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Discussion on Irritated Coronary Band

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Leilani Clark
Member
Username: Leilani

Post Number: 185
Registered: 4-2000
Posted on Thursday, Jan 4, 2007 - 11:10 pm:   Edit PostPrint Post

Dr O.,
Attached is pictures of a 20yo gelding that I am taking care of. I have been using chlorhexidine followed by Desitin. Kekai doesn't seem to be in pain and is not lame. I believe it is fungal so what is my next step in treatment. Thank you. Leilani





Kekai feet
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Leilani Clark
Member
Username: Leilani

Post Number: 186
Registered: 4-2000
Posted on Thursday, Jan 4, 2007 - 11:13 pm:   Edit PostPrint Post

Kekai's back feet. Thank you. Leilani
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Susan Ragan
Member
Username: Srfotog

Post Number: 12
Registered: 10-2006
Posted on Thursday, Jan 4, 2007 - 11:33 pm:   Edit PostPrint Post

My vet recommends T-Gel shampoo, left on for 15 minutes, then the Desitin. It really worked on a vicious case of scratches. When it's on the hoof, I put a mixture of one part bleach, three parts water being careful not to get it on the skin.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 17409
Registered: 1-1997
Posted on Friday, Jan 5, 2007 - 8:38 am:   Edit PostPrint Post

Excellent picture Leiliana, it clearly displays the winging out of the hair at the coronet and its thickened scaly condition that run all the way around the heels. This is not clearly a case of typical scratches Susan but I am uncertain this is fungal either. It is best described by the pathology present: superficial irritation to the coronet band or coronitis. It may be do to infection but there are a long list of problems, some local (like infection), some systemic (like vitamin deficiency or mineral imbalances), and even some immune disorders that present this way.

I see these from time to time and because this is a difficult area to biopsy I usually treat with a broad spectrum therapy that gets most of the disorders that are treatable. You start with a thorough review of the environment and diet. Once I believe we were seeing a reaction to the hydrated lime left lying on the exposed stall floor. Wet conditions will definitely promote infectious causes.

After correcting anything suspicious, the most consistent treatment I have found for such conditions is using Panalog twice daily in combination of keeping the coronet absolutely dry until healed. About the only place you can get Panalog or anything like it is from the veterinarian. The use to make a larger (8oz?) bottle that is more reasonably priced than the little tubes and normally 2 to 3 weeks of treatment are required.
DrO
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Leilani Clark
Member
Username: Leilani

Post Number: 188
Registered: 4-2000
Posted on Friday, Jan 5, 2007 - 6:12 pm:   Edit PostPrint Post

Thank you so much Dr. O. I have some Panalog that was Rx for my dog's ears.

There aren't many horses that I would assume the positions I used to take the pictures.
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Leilani Clark
Member
Username: leilani

Post Number: 254
Registered: 4-2000
Posted on Wednesday, Jun 13, 2007 - 6:32 pm:   Edit PostPrint Post

Dr O,

Kekai has been diagnosed with Coronary Band Dystrophy. His feet continued to worsen and the heel bulb became inflamed and mushy. He is currently at my vet's in a dry stall awaiting treatment recommendations. What exactly is this? Thank you. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18690
Registered: 1-1997
Posted on Thursday, Jun 14, 2007 - 8:41 am:   Edit PostPrint Post

Hello Leilani,
Coronary Band Dystrophy (CBD is also labeled in the literature as "CB Disorder" or "CB Dysplasia") is a inflammatory condition of the coronary band with no known cause currently. So the diagnosis starts with ruling out known causes of coronitis. It does have a characteristic neutrophil and lymphocyte infiltration on biopsy to help with the diagnosis. Clinically it resembles many conditions of the coronary band but the fact that all coronary bands is a characteristic of CBD and puts infection lower on the list. Toxins, nutrition, contact dermatitis and autoimmune disorders remain on the list however.

May I ask what is the basis of the diagnosis?

This is a good topic for a new article and I will get started on it. We are about to leave for a horse show however so it may be next week before it is completed.
DrO
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Leilani Clark
Member
Username: leilani

Post Number: 255
Registered: 4-2000
Posted on Thursday, Jun 14, 2007 - 3:55 pm:   Edit PostPrint Post

Dr O,

My vet pulled blood first and then followed with a biopsy of a hoof.

I look forward to your article. Thank you so very much and good luck at the show. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18725
Registered: 1-1997
Posted on Friday, Jun 22, 2007 - 11:50 am:   Edit PostPrint Post

Hello Leilani,
The article is up and you will find it at, Diseases of Horses » Skin Diseases, Wounds, and Swellings » Hair and Coat Problems / Itching / Irritated Skin » Coronary Band Disease: Coronitis.

I have used one of your images in it because it is such a great example of an inflamed coronary band. Let us know when you get your results back as following the research for the article I think I must be Mr. Coronitis. While writing it I realized we only briefly touch on trauma to the coronet in other articles and just about have a second article on treating coronary trauma and it should be up next week.
DrO
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Leilani Clark
Member
Username: leilani

Post Number: 259
Registered: 4-2000
Posted on Friday, Jun 22, 2007 - 5:12 pm:   Edit PostPrint Post

Dr O,

Thank you so very, very much. Leilani
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Leilani
Member
Username: leilani

Post Number: 277
Registered: 4-2000
Posted on Monday, Jul 16, 2007 - 12:03 am:   Edit PostPrint Post

Hi Dr. O,

This Tuesday Kekai will finish his 1st 2 weeks of dexamethasone orally @2.5cc once per day. Then he will receive 1.25CC once per day for 2 weeks and then 1.25cc every other day.

He is getting around really well even up and down hills.

I had been using Thrushbuster on his feet, but my vet recommended 7% iodine as a cheaper alternative. Currently I can't find any so I am using generic betadine and so far so good.

Once again, I cannot thank you enough for taking the time to research this. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18856
Registered: 1-1997
Posted on Monday, Jul 16, 2007 - 7:21 am:   Edit PostPrint Post

How are the coronary bands doing Leilani?
DrO
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Leilani
Member
Username: leilani

Post Number: 279
Registered: 4-2000
Posted on Tuesday, Jul 17, 2007 - 6:23 pm:   Edit PostPrint Post

Dr O,

Kekai's coronary bands look GREAT! He has approximately 2cc of growth and the hair is not standing straight out. Thanks for asking. Leilani
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Leilani
Member
Username: leilani

Post Number: 325
Registered: 4-2000
Posted on Tuesday, Aug 21, 2007 - 4:33 pm:   Edit PostPrint Post

Dr. O,

RE: Kekai CBD

The growth in between the heel bulbs on all four hoofs is reappearing. Any idea where to go from here? Kekai is still on Dex 1.25 cc every other day. Thank you. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19055
Registered: 1-1997
Posted on Wednesday, Aug 22, 2007 - 6:29 am:   Edit PostPrint Post

What did the biopsy find Leilani and I presume from the above treatment selected they diagnosed autoimmune disorder.

If that is true, I would consider increasing the dex frequency and dosage until you get control again. Return of symptoms does not change the diagnosis and in fact may support the idea of autoimmune disorder: autoimmune disorders cannot be cured though occasionally they disappear on their own and clinically it appears you have gone below the lowest effective dose of dex and now the body is attacking the coronets again.

However some of these are allergic type reactions to the flora on the skin so I would also do what it takes to keep the coronets clean and dry and based on the earlier biopsy results consider a microbial swab just to see what is growing there.
DrO
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Leilani
Member
Username: leilani

Post Number: 328
Registered: 4-2000
Posted on Thursday, Aug 23, 2007 - 4:25 pm:   Edit PostPrint Post

Dr O,

I have requested the biopsy results and will post when I receive. Leilani
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Lisa Stehl
New Member
Username: lisasteh

Post Number: 1
Registered: 8-2007
Posted on Wednesday, Aug 29, 2007 - 1:44 am:   Edit PostPrint Post

Thank goodness that I found you guys...our 19 hand 2140lb shire gelding has just been diagnosed with coronary band dystrophy. It has been a nightmare to find any information at all. I looked at the pictures that are posted here and our horse's feet are far more advanced and affected. We were misdiagnosed by 2 different vets and in the meantime his feet have been getting progressively worse. We have a dermatologist coming on thursday to do a biopsy and take skin scrapings. King's coronary bands are thickly crusted, in some places up to an inch. His ergots and heels are huge and inflamed and have cauliflower looking growths on them. His chestnuts have fallen off and now his frogs are softening and covered with some strange white spongy growth that is starting to kind of slough off. It does not look good at all. We can see it progressing in just days. We are so worried because our horse is so big and if he founders we don't know if he could ever recover. Dr O can you give me any idea of the severity and survival rate on this disease. We love our boy and will fight to the end but we would like to know the reality of the situation. Thank-you so much and I am so glad that I found you.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19096
Registered: 1-1997
Posted on Wednesday, Aug 29, 2007 - 7:46 am:   Edit PostPrint Post

Welcome Lisa,
Did you read the article associated with this discussion? It contains the prognosis for this condition as found in the literature. However there are different diseases that have a similar appearance so your prognosis depends on your particular diagnosis. I have had several cases with a similar appearance to Leilani's horse above but no biopsy and have been able to get them treated using the recommendations in the article.

If after reading the article you have more questions be sure to start your own discussion rather than posting in Leilani's. The new discussion button is at the bottom of the article page.
DrO
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Leilani
Member
Username: leilani

Post Number: 337
Registered: 4-2000
Posted on Wednesday, Aug 29, 2007 - 4:23 pm:   Edit PostPrint Post

Dr O,

Per my vet, I have increased Kekai's dosage back up to 2.5cc every other day until I can get this back under control. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19102
Registered: 1-1997
Posted on Thursday, Aug 30, 2007 - 1:09 pm:   Edit PostPrint Post

Any word on the biopsy yet Leilani?
DrO
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Leilani
Member
Username: leilani

Post Number: 340
Registered: 4-2000
Posted on Thursday, Aug 30, 2007 - 6:58 pm:   Edit PostPrint Post

Not yet.
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Leilani
Member
Username: leilani

Post Number: 357
Registered: 4-2000
Posted on Friday, Sep 14, 2007 - 4:50 pm:   Edit PostPrint Post

Dr O,

Biopsy from Kekai.

Source/History
Skin of left front coronary band - 2 sections
There is a history of chronic abnormal growth at the top of all four feet. The lesions are not responsive to topical antibiotics or cortisone or dietary changes.

Microscopic Desc
Punch biopsies of tissue from the coronary band of this consist of hyperplastic stratified squamous epithelis amount of underlying dermal tissue in one of the sections largely unremarkable. In this section there is very parakeratotic hyperkeratosis with a few areas of very neutrophilic inflammation in the superficial keratin pallor within the outer layers of keratin in the one second section is comprised entirely of hyperplastic is very mild disorganization of the basal cell layer visible.

Diagnosis
Epidermal hyperplasia with marked parakeratosis and dysplasia

Comments
The submitted biopsies consisted predominately of ep (cut off) tiny amount of underlying dermal tissue in one of th (cut off) lacked any obvious inflammation but had very mild di(c/o) the basal cell layer that could potentially occur with such as corneal band dysplasia/dystrophy. There was within the outer layers of the epidermis and keratin section and if the horse has any clinical signs of h(c/o) ruling out a condition such as hepatocutaneous syndrome warranted. Most case of hepatocutaneous syndrome have superficial parakeratosis. The clinical distribution and parakeratosis could also be compatible with selenium but if the horse is not living in an area where selenium is common, this would be unlikely.

Sorry about the missing text. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19225
Registered: 1-1997
Posted on Monday, Sep 17, 2007 - 9:15 am:   Edit PostPrint Post

Hello Leilani,
I apologize for the slow response I was hoping to get to my library and check several references however that was not to be. We have been traveling and did not get back to the office before going out again.

So let me comment on what I see and when we get back on Friday I will see if there is further info. The most interesting aspect is the low level of inflammation which suggests that this is not an autoimmune or infectious disorder. However prior treatment may have effected results and the horse has responded to corticosteroids before. From the information provided above it looks like increasing the steroids again and then finding the lowest effective dose preferably of oral prednisolone. What is the concentration of the dex you are using?
DrO
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Leilani
Member
Username: leilani

Post Number: 358
Registered: 4-2000
Posted on Thursday, Sep 20, 2007 - 5:19 pm:   Edit PostPrint Post

Hi Dr O,

Per label, 4 mg per ml eqivl to dex 3mg/ml. Hope this is what you wanted. Leilani
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Leilani
Member
Username: leilani

Post Number: 369
Registered: 4-2000
Posted on Friday, Sep 28, 2007 - 4:43 pm:   Edit PostPrint Post

Hi Doc O,

What is your opinion on the dex concentration. Thank you. Leilani
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19277
Registered: 1-1997
Posted on Saturday, Sep 29, 2007 - 9:39 am:   Edit PostPrint Post

I think the 8 mg every other day is still quite a low dose and if you get it under control with this the next step is not going down on amount first but to once every 3 days.
DrO
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Charlotte Ziems
New Member
Username: cziems

Post Number: 1
Registered: 12-2010
Posted on Thursday, Dec 16, 2010 - 12:54 am:   Edit PostPrint Post

Hello Leilani and Dr O,
I discovered your message string while researching coronary band disorders. I'm attaching photos of my gelding's hooves showing the same swollen, flakey, soft and gooey coronary bands, which he has on all four hooves. He's a 22yo Hanoverian who lives in a barn stall with a paddock in Northern California. We're dry for 7 months but get a lot of rain in the winter.

I'm trying to keep the bands clean and am applying antiseptic ointment and antifungal spray. Considering getting them biopsied. Panalog seems like what I should be applying. Any advice?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 25372
Registered: 1-1997
Posted on Thursday, Dec 16, 2010 - 8:35 am:   Edit PostPrint Post

Welcome to Horseadvice Charlotte,
I believe we can help you with your question but let me get you started off right so you can get the best answer as quick as possible.

You will get more responses if you start your own discussion rather than post at the bottom on another member's discussion. Each discussion is "owned" by the original poster and all replies in that discussion should either directly or indirectly address the concerns of the original poster.

To start your own discussion back up one page using the navigation bar at the top of this page. This will be a Article Page on this topic. Below the article you will find a list of already existing discussions on this topic. Under this list you will find the "Start New Discussion" button. This is a good topic on your subject so you should first review the article as it will have important information on your subject. Next check the titles of the already existing discussions to see if your question has already been answered.

If your question remains unanswered, now is the time to Start a New Discussion. Select a short title that describes your specific concern. A title like "Help!!!" does not help others find your specific topic. Instead something like "Ace for Colic?" allows others to rapidly find and understand what your topic is about just by viewing the title. This is likely to bring more responses from those with some experience with your topic and allows members to find answers to their questions quicker.

Thank you for helping us keep more organized.
DrO
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Charlotte Ziems
New Member
Username: cziems

Post Number: 2
Registered: 12-2010
Posted on Thursday, Dec 16, 2010 - 12:44 pm:   Edit PostPrint Post

Thanks for the advice Dr O--will start a new discussion!
Charlotte
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