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| Discussion on Nasal Cyst-Presentation symptoms, diagnosis and treatment- A case study | |
| Author | Message |
| Member: rubysmom |
Posted on Saturday, Jul 25, 2009 - 12:34 pm: Hello all! This is the story of my wonderful gelding James and his nasal cyst.A bit of history...James is a 13 yo Westfalen/TB cross gelding, primarily a dressage horse (third level, now), but we do trail ride and jump a teensy bit. I've owned him since he was 6yo. He started with a unilateral drainage out of his left nostril about 2 years ago, at first it only happened during one of our dry Santa Ana episodes and would clear up when the Santa Ana passed. The snot never smelled bad, and the color ranged from a grayish thin exudate, to a sticky greenish boogery-ness. During all this, James was fine, working well, eating well, bright and happy. I would take his temp daily during these episodes and it was always normal. I would ask my vet about it and we both agreed that since he was perfectly fine otherwise, just to keep an eye on it and to call him if it got worse. Last December the exudate started again, James, as always was bright and healthy otherwise, no fever no sign of active infection, etc.. I had my vet out in Jan for routine stuff and we talked about it, but at that time James' nose was clear and clean, so my vet told me to call him when he started up with the boogers again and we'll do some dx. work on him to see what showed up. In late Jan, I had James scoped and xrayed. Everything looked good, and we sent the xrays off to a specialist to diagnose and at the time he did not see anything. In Feb, for the first time, James seemed uncomfortable and the exudate increased. Only the left nostril was affected. Temp was fine, the exudate was not smelly, but it was very sticky. I had my vet out again and we scoped and xrayed his skull again, did a few different angles, he also flushed out the gutteral pouches with a betadine/saline solution and they were clean as a whistle. We sent the xrays off to the specialist and in one of the oblique views he noted a fluid line indicating a mass present in the sinuses. We went to our local clinic, I had him scoped (again!), but again, it did not show anything at all and then I had a CAT scan done on his skull and sure enough, there was a cyst way up there, under the left eye orbit. It presented clearly, and then I had some decisions to make....Surgery or leave it be??? I agonized over the decision, as my horse is healthy otherwise, surgery has it's risks and he's so precious to me. In the end, I decided to go with surgery. The cyst, though slow growing according to the surgeon, WILL continue to grow it's not going to get better with time. He's only 13, healthy and sound with many good years in him. I have some experience with nasal cysts as my Ruby mare was diagnosed with them at 20 years old, at the time I decided not to go for surgery as she was 20 and the cysts were massive. The surgeon could not guarantee he could get them all and they could re-occur. I retired her and she lived happily in retirement til her passing at 27 years old, (and it was not the cysts that caused her passing). So what are the chances of me having TWO horses with nasal cysts??? <sigh> Here I am...making this decision again, but in this case, James only has ONE cyst, that the surgeon feels confident about removing completely, he's younger and better able to deal with surgery...I still agonized over the decision, but in the end, knowing what I know and thanks to a great support team, feedback from my family and friends, and solid research on my part, I decided to go with surgery. Knowledge is power, I knew the risks, and they scared the crap out of me, but I also knew that James would feel so much better if everything went as planned. The surgery was June 1st 2009. James came thru with flying colors. The cyst was much, much larger than the CAT scan showed..went from maxillary sinus to frontal sinus, (Dr was surprised, he thinks it may have grown ALOT since the CAT scan was done 6 weeks prior). The cyst was full of pus and had adhered to the bone, so the surgeon had to chisel some of it off the bone. He feels confident he got everything and removed as much as he could of the cyst walls. Of course it could re-occur, but that's the chance we take, at least it's out NOW and that's the good news. I have a pic here of James immediately post-op:  It was a "c" shaped incision just below his left eye. This was about 20 minutes after he came out of recovery and he's in his stall at the clinic. He immediately started greedily munching on the pile of hay in his stall and the surgeon laughed and said there is nothing wrong with his appetite! He was very bright and happy, and came thru everything beautifully. I was SO thankful! He stayed at the "horspital" for 3 days post op. You can see the drain tube in the pic. He was on antibiotics and bute for pain control and his sinuses were flushed twice a day for the 3 days. He came home with instructions to keep an eye on his temp and demeanor and to call immediately if any signs of infection showed. He recovered very uneventfully..here is a pic of him 1 week post op: The staples were removed a week later and I was able to start riding him two weeks post op. He feels GREAT!!!! I have no doubt that the surgery (in this particular case) was the absolute right thing to do for my horse. I hope this will help others faced with the same decision. Now of course, every one is different and recovery issues and complications can happen, but in our case it went really well and I am glad I took the risk and had this done for my precious boy. Here he is a little over 6 weeks post op, under saddle and going FANTASTICALLY well! He's quite the smarty pants, too....<grin> But when he's good..... Please feel free to ask me any questions....it was a scary journey and I"m glad James has recovered so well. 
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| Member: rubysmom |
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| Moderator: DrO |
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