back to normal, we’re just careful with blood draws and IV injections on her good side.

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Adding that they also told me to use Surpass over the area of the thrombus to reduce the local inflammation (since the clot was somewhat close to the surface). Maybe something to ask your vet about doing for your guy?

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Thank you - I have it on my list :wink:
Did your guy have any trouble breathing? Or “exercise intolerance”?

No trouble breathing, but my guy’s clot is in his RH groin. He had been having NQR lameness for about 1-2 months before we discovered this. He wasn’t really lame, but he was struggling on the RH and not pushing off as well as he could. We had done a stifle injection…then a course of Adequan. Then I was waiting for an appointment with the sports med specialist when the sudden severe fever/lameness/cellulitis episode happened. So I would say yes to the exercise intolerance. They can’t really tell me what happened first though…did he have a clot and that was causing the “lameness” issue. Or was there something orthopedic going on…and he took a bad step in turnout (he had been playing rough over the fence) that caused a cellulitis/clot. No one seems to be able to sort out why/how.

Oh that’s right, I forgot it was groin.
Ugh. These animals :sob:

@ghst13 Did she have any issues breathing?

She didn’t have any difficulty breathing. At the IV site she had swelling and fibrosed tissue over an area approx 3"x6"(?). We treated that with topical DMSO/furazone. The edema in the head ran from right behind her ear down through her throatlatch and then slightly forward through her cheek. My vet said she probably had a hell of a headache, but it didn’t impede her breathing. She stayed on aspirin for quite a while and the edema did seem to come and go initially but eventually went away and hasn’t returned.

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My very old mare has a lump on her jugular in the lower portion of her neck. I don’t know if it is a thrombosed jugular or perhaps an aneurysm. Doesn’t seem to bother her though. I plan on having the vet check it.