July 29, 2020: Patient Spotlight
Cocoa is a teenage miniature horse who lives at Nestldown Therapeutic Riding Center in Los Gatos, California. In September of 2019, she suffered a traumatic fall...
When initial conservative management of her lameness at home under veterinary guidance did not result in significant improvement, Cocoa came to Steinbeck Peninsula Equine Clinic for further evaluation. Based on imaging and Cocoa's presentation — a toed-out stance and appearance of shortening of her right hind limb — we were able to determine that Cocoa had luxated (dislocated) her right hip joint.
Unfortunately, treatment of this type of injury by reduction, or replacement of the head of the femur back into the hip socket, becomes nearly impossible after 24-48 hours of initial injury in horses. The only option for Cocoa was to perform a Femoral Head Ostectomy, or FHO. This surgery involves removing the head and neck at the top of the femur so that the bone ends are no longer rubbing against each other, which can be a significant source of pain. Gradually, the abundant surrounding soft tissue structures are able to adapt and take over the job of supporting that side of the pelvis and allowing ambulation on that limb by forming a "pseudoarthosis" or false joint. While this procedure is commonly performed in small animals, it is relatively rare in horses due to size and is only attempted as a salvage procedure in small ponies or miniature horses. Cocoa's size and weight is greater than that of previously published cases, making this more challenging, but her docile and stoic nature made her an ideal candidate.
Understanding that this was an invasive procedure that would require a prolonged recovery time and at best, a degree of lameness that was reasonable for a good quality of life, Cocoa's very dedicated owners and caretakers at Nestldown opted to proceed with surgical intervention for their very special mare.
The surgery went well and, after spending a few weeks at Steinbeck Peninsula Equine, Cocoa returned home for lots of TLC and to continue her rehabilitation using exercises and recommendations provided by our Equine Sports Medicine and Rehabilitation colleagues at Colorado State University College of Veterinary Medicine. Ten months later, Cocoa is enjoying her wonderful life and pasture mates at Nestldown, where she provides a calm, approachable, and loving demeanor to everyone she encounters.
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