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  Discussion on Bilateral Hoof abscess
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New Member:
mariean

Posted on Tuesday, May 4, 2010 - 12:52 am:

Need advice regarding what have been diagnosed as abscesses in the rear hoofs.

I have a coming 6 yr old Saddlebred with a history of hoof problems (see my discussions under white line disease). However, recently have been making progress, almost no more separation in the front, working sound until three weeks ago. This is what happened-Robie is still three legged lame, and I am at a loss as to what to do next.

April 11, Sunday: My daughter is riding in the indoor arena, has warmed up 5 mins at a walk, 5 mins relaxed trot, no problems, then turns a corner going to the right, and Robie comes up obviously lame on the left rear. We give him bute-no heat, no swelling , no puncture -farrier is due out the next day. That evening BO sees he is still obviously favoring the left rear, and cold hoses him.

April 12. Farrier puts hoof testers on Robie, and believes it is an abscess at the toe. He pares out a bit, but is relucutant to pare out any more, recommends aggressive soaking. He is able to reset the front shoes, but cannot trim the right rear because Robie wont put any weight on the left rear. Later that afternoon Vet 1 comes out, also believes it is an abscess, pares out a bit more, but does not find any fluid, recommends wrapping with ichthamal.

April 19, Not much improvement. Vet 2 is at the barn for spring shots, examines Robie, also believes it is an abscess, pares out more, draws alot of blood (I am not there, this is per the BO) RX antibiotics and wrapping. (Both Vet 1 and 2 are familiar with Robie, I trust both, its just a matter of who is available).

April 26, after brief improvement, back to obviously lame on the left rear. I spoke to both Vet 1 and 2, both recommend x rays, Vet 1 is the first available so:

April 27 Haul a reluctant Robie to Vet 1 for xrays. No obvious fracture, only a minor, questionable defect at the very tip of the coffin bone. Vet does not find it worrisome, though says that if in fact there is a separated piece of bone, the body might treat as a foreign body, and it is possible that he might have to operate to clean this out, however did not feel this was likely, felt instead we need to give Robie more time to heal. Increased the antibiotics.

April 27, 8 pm I go out to the barn to check on Robie, and have to do a double take: he's holding up the right rear. At first I thought he was having me on, but his gut is sucked in and he is in obvious distress. Fearing laminitis, I ice the right rear, give him bute, call the vet.

April 28, Vet 1 comes out, finds an abscess in the right rear, pares it out, does draw fluid. Thought it had been brewing for some time.

May 3, Back to three legged lame, favoring the left rear. His wrap on the left hoof did come off while he was turned out in the indoor arena, and there was some dirt packed into the pared out area.

I spoke with Vet 1 this morning-he thought that as there is sensitive tissue exposed, any pressure would hurt, and that we may just need to give Robie more time to heal. We agreed I would clean out the hoof and re wrap, continue the antibiotics, and see if there is any improvement, and contact him again Wednes.

Tonight, when i went out, Robie would not put the left rear on the ground, I could hardly get him out of the stall. I soaked it, washed it with a iodine shampoo, and re wrapped with icthamal. He could not get that foot high enough off of the ground-had it up to his belly! But otherwise, he is eating, no temp, not really depressed, (but certainly makes it clear his foot hurts), has a glossy coat, and is about a 5 for a body score.

So, my questions are as follows:

1. Given the very sudden onset, does an abscess make sense?

2. Is there any way to confirm that it is an abscess, other than digging around in his hoof? I am not doubting that this is a hoof issue.

3. If there is a separated fragment at the tip of the coffin bone, does this need to be "cleaned out"? If so, what is the prognosis?

4. If the Vet 2 exposed sensitive tissue when he was paring looking for an abscess, could this explain the current symptoms?-he did improve for two days after Vet 2 pared out the hoof, then went back to three legged lame. If so, how long would this take to heal?

4. What other diagnostic tests would you recommend?

Robie still has some separation on both rears, though it has improved somewhat. Both farrier and vet have suggested shoes on the rear. Vet 1 says he does not think it is "white line disease"

There is no heat or swelling higher up on the leg. He does not react to manipulation of the leg or hip. The vet commented that the rest of the xray was very clean. I can't find a digital pulse, but I have never been very good at finding it. Both Vets also have commented that Robie is perhaps not the most stoic of horses-nevertheless, he was pretty pathetic tonight.

Any advice would be appreciated.
Moderator:
DrO

Posted on Tuesday, May 4, 2010 - 8:26 am:

Welcome Marie-Ann,
You will find the answer to your general questions about abscesses in the article on "Abscesses" associated with this discussion area. The answer to your questions specific to your horse's diagnosis and treatment depend on the nature of the fluid drained out of the foot: was it purulent?

As to the question about a coffin bone fracture usually pieces do not need to be removed unless there are also radiographic signs of osteomyelitis.
DrO
New Member:
mariean

Posted on Wednesday, May 5, 2010 - 10:58 pm:

Thanks, I have reviewed the articles, still have a few questions.

Vet examined Robie yesterday, said to give it more time, and to give bute for pain. He was given 2 grms bute last night, 2 this morning. He was kept in, the hoof wrapped. Tonight, in his stall he was ok, still favoring the left hind, but not as dramatically (when I came in he was resting on the ground). I hand walked him 50 yds to graze a bit (hoof is wrapped), ok going out, still a bit off but had a spring to his step, but increasingly sore coming back. By the time we got back to his stall (we had been out less than 10 mins), he was in obvious distress, sweating, wouldn't put his foot on the ground, shaking, breathing hard. We gave him a shot of banimine, and he calmed down but still avoided putting any weight on the left rear.
Does this still present like an abscess? Would a small amount of walking increase the symptoms of an abscess so dramatically? The hoof has been xrayed. He is very lame-would blocks be recommended, or even useful? I guess I feel I am missing something, but I'm not sure what. Still no heat or swelling above the hoof.
Moderator:
DrO

Posted on Thursday, May 6, 2010 - 7:19 am:

Marie Ann, an abscess can cause that much pain. Blocking out the foot completely would help localize the problem but not diagnose the cause. I repeat, the answer to your questions specific to your horse's diagnosis and treatment depend on the nature of the fluid drained out of the foot: was it purulent? If there is an abscess present it has obviously not been drained well.
DrO
New Member:
mariean

Posted on Thursday, May 6, 2010 - 7:31 am:

There was fluid drained from the right, it was greyish according to the vet, when I rewrapped the right there was no more fluid, no foul smell,the right is no longer a real problem. (Since he won't put the left on the ground, he has to use the right). On the left, although they dug deep there was no fluid, only blood. The vet told me that to pare anymore out he may need to give him a general anesthetic.
Moderator:
DrO

Posted on Friday, May 7, 2010 - 7:04 am:

If he drained puss from the foot then we know your horse has a foot abscess. But a fully drained abscess treated as described in our article is much better in 24 hours and usually quite sound in 72 hours without antibiotics or bute.
DrO
New Member:
mariean

Posted on Friday, May 7, 2010 - 8:33 am:

Yes, I believe the right rear abscess has been successfully drained. Still leaves the problem with the left rear which was symptomatic first. He is still markedly lame and . I am going to have it xrayed again. Vet suggested taping a pad to the hoof to see if that helped, so I will do that over the weekend, and bring him in Monday for a 2nd set of xrays, and if necessary have him sedated to explore further for an undrained abscess.
Member:
mysi

Posted on Friday, May 7, 2010 - 6:21 pm:

Marie Anne,

My horse had an abscess about a year ago (my first experience with one) and it went on for almost 5 weeks. The farrier found it in the toe, pared it out, I followed all the protocol, it drained, blood too, he only improved but about 50% and stayed that way for weeks. Had the farrier and vet out 2x. When the farrier came out the second time and I pulled Moose out of his stall and the abscess had then popped out the coronet band. It apparently stayed in there brewing even with the soaking.

Maybe it's not completely out. I remember going crazy while this was going on.

Good luck!
MElissa
Member:
mariean

Posted on Friday, May 7, 2010 - 8:57 pm:

After speaking with my vet and farrier, Robie went to the vets today to be re xrayed, and to spend the weekend so they can monitor his progress, ( or lack of it). My farrier seems to think when the foot was pared out more aggressively in week two it exposed sensitive tissue, which is why he is still lame, and that we should put a surgical plate on the hoof to relieve any pressure. I'm still worried that there may be infection in the coffin bone. Hopefully second set of xrays will prove me wrong.
Moderator:
DrO

Posted on Saturday, May 8, 2010 - 10:05 am:

While sensitive tissue remains exposed there may be mild lameness particularly on rough ground. But as long as it is supported and bandaged as described in our article I find these horses are very comfortable at a walk while it heals. It is the presence of infection that makes abscesses so painful.
DrO
Member:
mariean

Posted on Friday, May 14, 2010 - 4:45 pm:

My horse has spent the last week with the vet, they put him under, dug out to where they think they have cleared any abscess. He came home today, still a bit sore, but moving much better. He is still on smz and 2 grms bute in the morning.

Several times the vet has referred to the fact that Robie "shows his pain" , is "sensitive" or is otherwise a wuz. I'm a little sceptical: so I'm asking those with more experience: how much variety is there with horses and pain tolerance? The horse is otherwise relatively sensible, forward but not spooky under saddle, though he can work himself into a lather (he was soaked when we unloaded him from the trailer after a 20 min ride this afternoon).
Member:
rtrotter

Posted on Friday, May 14, 2010 - 6:22 pm:

Marie Anne,

I can give you my thoughts from a racehorse trainers perspective. I have had big strong horses that were very big wusses, where the least little thing bothered them and I have had fragile mares who were and are are the toughest horses that I have ever had. So to answer your question, yes, there can be different levels of pain tolerance between horses.

I have a thread on here ( You can do a search on Road Rash) about my race mare who went down on the track in a freak accident, she had very deep cuts on her knees and shoulders and I thought she was done as a race horse (very scary). Not only was she back racing within 6 weeks( with the help of Dr. O 's articles on wound care and all the helpful advice from all the HA members) but she won handily almost exactly 2 months from the date of the accident. Not once in the two months before her win did she take a lame step or miss a day jogging, towing or training. In fact I attribute her coming back so quickly to keeping her moving during her entire rehab period.

I had another mare twice her size, big, strong and fast, but really a bug wuss. Any kind of anything( from her heat cycle, to a hang nail) and this mare was on the shelf for long periods of time. She could not handle any type of pain and was not stoic at all.

Some can take it and some can not. Just depends on the horse.

Rachelle
Member:
vickiann

Posted on Friday, May 14, 2010 - 8:30 pm:

There absolutely are, as Rachelle has stated, differences in the level of pain that horses can tolerate.

They are no different than humans in this regard.

But it is out of order, in my mind, for a Vet or anyone else to judge a horse with a lower pain threshold and label the horse as a "Wuz."
Member:
mariean

Posted on Friday, May 14, 2010 - 9:49 pm:

Rachelle and Vicki, thank you for the perspective. In the vet's defense "wuz" is my word, not his, and I do not believe that his treatment of Robie in this instance was overly influenced by his opinion of Robie's pain tolerance. I have never had another horse with an abscess so I don't have anything to compare Robie's reaction with. I just worry that any future problem may be dismissed because he now is labeled as "sensitive".
Member:
vickiann

Posted on Saturday, May 15, 2010 - 1:25 pm:

Rachelle,

To clarify, I didn't mean that an owner who knows her own horses shouldn't be able to label their own horses. I've got one myself who is kind of a "wuz" comparatively speaking.

But I've also got a very stoic one who Vet's have told me seems to have an incredible pain thresh- hold, but he suffered greatly and was reduced to lying down practically crying with a gravel abscess that took weeks of soaking before it finally popped out at the Coronet band. That was back in the days when soaking was still done frequently for abscesses rather than digging them out.

It just kind of got my ire up that the Vet would criticize Robbie.
Moderator:
DrO

Posted on Sunday, May 16, 2010 - 9:21 am:

Hello Marie Ann,
There are two aspects of your question about your veterinarians pronouncement of your horse's sensitivity to pain. You hear from professionals that some horses that show clinical signs of pain more acutely than other horses do. I do not subscribe to this to much degree and believe a horse when he shows indication of discomfort.

The other aspect of this concept is how well a horse will tolerate pain while being worked on. This is a entirely different matter that has to do with temperament and training. There are some horses that will stand stoically while you open the most painful and nastiest solar abscess on a hind foot. Then there are horses that will not stand for the smallest of needle insertions into the skin. Here there is obviously a large difference in horses and I am uncertain which of the two your veterinarian was discussing.
DrO
Member:
mariean

Posted on Monday, May 17, 2010 - 8:53 pm:

Thank you for the response. I think it was a combination of both, but he was increasing sensitive to anyone working on that hoof, so I am not second judging the vet's decision to lay him down to treat the abscess.

In any event, he is walking almost sound-a vast improvement to the flamingo stance-just an occasional limp on uneven ground. Crossing my fingers he continues to improve.
Moderator:
DrO

Posted on Tuesday, May 18, 2010 - 7:11 pm:

Sounds like progress, I'll keep my fingers crossed to.
DrO
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