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  Discussion on Pedal osteitis and my horse?
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New Member:
amigo123

Posted on Monday, Aug 4, 2008 - 3:35 pm:

Hello,
I have a 5 year old gelding western pleasure horse who suddenly came up lame in the right front foot on the day we were supposed to show at the fair. Called veterinarian out and she thought of an abscess since he tested positive with hoof tester. Farrier came that night and found small spot by one of the nail holes that seemed to have some secretion so we thought abscess again. We began soaking his foot to draw out the abscess. After almost 2 weeks it still hadn't changed. Doesn't limp at the walk but definitely at the trot. Called veterinarian again and he came out and did anther lameness exam. Used hoof tester and horse gave more at the toe. Watched him travel, felt some heat, some additional digital pulse, took x-rays. Only thing that shows up on xrays is some demineralization of the coffin bone. He says to finish out his 5 days of bute and give him 20ccs of penicillin for 3 days, then 12 pills of some other kind per day with light exercise beginning the latter part of the week. Call him back on the following Monday. I am really worried that this horse will not go sound and be able to show again. Do you have any advice for me? I could sure use some about now. My vet says he will probably have to take more radiographs next week.
Member:
mrose

Posted on Monday, Aug 4, 2008 - 4:58 pm:

Hi Gail, while you're waiting for Dr.O. to give his advise, I thought I'd just mention about making sure his feet are totally in balance. We had a similar situation with one of our horses in training, and the entire problem was caused by his hoof being out of balance. He's an older horse and is showing a little bit of demineralization of the pedal, but it's very slight. It has taken for ever as it had to be done gradually, but he is now in balance and going sound again. The trainer lost the regular farrier and had the horses done by a "certified farrier" that supposidly knew what he was doing, but he gradually totally lamed up this horse. So, if you haven't already, have some good laterals taken (we had digital x-rays done)and make sure he's in allignment and balanced. Being off balance just a little really can make a difference in a horse that is getting worked a lot.
New Member:
amigo123

Posted on Monday, Aug 4, 2008 - 8:32 pm:

Sara,

Thanks for your input. That makes sense and I will look into it.
Moderator:
DrO

Posted on Tuesday, Aug 5, 2008 - 7:47 am:

Welcome Gail,
First let me say a horse with acute lameness of 2 weeks variation is not a likely candidate for "permanent lameness" and has a great chance of going sound again. I suggest we get a better idea of where the pain is coming from in the hope of getting a diagnosis. You should note that radiographs are poor tools for localizing lameness so to the variability of normal and overlap of normal and significant findings. This is especially true of the coffin bone. Since the foot is suspicious but it seems there is some uncertainty start with the advice in Diseases of Horses » Lameness » Localizing Lameness in the Horse.
DrO
New Member:
amigo123

Posted on Tuesday, Aug 5, 2008 - 6:38 pm:

Dr. O,

Thanks for responding so quickly. I have been extra worried about a permanent lameness because I bought this horse in April to replace a pleasure mare I had for 3 years that went lame and we STILL can't find out what is wrong with her. So when he came up limping on the same foot as she did, kind of suddenly, like she did, I REALLY began to worry.

I think I forgot to say the vet did a lower nerve block on him about a week ago. Then we lunged him and he said it got about 80% of the lameness so he did another nerve block a little higher up. When we lunged him he was more relaxed in his travel and wasn't bobbing his head anymore. That's when he did the x-rays. He originally thought it was the navicular bursa.

And when he called back after reading the x-rays and having a surgeon look at them he said there was some demineralization of the coffin bone.

He mentioned a bruise, or an infection. To which I asked couldn't we give him penicillin or something and that's when he said we could give him 3 days of penicillin and he would send sulfamethoxazole and trimethoprim pills.

Let me also go back a little. July 13th was when he suddenly went lame at the horse show. July 14th was when the farrier was to come out and reset our horses. He took his right front shoe off and used a hoof tester to find he was sensitive by a nail hole on the side. So he scraped around the nail hole and some secretion came out. That's when we started soaking the foot and packing it with icthammol (spelling?) to draw the infection out. Well we weren't getting anywhere and my husband used a hoof clincher around the foot and the toe was more sensitive this time and we both saw a little bit of something ooze out of that side spot again. (I wonder if that happened when he clinched the toe area.) So we soaked it some more until July 30th when the vet came out again and we did the blocking and the x-rays. And that brings us to today. We are on the second to the last day of bute and the penicillin. Then we have three days of the pills. Then I am to lunge him lightly (walk and trot) and call him on Monday. Is anything jumping out at you through all this rambling?
Member:
rtrotter

Posted on Tuesday, Aug 5, 2008 - 7:56 pm:

Amigo123,

Foot abcesses are insidious things and it would not surprise me in the least if your other horse also had something going on in her foot too. Sometimes with pus pockets or abcesses they can hang around for months causing various degrees of lameness and making us horse owners go nuts trying to find out whats wrong.

What jumps out at me is that your vet put your horse on bute and antibiotics. The may be contraindicated for a hoof abcess problem and as you can see are not very effective. Not much of either bute or antibiotics actually get into the foot and as a result may extend the time for your horse to get better.

I've dealt with several pus pockets and abcesses in my racehorses. Some of which had the horse suddenly be broken bone lame. My vet always says to soak the foot in Epsom salts and warm water,poultice and leave the poultice on for at least 24 hours evaluate and then repoultice. He rarely prescribes anti-inflamatories or antibiotics for these types of issues. If the lameness does not dissipate by the second day of poultice. He will then take an xray to see if there is another obvious problem.
Member:
juliem

Posted on Tuesday, Aug 5, 2008 - 8:48 pm:

I've dealt with a lot of hoof abcesses, and my vet follows the same protocol as Dr. O. He feels soaking and poulticing allow to much time to pass and the infection does more damage to the hoof than paring out the abcess track and getting good drainage established. Read Dr. O's article on hoof abcesses. If you had some amount of drainage already, that's the track to follow. Your farrier may be able to do this, but I've always had to have my vest as getting to the sensitive tissue is painful, but the relief is almost instant! I agree with Rachel that antibiotics will not help and may even delay getting the abcess to drain. If this is an abcess, the longer it goes without draining, the more damage is done inside the hoof. If money is an issue, I think soaking would be the next option, but I personally can't stand watching them be three legged lame and have been fortunate enough have the resources to have the vet treat each time it's occurred. All this is assuming what you're dealing with is an abcess. Sure sounds like that's a good possibility. I've had them present with slow onset, sudden immediate onset and off again on again onset! Even had varying degrees of lameness from just off at the trot to three legged lame.
Moderator:
DrO

Posted on Wednesday, Aug 6, 2008 - 8:29 am:

All right, with the nerve block results (I am assuming a PDN block was done followed by a ASN block) we can move along from the general article on lameness diagnosis to the one on diagnosis of the foot, see Diseases of Horses » Lameness » Diseases of the Hoof » Overview of Diagnosis and Diseases of the Foot.

Surely the veterinarian used his hoof testers before dragging out the radiograph machine? What were the results of that and was it done on the foot with the shoe removed? I personally think the diagnosis of demineralization from a single field radiograph is very subjective. I would also review the Abscess article as you are getting off on the wrong foot treatment wise if this is the problem.
DrO
New Member:
amigo123

Posted on Wednesday, Aug 6, 2008 - 10:17 am:

Thank you Rachelle and Julie for your posts. I am trying to process all the feedback I'm getting and now wonder if we didn't get sidetracked in our lameness exam.

Dr. O, the vet used the hoof testers on the foot without the shoe and at that time he flinched most when he used the testers across the frog to the outer portion of the hoof and at the toe.

The first time on the 14th, when the first vet and farrier clinched him, he didn't flinch at the frog and only slightly at the toe.

Something I read about abscesses is that if it can't find it's way out it will travel around the foot looking for a way. Is that right Dr. O? Could this possibly be that kind of situation? Do you think I should call the vet out and have him explore that spot more? Or let this play out until Monday and see what gives then?

I really appreciate all the comments and this web site is such a help.
Moderator:
DrO

Posted on Wednesday, Aug 6, 2008 - 7:57 pm:

Yes abscesses not pared out will undermine more healthy horn on its way to finding a way out. This is explained in the article on Abscesses. Whether this is what is going on or not I cannot tell from the information provided but the article on Abscesses explains how to pursue the possibility. Is the sensitive area also the area you have seen drainage from, if so it reinforces the idea.
DrO
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