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Discussion on Abscess on mini horse coronet
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Member:
Bethyg2
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Posted on Friday, Jul 8, 2005 - 11:48 am:
Hi Dr. O,
My mini has an abscess that appeared less than a day after severe lameness set in- the poor little guy can hardly walk. I didn't feel an increased pulse or heat but in the beginning to my untrained eye it looked like both front legs were involved, so I called the vet out. When she arrived the next morning, a gaping (for the mini's hoof) hole, with red tissue all around- inflamed- with pus (yellow) was clearly visible on the middle of the coronet band (where the hair of the leg meets the hoof). The swelling is so bad. The vet advised to put a drawing poultice on it and wrap, every day, 2 x if I could. I am on my 2nd soak and wrap cycle, and the abscess does not seem to be better but worse. The horse grazes and eats normally, thank goodness. Yesterday the vet gave an injection for pain (something beginning with "A"- not ace- that she said was like motrin. ) I gave banamine this am. After the soak this am (warm water- he was very ouchy and did not allow a full soak) he was shaking, I imagine from pain. (Could the betadine wash cause pain?)Then I gave the banamine, and a half hour later he hobbled out to the field and is grazing. I really do not want to casue another problem by medicating, and then changing the horse's routine, so as to colic him, so I am trying for normalcy as much as possible. I also like to avoid bute with the minis.
My specific question is, what do I do now? The wound is not draining as well as I had hoped, probably due to the positioning of the abscess on the top, rather than underneath the hoof.I cannot imagin "paring out" this abscess becasue of where it is- it is pretty much in the coronet band.No antibiotics? Oh- I did bathe the horse this am after the soak in a surgical/ betadine dilution. Then I dried it before wrapping. It just looks so bad that I am afraid it has got some weird fungus in it or something, as it is not getting better (still, it has only been 2 days...) Oh- he had been standing in water for some time as there was a large puddle in his pasture- maybe why he got this in the first place. He is high and dry now.Is there a better product to place on the wound, under the wrap, than the clay I am using? I feel I should be giving him oral antibiotics, for some reason. I have gone over the articles but am not sure what I have here. Dr. O- any help is much appreciated, as always. Beth, S. Fla.
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Member:
Angelvet
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Posted on Friday, Jul 8, 2005 - 12:58 pm:
Beth-I know there are several different viewpoints on handling these sorts of foot abscesses, but in my experience, soaking these infections once they have opened only makes things worse. My approach has been to poultice the coronet and allow that to draw out the infection.I like the animalintex product as it is easy to use and absorbs the goop from the abscess better than the clay. I have also had luck with hot bran and epsom salt poultices placed on a gamgee or baby diaper and taped on over the foot. This also seems to work better as the infection has something to soak into. Abscesses at the coronet can definitely take longer to clear due to the lack of drainage, but I have found that the foot soaking almost always drives the infection in deeper once it is open. Soaking works to soften the foot and draw a deep seated abscess closer to the surface so it can open and drain. However, once that opening has been established and draining is occurring, it just seems to drive the infection deeper.
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Member:
Bethyg2
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Posted on Friday, Jul 8, 2005 - 1:20 pm:
Angel- thanks, I am definitely NOT going to soak that foot in warm water again- I am only going to have it in water to wash off the gunk if necessary. I think it was too painful for the little guy, and like you said, doesn't do any good once there is a drainage wound. Is the animalintex product the one that comes in small clear plastic bags and is very dark colored? I was in the store yesterday and grabbed a bunch of different things, not knowing what the vet would prefer. I am going to go back later and if I do not have the animalintex I am going to get some. Also, maybe just plain gauze would help for drainage. I just hate the thought of this gigantic open wound not receiving antibiotic care. I mean, if this were on a human, you'd probably run to the emergency room. I'm calling the vet now with these thoughts....
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Member:
Annes
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Posted on Friday, Jul 8, 2005 - 1:43 pm:
I agree with what Angel said above. I had a mare with an abscess that popped at the coronet. I did not soak but used a drawing salve under the dressing. My mare was on an antibiotic (I believe it was tucoprim)because her infection did get worse and the opening looked horrible. Just from my experience, I will insist on the antibiotics if one of my horses ever has another abscess that opens that large. Hope your mini feels better soon.
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Member:
Annes
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Posted on Friday, Jul 8, 2005 - 1:55 pm:
Beth, I wanted to add that I used ichthammol antiseptic drawing salve. It is rather messy but it will stick to the wound and you put the gauze over that.
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Member:
Bethyg2
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Posted on Friday, Jul 8, 2005 - 4:34 pm:
Dr. O,
What do you think about antibiotic use here- the swelling is pretty bad. -Beth
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Member:
Bethyg2
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Posted on Friday, Jul 8, 2005 - 4:56 pm:
Just to update- I called another vet for a second opinion, just to feel like I'm doing something....because the little guy is in such pain. He may want to x ray the hoof to see what's going on, maybe there is a foreign body in it.I was sort of concerned about the vet's advice to soak in epsom salts, given the open, raw and red look of the wound. I know I wouldn't want an open wound put in salt! -Beth
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Moderator:
DrO
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Posted on Saturday, Jul 9, 2005 - 8:48 am:
A couple of things Beth, if this is a solar abscess that has risen up the wall then opening it at the bottom of the foot will greatly speed healing. However if the horse was only painful 24 hours before you saw the abscess the timing and the amount of pain suggests a wound that may well have been from a penetrating injury with something, usually a wood fragment, driven down between the wall and bone. They can be hard to see and harder to remove. Either requires the same thing to diagnose: a careful exam for the origin of the abscess. For more on both of these and treatment see the article associated with this forum, look under the gravel heading. If warm water soaks are too painful you can use cool water. In poorly draining wounds I do think soaking can help keep it open and help control infection so it can drain. Soothing ointments like Icthammol can helpp, though I prefer a antibacterial ointment or creme like povidone (Betadine) or chlorhexidine (Nolvasan).
DrO
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Member:
Bethyg2
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Posted on Monday, Jul 11, 2005 - 11:13 am:
Dr. O,
The second vet that came out said he was looking for a foreign object in there but he didn't see anything when he examined the hoof. If it is in there, and we just can't locate it, will it come out on its own eventually? He said I should use "Tucoprim", like Ann said she did. He also said that even though it looked to me like it had popped, that it had NOT popped yet and that I was to continue to soak the hoof in epsom salts, as hot as he could take it. He did say though that it was a big, nasty looking abscess, and that if we could resolve it with antibiotics it may be better than letting it just drain, as it is not really in the best position for draining. He gave me a bunch of small, black pads of Icthamol that I position in the small diaper and wrap after soaking, so that's what I'm doing. I think the antibiotic has helped even though it has only been since Saturday, but it seems as if the swelling isn't so angry.
The only further problem I see is if there actually is a foreign object in there. The vet carefully tested the hoof and examined it on the bottom but saw nothing.If this were a riding horse or a race horse, he'd be out of it for at least another month by the looks of it! Luckily his only job is to be petted....and occassionally pull his cart in the Christmas parade.  Thanks, all.
-Beth PS- My "second opinion vet" has just become my 1st call vet...I am a big fan of antibiotics when needed. This particular mini has never had antibiotics.
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Moderator:
DrO
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Posted on Tuesday, Jul 12, 2005 - 7:05 am:
The problem with abscesses and antibiotics is that the abscess is a relatively "dead space" that the antibiotic has trouble penetrating into. As a result the antibiotic may slow down the rupture and draining process but if you have a true abscess, as opposed to just a infection of the tissues, it may not cure it. I see foot abscesses frequently and don't use antibiotics and still get the horses comfortable in less than 24 hours and near sound in about 3 days.
However if the cause has not been found and the pony that painful perhaps this will act as a go between until it can be opened and drained.
DrO
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Member:
Bethyg2
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Posted on Tuesday, Jul 12, 2005 - 12:10 pm:
Dear Dr. O,
Comfortable in one day, sound in three! I wish you were here. But probably, since the entire coronet band are was inflamed, we had more than an abscess here. I think the surrounding tissue was infected too- probably from standing in a stagnant puddle all day (great Florida weather...) Since the little guy has white stockings you can really see how inflamed the area is. Here we are on day 6 or 7 and he's still hobbling along. The soaks, wrapping, and the antibiotics have made it look better, but the lameness persists. If it continues into next week, and he is still lame, would an x-ray be in order to see if there is a foreign body stuck in there? Would a wood sliver even show up on an x-ray?
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Moderator:
DrO
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Posted on Wednesday, Jul 13, 2005 - 8:31 am:
Often these are rather large slivers that have been driven deep into the hoof. A really good radiograph designed to highlight soft tissue that catches the foreign body without the coffin bone overlying the object should show it up. Usually a radiograph is not needed however and the article on abscesses and gravels explains how to locate these foreign bodies. But as you say we may be talking about two entirely different problems.
DrO
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Member:
Bethyg2
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Posted on Wednesday, Jul 13, 2005 - 1:52 pm:
Dr. O,
I would like to post a picture of the coronet so you can see it- the only difference from a few days ago is the redness is gone. Here goes.
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Member:
Bethyg2
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Posted on Wednesday, Jul 13, 2005 - 1:54 pm:
another angle
the black stuff is ickthammol, not dirt
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Member:
Bethyg2
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Posted on Wednesday, Jul 13, 2005 - 9:08 pm:
Anyone seen anything like this before? Is this what a gravel on the coronet band looks like? I never had a horse with this before.-Beth
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Moderator:
DrO
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Posted on Thursday, Jul 14, 2005 - 7:42 am:
The coronet is certainly very inflamed but the pictures do not answer the question of why? Usually the best clues come from how the problem started and subsequently has progressed. I go back to your fist post which started with a clear description of a ruptured and draining abscess. If this is how it started and the inflammation is not getting better, it strongly suggests either it is not draining well or there is a foreign body.
DrO
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Member:
Bethyg2
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Posted on Friday, Jul 15, 2005 - 1:33 pm:
Dr O'
My farrier came and said that he couldn't find an opening for the abscess on the sole, either. He told me NOT to use the animalintex product as it has betadine (blackish red)and it is aggravating the condition.He said that probably some dirt got in though a crack in the toe, causing a gravel. Lots of differing opinions here. I think I will give the Tucoprim until next Monday and then stop it, and continue with the soaking/ wrapping that the vet told me to do. That will have been ten days on Tucoprim. It is sort of in a holding pattern. I have left the bandages off and the mini is walking OK though he trots funny. I think the wrap made him limp worse at a walk. I really just don't know what to do to speed this along.Probably the antibiotics have slowed the whole process down. But I imagined the whole thing turning gangrenous overnight! So, I will do nothing after Monday and see what happens. -Beth G
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Moderator:
DrO
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Posted on Friday, Jul 15, 2005 - 6:44 pm:
Betadine is not aggravating to exposed sensitive tissue unless the horse has a allergic reaction to it. Betadine has been used to treat eye infections and to rinse out opened abdominal cavities with contamination or infection. I assure you it is unlikely to irritate your horse's foot.
If you cannot find a solar start to this abscess, and that is not surprising since the place at the coronet ruptured after just 24 hours of lameness, you should start at where the abscess ruptured at the coronet and follow it down to the source. You will be surprised at how fast exposed wall corium heals (recornifys).
DrO
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Member:
Bethyg2
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Posted on Saturday, Jul 16, 2005 - 11:59 am:
Just to update: still looks the same, although obviously less painful- horse only limps a little bit- willl not canter across pasture but grazes normally. This is like day 11- when should I really worry that there has been no resolution? Dr. O, I'm not sure what you mean by "start at where the abscess ruptured." The farrier? The vet? I cannot imagine digging in there as it is painful to the touch. Could (or should) I try something myself? I hate to waste money if this will resolve on its own, but if an x-ray is needed now, so be it. -Beth G
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Moderator:
DrO
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Posted on Saturday, Jul 16, 2005 - 1:44 pm:
As long as it is improving Beth you can consider continuing with your current treatment regimen bit if it quits improving or begins to worsen then further workup should be done. The article referenced above tells how this is done with the horse very painful. This should be done by the vet or the vet working with the farrier. The vet is needed to block and probe but the farrier may have better tools (sharper hoof knives for instance) for removing the overlying horn. I use a Dremel in combination with a hoof knife myself.
DrO
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