# Keratoma



## horselib (26 July 2009)

I have a TB mare (ex flat racer)diagnosed with this in a front foot.
The vet is pushing me to take radical action and I just don't know what to do .She has also some arthritis in the coffin bone joint. He feels at present the keratoma is not causing lameness and she has undergone steriod treatent on the coffin joint and navicuar area(4 weeks ago).She isn't yet sound but is having heart bar gel cusion and pad fitted this week.(at present she is still lame on 2 danelon a day)
If she isn't sound after this treatment then my instinct is to put her down at the end of the summer.
My dilema is if she comes sound do I have the treatment for the keratoma is it fair on a mare her age to have this surgery done.
I have owned her for 18 she is insured veteran so not covered for this
have already spent in excess £1500 on this I am on a limited budget.
Just out of interest does anyone know the sort of cost involved with surgery?  
Please be kind I feel very fragile and tearful about this at present. thanks J


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## Box_Of_Frogs (27 July 2009)

Oh hun - what a nightmare for you. You say you've had her for 18yrs, so how old is she now? The only 2nd hand experience I've had of a keratoma is my friend's TB x, about 2 yrs ago. He had his treated and cut out just sedated and he was right as rain a few weeks afterwards. Still going strong now. But your girl has all this other stuff going on too so you have to look at the bigger picture. You're the one who knows your ned best so ask yourself, do you feel that she's had enough and has little or no quality of life? Or is she a tough old bird still trying to enjoy life? Once you're sure you know the answer to that, I'd ring the vet and have a heart to heart. Find out whether the removal of the keratoma would involve a general anaesthetic (ie ned fast asleep) or just heavy sedation. Ask how much. Ask if they have done the same operation on other horses and what was the outcome. Explain how you feel, ie she's had enough or you want to press on and give her a good chance. Ask if your girl was THEIR horse, what would they do. It sometimes helps to write all your questions down but the important thing is she's YOUR horse and you know how she's coping with her ongoing health problems. Please lib hun, if you need an ear or a shoulder, PM me. Thinking of you and welcome to the Forum xxx


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## ihatework (27 July 2009)

A friend of mine has recently had this diagnosis for one of her mares.
The mare was fractionally lame and quite a deep and relatively large keratoma was observed on further tests.
The vets did offer to operate but due to the location of the keratoma the surgery would be very invasive, painful and with a long recovery time. My friend decided not to put her mare through this.
Currently the mare is happy out in the field but no one seems to be able to say how fast these tumours grow and how long the mare will be able to go on before other decisions have to be made.

In your situation, given the current other ongoing medical conditions, unless the keratoma was very easily accessable for removal then I wouldn't be putting the horse through this type of surgery myself. I would treat the other conditions and just then take every day as it comes.


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## Evadiva1514 (27 July 2009)

My horse had a very large keratoma removed last October at Rossdales after several months of very mild undiagnosed lameness. After MRI and all of the usual lameness workups and tests this lesion was the only thing that could be found that could have contributed to his lameness. The keratoma itself was particularly large and unusual in that it was both inside and also wrapped around the pedal bone, spreading from his coronet to his sole. So basically it had grown to the point where it had encompassed the majority of his near fore. 

He had surgery under general anaesthetic and was hospitalised for almost 3 weeks, having daily bandage changes and packing of the operation site. Andy Bathe who operated on him was very pleased with his progress and he was discharged for us to continue his bandage changes and to box rest him until further notice. His operation took place on the sole of his foot although i think they can also operate and remove keratomas from the hoof wall and the heel depending on where the mass is. He wore a hospital plate which was bolted on to protect him and guard against infection. 

Sadly in December we called our own vet out as we were concerned about his progress as he was starting to develop proud flesh and in January had gone very lame. We rushed him down to Rossdales where they performed a similar proceedure to the original operation standing under local anaesthetic to remove the excess flesh and flush out the pedal bone. I was able to watch this and found it both to be fascinating but rather worrying at the same time. He was hospitalised at Rossdales for a further 5 weeks as sadly infection set in and he was an extremely poorly boy. After a lot of hard work and dedication from the team down there we finally got him home on February 13th and on March 13th he was discharged and i was instructed to bring him back into very light work despite him being ever so slightly lame still. I'm pleased to report that i now have a very fit healthy sound horse a few months later and at only 12 years old im pleased i took the risk and had him operated on. There were a few times when we all questioned whether we had done the right thing and at one point we were facing a decision as to whether we should call it a day but i'm so pleased it has all worked out. I think you've got to realise that if your horse does go down the operation route that it does take a long time for recovery. Only now am i contemplating bringing my horse into any form of proper work again. 

I've got to pop out in a min, but when i get back, i'll pop a few photos on here for you. 

The total cost from the start of investigating Alfies lameness to today is well in excess of 10K. 5k of that was covered on our insurance with NFU.


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## horselib (27 July 2009)

Having typed a reply I lost it so here goes again sorry if it gets posted twice.
Thanks for the replies. the mare is 20 I bought her from a friend who was a breeder when she was a 2 year old straight out of racing. She is head of the herd which consists  of 3 others all gelding one is her son.
After the treatment (steroid injection into the joint) she was very depressed not interested in food not in charge didn't care didn't call to me when I went to fetch them in it broke my heart.She is a bit better now and back in charge but very lame .Hoping the special shoeing will help.(today)
The keratoma is on the front of the foot and on x rays show is causing a groove down the pedal bone .The farrier wonders if removal may compromise the weight bearing ability of the foot but not sure of that until the surgery goes ahead.
I am not sure I will go ahead with the surgery but feel I am letting her down by not giving her a chance! The recovery would be long and hard and the I feel could break her spirit and if after surgery she can't weight bear on that foot I could loose her anyway.
If I could get her comfortable I would consider retiring her until things begin to get too bad .She was always bold and brave  and full of life and it breaks my heart to see her cowed .On good days I want to carry on but on bad days I can't bear it. I will seeing what happens withe the shoeing and then I probably need to heart a heart to heart with the vet .Thanks for listening J


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## Evadiva1514 (27 July 2009)

Here are a couple of photos of my boys foot. This was the first dressing change i did after he had been sent home in October last year. 













I've just reread my last post to you and it does sound dreadfully bleak and depressing which i never intended it to be. If i had to make the decision again on any of my other horses i would always opt for the keratoma removal. Alfie was fantastic straight after his op and was walking about soundly within hours. I was amazed at him when i went to visit him a day after it was removed. It was just unfortunate we had the set back that we did with him, which inevitably put the costs up but i have been told that complications like his are fairly rare and most go on to heal nicely. 

As for your farriers concerns, Alfies Keratoma had taken over a large majority of his pedal bone and the main concern with his surgeons was the risk of fracture. We were told at the time that if the operation was successful that the pedal bone would remodel itself and therefore would not cause too mch of a concern in the future. When Alfie had all of his problems after christmas his foot was xrayed and the pedal bone looked absolutely fine. 

A girl we know also had her horse operated on for a keratoma in his heel at a similar time to ours and hers has recovered successfully also and within a budget that would be covered by most insurance companies. Our actual op wasn't that expensive, the MRI, bone scanning and various workups to establish what was going on actually cost us the most money. 

It is absolutely heartbreaking having to make a decision like this and we were unsure at the time as to whether we should have put Alfie through it but im so glad we did. If you need any more info or support, i'm only a PM away!

Hope this helps...

Becca.


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## horselib (27 July 2009)

Thanks for the photos doesn't look as bad as it sounds .The farrier says that foot is smaller and the pedal bone has dropped (not laminitc related)The inside of that foot is very straight and there is only a small area either side due to the pedal bone position that will support nailing ,her foot is typical thoroughbred with flatish feet and not a lot of ground clearance so needs heart bar gel and pad to support that foot and give clearance off the ground, He wonders if any hoof wall is removed how much weight bearing surface will be left of course that depends on what is found if surgery goes ahead
Unfortunately I will have to cover the entire cost myself as she has veteran insurance (20 years old) and therefore they will not cover this under the terms of veteran NFU policy.
More specialist shoeing will be done today in the hope to make her sounder I think I will have to see how that goes I guess it is one step at a time.  J


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