“Your horse has a sinus problem. And it’s an unusual one.”

24 August 2011 9 Comments

There’s something disconcerting about standing in a room with half a dozen people, most of them vets, while they ooh and ahh over your horse’s unusual sinus condition.

Here’s the backstory, since I have not been posting much recently.

After we flushed Ro’s sinus out in May, she got better. Then she got sort of iffy again, and we decided to try a stronger antihistamine. A week after that, I got off Ro after riding and stared at a bloody nose. I was, I’ll be honest, freaked out—and I hadn’t even been on the interwebz looking up possible causes of nosebleeds yet (incidentally, don’t do that. You’ll never sleep again). Ro was unperturbed, although she thought I was insane for leaving her tack on and dragging her all over the property trying to find my phone to call the vet and the keys to my trailer in case we needed to trailer out and… Ro just wanted to eat grass, and if I would remove the saddle, that would be peachy.

Ultimately, we determined that the antihistamine had dried out her sinus and she’d gotten a nosebleed. No different than people getting one. Nothing to worry about. But in the course of making sure this was the case, we rescoped and discovered the snot was coming back. Rather than wait for her to actually start dripping snot, we reflushed her sinus very aggressively, including a long-acting antibiotic that left her nostril coated in foamy white stuff.

After the vet left, Ro and I were standing in the barn aisle in front of a fan while I waited for her to wake up enough from the sedation so I could turn her out. One of the trainers walked in, looked at Ro’s foamy white nostril, looked at us standing in the middle of the barn, all unconcerned, and asked tentatively, “Is she all right?” I think this was code for, “When is the vet coming, and why is your snotty horse standing in the middle of the barn and not isolated somewhere?”

I explained what was going on, and then tried to figure out how I had reached a point where I could talk cheerfully about drilling holes in my horse’s head. The trainer seemed confused about that, too, but decided we probably weren’t incubating the plague and wandered off.

A week or two after this, Ro came in from a ride with her nostril covered in thick, yellowish mucus.

At this point, I think both my vet and I were ready to cry uncle, and he referred us to a specialist. Naturally, the snot disappeared and Ro began to look healthier than she had all summer.

I didn’t believe her sudden symptom-free self and we went to the specialist today anyway. I figured we’d either get a clean bill of health and know this was all behind us, or we’d find something brewing and just waiting to rear its ugly head in a week or two.

Incidentally, I have reached a new high in my ability to get lost while driving. I can get lost on a straight road. With a GPS. I am just that awesome.

At the specialist’s, we started with the obvious: re-Xray her sinus to verify it was not a tooth issue. Xrays looked fine.

Then scope the guttural pouch to make sure we didn’t have anything going on there. Ro had some blisters on her tonsils that the vet said were not unusual in horses her age, although possibly a little enlarged. She had the same blisters in the guttural pouch, which he said is unusual but he didn’t think it was the cause of the recurring snotty nose.

At this point, we stopped to talk about options. Here was Ro, looking perfectly normal. She didn’t even have the decency to have the clear watery discharge she’s had all along—nope: clean, dry nose. Here’s the clean xrays. Here’s a scope result that the vet thinks suggests allergies.

If I wanted, we could drill into her sinus and scope that way (top down instead of bottom up, essentially, and with better access to see everything). The vet didn’t think we’d find anything—we’d be doing it to confirm the sinus cavity was snot free. All signs certainly pointed that way. The next step would probably be treating allergies aggressively via steroids—either now, or waiting to see if she got snotty again.

Honestly, I think if I had been standing in that room with that decision even a month ago, I would have skipped the additional scope. But I was so tired of it all, and so frustrated, that I wanted that confirmation that her sinus was clean. I was afraid that if we skipped it, we’d end up doing it in another two or three weeks anyway.

Fortunately the surgeon was available this afternoon and we were able to do it all in one day. The plan was to drill one hole below her eye and a little towards the cheek; depending on what that showed, we might drill another hole on her forehead, near where we had drilled to flush before. These holes would both be small—just large enough for the scope. If necessary, the next step would be to take a big flap out of her skull and scrape stuff out.

But we started with the first small hole—hand drilled it, put in a metal tube, threaded in the scope… honestly, it’s weird to see metal tubes sticking out of a horse’s skull. Just saying. Everything looked good, up until the surgeon said, “Huh. That’s not normal.”

Indeed not. There was a little yellow mass that clearly did not belong.

They drilled the second hole and went in that way to get a different view on it. Much to no one’s surprise, it was still odd, even from a new angle.

Then they sent one of the techs to go fetch my vet, because he “might like to see this.” Another vet wandered in shortly after. Plus the intern.

And everyone staring at the little yellow mass going, “Huh. That’s not normal.”

I kind of wanted to start charging admission.

Initially, it was the placement of it that intrigued them. It was just not a location where they expected to see anything. Granted, they weren’t expecting to see anything at all, But if they were going to find something, this was clearly not where they expected it to be.

Then the surgeon moved the scope back to the lower hole and stuck a metal pointer thingy (this is a technical term) into the upper hole. Remember, the scope was threaded through a metal tube. It was like a giant pair of chopsticks were sticking out of her skull.

They had already rinsed the mass a little with saline and it hadn’t moved, so when they poked it with the pointer thingy, they were all surprised to see it was unattached to the sinus. This, too, I think intrigued them. Things they hadn’t expected to find in places they didn’t expect to find them behaving in ways they didn’t expect… fun times. Basically, the mass was just a ball of mucus and bacteria positioned where normal flushing wouldn’t get it. So when we flushed earlier this summer, we cleared out the worst of the infection but this pocket stayed behind and regrew.

They grabbed a sample to culture and then broke the ball up and flushed it out. Ro was a rock star through the entire process—we did this standing, with her sedated, and she was very cooperative, even when they were poking around at the mass. She’s staying at the vet’s for a couple days while we wait for the culture to come back, and they’re going to keep flushing the sinus out to make sure it’s clear.

The blisters on the guttural pouch are still a little bit of an unknown. For now, we are going to focus on the sinus cavity—get it flushed out, run a course of targeted antibiotics, make sure it is well and truly cleaned up. Then we’ll reevaluate the blisters. We know they were not present in February, so it’s possible they are secondary to the cycles of infection/inflammation of the sinus cavity. With any luck at all, they will disappear once the sinus infection is wiped out.

And then, knock on holey skulls, this entire thing will be behind us.

Horses and Riding, Horses I Have Known, Ro

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