I heard from the vet today. This mass is a tooth root tumor. Very rare. Only 3 reported cases in the world. Massive complications. Surgery is going to cost thousands (that's not a problem if she pulls through!). She may end up with a great quality of life. She may not, and need to be put to sleep anyway.
We need a CT scan at Charles Sturt Uni in Wagga Wagga (which means travel 4 hours there and back, $1500 or so for the bill) to see exactly what we are dealing with before opening her up. If we open her up. Depends on the current damage. Basically we need the CT to see if she is even salvageable.
If she is salvageable, surgery will go ahead. Apparently planning is the key here.
Surgery involves a big giant bone flap, to go in through the sinus and then remove the tumor and any damaged surrounding material. The extent of the damage is unknown - best case scenario the other teeth (the last two in the upper left arcade) are ok to stay, although they haven't erupted properly and will never be in the right place.
Worst case scenario, there may be other teeth and bone to remove, leaving a gaping hole. Encouraging a gaping hole to heal and stay closed so there is no communication (i.e. food and debris) between the mouth and sinus is imperative. Her quality of life moving forward partially depends on this.
The other major consideration is the orbital nerve which runs very closely to the area - if this nerve is damaged, the horse does NOT cope well. It innervates the horse's nose, lips and face. Without some or all of this, apparently the horse just goes nuts and is a danger to itself and all around it. Preserving this nerve is their #1 priority during surgery.
Last but not least, it is a possibility that she can bleed out during the sinus surgery, so a donor horse is kept on hand just in case she needs a bloody blood transfusion.
Fuck me. This is the most difficult thing I have ever had to deal with. My beautiful, sweet mare has a major rare life threatening tumor that needs major surgery to remove. Prognosis if all goes well is quite good, the horse may suffer from frequent mild sinus infections that will be controlled with medication when required. Frequent dental will be another life long commitment.
That's if she gets to that stage.
Why my beautiful mare? She is the sweetest thing, great riding horse. She had a bright future. The vets are very guarded with their prognosis.
What am I going to do if I loose her? If I have to say goodbye? I don't know if I will ever want to be involved with horses again. I think I'm already going to give up trimming in the meantime, until we know what is going on.
Fuck fuck fuck.