Fortunately ML’s problem was also fixable
|October 19, 2018||Posted by Melinda under Uncategorized|
Unfortunately, it required abdominal surgery and eight weeks off after getting tuned up at Amber’s for three months.
Fortunately we caught the problem REALLY early, something I probably wouldn’t have caught for a while (years?) because unlike Amber, I don’t see and interact with her daily.
What was this thing?
A granulosa theca cell tumor. Abbreviated either as GTCT or GCT. If you want to skip ahead and get an “A” in the class, this was the best online fact sheet I’ve found.
Here’s the highlights:
GTCT’s are the most common type of ovarian tumor in horses. They are usually unilateral (only affect one ovary). They can get HUGE, like grapefruit massive huge or bigger. Considering that a normal ovary is about the size of a tiny potato, that’s pretty big. The tumors are most common in mares between the ages of 5 and 10 years (ML is 6 years old). GTCT’s pump out hormones that affect attitude and reproductive cycles. Testosterone, estrogen, anti-mullerian hormone, inhibin – all or some of these can be produced. The behavior and cycle changes in the mares personality are dependent on which hormones the tumor decides to pump out. Some of the most common signs that make me tell owners to get a repro ultrasound to look for one of these tumors is a mare that is suddenly aggressive and stallion-like, a mare that’s constantly in season, or a mare that isn’t getting pregnant or they are trying to get pregnant and the mare won’t come into season.
Here’s how we figured out MerryLegs had one.
MerryLegs has always been a dominant horse. Farley is the only horse I’ve ever been able to pasture with her that after a couple of weeks of “get to know yous” remained on top and keeps ML in her place. I had noticed that at the beginning of this year ML was starting to treat Farley more as an equal and Farley allowed it. She was getting way too big for her britches but I chalked it up to a young horse finding her footing as she matured, a result of the pasture dynamics changing a bit, and boredom since my plate has been more than a little full.
By the time May rolled around I was SO HAPPY to ship her off to Amber’s and let Amber deal with the teenage horse angst that had appeared this spring. ML had been in heat at least a couple times and was really distractable. I rolled my eyes and accepted the fact that after owning a string of mares that were not mare-ish at all I was due.
The first month (May) at Amber’s she was in heat pretty much constantly. We both remarked on it, but chalked it up to a new place and the comings and goings of a busy training facility. The last week of the months she was finally out of season. WHOO HOO!
Except she wasn’t.
A week later she was BACK in season. And then again. Both me and Amber agreed she physically uncomfortable while in season. It broke my heart is that she still tried so hard. She still raced to the gate every day, eager to work. Her nose was just a little wrinkled. Not wanting to lift her back or engage in the arena. Not moving quite as freely down the trail as we knew was her “normal”. It’s important to both me and Amber that the work is “fun” for ML so we tried to be responsive to what she was capable of that day – but also keeping in mind that just because the horse is in season does NOT give them a free pass for poor work ethic or poor behavior choices.
That second month (June) I finally accepted that she was likely to be a mare that I was going to have to manage on (expensive! annoying! tedious!) hormones so I started to research my options.
On fourth of July I got a call that ML was down and colicking. She had just come into season AGAIN and the timing how she went down sounded a lot like ovulation pain. A little banamine and some time and she was OK, but….I had to do something. The frequency and how hard these heat cycles were hitting were was ridiculous. This went beyond just normal hormones.
Did I call my horse vet and schedule an ultrasound?
OF COURSE NOT.
I was a dumb ass and decided it was time to start her on hormones.
I posted on my horse vet facebook group (yes, the same one I was busy bugging about Farley. They were probably sick of me by this point) asking for guidence on what hormones I could manage her on that wouldn’t both break the bank and my schedule (daily meds are really not my thing right now…).
Like the awesome vets they are, they said the words that I would have said to ANY client with this history, but that I couldn’t see on my own horse because my nose was pressed so hard into it I was sneezing horse hair.
Yeah…that was pretty likely.
Let’s actually do the thing we should all do before stuffing our mare’s full of supplements and hormones and have a repro ultrasound done.
On ultrasound the right ovary was small and unexciting. The left ovary was on the upper limit for normal size (almost too big). It had a honeycomb appearance that suggested a GTCT, but it was hard to tell for sure because there was also evidence of a big recent ovulation (probably the one that made her go down a couple days prior on Fourth of July).
The surgeon, me, and the vet that did the ultrasound, all agreed it walked, talked, and looked like a GTCT but I decided to do the blood test to confirm.
I was really tempted to skip it. Farley was still lame. I had just paid for 3 months of pro training. I had finally gotten a diagnosis for my eye and it was cancer and I had no idea what treatment was going to cost but I knew I was going to have to travel for it. A couple hundred dollars is a big deal, and if we were going to take that ovary out no matter what the results, what was the point?
I’m glad I did the bloodwork. I ran the ultrasound pictures by more of my colleagues after the appointment and many of them felt like the ovary looked like a giant ovulation event and didn’t feel like it was such a cut-and-dried GTCT. Getting the blood work back the next week that confirmed it as a GTCT was a huge piece of mind.
Her testosterone was mildly elevated, her AMH was sky high, and her inhibin was normal.
GTCT are the most common ovary tumors in mares but not the only one. The blood test also confirmed we were dealing with a run-of-the-mill GTCT and not something more sinister.
The surgery cost was at the limit of what I felt ML was *worth. If it had been more, I would have had to make some hard decisions. The sad reality is that I don’t have unlimited funds to spend on my horses. They aren’t insured, and I have multiple financial responsibilities in my life. Being a responsible horse owner doesn’t mean being able to pay for everything possible.
Whenever you decide to spend money on a medical procedure for a horse you have to be ok with the reality that you may spend that money….and have a dead horse at the end of it. No matter how good the prognosis, horses like to die in strange and weird ways. If I couldn’t spend the money on the surgery, and then still be OK afterwards if she didn’t make it, I didn’t have any business spending that money. I also knew that I didn’t have any reserve for any serious complications – like colic – during or after the procedure.
We debated the risk benefit of delaying the surgery another 3 weeks until she was finished with training. In the end she finished out the month with Amber and the laparoscopic surgery was scheduled for the beginning of August.
The surgery went well and the left ovary was removed. In “text book” cases the ovary without the tumor looks small and quiet so odds are the tumor was on the left ovary.
Of course she ripped out her sutures immediately after surgery. And don’t give me the bullshit of she must have been in pain. THE LIDOCAINE HADN’T EVEN WORN OFF YET.
Of course she was the first patient of this surgeon who had ever done that. If there was a border collie in a horse body, that would be ML. Wickedly smart and in need of an ecollar. We settled for putting a sticky sheet over the sutures. After she got sedated a second time that day and it was re-sutured.
Of course she would spike a fever mere hours before I picked her up after being cleared to go home. A sterile peritonitis is expected, but she waited a bit later than most and spent an extra day in the hospital.
Of course she refused to eat in the clinic unless handwalked outside.
I was already sweating about how I was going to keep this horse occupied during 4 weeks of stall rest, no exercise, and now I was being reminded that she didn’t like to eat when stalled either. Yay……
I won’t bore you with the toys, tricks, and games we played in those weeks except to say we both survived unscathed. Once again I was reminded that the building of an endurance partner goes beyond riding time or miles on the trail.
Fast forward 2 1/2 months post-surgery to today!
She’s back to work now. We’ve had multiple arena sessions. I haven’t gotten the courage to canter her since being at Amber’s, but she’s schooling in the arena at a walk and trot with lateral movements like we’ve never missed a day.
We’ve had 2 trail rides. I get a little choked up just thinking how GOOD she was on the trail. I just can’t stop thinking I don’t deserve this horse. I don’t deserve this six year old that has an old soul and who loves me with all her heart. I thought Farley was the one and only truly remarkable horse I would have the pleasure of owning and Minx was the last horse that would love me with her entire body and soul. Now I have this one that loves me like Minx, and is just as remarkable as Farley.
She takes care of herself and she takes care of me. She’s never bucked, never reared. Never done anything malicious towards a human.
On our first ride out, less than a quarter mile from the trail head on a windy cool morning a mountain biker passed me on a dirt road at full speed without a single acknowledgement. I screamed like a little girl as it whizzed by out of no where. She stopped and barely flicked an ear. Later when a mountain biker was coming down the trail behind us on a rocky single track at full speed, his off leash dog darting in and out and nipping at her legs, she extended the same courtesy and didn’t kill any of us.
I really need to set a higher standard for the success of our rides than “I didn’t die”.
Forget bikes, I’ll tell you what’s really scary.
Not high speed rude mountain bikers.
Pee rivers that come *out of nowhere* between your legs and run down the trail in front of you, where there was once no pee.
Never mind *you* are actually peeing. While standing on a slightly downhill single track.
Gotta watch out for those surprise pee rivers. o_O
I have more to say about our recent trail adventures, but I’m saving that…for my next post! 😉
In conclusion, her behavior is back to what it was a year or so ago, Farley is back to being queen of the herd, and there’s no more days of her being slightly “off”. She’s back to work with no sign she had surgery. Even the hair has grown back! Success! She should start to cycle again next year and I’m crossing my fingers her they are just blips and no longer the topic of an entire blog post!