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  Discussion on Severe bruising & thin sole
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Member:
Wabbit09

Posted on Sunday, Sep 14, 2003 - 3:54 pm:

Dear Dr. O.
My 20 yr old Peruvian gelding has had a nightmare of lameness the past three months. First, in June he foundered-could barely walk-I kept him in cold water for aprox 2 weeks. His soreness seemed gone, no more pulse and xrays showed that he had no additional rotation-since he foundered last spring. With signs of Cushings , I found a new vet since my old one didn't believe in the medications, etc. We did the insulin levels and he was around 80. We started him on Pergolide and in a week he shed out and was looking great.After a month his levels are normal.
We did xrays and found that he also has severe ringbone in his rt. front pastern. Injected him with H-acid w/o the cortisone as the vet said he cannot have that due to the Cushings.
Right around this time-aprox 5 weeks after he foundered, he and my other gelding broke down the stall guard we had across the barn and got loose-ran up our gravel driveway, into the road and all around. Luckily a neighbor got them back into the barn. We have never had a horse get loose before and were so lucky this time. We expected my gelding to be crippled after this adventure, but for a few days he seemed fine. Then he became completely lame in both front feet-was not able to walk at all. Had the vet back again-he pulled his shoes and found a bad stone bruise on his right front near the heel. Told me to soak it in epsom salts-wraping with a diaper. I continued to treat him this way , but his left front became even worse than his rt front. The vet on emergency call, not my regular vet, told me over the phone-wouldn't come out-that it was just from his putting all his weight on that foot to relieve the rt front. After a week, I insisted that my regular vet come out and look at him again. My heart was breaking watching him so lame and unhappy, standing in his stall for two weeks. Well, he discovered an abcess, pared it out and he is much better on his left front. Now his rt front is still very bad-he is still in extreme pain and on two bute tabs am and pm. Last Friday PM I came home from work to find his rt eye swollen shut. Another on call vet from the same group came out and checked his eye. He apparently had rubbed it, no damage. She checked his rt front foot for me and saw that where it had been pared away for the stone bruise, she said his sole is down to the tissue. Just pressing it with your finger is extremely painful. She told me to continue to wrap it in a diaper with some iodine and just wait for it to grow out. My regular vet cannot understand why after all this time the stone bruise has not healed. They pared his sole out to see if there was an abscess on that foot as there had been on the left, but only found the thin sole and tissue underneath.
My vet suggest we put back on his shoes which he took off-having the shoer mold them away from the bruise. I also want a pad on to protect him but am afraid it may put pressure on his sole.My shoer wants to keep his sole open so we can continue to put iodine on it to toughen it up and will put on a rim pad. Someone mentioned Rick Reddin's sole support system and also Sabre Sneakers. Do you have any knowledge of these or any advice you can give us. Our hearts are breaking watching this wonderful horse suffer so.
Thank you for any advice you can give me .

Bunny
Member:
Canyon28

Posted on Sunday, Sep 14, 2003 - 6:02 pm:

My one word of advice if you really love this horse and want him to recover, DO NOT PUT FULL PADS on him! that will be the end of him if you do. He will abcess under the pad and you wont have a clue as to what is going on and the next time your farrier takes the shoes and pads off you will have infection all the way into his coffin bone. DONT DO IT. I lost a mare by letting my vet and farrier talk me into using pads. Use something that is removable if you must, YOU HAVE to be able to medicate his sole and also see what is going on there at all times. the cushings disease may be why he isnt healing as quickly as he should. If this horse has thin soles now, do not allow your farrier to pare away ANY of his sole when shoeing. It was a mistake for them to cut away any of this horses sole. I have had several mares like that and there is really no reason to take sole, it is pretty much a cosmetic thing that farriers do. They are fine if their soles are left alone. You can use old mac boots, or davis boots over his feet to keep the medicine working, and these will also keep his feet clean. Good luck to you and I know how you are feeling. the mare I lost was my most favorite horse I have ever had and I was completely heart broken when the farrier removed the shoe and pads and found the her coffin bone was infected. I will never ever allow full pads on a horse I own again. there is no way you can keep the foot clean and dry, there is no way you can see what is going on under there, the pad keeps wetness in and blocks air thus allowing areobic growth of bacteria , etc. NO NO NO! Please for your horses sake, dont put pads on him. Only use something that you can remove when needed to medicate his foot , like a boot or taped on pads. Chris www.canyonrimranch.net
Moderator:
DrO

Posted on Monday, Sep 15, 2003 - 6:06 am:

Let's see, the big issue seems to be why is the sole not filling back in where it was paired out for the sole/bruise. I think the recent bout of founder is likely to be the cause. I have had this experience several times where a founder case develops an abscess: pare out the abscess and then it takes forever (a month or two) before a decent layer of sole is formed. The recent bout of founder seems to slow it down.

The second issue seems to be the recurring troubles you are having. Following a severe bout of road founder these are to be expected: bruising, abscessing of damaged tissues, and even exacerbations of the founder, for the next 6 months. I agree with Christine, covering up the problem makes it very hard to care properly for the foot.

For suggestions on specific treatment we have articles on founder, bruises, and abscesses that will cover all of our suggestions and recommendations. PRint them out and review them frequently, discussing out recommedations with your vet. Perhaps your most important treatment tool is two large dry stalls that are beded deep and soft. Rotate them to keep them dry. Then take the problems one at a time as they come.
DrO
Member:
Wabbit09

Posted on Tuesday, Sep 16, 2003 - 11:19 am:

Dr.O & Christine,

Thank you for your response and advice.Christine-my farrier and vet both agree with you about the pads. I agree for right now, but hopefully he will heal and eventually be able to take some lazy trail rides again-(I am praying for that time)-and our trails are very rocky. Would you suggest a pad at that time? Also, every winter we put on snow pads and studs on the horses shoes due to the ice, so they don't slip and also the snow and ice don't ball up in their shoes. When we don't have the pads on , they can barely walk when we bring them in due to the ice and snow balls.

My farrier and vet both came last night and he was given a shot of bute so he could stand to have his shoes put back on. The farrier put a rim pad in the front of the shoe and cut it out at the heal to keep any pressure off his heal areas. It seems to have worked. He is now at least able to take some steps-limping around, but better than he was. We are painting the soles with iodine.

Dr. O-he is in a big stall with a sand bottom and rubber mats on top, bedded deep with shavings. Attached to the barn is a run-in shed with sand bottom where he is standing now, for some outside time after two weeks in the stall. He is happy to be out with his buddy. He also has another problem which the vet is afraid may be due to his increase in bute to get him through this bout. He has been on 1 tab of bute daily for over a year, due to his laminitis and bone spur. It always kept him comfortable. If he didn't have it, he was very uncomfortable., When he foundered this time the original vet had me increase the bute to 2 am and 2 pm tabs. I cut it back down as soon as the acute stage was over. Then he got bruised and we had to increase again. For the past month or so he has had very loose, cow flop type manure. My new vet is concerned it is from the bute, however he is unable to have anything else for the pain due to the Cushings. I cut him to 1 & 1/2 tab this am and will gradually try to cut him back down. My vet did a protein level test last month and it was okay, but now took another sample last night to check again. I don't know what to do for his pain. Now I hope there is no damage due to the bute.
Bunny
Moderator:
DrO

Posted on Wednesday, Sep 17, 2003 - 4:31 am:

Sounds like snow pads are a must but let's just take the problems one at a time.
DrO
Member:
Wabbit09

Posted on Wednesday, Sep 17, 2003 - 8:23 pm:

Dr. O
Do you know of any alternative for the bute? have you heard of accupuncture helping this type of pain?
Bunny
Moderator:
DrO

Posted on Thursday, Sep 18, 2003 - 8:40 am:

No accupuncture is not likely to help and would not be antiinflammatory a important component of the NSAID therapy. We have a long list of alternatives at Anti-inflammatories: NSAID's, Steroids, and Arthritis Treatment. Of course Banamine is on that list and uncertain whether it would be that much safer in the long run. The others would be considered experimental but naproxen continues to appear to be a safer NSAID at the dose that is just as effective as bute. See the article on this for more and you can then discuss this with your vet. Did your horse come back hypoproteinemic?
DrO
Member:
Wabbit09

Posted on Sunday, Sep 21, 2003 - 6:16 pm:

Hi Dr. O:
No, he was not hypoproteinemic, however the vet on call said his white count was a bit low which made her concerned about colitis. I am now giving him pepto bismol before his bute. Also psyllium and Probios for the loose manure.
Bunny
Member:
Wabbit09

Posted on Monday, Sep 22, 2003 - 9:47 pm:

Dr. O:
One of my vets associates came out tonight after my horse became worse yesterday. His left front hoof was worse and when I examined it-the spot where the vet had pared out the abscess was really sore-when I pressed onit what appeared to be puss and blood came out-extremely painful to the touch. The vet who came today said it is his actual tissue protruding through the hole. We soaked both his feet and re wrapped them with betadine and epsom salt and she is going to get ahold of the main vet tomorrow and have him look at him. She said she has seen some vets burn off the tissue to make the horse more comfortable but has never done it. She is stumped and so am I and my poor horse is in unbearable pain. Any suggestion or advice or info you can give me will help.
Bunny
Member:
Juliem

Posted on Monday, Sep 22, 2003 - 11:13 pm:

I don't know if this applies to your horse, and of course your vet should make the call, but when I had founder related abcesses on my gelding the vet pared them out so that they could drain completely. Initially, he wrapped the foot himself, but for the daily bandaging that followed he taught me how. He had me put a piece of cotton in the "hole" he had created, add a few DrOps of iodine, and pack it in quite firmly. He explained that this would prevent his tissue from prolapsing (falling through the hole). The next steps followed what Dr O advised for an abcess hoof bandage and served to keep the cotton in place, the foot very clean and dry and take pressure off the sore part. As the hole "cornified" (new hard growth, about 2 or 3 weeks as I remember), he had my farrier create a shoe that enabled me to still pack cotton soaked with iodine into that hole until it grew in level with the sole. I've treated all abcesses this way, with help from vet and farrier, with complete success. Maybe just luck, but I followed instructions to the letter. I used the pointed end of the hoof pick to really pack that cotton in reasoning that the pounds per square inch a horse places on his hoof could certainly cause tissue to prolapse through that opening. As I said, ask your vet or Dr. O, but this is standard operating procedure for an abcess at the clinic I use.
Moderator:
DrO

Posted on Tuesday, Sep 23, 2003 - 7:30 am:

Pretty much this is all covered in the article on treating abscesses Bunny, including preventing prolapsed tissue again I suggest you carefully review, » Equine Diseases » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels. THe complications you are experiencing suggest you are not following the recommendations or you have another disease process going on.

Without looking at the problem I cannot suggest specific treatment, but I would be very cautious about cauterizing the solar corium. Unless there is remarkable granulation tissue, I would treat the prolapse by supporting it, as recommended in the article, with enough pressure to return it to the proper level until it cornifies.
DrO
Member:
Wabbit09

Posted on Tuesday, Sep 23, 2003 - 4:11 pm:

Thanks Julier and Dr O.
Well-unfortunately-i have followed all my vets recommendations. After the abscess was pared out I was directed to paint the area with iodine twice a day. That was it. His other foot which has the bruise and so far no abscess I was told to soak with iodine and epsum salt solution and wrap in a diaper. Also to wrap the left front in diaper. Nothing about cotton in the hole or supporting the area. I am very disgusted right now. I will follow your instructions to try to keep any additional tissue from prolapsing. It sounds as if this situation could have been avoided if I had been given the correct informaiton. It wasn't until after the fact that I looked at your site for additional information as I was getting very little from the vet.

Julie it sounds as though you are very lucky to have an instructive and thorough vet to help you with the care of your horses. The instructions you were given make complete sense.

Thank you both very much. It may be too late to pack with the cotton as he is so reactive to any pressure on that spot and the tissue is already right there. Can I still try this?

Bunny
Moderator:
DrO

Posted on Tuesday, Sep 23, 2003 - 5:41 pm:

You must remember: we cannot examine your horse so therefore can only make suggestions that should be run by your vet. If you do not have confidence in him you need to find one you do.

If I were having such a problem as you describe, I would first soak in epsons and betadine and then pack the best I could and hope that each day it would get a little better and could be packed a little firmer. It is not just the prolapse but the cotamination and puss that causes intense pain. It should improve with proper bandaging.
DrO
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