When “Mary’s” 16-year-old Irish Sport Horse Cian came in from the pasture with two cuts – one on his leg and one on his forehead – she was more concerned with the leg wound, worried that her eventing horse might be unsound. After cleaning up both cuts, however, she decided neither were serious enough to warrant veterinary attention. Two days later, though, Mary noticed the small wound in the middle of Cian’s forehead didn’t look so good. “It looked like there was pus coming out of it,” she said.

Concerned about infection, Mary called her local vet, who came out the following morning to look at the injury, which, by that time, was not only oozing, but also had a foul odour. “You could smell it through the whole barn. It was putrid,” she said. “It would hang on your clothes. If you entered the barn you’d think there was something dead or dying in there because of the smell.”

The wound was small, and seemed insignificant. Mary’s vet did an x-ray, which revealed Cian’s sinus was fractured on the inside. “The wound was like a paper hole punch. There was an indent,” she said. Her veterinarian determined there was an infection in the sinus, most likely due to bone fragments from the injury that were stuck inside the cavity.

Over the next week, Mary administered oral antibiotics and the vet visited daily to flush Cian’s sinus with a syringe, trying to clean out the infection. But after a week, when Cian showed no signs of improvement Mary decided to send him to an equine hospital, where he was given antibiotics and daily sinus flushes.

After a month of rigorous treatment, the vets at the hospital determined Cian’s infection was gone and he was ready to come home. Mary started riding him again, but noticed there was a bit of mucous coming out of his nostrils when he was in work. She called her vet and asked if this was okay and they told her if the mucous was clear, it was fine to continue.

Another two months went by and Cian continued to be symptom free. Mary went away on vacation and had a friend ride Cian. It was during this time the smell and pus returned. Concerned about her horse’s health, Mary sent Cian to the equine hospital immediately, where the vets there did flap surgery – cutting a piece of bone out of her horse’s face to access the sinus for a deeper flush. They also prescribed stronger antibiotics.

After the surgery, Cian seemed better, so again Mary brought him home. However, before she even backed him off the trailer, she noticed something was amiss. “He was shaking. I took him off the trailer to settle at home and he was still shaking,” she said. Concerned, she took Cian’s temperature. “It had spiked,” she said.

After five months and thousands of dollars spent battling the infection, Mary knew she was running out of options. “My vet told me these infections can go on and on. I felt like if I wasn’t able to cure him, I had to think about what was right for him,” she said.

Only willing to give it one more shot, Mary called Dr. Bruce Watt, a board certified veterinary surgeon, for a third opinion. “I told him I was at my wits’ end and at the point of putting him down,” she said.

When Dr. Watt arrived, he suggested a sinus flush as well – but on a much larger scale. Instead of just using a small syringe that puts a litre of fluid through the sinus, he’d drill a hole in the sinus and use a large pump to push 10 to 15 litres of fluid through the cavity in under two minutes. “It’s a technique I learned from a vet in the U.S. It creates a lot of turbulence in the sinus and we’re able to flush out whatever is causing the infection,” he said.

His theory was that the smaller flush hadn’t reached the floor of the sinus to clear out the objects that were causing the infection.

Over the next 10 days, Dr. Watt did the large flush and prescribed another course of antibiotics. On day seven, they did an ultrasound, which revealed the sinus was clear. “The infection never came back,” said Mary. “I told Bruce ‘You’re the master.’”

Now, a year later, Mary is back riding Cian, who is perfectly healthy. Mary jokes that she’s now somewhat paranoid about injuries that happen in the paddock, noting that recently Cian banged his head again and she immediately called out the vet. “He was fine; it was just me being overly cautious,” she said.