Untreated mass in sinus

[2DogsFarm]

Literally asking for a friend.
Her aged QH has been diagnosed with 3 large (orange-sized) masses per vet surgeon at the local college.
Symptoms were sneezing & nasal discharge - cloudy, then clear, then nosebleeds that clear after a minute or two.
Horse is in mid-20s (she’s had him since he was 4) and unrideable due to arthritis. Surgery estimate is in mid 4-figures.
She boards him, but is out to the barn several times a week to handwalk. She keeps a pony at home.
She called me last night and said she’s considering bringing him home w/o having the surgery done & will euth in Fall.
My advice was - IIWM - to ask the surgeon how QOL will be if the surgery isn’t done & get info on signs to look for that will tell her the issue is making horse uncomfortable.
Horse is a candidate for surgery, health is good aside from the arthritis.

Anyone have experience with sinus mass?
Either with or without surgery.

[stargzng386]

I personally wouldn’t do surgery on this horse. I think her plan sounds like the best for him. I wouldn’t put an older horse through recovery from a major surgery if they already have bad arthritis too. Is he a grey? Could there be more nasal tumors or tumors anywhere else? She might do surgery and then still have to euth.

[2DogsFarm]

Not gray, bay.
But thank you for your advice.

[CHT]

A former boarder’s big thoroughbred was diagnosed with a sinus mass (main symptom was nose bleeds, some discharge, some loss of cardio). It may have been a cyst? The cost to remove it was beyond her abilities to pay, and her horse wasn’t suffering in general. She decided to stop jumping him, but 3 years post diagnosis and he is still doing well as a casual trail horse. I think there are a few types of sinus masses, so knowing what kind would help, but there is likely no way to predict how fast it will grow.

[cayuse]

I’m going through something similar with one of mine but it is a recurring sinus infection. He had bone-flap surgery 18 months ago to clean what was a “mass” of snot out of his sinus and put a drain/lavage in to flush. Tomorrow he will be having diagnostics (CT Scan) and more work done as they think it is a tooth communicating with the sinus. Do they think your friend’s horse has an infection or is something more nefarious going on? Have they done a CT scan? If possibly an infection, I’d do the surgery, if the other, boy I’d have to think long and hard on it. Mid 4’s for the surgery sounds low, I paid over 7,000 but that included diagnostics (CT scan). I hope this helps a little even though the situation is different. Jingles for your friend and her horse.

[fivestrideline]

@2DogsFarm

My advice was - IIWM - to ask the surgeon how QOL will be if the surgery isn’t done & get info on signs to look for that will tell her the issue is making horse uncomfortable.

I would say the exact same thing. As long as there’s no reason to believe his QOL is declining, I’d bring him home and see how he does. He may be capable of being a walking trail hacking horse. I would not do surgery on him, personally.

[Simkie]

I also have a friend facing this sort of thing in an older horse, and is choosing to skip surgery & watch the horse for declining QoL, then euthanize. The assumption with this one is that the mass is cancerous, although I don’t think they’ve been able to biopsy.

Regarding surgery here…to what end? The horse is elderly, and lame. It sounds like his quality of life is okay now, but he’s not going to live forever. Why put him through cracking into his skull?

[outerbanks77]

My retired gelding had a sinus mass removed when he was 11. The recovery was not a big deal, but IIRC, he only had one mass, and it had not progressed to nosebleeds, etc. He is now 19 and has had no further issues or complications. A friend’s over-20 retired gelding was diagnosed with similar, and she opted for euthanasia. Honestly, I feel like it is a financial decision, and there is nothing wrong with that. Now that my gelding is 19, if he was in this situation I would probably have him PTS (he actually broke his knee while he was confined recovering from the sinus surgery, which forced his retirement).

[RMJacobs]

My Hackney pony, Crackers, had a suspected sinus tumor for which symptoms started when he was about 28 and retired. At first, the vet thought it was just an infection. He had a goopy discharge, mostly from one nostril. We did a round of antibiotics, Crackers got better, but then the symptoms returned. I think we ended up doing about three rounds of antibiotics, with initial improvement then return of symptoms. Finally, the vet said the only option was to scope it and remove whatever was causing the problem. I wasn’t going to do surgery on an elderly pony.

We waited to see what was going to happen after the last round of antibiotics. It started having a big effect on his ability to breathe with discharge from both nostrils, so I had him euthanized. I hated to do it, but I wasn’t going to let him suffer. He was the sweetest pony (as long as you weren’t driving him; then he was a maniac). I still miss Crackers every day.

I’m sure you know that horses can’t breathe through their mouths. I didn’t know that until we started dealing with this.

Rebecca

[2DogsFarm]

Again, thanks to all for sharing your experiences.

I don’t know if friend’s choice to just bring him home is financial or not.

@cayuse CT scan was done, masses were found then.
It had been thought to be a polyp from endoscopy, but surgeon was then brought in.
The vet college he’s at leaves no stone unturned. Also is very reasonably priced & will make arrangements if needed.
& Again, IIWM, as long as horse is not losing QOL w/o surgery, I’d probably do the same.

Friend is older & wasn’t understanding all surgeon told her when he called yesterday.
Nothing is being presented to her as emergent.
I said to make a list of questions (heck! I do that when I see my GP!) & go over that list when she talks to the surgeon again.

If I hear more, I’ll update here.
I’ll also let her know of the scenarios in your replies, if she thinks they’ll help her decision.

[erinmeri]

I think it’s really dependent on the type of mass. Orange-sized sounds quite large. My horse had a small sinus mass that we discovered after nasal discharge led us to do X-rays, and we had it scoped. We couldn’t get a biopsy, although tried. Given the location and nature of the mass, we would have had to do a flap surgery to try and get a sample and/or resect the tumor and decided against it.

IIRC, the surgeon said most nefarious things in the sinus grow quite quickly, and he would expect signs and symptoms (wheezing, change in breathing sound, discharge, facial deformity, etc) to be evident within +/- 6 months. I also believe that he mentioned that some masses can increase likelihood of sinus infection, as the sinuses don’t drain properly. Horse had no changes within that timeframe, and we didn’t proceed any further.

Hope that helps…

[2DogsFarm]

Last Thanks.
Friend called & has decided to euth.
She spoke to the surgeon & Chief of Surgery this morning.
From what she told me, the surgery would be the bone flap between his eyes, with cath for lavage, return visit in 5-6wks.
The aftercare between visits was daunting - both her & DH are older (80s).
I told her she made the right call & also told her both horses I had put down at the college were donated for necropsy & research for the students.
@erinmeri from what you described she may have been facing the same & for myself, watching the untreated (by surgery) issue stress the horse further at home would be too much for me.
I’m going to share this thread with her when we GTG.

[erinmeri]

Sad update but completely understandable given the age of horse and owner. I was fortunate that the mass we found didn’t progress, but it does sound like it can be pretty terrible if they do.

You’re a good friend to hold her hand through this and try to get some answers for her. Hugs.

[RMJacobs]

I think your friend made the right call. Glad you are helping her get through it.

Rebecca