Horse with a humeral fracture

Question
We currently have a 21 year old thoroughbred gelding with a comminuted humeral fracture that occurred this past Thursday.  We obviously know the real logistics of a horse surviving a fractured leg, etc.  but long story short he has given us and thousands of kids (literally) so many years of tolerance that we feel as if we owe him a chance.  We are not opposed to euthanizing but we want to exhaust all options first.  And he is eating, drinking, and taking this accident in pretty good stride, we are even amazed at his ability to hop on three legs.  And impressed to see him run away from us when he sees the bute coming!  After speaking with our local vet and being advised to euthanize, we consulted with rood and riddle in Lexington to learn that a study showed that a horse stands just as good of a chance to recover from a humerus fracture with conservative non surgical intervention as he would from a surgical intervention. Our goal is to essentially have him pain free and  "pasture sound" we obviously do not expect any miracles. :)  With that being said I am so thankful with the consult help of rood and riddle, and I feel bad calling them back hence why I am here.  So any help would be helpful! To give you an idea of what we are doing thus so far he is on complete stall confinement, and tolerating it perfectly, (he was a herd horse with 71 other horses at a non-profit riding program so he thinks stall rest is GREAT!! ha ha) and we are giving him two grams of bute, and are tapering it back to 1.5 grams on Tuesday, and then to 1, on Saturday.  We are also seeing if Banamine is an option however, we know Bute is a better option with the skeletal component, we are looking into an anti-ulcer medicine, and not looking into any blood thinners such as isopropine ( I believe that is the name) to help him from foundering.  He is also wrapped on all three other legs with stable wraps, and we are constantly checking for heat in the feet and a increased pulse in the legs.  Also we are considering Equinox (I believer the name) because of it non GI component however, we have had two vets say it is not worth the money..so please weigh in on that too if you could! thanks!  But my main question is obviously there is a large amount of edema in the leg that is getting increasingly more as the days go on, should we be worried about the pressure that this is causing to the tissues, and is there any need to worry about this, or something we should do to alleviate this pressure? Or is there an anti-inflammatory that could help as well.  Also the vet at rood and riddle advised against slinging it, and just to leave it go because we could possibly do more harm, but should we be propping his leg in the right position to make sure it tries to heal in some sort of alignment?  Or just leave it go?  Once again, any help would be appreciated!  Thanks you!

Answer
Christina:

to start with, if you've been to Rood and Riddle, youve consulted with the best equine surgeons in the world. Any advice from me will be far less qualified and seasoned than what youve already heard. That said, my input on this is limited. I suggest that you continue to recall that he is 21 years of age and that a situation like this, even if he is doing well now, will be much more challenging to him than a younger horse. As such, if he has been such a good horse for you and many others, you also owe it to him not to just give him a chance, but to keep him from having to go through more than he should have to. I dont know how to tell you what that limit might be for him. I dont know him nor have I examined or seen him. It would be very unfair, in my opinion, to ask him to continue to fight through this if he suffered the least indication of any laminitis. As far as what it takes to heal, just remember, its going to be ALOT of time for this, especially with a comminuted fracture and he will not look as good as he does now throughout this whole ordeal. YOu wont be able to control the edema, but it could become a real issue for him if he develops a compartmental syndrome in the leg. I  think its great you want to give him a chance, but as you go I strongly encourage you to be fair to him and dont prolong something because if makes you feel better that you are giving him the chance and giving it everything. That is not always in his best interest. I cannot make any more specific a recommendation. Im neither his vet, Ive never examined him and I dont know him and how he is doing. Just keep up with the expert veterinary advice you are receiving from Rood and Riddle and remember that being fair to him does not always mean taking it to the point where you do start to see him deteriorate and exhibit pain. FWIW, my $.02. Good luck to you and your special horse.