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.