CASE 6:  Quarter Horse Mare, 15 yrs old -- Fatal Sinker Syndrome

case_fatal_sinker_1Fatal Sinker Syndrome is the worst case scenario in Laminitis. These horses have traditionally been put to sleep. Dr. Ric Redden of Versailles, KY started investigating saving these horses through a procedure known as transcortical fixation and hoof wall ablation. As of this writing nine research cases have been tried, three were at Serenity Equine.  We have a survival rate of two horses in our hospital.  It is critically important that the horse reach surgery before all blood flow is lost to the foot. Once the hoof dies, it contracts, acting as a tourniquet causing bone and lamellar death. By placing pins in the cannon bone, removing the hoof capsule and casting the leg so as to cause weight bearing at the cannon bone while suspending the foot in a non-weight bearing mode, we are able to save the blood supply and the lamina. In a matter of weeks the lamina will harden and new hoof will grow. In one year all new tissue is normal. We expect our two cases to return to their previous abilities. 
case_fatal_sinker_2Venograms of Right Fore & Left Fore. Note the lack of blood supply to Right Fore and congestion of blood above coronary band. Left Fore has adequate blood supply and is a Grade IV rotation that required a deep flexor tenotomy. 



case_fatal_sinker_3The hoof capsule after removal or ablation appears normal from the outside, but once turned on its side shows the congestion and swelling from the dying lamina.



case_fatal_sinker_4After 3 weeks in a cast, hardening of the digital corium (hoof wall) and solar corium (sole) is almost complete. The cast & pins were left on for a total of 11 weeks (note arrows pointing to transcortical pins).





14 weeks post-op mare is comfortable enough to try and escape from stall.






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