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  Discussion on Deep pussing wound to coronet
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New Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 9:33 am:

My 6 yr old QH gelding has had a large ugly scar on his back hoof going a little up the leg since we bought him about a year ago, but he has never been lame on it. Occasionally he would short stride a bit, but that was it. He's always been wonderful, went on a light kick and never refused a thing.

In late Dec he started getting harder and harder to move on, but we didn't really think much of it since it's my 10 yr old daughter that rides him and we though he was just being a brat.

Then in late Dec, maybe the very first of Jan, he came in to the barn with a very obvious limp on that back foot. Our young vet came out and said that he was sure it was the old scar that was hurting him and he was obviously tender around it. We started soaking in epsom salts and kept the wound bandaged A couple of days later, he blew out what we thought was an abscess at the back of his hoof above the bulb. But, he was putting a little weight on it at least.

He was then on SMZ tabs and 1grm of bute morning and night. As he was appearing a little better, the vet thought it would be best to leave the wound open to get air and heal. He had been kept in the stall but we started letting him out a bit. We cut down on the bute.

Then he went down hill again, he's been up and down for two months now. The young vet took some xrays a one point and a huge puss pocket was very evident. After it stopped draining so much he took another xray and we could tell that it had greatly cleared out and we thought that we were making good progress.

The latest is that we called another vet out because he got worse again and just wasn't progressing. By the time the other vet came out, he was at least putting weight on the foot and it wasn't pussing anymore. We ran out of the SMZ tabs and stopped since it wasn't pussing.

She said that it was just a bad injury that would probably cause problems for a VERY long time, getting hot and then not, as time progressed, but that he needed some support on the heel where part of it had been lost when the abscess burst. So, she recommeded this "great" farrier and called him for us because I had been trying for weeks to get ahold of him and he never returned my calls. He came by the same day, was very positive that my boy would heal just fine, but did need a shoe for support. He put a shoe on that hung past the back of the hoof and has little pieces on the back.

Well, it's just been horribly down hill from there. By night he couldn't put any weight on the hoof and it was oozing puss again. The problem is that we don't know if it's the shoe or that he stopped the SMZ.

That was two weeks ago. I've left multiple pleading calls for the farrier and he won't call back. That vet is impossible to get ahold of so I called the young vet back because he is always so great about coming out. He gave us more SMZ tabs and put him on bute 1gm morning and evening.

Here I am now, a week later and the horse still can't bear weight on that hoof. A new farrier that works with a trainer I know came out yesterday and he thinks that the shoe is a big part of the problem because it's putting more pressure on the wound everytime he steps down. But, he sees how deep the wound appears and wants me to call another vet he knows to make sure that the infection hasn't reached the bone.

I called the vet and he doesn't even want to come because he says that I just need to take the gelding to the equine hospital because they probably need to take out some of the sole (when he hasn't even looked at it). This is a vet that some friends said did a fairly good job, but was scared of horses.

Honestly, I've put so much $$ into this and he's horrible to try to load onto a trailer when he can walk, I can't imagine trying to get him on like this and then expecting him to hold himself up on one leg all the way to the hospital and I'm scared to death of what a hospital is going to cost.

I'm not sure how to upload pics, but I'm going to try. Please, any kind of advice would be appreciated. This has been going on sooo long and I have an extreme amount of patience and we love this guy to death. At this point, I really need some guidance:

Hot soak in epsom salts or cold hose? (how long)
Keep it bandaged or leave it open?
What to put on it? Furi zone, Koppertox, Iodine (we've been told a different one by each vet)
Take the shoe off? The new farrier thinks that a keg shoe would be better, or even a bar, but with him in so much pain, I hate to have to put him through someone pounding on that foot again.
Keep him in the stall or let him out in a dry paddock? I know he needs to get some blood flowing.

Any ideas what I could expect an equine hospital to cost?

Please, any advice would be helpful.
New Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 9:50 am:

Full side view now with shoe

The top picture is now, the bottom is before the new vet came out. When she came, she cut off everything below the crack because it turns out it was all just hanging. But that also removed some of his support which is why she thought that he needed the shoe. The top picture is now.
Member:
erika

Posted on Friday, Mar 6, 2009 - 10:13 am:

Oooh, ouch! What a way to welcome you, Wallene.

In my layman's opinion, it appears you haven't cleared up the infection--perhaps stopping and starting the SMZ's was less effective than long-term use until healing begins.

For an active infection, I would soak in epsoms, and keep it wrapped to prevent dirt getting in. Perhaps even a clean stall for some time.

Can't help you with the hospital estimates, but you have been battling this for quite some time without improvement...can you call and ask for rates/estimates? Appears to be time to get to the bottom of it.
Good luck, I hope you'll keep us posted on how the horse does.
Erika
Member:
hollyw

Posted on Friday, Mar 6, 2009 - 10:34 am:

Oh, dear, Wallene . . . that looks really awful, especially considering all the vet/farrier input you've had and all the work you have done, too. There must be a way to deal with this.

Seems like wrapping with medication would be good . . . maybe with a shunt put in for drainage . . .
I would take him to the hospital at this point. I really don't know how much it would cost, but if the vets can't help you at home, then it might be your only option.

Call the hospital and ask them about their charges. Maybe they have an e-mial address where you can send the photos?
Member:
dres

Posted on Friday, Mar 6, 2009 - 10:34 am:

Ouch is right.. Poor guy. . Poor you.. I agree I can't offer much help other then I would try to shave all the hair around the wound , keep it clean and dry.. & take off that shoe, Not sure why the farrier put the heel up a degree or so ??? If anythng I might have put heel extenders on ..
You have vested a lot of time and $$$ already, A vet clinic tho will have all the toys to dianose this and put you on track.. It might be worth the monthly payments ...

Welcome to the site.. and please keep us posted..

On the first day God created horses, on the second day he painted them with spots..
New Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 10:50 am:

Thanks everyone. Yes, taking him off the antibiotics was definitely a bad thing. Up until 2 days ago, we had been keeping it absolutely clean and wrapped with a cushioned canvas boot on the hoof to keep all the crud out. We changed the bandage 3 times a day and put iodine on it and let it dry before re-bandaging and it just kept pussing so much that the newest farrier agreed with the lady vet that it needed to air. So we've left the bandages off and have been coating it with Koppertox to try to keep the bacteria from causing problems. Thanks for the suggestion about getting the hospital pictures. I never thought that a hospital might let me make payments, but if they will, then that's a definite possibility! Thanks for the suggestions, I'm going to call the hospital.
New Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 12:58 pm:

So, we just finished cold hosing it, let it dry and coated with Koppertox (that's the green in the pic) and I actually think that it looked a little better and definitely didn't seem to be oozing as much.

I've scheduled an appt with an equine hospital, but they are 1.5 hours away.

I'm really concerned about whether his good leg can withstand the stress of a ride that long. He's horrible to load when he's sound and I have no idea how we are going to get him on the trailer the way he is right now, but I'm trying to be positive.

My gut really tells me that we need to remove that shoe before he tries riding in a trailer, but I really need some input here. I've called the young vet and he's willing to come out on Sunday afternoon to tranq him so that a farrier can remove the shoe and I've left a message for the farrier, but haven't heard back yet.

I really feel like I'm offending my vet, and he's been SO wonderful about coming over here all the time and being here when we need him. I just feel so helpless here.3/6/09 after hosing
Member:
dres

Posted on Friday, Mar 6, 2009 - 1:07 pm:

If a vet is worth their salt they won't be offended..
Dang that hoof does need support, still not sure it needs a wedged heel tho..:-(
Not so sure that Koppertox is the medicine that should be used here... again keep it as clean and as dry as you can.. maybe a very lightly bedded stall?

When you travel, put standing wraps on all 4 legs.. they tend to help make the supporting legs ''feel'' better..
Maybe you can use a little Ace before loading up, to take the edge off??

On the first day God created horses, on the second day he painted them with spots..
New Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 2:11 pm:

I got a call from the lady vet that's been here once before that recommended the farrier put the shoe on for support. She can see Doc tomorrow if we can get him down there. This one's about an hour away, but they helped us with my gelding that lost and eye and were great about it.

I don't think that I can get the other vet out to give a sedative tomorrow though because he was out of town all day.

I'll definitely wrap the legs, thanks for that advice.

I have some Bach's rescue remedy, do you think that would be ok to help get him loaded up?
Member:
stek

Posted on Friday, Mar 6, 2009 - 2:18 pm:

Wallene, what an awful looking wound, so sorry for you and your horse. I also wondered about using Koppertox, I believe it can damage soft tissue?

I would be more more likely to soak in epsom salts/betadine, clean with a betadine scrub, and either leave open and treat with furex or wrap with betadine.

You will find a lot more useful and indepth info in the articles on this site though. The attending vet is usually the best provider of instruction .. I say usually because it sounds like you are having trouble getting the help of a good horse vet? Your best bet at this point might be the hospital.

I would think this horse should be on injectable antibiotics .. is the intermittent SMZ the only thing he's had? I would also be using a standing bandage on the other hind for support. And yes, definitely wrap all 4 legs if you end up trailering him.

Good luck and hang in there.
Member:
dres

Posted on Friday, Mar 6, 2009 - 2:26 pm:

Wallene, do you have help in loading? One way I have used with hard loaders is to back my trailer almost into the barn, so that the only way out is to get into the trailer.. Use bribes/ carrots/ pellets in a bucket.. WHAT EVER WORKS to get him loaded and on his way to the vets.. Give yourself plenty of time to make it a slow and '' stressfree'' experience.. one step foreword, one step back. . just don't get excited/frustrated or mad..
I tried the herbal remedies.. never had any luck with them..
Keep us posted..

On the first day God created horses, on the second day he painted them with spots..
Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 2:30 pm:

The lady vet that we've used before is the one that said to use the Koppertox, but she just called me back after seeing a picture of the hoof and she's sending a vet out here tonight.

She also just said to soak in epsom salts and betadine, that I'll go do that next. She said that she's also checking with another hospital to make see if they have any other recommendation for the antibiotics too.

Thanks so much for everyones encouragement. I'm a big cry baby and this guy is the first horse that my 10 yr old daughter has ever had 100% trust in. He taught her to slow lope and move out for a canter as well as everything else. Her first season with him she won multiple blue ribbons at fun shows and and overall high points. She can ride him english or western, or her favorite, bareback with just a bridle. He is just such a good boy with an amazing and wonderful temperment that I can't bear the thought of losing him.
Member:
erika

Posted on Friday, Mar 6, 2009 - 2:40 pm:

Obviously we all "hear" your concern, Wallene. Been checking all day to see what you post.

There are several HA members in NC, I wonder if anyone is near you that could help load if your vet says get him to a hospital? You might post the area without being too specific--maybe someone is right down the road, you never know!

I am so happy to hear that a vet will come to you tonight. What a relief! He sounds like a wonderful horse. Hope you find some help for him soon! You're in our thoughts and prayers.
Erika
Member:
hpyhaulr

Posted on Friday, Mar 6, 2009 - 4:31 pm:

Wallene,
I am not too far from you, please email me privately and let me know what we can do. We have a 6 horse trailer which will be back here in an hour. It will be far ore comfortable for your horse. If you need it, please let me know asap.
Member:
wlreimer

Posted on Friday, Mar 6, 2009 - 8:36 pm:

I can't thank you all enough for your support. Cyndy, thanks so much for the offer, for right now it looks like we won't need to transport yet.

The vet has just left and he took 4 or 5 Xrays. After calling the lady vet and explaining what he saw, they both agreed that the shoe needed to come off, so he took it off before he left. That was quite a job and I have to give him lot's of credit for sticking with it!

Doc was so tender that even though he was heavily sedated, between my husband and the vet, they had to pull each nail out separately.

After the shoe came off and Doc was still sedated, he finally put some weight on the bad foot and the vet checked the digital pulse there and said that it still sounded good although he's worried that it could turn laminitic quick with holding so much weight consistently.

He said to put a thick layer of wood shavings in the stall to give the good leg some cushion and to get some styrofoam, and cut it to fit the good hoof and tape it to it with duct tape. Or, he said that there is some kind of EasyBoot that can be ordered that is cushioned specifically for this kind of thing. Does anyone know what they would call it? I have normal EasyBoots, but haven't seen anything else other than the rubber medical boot that they make.

After seeing the hoof, the vet said there is definitely some bad separation between the sole and the wall in the while line area, but a greater concern is that there may now be some infection in the bone.

The lady vet is going to develop the XRays in the morning and call me to let me know what she finds.

It's crazy that with all of the vets and farriers that I've had here, that it's gotten to this point.

Thanks again and I'll let you know what the XRays turn up when I hear from them in the morning.
Member:
hollyw

Posted on Friday, Mar 6, 2009 - 8:51 pm:

Wallene, it's great that you are getting some good help from the vets. "The squeaky wheel" and all that . . .

So sorry that you all, and especially Doc, have suffered with this for so long. Hopefully, now that the vets are working together, you will see some good results.
Member:
mitch316

Posted on Saturday, Mar 7, 2009 - 5:47 am:

Wow, an ugly wound is right. Hopefully they have you on the right track now. There is some special shoes/foot supports for injuries such as this, but with the drainage, I would let the vet and not the farrier decide which to use. These things can turn even uglier, quicker, so stay on top of it!
Member:
jojohn

Posted on Saturday, Mar 7, 2009 - 8:07 am:

Wallene, if you don't have an easy boot, take a roll of thick cotton and after treatment, wrap in the cotton then rewrap with duck tape. The cotton will help with keeping it dry and the duck tape won't let fecal matter or dirt in . I once had a horse that absesed and this worked to keep things clean. Duck tape should only be around hoof and not leg. Don't want to cut any circulation off.
Moderator:
DrO

Posted on Saturday, Mar 7, 2009 - 9:23 am:

Welcome Wallene,
Sorry to meet you over such a mess. The problem here is we do not know what is going on. From the information so far it could be as simple as a tough solar abscess that has graveled or as complicated as penetrating foreign body that has penetrated into a synovial structure. I think the radiographs will go along way to helping as long as the Coppertox was carefully removed, I believe it will interfere with getting a good shot.

Until a diagnosis is made consider the examination, first aid and treatment described in the abscess section of Diseases of Horses » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels. Please stop the Coppertox on a open wound it is harmful to living tissue and meant for putting on horn. Until more is known I think systemic antibiotics are logical. Let us know how the radiographs turn out but the final therapeutic step here is: locating the infection opening it up, draining, and good local treatment. I am uncertain what the cost is likely to be.
DrO
Member:
jowidner

Posted on Saturday, Mar 7, 2009 - 12:44 pm:

Oh Wallene, I feel your pain. You certainly have been a wonderful advocate for your boy through this difficult situation. It sounds like you are finally getting some traction in treating his wound.

As far as supporting the "good" leg, Soft Ride www.soft-ride.com makes boots that have an insole specially designed for the laminitic hoof. I don't know if they are designed to prevent laminitis or if they are just to be used after the fact. They also have other insoles with different degrees of support. They are pricey, so styrofoam is a much more economical alternative. If you use styrofoam, make sure it is about 2 inches thick and replace it with new styrofoam after it compresses. On my horse I had to start over with new every day and a half.

I've also used anti-fatigue matting that is available at any home store such as Lowes or Home Depot. It is inexpensive and can be easily cut to fit the shape of your horses hoof. It doesn't compress as quickly as styrofoam so you don't have to replace it as often. Also, don't underestimate the cushioning ability of deep shavings. Just be sure to fluff then up daily as they will compact quickly.

Good luck, and keep us posted. Sending healing thoughts your way.
Member:
wlreimer

Posted on Saturday, Mar 7, 2009 - 2:56 pm:

Well bummer, I haven't heard from the vet today as I expected and when I tried calling them, they are already closed.

They didn't remove the Kopertox. I'll ask them about it.

What is are systemic antibiotics? Is that the SMZ?

What about fura zone? I need something to keep the crud and feces out of the wound because it's really a hole that goes inside of the hoof.

Or, is it better to keep it wrapped, but then the puss builds up. I just don't know.

I haven't been able to get a pad under the supporting foot, we tried this morning and he was just nuts about putting any weight on the bad foot in order for us to get anything under the good one. I'm on my way to buy wood shavings since that's what the vet last night suggested.
Moderator:
DrO

Posted on Saturday, Mar 7, 2009 - 7:08 pm:

Any antibiotic administered either orally or by injection would be a systemic antibiotic. Furazone would be a topical antibiotic and good for the wound itself. Because of its location close to the ground a bandage would be better but it does need to be absorbent and changed often enough to keep it from getting saturated. hopefully good wound care will lessen the discharge. Did you review the article on abscesses? It has further treatment information.
DrO
Member:
ajudson1

Posted on Sunday, Mar 8, 2009 - 9:06 am:

Wallene,

No new advice for you, just wanted to let you know I am following this too, and thinking of you and Doc.

The last picture has a very bright red spot in it, is it possible there is a sliver in there causing all this trouble? And it's just coincidence that it's where the old scar is? Probably a silly long shot idea, but stranger things have happened.

Hang in there.
Member:
36541

Posted on Sunday, Mar 8, 2009 - 9:25 am:

Wallene, IMO you should go to the closest university hospital as soon as you can. All these home visits have got to be adding up, and you are getting nowhere. You aren't always able to get ahold of your people and that isn't satisfactory. If this is osteomyelitis(bone infection), oral antibiotics aren't optimal no matter the species of patient concerned. You will likely get more diagnostic information and treatment in 3 days than you have gotten in 3 months, and when you leave you will have a plan and professionals you can contact around the clock. Surely your younger vet has suggested this as the better option at this point??
Member:
wlreimer

Posted on Sunday, Mar 8, 2009 - 2:11 pm:

Thanks Stacy, unfortunately he's not suggested anything other than that it will just take time.

And, we soaked in Epsom salt last night and this morning when I changed his bandage (we normally bandage at night because he lays down and gets crud in the wound), it was actually much cleaner than it's been. Pussy, but better although I could see that some of the puss had seeped out between the wall and the sole.

However, I just came in from cleaning his stall and changing the bandage again and the bandage had blood in with the puss. Does that mean anything? I've really been looking at the wound closely and although I think it looks like the wound itself is looking a little better, I can clearly see basically a canyon? between the wall and the sole. It's like a finger nail that is attached on one side, but is separated from the finger on the other.

So, I am determined to get him to a hospital this week. However, I have so many people pushing me in different directions. I'm between Charlotte and Asheville in NC and I've been told that each of these are all good places from different people, but I'm really tired of messing around and want to make sure that we get him to the right place.

Davie County Animal Hospital
Animal Hospital of Statesville (one person says that they are equine lameness specialists, but their website says nothing about this and I'd think it's something that they would advertise if that was the case).
Tryon Equine Hospital (supposedly surgery specialists, but not sure that this is really what we need)
Stony Point Animal Hospital

Can anyone please give me experiences or direction as to who might be the best to go to for this problem?
Member:
leslie1

Posted on Sunday, Mar 8, 2009 - 3:56 pm:

Hi
I would try vets who specialize in Horses and from the list above it looks like the only one that is specificaly equine is Tryon Equine Hospital. They are lameness diagnosticians as well as surgical.
I would definately use an equine vet and not just an 'animal' vet.
Good luck
L
Member:
paul303

Posted on Monday, Mar 9, 2009 - 1:13 am:

I'm relieved to hear that Doc will be going to the hospital as soon as possible. Diagnostics are key in your case, and a hospital has the best equipment for that. Far better than a vet can carry around in the field.

If you've never had experience with an equine hospital before, you may be pleasantly surprised. I've been, many times, and have always been charged less than I expected. Also, they keep you informed every step of the way, so that you can make the decisions about how far you want the treatment to go. The "reins" will be in your hands there, and the doctors and staff will bend over backwards to explain things clearly and provide you with the tools and understanding you'll need to make solid decisions for Doc's welfare.

When I deal with a foot wound or infection, I like to have on hand a good supply of sterile non-stick gauze sponges, tape to hold the sponges in place during application of the dressing, "premie" disposable diapers, plenty of vet wrap, and loads of duct tape.

I first thoroughly clean the wound with very warm water and betadine or Novalsan. As gently as possible, get it as clean as you can. Then soak in a weak solution of betadine ( the color of weak tea )warm water, and Epsom Salts ( to draw ). After soaking, place a piece of clean rags or towels where the affected hoof will be to avoid re-contamination. Dry well....I use paper towels, gently patting until dry. Pack the wound with an antibiotic ointment ( I use Novalsan ointment - sometimes Furazone might be irritating ). Never use Coppertox near sensitive tissues - it is too caustic. Sometimes, if more "drawing" is necessary, I use sugardine ( a pasty mixture of sugar and betadine).

Cover the wound and ointment with non-stick gauze pads and tape pads in place lightly. Either cut the premie diaper and cover the gauze pads or use it whole and enlist the aid of the sticky tabs to secure the diaper. Further secure the diaper with a piece of duct tape that will ensure it stays in place while you snugly wrap the whole hoof ( all around and underneath ) with vet wrap. Secure the end of the vet wrap with a piece of tape. Wrap the vet wrap snugly, and wrap ONLY the hoof - not the pastern. Reinforce the bottom of the vet wrapped hoof with 2 or 3 strips of duct wrap.

Now for the duct tape boot: before you begin this whole process, find a flat area where you can lay about 4 or 5 pieces of duct tape about 8" long sticky side up....overlap each piece by about 1/4". Do a second layer crosswise to the first - one carefully laid strip at a time. I find it easiest to hold the affected foot up and stick this "duct tape plaster" to the bottom of the foot- as centered as possible. Carefully bring the hoof to the floor and grab some very sharp scissors that you left within reach and cut slits in the duct tape toward the hoof bottom. As you cut a section, fold it neatly up against the vet - wrapped hoof. Continue slitting and folding up ( in about 4 or 5 sections ) until the duct tape mat is fitted around the hoof. Trim the top even ( keep it near the coronary band level - don't go above it )and add one or two more pieces of duct tape encircling the hoof.

This dressing came from this site years ago. It has always afforded incredible relief for hoof pain. It lasts 24 to 48 hours ( you wouldn't let a hoof problem go any longer, anyway ). I prefer it over boots, that don't fit like "second skins" and that encourage a warm, moist, wet environment - perfect for bacteria. The diaper wicks away and absorbs moisture wonderfully, while keeping the "dry, inner liner" against the wound. It sounds like a lot of trouble, but it really isn't - once you get the hang of it. The duct tape mat is the hardest part. Get your supplies ( and mat ) lined up in front of you before you start. Then it just goes along step by step while you ensure as clean a field as possible.

I've tried at least two different boots as medication dressings, and as I said, the duct tape-vet wrap-baby diaper dressing was far superior. It made the horse comfortable, didn't rub them sore, and kept the wound and wound area dry.

You may not need this since you'll be going to the hospital, but keep it for future reference. In the meantime, if you get a chance, please keep us informed. We all learn so much from people gracious enough to share their experiences with us. Thank you, and best of luck.
Moderator:
DrO

Posted on Monday, Mar 9, 2009 - 8:14 am:

Wallene, Dr Meeker at Davie County should be able to help you.
DrO
Member:
wlreimer

Posted on Wednesday, Mar 11, 2009 - 1:04 pm:

I just wanted to update everyone on what's happening with Doc. We went to Statesville Bovine and Equine center today and met with Dr. T. Blackwelder who is an lameness specialist.

He took a few more X-Rays because the ones that the vet took Friday night didn't show enough since the shoe was still on. There IS infection in the bone and some very deep infection in the hoof wall.

He immediately gave Doc multiple intravenous antibiotics and said that the SMZ tabs just aren't strong enough to reach the hoof with enough force to kill the infection.

He's going to keep Doc until at least Friday and continue the antibiotics. Hopefully on Friday we can get a good farrier into the Dr's office. If not, we will transport Doc to Davie Cty where they have a couple of farriers in on regular days of the week.

Dr. Blackwelder was very knowledgeable and perfectly agreeable to calling a hoof repair expert (Rusty Freeman) to confirm his plan of action. Rusty and I spoke last night when he replied to an email that I sent him. He is wonderful and they both pretty much agreed on the best way to proceed.

I know that healing is going to be a long process, but I'm very positive that we are finally getting somewhere. Both Rusty and the Dr. think that he can come out of this, but if things hadn't progressed so far, it could have been MUCH easier. Hard lesson learned! I understand now that there are specialists out there for everything and it is well worth the time, effort and $ to get to one whenever possible!

One more note, I have to thank GOD, he answered my prayers and Doc actually loaded fairly easily. It only took about 15 minutes to get him onto our trailer.
Member:
sdms

Posted on Wednesday, Mar 11, 2009 - 2:10 pm:

Wallene, this is very good news! Hind sight is always 20/20 but, as you know, there's no sense in dwelling on the past. You just have to learn from it and use it to your advantage as you're doing. With a positive prognosis from both the vet and the hoof repair expert there's a light at the end of the tunnel! Best wishes to you and Doc and I'm sure with all your hard work and love he'll be good as new before you know it.
Member:
36541

Posted on Wednesday, Mar 11, 2009 - 2:18 pm:

I'm so very glad to hear your news. Sending healing thoughts to Doc and strength for you. Stacy
Member:
lilo

Posted on Wednesday, Mar 11, 2009 - 3:07 pm:

All the best to you and to Doc. Probably a long road ahead until full recovery, but at least you have a diagnosis now.
Lilo
Member:
hollyw

Posted on Wednesday, Mar 11, 2009 - 7:08 pm:

No wonder it wasn't healing correctly, Wallene. Great news that the infection was found and is being treated by the experts! Doc is going to feel SO much better (and you are, too!).
If you can get photos of the progress of the healing, I would really appreciate seeing them.
Take care. I bet God sent some angels to help load Doc. He loves Doc a bunch, too.
Moderator:
DrO

Posted on Wednesday, Mar 11, 2009 - 7:31 pm:

It sounds like good news Wallene if I understand your post correctly and the joints or navicular bursa aren't involved. Concerning the bone infection, sometimes this requires surgical removal, does the veterinarian feel this may be necessary? What are the chances you could post the radiographs?
DrO
Member:
vickiann

Posted on Wednesday, Mar 11, 2009 - 7:33 pm:

Happy and thankful that it sounds like you are now going toward treatment that will yield good results. Best of luck to you.
Member:
wlreimer

Posted on Wednesday, Mar 11, 2009 - 8:10 pm:

I think that the chances are pretty good that I can get the radiographs. I know that they're digital. He didn't mention anything about surgical removal. Right now the focus is on killing the infection and trying to get a hold of a good farrier.

I'll ask him about it though.
Member:
paul303

Posted on Thursday, Mar 12, 2009 - 12:44 am:

WHEEEW!! Good to hear things are progressing....wishing you continued good luck!
Member:
mrose

Posted on Thursday, Mar 12, 2009 - 1:31 am:

I'm so glad you are getting to the bottom of this and I hope he continues to improve. Keep us posted. I think we've all been there on the "live and learn" bit. Don't feel bad about it; you did learn and are doing the best you can for your guy.
Member:
frances

Posted on Thursday, Mar 12, 2009 - 6:08 am:

Thank God they've found the infection and are treating it properly. What a relief for you and Doc (and for us too, just reading about it!).

All the best for continued healing.
Moderator:
DrO

Posted on Thursday, Mar 12, 2009 - 8:40 am:

Let me clarify the "removal" statement Wallene. Often long standing bone infections with draining tracts center around an area of dead bone, called a sequestrum. The sequestrum needs to be debrided or removed before the infection can be resolved. Without removal antibiotics cannot resolve the problem.
DrO
Member:
wlreimer

Posted on Thursday, Mar 12, 2009 - 2:32 pm:

The vet just called me and said that he spent some time last night studying the radiographs better and feels that the infection had progressed into the bone much further than he originally thought. He also forwarded them to a specialist at NC State who concurred.

It does appear that he's going to need surgery. But, I was so upset at hearing everything that I just couldn't even speak to ask enough questions. A good friend of mine who also has horses has left a message for him to ask questions for me.

It sounded like the surgery had a good possibility of being successful, but really the vet was pretty upset too and was trying his best not to make me feel bad and I don't know that I really understand all of the implications.

Dr. O, I know that this is what you were referring to above. What are his chances of being sound again with the surgery? I was so upset that I couldn't ask for the radiographs, but I'll email him and ask.

Right now, I'm so angry at the two vets that were out here. Should they have known that the SMZ wasn't strong enough to get to the hoof like the vet where he is now did?
Member:
stek

Posted on Thursday, Mar 12, 2009 - 3:00 pm:

Wallene, so sorry to hear the news is worse than originally anticipated. At least you know now he is in the hands of capable vets who will do the best possible for him.

My own vet who is an equine vet INSISTS on using injectable antibiotics for hoof issues, even for my mare who is difficult to inject. He says the efficacy is just not there for oral antibiotics when trying to get to an infection in the foot.

Considering the fact that one of your vets (not sure if it was the same one who prescribed the SMZ) recommended using Koppertox on an open wound, in my opinion they should not be practicing on horses.

Again my sympathies and best wishes.
Member:
wlreimer

Posted on Friday, Mar 13, 2009 - 6:33 am:

Ok, here are some of the radiographs Dr. O.

XRay1

Xray2

Xray3
Moderator:
DrO

Posted on Friday, Mar 13, 2009 - 10:34 am:

Let's back up on the discussion of antibiotics. For the most part antibiotics are not more or less potent by the way they are administered. And trimethoprim sulfa has been a very effective wide spectrum antibiotic. There is a general belief that through overuse it has lost some of it's effectiveness but remains a good choice for many infections prior to establishing culture and sensitivity.

Great radiographs Wallene but we need a good description by those who can see a full size image best on a viewer. Because of limitations of the size and quality it is impossible to rule out problems but I can describe what I see above:

There is some bone loss and increased irregularity around the distal outside margin of the coffin bone but I do not see any areas of bone that need removal. If this is all the abnormal information available on the radiographs a thorough debridement and removal of undermined and infected horn in combination with appropriate local treatment and antibiotic should return the horse to soundness though it will take 9 months for a complete return of function.

However one area I find hard to read is the region of the lateral wing of the navicular bone. There is a radio-dense area overlying the lateral wing of the navicular bone and it is difficult to make out the normal navicular margin at this point. To complicate interpretation here is a lot of artifactual irregular radiodense areas just lateral and plantar to the coffin bone that extends up to this same navicular region. I cannot tell if this is a artifact, the lateral collateral cartilage, foreign body, or possibly even a fractured off piece of the navicular bone though this seems least likely. Putting the case description together with the image above suggests infection in the lateral cartilage a fairly common problem that would present as your case has. This is often termed a "quitter" and will require surgery and the prognosis dependent on what other structures are involved with the infection but horses have returned sound from the operation. One problem with this idea is the radiolucency seems a little to medial for simple infection of the lateral collateral cartilage. A straight on ap radiograph should clear this issue up.

What does your veterinarian and specialist say?
DrO
Member:
wlreimer

Posted on Monday, Mar 16, 2009 - 6:45 pm:

We took Doc to NC State this morning. Although the wound itself that looked so bad last week had healed extraordinarily well in the few days since the trip to the specialist, the X-Rays that they took were much better quality and showed a large amount of bone loss and extensive swelling and infection.

They said that his chances of returning to even be pain free were very low and it was very depressing that they just kept finding more problems.

Within a couple of hours of arriving at the hospital, Doc began to show obvious signs of colic.

We chose to put him out of his misery.

I have given the specialist permission to speak to both of the other vets that worked with Doc in hopes that they will also learn from this unnecessary loss of a really wonderful life.

I let him down as much as everyone else by not questioning his lack of progress and getting more help sooner. I'll never make this mistake again.
Member:
shirl

Posted on Monday, Mar 16, 2009 - 7:12 pm:

I am so very sorry for your loss. Words can't help at this time, but know you are in my thoughts and prayers.

Shirley
Member:
hollyw

Posted on Monday, Mar 16, 2009 - 7:15 pm:

Please don't beat yourself up over this, Wallene. Oh, I am so sorry for your loss. Bless your heart. Bad things do happen to good people. Sometimes we just don't know the questions to ask, and we trust the folks whom we think know more than we do. You did what you thought was the right thing . . . and Doc knew you were trying . . . and he got right in that trailer for you. Isn't it hard to learn through the pain? I, too, have made mistakes out of ignorance or not listening to my heart . . . and sometimes, even with the right knowledge and with all of our trying, there is still pain and loss.
Big Hug from Kansas, Wallene.
Member:
mitch316

Posted on Monday, Mar 16, 2009 - 7:26 pm:

Wallene, I am so sorry to hear of your loss. You really should not beat yourself up, as you and Doc both fought a valiant fight. Sometimes things just end this way, and there are not a whole lot of explanation. If your farm is like ours, then the loss of a horse is a major thing, and I pray that you and yours do well. I will say again, you did a fine job trying to help Doc on his journey to recovery. Dr. O and the other vets can back this up: some people bring their animals way past too late to do anything. Based on your post, I can assure you that you didn't. And "shoulda, woulda, coulda" will not solve anything, so just rejoice in the GOOD memories you have of Doc, and use the knowledge you gained through this experience to educate as many people as possible, not just the vets, to avoid all of the bumps in the road you did. I say again, job well done. You did as much as you could...it was just ole Doc's time to go to that beautiful pasture in the sky!
Member:
ajudson1

Posted on Monday, Mar 16, 2009 - 7:37 pm:

I am sorry to hear that Doc is gone. It's been a roller coaster ride for you, hasn't it?

Sometimes the simple things get complicated really quickly, and no matter what we do, it may not change the outcome.

Everyone does their best at any given time, based on knowledge, resources, time, etc. And you did your best.

Doc is painfree, and in good company with one of the best "mom mares" in the world, Fancy.

Hugs from MI,

Angie
Member:
erika

Posted on Monday, Mar 16, 2009 - 7:50 pm:

Oh how sad, Wallene. We were all so hopeful for a better outcome for your special horse.

You kept after the problem trying to help Doc. I suppose this could have all started before he even got to your farm. I'm glad you did what you could, and i'm so sorry that you had to make the kind, but terrible decision to relieve him of his pain. I hope the good memories of your nice horse will give you comfort. You are in our thoughts and prayers. Many of us have lost horses we've loved. We share your sorrow
Erika
Member:
36541

Posted on Monday, Mar 16, 2009 - 7:51 pm:

Wallene, I am so very very sorry for the loss of Doc you and your family are going through. My deepest sympathies, Stacy
Member:
pattyb

Posted on Monday, Mar 16, 2009 - 8:15 pm:

Oh dear Wallene, I am sooo sorry. I had never dealt with a situation like yours so I just followed your thread from the sidelines. My hopes were way up there for you when you got to the specialist, then my heart sank as I read your post tonight.

Due to a very bad experience I had with one of my horses, the vet I have now is very understanding of my peppering him with every question that comes to my mind whenever something new happens here. If or when you change vets, just let your new one be aware of the situation and he/she will be understanding.

Sadly, sometimes we just don't know what questions to ask but remember, it was not your fault, you did what any normal owner would have done, hung in there with the prescribed treatment until you saw that it was not working.

I learned from my own experience that specialists are worth their weight in gold. Now, the second I or my vet waiver in our understandings of the given problem, I'm on the phone to a surgeon whom I worship and have the trailer ready if need be.

Hang in there knowing that you did your very best with the situation you were given. God knows what he's doing, at the very least you were there with him and he knew your had tried. Find comfort in that in the days to come, that you tried will bring you a lifetime of knowing that you did your best....and he knew it.

((((((((((Wallene and Doc))))))))))
Member:
mrose

Posted on Monday, Mar 16, 2009 - 8:58 pm:

Wallene, I'm so sorry you had to put your guy down; I'm sure it is especially hard for your daughter. Bone infections can be terrible to deal with no matter what. One of our mares developed some bone infection from a bad leg wound. Even though the infection was caught pretty early and she was on massive dosses of antibiotics, the infection didn't respond and kept flaring up. The only thing that saved her life was hyperbaric chamber treatments as it turned out the bacteria couldn't survive in oxygen. If she hadn't received the treatments, or recieved them much later than she did, we would have certainly lost her.

In spite of their large size, horses are such sensitive creatures and so susceptable to so many things it is a wonder they have survived as a species! You did all that you could do with the knowledge you had. That's all anyone can do.

My condolances to you and your family. He sounds like he was a great horse. I hope your daughter is able to find another someday to fill his shoes.
Member:
scooter

Posted on Monday, Mar 16, 2009 - 9:27 pm:

Wallene, how sad, my condolences. We all have at one time felt we didn't make the right choices for our horses. All we can do is our best and it certainly sounds like you did.

Godspeed Doc
Member:
dres

Posted on Monday, Mar 16, 2009 - 9:39 pm:



sent your way..

On the first day God created horses, on the second day he painted them with spots..
Member:
jowidner

Posted on Monday, Mar 16, 2009 - 10:33 pm:

Wallene,

I am so sorry for you and your daughter's loss, and for the passing of Doc.

As you can see from the number of posts, many of us in the Horseadvice community have been following along. Many of us have also lost beloved horses and understand the grief that you are undoubtedly are now going through.

I'm glad that the specialist is going to speak with the other vets. I am sure that they will look at the next wound they need to treat with Doc's story in mind.

Its hard not to second guess yourself when things go wrong, but I firmly believe that you did the best you could with the knowledge you had at the time, and that is all any of us can do.

Blessings to you and your daughter during this difficult time. Be kind to yourself.

Jo Ann
Moderator:
DrO

Posted on Tuesday, Mar 17, 2009 - 12:22 am:

My deep condolences Wallene. When you get to feeling up to it, if you would transcribe the discharge sheet with a good description of the diagnosis on it it may help someone else.
DrO
Member:
canter

Posted on Tuesday, Mar 17, 2009 - 7:23 am:

I'm very, very sorry to hear of your loss, Wallene. From your posts, I don't doubt for a moment that you always had Doc's best interests at heart and that you made every effort to do your absolute best for him.

I hope you find some comfort in knowing that you gave Doc exceptional and loving care.

Fran
Member:
rtrotter

Posted on Tuesday, Mar 17, 2009 - 7:54 am:

Wallene,

I am so sorry for your loss, you did everything you could and did the right thing at the end. It is very difficult to make that final decision, but you should not second guess yourself at all.

Doc crossed over the Rainbow bridge and right now he is thanking you as he cavorts painfree with all those other loved animals that crossed over the bridge before him.

My condolences to your entire family from my family and all my own animal friends.

Rachelle
Member:
hpyhaulr

Posted on Tuesday, Mar 17, 2009 - 9:19 am:

Wallene,
I am so sorry for your loss. The past few weeks have been so difficult for you we had all hoped for a better outcome. Thank you for your courage in sharing and your steadfast loyalty to Doc. You both have taught us well. Our hearts are with you all.
Member:
frances

Posted on Tuesday, Mar 17, 2009 - 10:34 am:

My deepest condolences Wallene. Doubly sad that just when things seemed to be looking up, they took a steep plunge. You mustn't blame yourself AT ALL - you are not a vet and you could only put yourself in a professional's hands and follow the advice given.

As everyone here has said, try to make peace with yourself and move on, remembering the good times.
Member:
vickiann

Posted on Tuesday, Mar 17, 2009 - 11:21 am:

I am deeply sorry to hear of your loss.

It is impossible to say for sure whether you could have had a different outcome by asking questions.

When dealing with a serious problem, most people prefer to have trust and faith in their health care professionals, who too often do NOT make it easy to ask questions.

You tried hard to do the right thing for Doc, so please don't blame yourself for anything.
Member:
stevens

Posted on Tuesday, Mar 17, 2009 - 11:43 am:

Wallene, you did everything you could. The important thing is what Doc added to your life and your experiences. Let me add my condolences.
Member:
tamarag

Posted on Tuesday, Mar 17, 2009 - 11:55 am:

I am so very sorry. Dealing with a major wound on my rescued mare currently. I know how hard we work to heal them, then to realize after all of it, there is nothing you can do must be so heartbreaking. I feel your pain to loose him. Knowing you tried everything you could to help and then being strong enough to let Doc go tells me the type of person you are.

Just know you are in my prayers. Think how happy he is running with no pain in a lush green pasture, where they can eat and eat forever.
Member:
stek

Posted on Tuesday, Mar 17, 2009 - 12:24 pm:

My heartfelt condolences Wallene. There is perhaps nothing harder than the decision you made, but trust that you did everything you could for him.
Member:
lilo

Posted on Tuesday, Mar 17, 2009 - 5:08 pm:

My deepest condolences, Wallene. Those decisions are so hard, but we have to make them for our beloved horses when there is no hope for a quality life.
I am very sorry for your loss,
Lilo
Member:
zarr

Posted on Tuesday, Mar 17, 2009 - 8:03 pm:

When we lose the ones we love when we have been fighting so hard for them to live it is exhausting to the body and the soul! You never gave up and Doc knows that and you will to in time. Plant a tree that smells wonderful in the spring gives shade in the summer and blazes with color in the fall.Call it Doc's tree so each time you are near it Doc will be right there enjoying it with you!
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