Abscess!!!

[evelynwolfe]

Okay, so I know this has been a hot topic lately...but now my Cutter Butt has one in his front left heel and he's not putting any weight on it. We're doing the packing with Icthamol (sp?) and making sure that he's in his own paddock so that the other horses can't case him around. We're also changing the dressing every day just to make sure, and keeping his water supply dry around the tank *the problem area it seems around here*. It's only been 3 days of the treatments but he's still not putting weight on his heel...
He's a quarter horse with soft hooves if that makes any difference. I am following all of the things that our farrier has told me to do, I just am getting anxious for my baby and haven't ever delt with this before...bad case of thrush from a rescue, yes, abscess, no.
I know I'm probably over reacting...
I heard that sour kraut will help, but I don't know the person that told me that, he was a passing horse person that I was talking to when he saw me buying all the stuff to take care of it. I think it sounds crazy, but at this point i just want him out of pain...It good news though all of the heat is out of his hoof and cornet band.

[David]

Maybe this will help....

http://www.thehorse.com/ViewArticle.aspx?ID=757



Q: My horse became very lame without showing any signs of cracks, bruising, or having a "hot" nail. The barn manager said my horse was "graveled" and called the veterinarian. After treatment, the horse became fine, but since my horse is never on gravel, could you please explain the term?


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A: The diagnosis of a graveled horse is usually not difficult. It is one that should be investigated in cases where lameness occurs shortly after the farrier has trimmed and shod a horse. Properly called suppurative pododermatitis, it is an infection that manifests itself in the sensitive parts of the hoof and sometimes undermines the sole. While the name might lead you to believe that it is caused by a piece of gravel getting into the white line of the hoof and working its way out the top of the foot at the coronary band, the actual cause more likely a particle of sand or soil that introduces bacteria to the white line area and results in an infection inside the hoof wall.

The typical scenario of a graveled horse is a horse in which an infection enters the white line area of the hoof via a close nail, or a hoof with a wall defect or separation, all of which allow soil into the softer white line area. The hoof then becomes painful, and the infection works its way up the wall of the hoof to break out as an abscess at the coronary band. It follows the path of least resistance.

"Gravel" also can occur under the bars instead of at the white line. This type of "gravel" will keep the horse off of its heel, so that it walks on its toe. This type emerges as an abscess at the bulbs of the heel instead of at the coronary band. Equally as common, both types of gravel require the same treatment regimen.

Initially the infection may occur and not bother the horse. The reason for this is that the infection starts out at the ground surface, and when it is low on the hoof, the horse is not bothered by it. However, when the infection makes its way up to the sensitive areas of the hoof, the horse becomes lame, sometimes to the extent of giving the appearance of having a broken leg! The horse often has a low grade fever.

This scenario alarms many horse owners because the horse becomes extremely lame with a very swollen leg. Congestion of the blood vessels in the leg causes tendons to become painful and swollen, mimicking a tendon injury. The horse does not want to bear any weight on it.

The first thing your veterinarian may ask when he suspects the horse might be graveled is: "Has your horse been shod recently?"

When a horse comes up lame shortly after being shod (within two weeks), it is possible that one of the nails was driven too close to the white line and allowed moist soil to enter the porous white line area. After the moist soil has penetrated the wall of the hoof, bacteria sets up housekeeping in the white line area and works its way up the hoof wall. Then, the weight bearing, or the packing from the repeated pounding of the hoof on the ground, will drive the infection higher into the foot.

Treating the graveled horse consists of pulling the offending nail or the shoe in order to find the affected area of the hoof. The infected area is trimmed and allowed to drain, which relieves the pressure. To pull the remaining infection out of the hoof, a poultice is applied to keep the infection from progressing to the coronary band. The poultice can be applied in a special boot with a nylon bottom and a cotton ankle. It consists of a mixture of two parts wheat bran to one part Epsom salt, and warm water with a tablespoon of Absorbine added to it. Every 48 hours, the poultice should be changed, and twice a day, it should be rehydrated with a two ounce syringe of warm water.

Even with the poultice in place, the infection sometimes will emerge as an abscess at the coronary band. Once drainage has begun, and the pressure is released from the hoof capsule, the horse should become sound again.

Even with a fast onset that produces black or brown pus, the horse should recover in two to four days, if the poultice is applied immediately after establishing drainage. If the infection starts from a misdriven nail, the horse should still recover in four days if the poultice is quickly applied after pulling the nail or shoe. However, if the horse is suffering from other types of hoof disease or a problem such as laminitis, then the recovery time will be longer, depending on the severity of the other problems. If the inflammation was caused by trimming the hoof too short, then it will just be a matter of time until the hoof grows out. Bute or other NSAIDs, along with the poultice, can help alleviate soreness in the absence of infection.

Typically the shoe can be re-applied two to four days after treatment begins, although it might take up to a week. After the shoe has been on for a couple of days, the horse usually is able to begin work. Take it slow and start out walking the horse, then work up to trotting.

Maintaining a regular schedule with your farrier is the best way to prevent a graveled horse. The timely trimming and resetting of shoes by a qualified farrier is important to the overall health of the hooves. Daily foot care by the owner also is very important. Treat each horse individually when it comes to scheduling a farrier's visit; some horses need attention to their hooves every four weeks, while others can go up to six weeks between visits. When it comes to graveled horses, it is usually the foot that has a little too much toe or an excessive bar that ends up being affected by this condition. With this in mind, keep your farrier trimming your horse on a regular basis.



David

[evelynwolfe]

I really don't think he's "graveled" he was gimping before the farrier came out, and when he checked him out he confirmed an abscess, he didn't start this after the farrier trimmed him, as seems to be the case with "graveled" horses. He also does not have shoes, has not had them sense august when we pulled shoes last, he's been on a regular trim schedule though...You are correct, the symptoms are exactly like Cutters, however the process leading up to graveling seems to not fit. I will try the poultice as soon as I get home as the farrier is supposed to be coming out at the end of this week again and checking up on it.

[Sharon Danielson]

DAVID! WOW!!! Thank you for all the information, what a huge help.

[evelynwolfe]

Yes, very good information, I'm sorry I didn't thank you. You got me thinking and I tend to go off on a rant in my mind and forget everything else....

[David]

As far as I know they are different words for the same thing. A horse doesn't have to be freshly trimmed to get graveled ( it just seems to be more likely to happen after trimming ) all that is required is a small scratch in the right place and exposure to bacteria.

Here is another article (which speaks specifically to abcesses)...

http://www.horse-previews.com/1000ar...orner1000.html

Veterinary Corner 10/00: Hoof Abscesses


by Frosty Franklin, DVM
Edgecliff Equine Hospital
S. 1322 Park Road, Spokane, WA 99212 * 509/924-6069




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The horse's hoof is a very durable, tough structure that is constantly renewing. The hoof is always in contact with the environment and, as such, experiences a wide variety of traumatic insults that occasionally damages the hoof and enclosed structures. One of the most common problems occurring to the hoof is the introduction of bacteria and other microorganisms to the sensitive structures within the hoof. A hoof abscess is the result.
A hoof abscess, in my mind, is either a direct hoof abscess caused by penetrating wounds or an indirect hoof abscess caused by the migration of moisture and bacteria into fissures and cracks along the white line.

Almost always when the horse is acutely lame to the point where weight bearing on the affected limb is difficult, the diagnosis is a hoof abscess. Rarely, that non weight-bearing stance is caused by a fractured bone somewhere within that affected limb. By examining the foot for heat and swelling just above the foot in the pastern and fetlock and by evaluating the digital arterial pulses the owner can quickly rule in or rule out a hoof abscess.

In talking with my clients I was amazed to find a large percentage of horse owners that are not aware of the importance of being able to check for the presence of pulses within the digital arteries. In the normal resting horse the digital arterial pulses are not palpable. The digital arteries are present on each side of the pastern. The digital vein is visible on each side of the pastern in most horses, especially if the hair on the pastern is clipped. The digital artery is just slightly posterior to the vein, the vein being a good visual landmark. Whenever inflammation or infection occurs in the foot, the pulses in the digital arteries are obvious to anyone that feels for them. It would be a good idea for horse owners to become familiar with the digital arterial pulses and how to palpate for them. Ask your veterinarian for help if you are confused about the anatomy. Check your horse right after exercise, because then the pulses are palpable.

Penetrating wounds of the hoof can be very serious and should be treated as a potential career ending or life-threatening wound. It is difficult to tell which of the vital structures of the foot have been injured and contaminated with microorganisms. Penetrating wounds of the middle third of the frog are particularly scary because in this region the navicular bone and bursa are present, as well as the deep flexor tendon and the coffin joint. Some of the puncture wounds to the hoof are well hidden by the spongy, elastic frog or the dark dirt-filled sulci and go undetected. In other cases, the nail is simply removed, some iodine squirted in the wound and the incident is not taken seriously and several days may have lapsed before treatment is sought. By then a very serious situation has precipitated requiring surgery, long-term antibiotic therapy, and special hoof care with only a fair chance of returning to full use. In one study, 12 of 38 horses with puncture wound to the navicular bursa or navicular bone returned to satisfactory function.

Fortunately, indirect hoof abscess are much more common. In our practice, they occur when the footing is wet. Defects and fissures in the white line allow the moisture, manure and bacteria access to the sensitive structures to form this type of abscess. These abscesses are relatively easy to treat if the fissure is readily located. These fissures and the structurally comprised white line are common in chronic laminitic (foundered) horses. The "stretched" or widened, pithy white line does not have the integrity of a normal white and allows filth access to the sensitive tissues of the foot. Horses that are recently trimmed and then exposed to muddy/mucky corrals also seemed to be predisposed to a indirect hoof abscess. The infection that gains access to the foot through the white line may travel up the sensitive lamina underneath the hoof wall forming a "gravel" that drains at the coronet. Or much more likely, the infection involves the sole and becomes a sole abscess. This type of hoof abscess is very painful but usually resolves within a few days with proper treatment.

Diagnosing indirect hoof abscess is usually straightforward. Examining the foot for heat, pain, and swelling. Removing the shoe, and proper cleaning of the hoof with a hoof pick and hoof knife is essential. Paying particular attention to the coronet, frog, sulci, and the white line. The hoof testers can be very useful or they can make the horse very defensive because you apply them too forcefully at the beginning. Once the black line or fissure is identified the line is followed with the hoof knife and most of the time grayish exudate will drain the abscess.

Establishing surgical drainage is the most important aspect of therapy. A small loop knife works well. Once a small drainage hole is created the foot may be soaked in hot Epsom salt solution (2 cups per gallon of very warm water). Instead of soaking, I usually apply Magnapaste ointment and bandage the hoof. Magnapaste is an osmotic and "draws" the abscess. Recently, over the bandage I have been applying a new product called the "Equine Slipper." The Equine Slipper has a thick leather bottom and the upper part is breathable cordura nylon with handy Velcro fasteners. It seems to protect the bandage and keeps the hoof clean. Tetanus toxoid should be administered if the horse has not been vaccinated within the last 6 months. I usually prescribe phenylbutazone: 2 grams daily for 6 days.

Penetrating wounds or direct hoof abscess are managed more intensely. The penetrating object is best left in place. The veterinarian is summoned and the hoof radiographed. Even then, evaluating all the structures involved is difficult. Dr. Schneider at Washington State University College of Veterinary Medicine is using MRI to evaluate the structures of the foot damaged by puncture wounds. The more information one can delineate the more accurate the diagnosis and prognosis. Treatment of these direct abscesses many times is difficult. Surgical curettage of bone infections to the third phalanx or navicular bone caused by nails puncturing the bone, debriding the deep flexor tendon and drainage of the navicular bursa or joint lavage of the coffin joint are procedures requiring expertise and considerable expense. The prognosis is guarded to unfavorable in many cases. If the penetrating object does not encounter a vital structure as around the periphery of the hoof, most of the time the prognosis for complete recovery is good.

Some hoof abscess can be prevented. Start by keeping the barnyard and stable free of nails and other sharp objects that can penetrate the hoof. They are the number one cause of penetrating injuries to the foot.

Should an acute lameness occur, seek veterinary attention early. Early treatment usually has a higher success rate.



Hope this helps
David

[David]

Even though this is not a peer reviewed piece I'm still going to add it here because I believe it has some good advice in it. Also meant to add that I think the reason that sour crout was suggested as good for it is because of the vinegar used to make the sour crout. I think soaking in vinegar would be a better solution than the sour crout though.

http://coursesonhorses.blogspot.com/...bout-hoof.html

Friday, June 27, 2008
What can you tell me about hoof abcesses?
Abcesses are quite common. Some horses are more prone to abcesses than others.

A horse with a hoof abcess will show signs of lameness, sometimes severe. An abcess is basically just an infection inside the hoof, an area where pus is gathering and causing pain and pressure as the infection grows. A good indicator of an abcess is the horse standing with the toe pointed out forward, (rather than resting it behind them) as they are trying to relieve the pressure. Abcesses can be extremely painful.

Abcesses have been called "gravel" for many years because it used to be believed that a small rock (gravel) entered the bottom of the hoof and got infected. It's now known that abcesses are usually called by bacteria entering the hoof through a puncture wound or crack. Often, the wound will be so tiny that you will never see it or know that its there. Abcesses can also occur during or after founder rehabilitation.

Abcesses almost always increase during the rainy seasons or anytime a horse has to live in very wet surroundings. Fungus and bacteria grow and thrive in moisture. Abcesses can also occur if the horse lives in or is forced to stand in extremely mucky or dirty conditions for any length of time. The hoof actually acts somewhat like a filter or a sponge. The hoof sits in the muck and when the water drains out of the hoof, that leaves all of the bad stuff, (i.e., manure, urine) and therefore concentrated amounts of bacteria left standing in the hoof.

Opinions on treatment for an abcess varies greatly by individual. There are questions on whether the hoof should be covered or bandaged and whether or not soaking the hoof has any real benefits. I'll explain what has worked for me. I highly recommend at this point that you consult with a farrier to diagnose your horse, preferably one who is familiar with (and practices) Natural Hoof Care.

I used to think it was best for a farrier to pare out the abcess/infected area to let the infection drain and allow air to get to it. After reading Pete Ramey's book, "Making Natural Hoof Care Work For You", I was convinced otherwise. Ramey has documented proof of astounding success in many areas of hoof care and I trust his opinion. He recommends that it is best to allow nature to take its course and allow the infection to work its way out on its own. Opening up the sole of the hoof can allow bacteria into the bloodstream, thereby causing a secondary infection.

Normally, the infection will travel upwards through the hoof, following the path of least resistance and will eventually blow out, usually at the coronary band. It's hard to watch a horse hobble around, knowing they are in pain but it's far better than risking serious health issues or death because of a secondary infection caused by opening up the sole of the hoof.

Even if I suspect an abcess, I still always call my farrier, just to be sure there is nothing else causing the lameness.

I believe in soaking the hoof but in moderation since too much wetness can actually make the condition worse.

Ramey suggests a soak in 50% apple cider vinegar and water, 2 hours, twice a week.

I personally do not bandage the hoof for several reasons. 1) a bandage that is too loose is a pain to keep on and they usually fall off, (repeatedly!), 2) its easy to put a bandage on too tightly, (or sometimes when they get wet and dry, they tighten on their own), which can cause more harm than good by cutting off circulation and 3) I believe fresh air is best but that is IF you can have the horse in a fairly clean and dry environment. Confinement to a stall is not recommended because the horse moving will help the abcess to work its way out.

I strongly advise against a poultice because poultices seal the hoof off, which means they seal the bacteria in.

The best things you can do to prevent abcesses are:

Keep your horse in as dry and clean environment as possible. The harder and drier their pasture or paddock is, the healthier the hooves will be. Horses should never stand in wet, muddy, mucky conditions, especially where there is a lot of manure. Keep stalls cleaned out. If your horse stays in a small turnout or paddock, routinely scrape out and remove excess manure. If they are pastured horses, possibly you can rotate pastures, etc.
Pick your horses hooves out every day and get in the daily habit of looking for any wounds, lameness or the dark, foul smell of thrush.
Keep your horse on a routine trimming schedule, about every 4 to 6 weeks or as recommended by the farrier.
Regardless of what you do, there is no 100% guarantee that your horse will never get an abcess in the hoof, however, following the steps above can greatly improve the chances that they won't.

On this page, I have a link to "Making Natural Hoof Care Work For You" by Pete Ramey. I highly recommend taking a look at his website and getting a copy of his book. It will change the way you view the hoof and care for the horse forever.



I also think that Pete Ramey's website is a good source of information ( as the author suggests) so I'm going to post a link to that as well.

http://www.hoofrehab.com/


Hope this helps
David

[evelynwolfe]

Thank you so much! You are a life saver David! According to the farrier *just got off the phone with him* his abscess was caused by the abnormal ammounts of rain that we've had, it's caused his hoof to get soft, so something as simple as a minimal stone bruise quickly becomes infected by bacteria in the hoof from the fissures opening and allowing the bacteria to migrate.
He's suggested Apple Cider Vinager and epsom salt baths for the hooof with the abscess.
I've been reading the articals that you've posted and one of them I've already read, very good information, I'm learning more about the hoof now than I think I've ever thought about! Now it's just a waiting game as the farrier can't create a drainage hole due to it being on his heel and so deep into the hoof.
I also read that PCN is good to give them to help them fight the infection, read that from Horsemans magazine. It did not state how much or for how long however, any ideas?

[GV4]

Problems of the feet are something that I, unfortunately, deal with on a regular basis. First, if it is actually and abcess, then it has to find its way out before it will get better. The build up of fluid and infection must drain to release the pressure. Once it does drain, the results are almost immediate.

Soaking in warm epsom salt water will help move the fluid toward an opening, either through the sole or out the hairline. Keeping the area clean afterward is key to correct healing.

Vinegar (apple cider to be exact) is a good agent to harden the foot and it also changes the ph around the area making it difficult for bacteria to grow and cause a problem. This should be used as a soak after the abcess has drained.

We have an aged QH who is prone to foot issues. He will often abcess in one foot, then another while he is compensating for the original one being sore. The worst was when he blew out the ENTIRE frog...I could fit half of my fist in the hole left behind! After 3 months, he had grown back a new frog and all was well.

[evelynwolfe]

Originally Posted by GV4

Problems of the feet are something that I, unfortunately, deal with on a regular basis. First, if it is actually and abcess, then it has to find its way out before it will get better. The build up of fluid and infection must drain to release the pressure. Once it does drain, the results are almost immediate.

Soaking in warm epsom salt water will help move the fluid toward an opening, either through the sole or out the hairline. Keeping the area clean afterward is key to correct healing.

Vinegar (apple cider to be exact) is a good agent to harden the foot and it also changes the ph around the area making it difficult for bacteria to grow and cause a problem. This should be used as a soak after the abcess has drained.

We have an aged QH who is prone to foot issues. He will often abcess in one foot, then another while he is compensating for the original one being sore. The worst was when he blew out the ENTIRE frog...I could fit half of my fist in the hole left behind! After 3 months, he had grown back a new frog and all was well.

Ugh I feel your pain now. I'm not sure what to do, it's like I'm sitting on my hands and not able to do a thing as he gimps around his little paddock, luckily he's a bit of a loner anyway.

Thanks everyone for all of your help and advice, it's good to know that there's someone else out there who's feeling my pain. Rock check for the pasture this weekend...sigh.

[bntnail]

David,
Very nice and informative! You must be better at this "puter" thing than me. I'da had to type all of that.

I personally prefer to open abscesses(under veterinary supervision) because it gives nearly instant relief. Then a shoeing/treatment protocol can be set up right away. However this depends on the individual(farrier/vet).

Very good info given to OP regardless.

bntnail,farrier

[David]

Hey bntnail, I was hoping you'd find this, I just googled abcesses in hoof then sorted through the crap to find good info. I don't know about your area but I've had better luck letting them blow out, but then down here most of the horses are pasture kept so it's pretty hard to keep them clean once you open and drain.

With letting them blow out you usually have a short period of extreme lameness, where as with opening the abcess (unless you have a good stall and adequate care) you have a longer period of less severe lameness (IME).

As to the PCN the dosage depends on your horse, you should either call your farrier back and ask him or call the vet and tell them weight of horse and ask about dosage. My horses are all between 800 and 1200 pounds and I usually give 20 ccs IM for 3 days, skip a day and then 20 ccs for one day. Also, it's safer to give in the neck than the hindquarters but if you've never done it have someone show you how.

Hope this helps
David

[Korven Kuningas]

I know your frustration, I dealt with a hind heel abscess for 3 whole months before it burst.

[BornToRide]

For abcesses you can also soak em in hot water and epsome salt

[evelynwolfe]

IT FINALLY BUSTED

Went out to change the dressing last night and we had a pin hole that was leaking some nasty stuff...icthamol laced! Pressed on it and it shot out like a water gun. Immediate improvement. He's putting weight on his foot now and is just a lot more relaxed. Still packing it with the Icthamol and bandaging it up, as I don't want any bactiria going into it.

Funny thing now though, is when I went to TSC to get more vet wrap all they had left was hot pink, so now my gelding is wearing hot pink ...good thing he doesn't really care about that kind of stuff!