Chronic Abscessing

[Katie-Nicole]

So, poor Mini Cooper keeps getting hoof abscesses. They're under his frog and blowing out at his heel. He's an old founder (we're talking 10+ years ago) but lacked in hoof care for several years. When I got him his feet were curled (one hind doubled over). Over the last month or so, this guy has been blowing out abscesses like no tomorrow. I don't want to oversoak and wind up compromising his hoof wall. He's trimmed ever 4-6 weeks and gets lots of turn-out. Anyone have any tips on drawing this crap out?

[Sansena]

Pack with 4x4's dampened w/betadine solution, and mound epsom salt heavily in a pile on the gauze. Place over the suspect area. Wrap w/sofband, baby diaper, vetrap and duct tape.

Or you could just go the ichtalmol and baby diaper/ duct tape route.

[Patty Lynch]

I'd get some current rads if you haven't done so. For whatever reason, it sounds like the pocket isn't draining completely each time and walling off another new pocket. You want to make sure you don't have a foreign body in there. Is he sound between blow outs or has he been off the entire time? How long have you had him?

[Katie-Nicole]

I've had him 3 years. It's hard to tell how "sound" he is between blow-outs because he's always walked "off" due to the severity of his hoof deformity that caused some arthritic changes in all four legs. His feet now look relatively nomal. He's on one gram of bute a day right now. I do have magic cushion I could pack him with. I don't know how drawing that is. The other thought I has was squirting some mastitis treatment in the void in his heel. I have soaked him with white lightning. My vet has raved about how clean his feet are and said just keep on top of it. No radiographs at this point. Vet didn't feel they were warranted because the abscess is open and actively draining. He said keeping it clean and keeping him moving are going to win most of the battle.

[FlashGordon]

Hmmm I'm thinking the Magic Cushion may have the opposite effect?

My aunt had an Arab gelding that had a winter of abscessing, she was an absentee owner so lucky me got to take care of it. I used to soak in warm water and epsom, then pack his feet with betadine and epsom, or use that minty green epsom goo. Wrap with diaper, then vet wrap, then duct tape. Repeat daily.

I think we eventually put him on SMZs as well.

Good luck with your little guy...

[Patty Lynch]

Ah, good :). Packing it with something moist is the best bet to keep it draining then. A 2:1 ratio of bran to epsom salt, mixed with a solution of Betadine and water to form a thick paste is good. Diaper it and wrap. The bran will help retain moisture and body heat to facilitate draining. I would make sure the foot doesn't become overly soft though. Sounds like you are doing well. Mastitis treatments do work well on frogs with an overly deep sulcus. I have a client that says that it works well on the abscess itself. I have never tried it though.

[Patty Lynch]

While Magic Cushion is fantastic for reducing inflammation in the hoof... you actually need inflammation to exit the abscess. I would stop the bute while he's draining too. It's hard to see them uncomfortable, but they heal much faster when the inflammation helps get rid of the drainage.

[Cherry]

Katie-Nicole, with horses that have chronic abscesses I can't help but wonder if they aren't insulin resistant. Is your Mini Cooper IR???

If you don't know then I would have the vet over to test him. Until you get to the root of his problem this will, most likely, keep happening. I don't think it's a matter of "drawing the crap out" as it is stopping the crap from materializing.... What is this guy eating currently? Removing most grain, and sugars from the diet (by soaking the hay, no apples or carrots, etc.) would probably be of benefit....

Good luck!

[jpalisades]

I always had luck using icthamol (sp?) and soaking in between wrappings!!

I do however second the vet and xray idea given by another poster. Sometimes the vet, if the pockets are numerous or in certain places, will 'cut' open area(s) to allow better drainage or remove gravel that is causing the ongoing problem.

[Katie-Nicole]

Katie-Nicole, with horses that have chronic abscesses I can't help but wonder if they aren't insulin resistant. Is your Mini Cooper IR???

If you don't know then I would have the vet over to test him. Until you get to the root of his problem this will, most likely, keep happening. I don't think it's a matter of "drawing the crap out" as it is stopping the crap from materializing.... What is this guy eating currently? Removing most grain, and sugars from the diet (by soaking the hay, no apples or carrots, etc.) would probably be of benefit....

Good luck!

Oh, Mini Cooper is everyone's metabolitic nightmare. His bloodwork revealed that he's Cushingoid, IR and possibly diabetic (didn't know they could have all three) He's wooly, fights chronic skin, eye and now hoof infections. He's on Seminole's happy hoof (or TC safe starch forage) and Purina LS. No grass, no grains. He does OCCASIONALLY get a carrot-teeni (itty bitty baby carrot) if a pack of them was in my lunch order from the local pizzeria. But, he's bright, funny and generally unaffected by it all (until his boo-boo hoofs get him really gimpy) Taking him off of bute is a no go, as he needs it for his arthritic changes. He's on Cyproheptadine, because he cannot tolerate Pergolide at any dose. Ahh... the joys of rescue ponies.

[BornToRide]

Chronic Abscessing = bad hoof form combined with possible IR and/or Cushings!

I would take a hard look at his diet and remove anything that may be high in sugars and starches - that includes pasture. My mini foundered on pasture alone!

To find out for sure, have the blood tested for glucose and insulin levels and possible ACTH, to rule out Cushings. Check the Equine Cushings group for more info on the subject: http://pets.groups.yahoo.com/group/EquineCushings/post

Best wishes!

[Katie-Nicole]

He's on a low starch diet. He's on special forage with an NSC less than 12% and on purina LS concentrate. No grass and no grains. His diet is as strict as it could be. We have run bloodwork and his insulin, glucose, ACTH and T4 all point to cushings/ir/diabetes. He is not hypothyroid. I understand his metabolic issues are a precipitator to the abscessing, but don't feel that there's any further changes we can make to his diet that would offer any greater control over the systemic issues. I just wish I could make him feel better. :(

[BornToRide]

I'd withold any processed feeds for a month just to see what you get. Not sure what is in the stuff you feed, but it could be too much for him. Does he get extra magnesium and is he on a good mineral supplement? Have you had his hay tested to make sure he gets what he needs?

In addition it sounds like you have not had him for very long and the hooves were a mess. He may just need to go through a healing process untill all the crap is out of his system.

IR can in fact cause low thyroid function and once it is corrected, it tends to go away :)

[Katie-Nicole]

I'd withold any processed feeds for a month just to see what you get. Not sure what is in the stuff you feed, but it could be too much for him. Does he get extra magnesium and is he on a good mineral supplement? Have you had his hay tested to make sure he gets what he needs?

In addition it sounds like you have not had him for very long and the hooves were a mess. He may just need to go through a healing process untill all the crap is out of his system.

IR can in fact cause low thyroid function and once it is corrected, it tends to go away :)

He's not on hay. The forage is a hay replacer and is minerally balanced. He was on a chromium/magnesium supplement and he began losing weight rapidly. I put the four pounds I had left over on the giveaway board to be used by another needy horse. The purina LS is fed as a handful to be able to take up his bute and cyproheptadine. The feeds he's on are guaranteed low starch with an NSC of less than 12% (9-10% is more common though). Believe me, I've spent many an hour working with my vets and nutritionists to come up with a diet that is balanced, low starch and that he'll actually eat. The bloodwork also confirmed he was not hypothyroid, like I stated in my previous post. I don't need to address his diet, I need to address these pesky abscesses.

[BornToRide]

The purina LS is fed as a handful to be able to take up his bute and cyproheptadine
Two red warning flags - bute slows down the healing processes in the hooves and cyproheptadine is rather ineffective Cushings treatment. If this pony truly has Cushings, he should be on Pergolide.

If you are not doing so already, I highly recommend for you to visit the Equine Cushings group - they will tell you what works and what does not.

Not sure what is in his diet, so cannot tell if it might still affect him, but he should do fine on just loacl grass hay, soaked if necessary.

Simple is usually best - we tend to see more problems with horses whose diet has become too complicated.

[Katie-Nicole]

Dear Lordie BornToRide... You really need to read the posts more thoroughly. LIKE I'VE SAID BEFORE - taking him off the bute is a no go due to the severity of his arthritis. He cannot tolerate pergolide at ANY dose. He went into acute anaphalaxis. You can read about it on one of my posts when I replied about someone asking about reactions to pergolide. The cyproheptadine has helped with his skin infections and he'll continue on it for that reason. I've had hay from my area tested, from multiple suppliers, and not one has the low level of NSC and guaranteed consistancy of the forage replacer. I do belong to the Yahoo group and have spoken with Dr. Kellon personally. BornToRide, are you a vet or nutritionist? Have you personally examined Mini Cooper? Why is it that joining the Cushing's Group automatically makes you an expert in how to feed ANY AND ALL Cushingoid/IR horses? I understand that if Mini Cooper were your horse, you may do things differently, but that's your perogative. Sorry if I sound defensive, but I didn't post about Cushings Diet Issues, I asked about abscess issues.

[BornToRide]

Sorry I missed it. Sounds like you have everything covered. I know you simply asked about abscessing, but as you know this is very tightly related to diet, metabolism as well as bad hoof form.

Sounds like you are fighting a metabolic uphill battle with him, because of all the sensitivities he has. Soaking with epsom salt, packing with Ichtamol and making sure his hoof form is correct when he gets trimmed is pretty much all you can do at this point for the abscesses.

Best wishes!!

[Katie-Nicole]

I do agree that hoof form is playing it's part. We can't seem to get these heels to spread out. His heels are still years later very contracted. The frog is pretty necrotic. He's barefoot. So, if you have any insight on how to decontract those heels, it would be appreciated.

[LMH]

Katie-Nicole-even though Safe Starch is low NSC, there are some horses that simply do not do well on it.

It sounds like the poor darling has a couple of issues but that may be one feeding the problems.

As far as his feet, could his toes still be a little long? That could keep the heels from opening up.

[Katie-Nicole]

He has improved greatly on the feed considering the changes in all his other issues. His coat has improved, he eats better, his eyes are brighter and he's more alert and engaged. I don't want to go messing all of that up because people "think" it might be the feed. It's not, I guarantee you. He's been on the feed for about a year now. He was on TC low starch for med administration, but he likes the LS better and it has an NSC content of less than 11%, so he's been on that for a while now. His feet are "well balanced" as far as the over all angle. His toes are brought back well and his heels aren't under run but still contracted none-the-less. I've thought about changing farriers to a barefoot trimmer who might be willing to be a little more aggressive with the heels, but that isn't my area of expertise to assume that my current farrier isn't being aggressive enough. I plan on talking with him about it the next time he's out.

[Patty Lynch]

Try adding 10-15 ml of DMSO to the mixture I gave you earlier to go on top of the abscess hole.

Take some gauze squares drenched in mastitis cream and stuff it between the heels with a clean hoof pick or popsicle stick. I mean, really get that gauze up in there as best you can. Leave it and re-do as the heel opens and no longer hold the gauze.

Are you certain his heels are low enough and his frog is engaging the ground? The wee ones are hard.

Don't soak. I think it makes the foot too soft, inner structures don't get the support they need and it causes bigger and more compounded problems ;)

You are in a viscious cycle, I'm afraid.

[Katie-Nicole]

Try adding 10-15 ml of DMSO to the mixture I gave you earlier to go on top of the abscess hole.

Take some gauze squares drenched in mastitis cream and stuff it between the heels with a clean hoof pick or popsicle stick. I mean, really get that gauze up in there as best you can. Leave it and re-do as the heel opens and no longer hold the gauze.

Are you certain his heels are low enough and his frog is engaging the ground? The wee ones are hard.

Don't soak. I think it makes the foot too soft, inner structures don't get the support they need and it causes bigger and more compounded problems ;)

You are in a viscious cycle, I'm afraid.

That is a fantastic idea Patty! You're a genious! His frog is all nasty and necrotic. Most of it has fallen off. If it were still there, yes, it would have been engaged.

[Patty Lynch]

If he has no frog, give him one and he will heal faster ;)

If you have to wrap some gauze folded up and made into a "frog", do it and vetwrap that sucker on there :lol: It will go on top of the medicated ones stuffed in the heels. You can cut up anything squishy soft and place it in there. It will help his heels open too, but his coffin bone really needs to have frog support, real or artificial. Before you do anything though, try getting that heel area as dry as you can. A blow dryer works good ;)

Best of luck :)

[andy825]

I had some chronic abscessing with one of my guys last year. He kept blowing out his heels, but it turned out the problem was in the toe, and wouldn't drain from there, for whatever reason. Eventually it grew out enough that the vet was able to trim the tract open and it could heal properly. Because the infection was travelling such a long way before it exited, it never fully drained before the hole closed. It was a mess, but such a relief when we finally found the source and could treat it and let it heal from the inside out.

[candico]

I would get an Xray. We finally did when my older guy abcessed for the third time in about 8 months. It turned out to be a keratoma that had done too much damage to even really consider trying to surgically remove it. The vet said it is wise to rule it out for slow to resolve or repeating abcesses...
Hope in your case it is not a keratoma.

[matryoshka]

Another trimmer piping in here. I would think that rads of the foot would be in order just in case there is something in there causing the repeated abscessing (from bone remodeling, sequestrum, etc). You are shooting in the dark, treating the symptoms (abscess) without knowing what may be underlying it inside the hoof. JMHO.

I trim a mare who foundered (sank) some years ago. She frequently abscesses in the same spot--hoof and coronet are scarred. The last time, the severity caused more sinking in all fours (judging by how much flatter the feet got after that episode). The vet is reluctant/too busy to take rads. So, we are treating the symptoms time after time. It is frustrating for the owner, but I can't convince him to pressure the vet into taking rads. Poor mare.

It sounds like you are doing fine treating the abscesses. It would just be sooo much better to have an idea of why it keeps happening. It would be good for your farrier to know what that coffin bone looks like, too.

[Patty Lynch]

The vet is reluctant/too busy to take rads

:no::no::no: Get another vet. There is NO excuse for that.

[BornToRide]

Because the infection was travelling such a long way before it exited, it never fully drained before the hole closed. It was a mess, but such a relief when we finally found the source and could treat it and let it heal from the inside out.That's a good point. Perhaps the hooves also have some unrecognised fungal/bacterial infection that is exacerbating the problem by weakening the hooves and should be treated

[matryoshka]

:no::no::no: Get another vet. There is NO excuse for that.Not my call to make. It is a client's horse, not mine. I have met the vet there before when the mare abscessed badly, but the vet is the expert, and I'm a just a trimmer...

[Patty Lynch]

I'm a just a trimmer...

So, what exactly does that imply or are you saying when you type that?

If you are going to work on hooves in a professional capacity (get paid for it) whether you are trimming, shoeing, or both, you have every right to be an advocate for that animal.

It is frustrating for the owner, but I can't convince him to pressure the vet into taking rads

You shouldn't have to convince the owner to pressure the vet to take x-rays :eek:

If you have suggested to the owner that he get another vet and he is ignorant/stubborn/cheap/whatever, enough not to in order to get the x-rays that his horse needs.... then there isn't a lot you can do.... except refuse to work on the animal unless it's done.

If I were in your position, that's exactly what I would do. You are putting yourself on the line working with clients like that. Trimming foundered/sunken feet "in the dark" isn't fair to the animal, or anyone that is supposed to be playing on the horses TEAM.

If you are going to be a professional at whatever you choose to do, whether it's trimming, shoeing or both.... then be one. ;)

[matryoshka]

Patty, I appreciate your advice, but it isn't your call either. I've been trimming this horse for four years now. If I quit, the owner will trim her himself. He was trimming her himself when I first went there because he couldn't get farriers to show up reliably for just one horse. I happen to prefer back-yard horses and their owners, so I run into similar situations fairly often. Somebody needs to go to these tiny farms tucked all over the county. That's what I choose to do, and I wouldn't trade it for any large show barn or high priced horses. I don't quit when somebody listens to the vet instead of me. That would be unprofessional.

I refused when the vet wanted me to carve concavity into her feet and I requested rads early on. The hooves had shown a fair amount of improvement in the time I've been trimming her, despite the abscessing, until the last bout where she refoundered (I can only go by external signs, since again, no rads). The mare continues to run around okay, even though I'm not happy about the situation. She's not what I'd call sound, but then again, she's had arthritis since I first saw her. She's in her mid 20's. I've been trying, unsuccessfully, to get the owner to put her on joint supplements, too.

So if I don't trim her, she will be worse off than she is now. That is my opinion as a trimmer. I'm not qualified to give a veternary opinion. This particular vet and I have had a few go-rounds, and she attends quite a few of the horses I trim. Like it or not, I've got to deal with her for more than just this one horse. I can make recommendations, not demands. It is part of being self employed.

Sorry for the digression. This thread is supposed to be about the OP's horse, not one that I trim. I brought up the mare as an example of why one might want to get rads and had no intention of hi-jacking the thread.

[matryoshka]

Patty, did we meet at the Paul Chapman clinic in Laurel? Are you trimming professionally now? I ended up with several clients as a result of attending that clinic--was just down there trimming the Icies yesterday.

[Patty Lynch]

Patty, did we meet at the Paul Chapman clinic in Laurel? Are you trimming professionally now? I ended up with several clients as a result of attending that clinic--was just down there trimming the Icies yesterday.

Yes, we did meet then. I have continued my education and because I want to be able to provide what any horse should need, shoe as well. I look forward to seeing you again on Saturday at the Wellshod clinic if you are still planning on going...

I wasn't dissing you and I hope you don't think I was. I was trying to get you to see that you hold a position of value and should be held with regard.... you are not, just a trimmer. You are more than that.

I understand your position though ;)

[Patty Lynch]

Katie-Nicole, Sorry for getting off track there.

How is little Cooper doing? Are his heels opening up at all yet?

[Katie-Nicole]

Yes, I'm here. (Busy weekend so I didn't check in.) I followed your advice and built up that frog and boy is he pushing crud out now. Big ol' chunks of discharge, which is good. We've got a little bit of blood, but it's trivial. Seems the root of the infection is near the apex of his frog. He has a trimming appointment coming up soon, so we'll see if we can't get that opened there safely.

And to clarify on the x-rays, my vet does not have a portable unit. To get x-rays, it's a haul to the clinic. While not a huge ordeal, this little man does not handle stress well and it can be a major setback to his other systemic issues. We take it slow with him, and if we can resolve this with less stress, that would be even better. We'll get the x-rays when their warranted, and the stress to his system is less of a concern than the chronic absessing of his hooves.

I'm really glad it's warming up this week. He's getting a bath and a pre-winter body clip!

[Patty Lynch]

Glad to hear he is getting rid of gunk. Go, Cooper! (I think his name is so cute!)

Good job, Katie-Nicole :)

[matryoshka]

I wonder if the abscesses that are under the coffin bone just sit there and are harder to resolve. Let's hope this is the end of the problem for Cooper, since you are getting so much out of there. I understand about the trade-off question of stress vs. diagnosis/treatment. We gotta do what we think best for each horse in each situation.

Hey Patti, I knew your advice was well intentioned and I truly appreciate it. :) I have had to walk away from a couple of founder cases when they were not going to get adequate veterinary care, owners would not do what was necessary to treat the founder, or when I simply did not have enough experience to take on an acute sinker. Each of those times, while I know I did the right thing by refusing to trim, the horse's pain was prolonged when I could have helped. I'm sure there will be more cases where I have to walk away in the future, but it's not something I do without a lot of thought.

I'll look forward to seeing you on Saturday. I'm bringing the same friend who came to the Paul Chapman clinic as well. I sure wish I had rads of the mare mentioned above to take along!

[Patty Lynch]

If you have pics of the mare mentioned, bring them to the clinic :)