Any ideas? Strange "tissue" in hoof won't grow normally

[Alice]

I'm hoping someone on this board has had a similar experience they could share.

I'll try to be brief but descriptive.

History:

Fall 2008:
Horse passed pre-puchase, promptly blew out a large abcess out the back of the heel. Only lame for a day or so. Horse was seen by Vet #1, presented like a normal abcess, x-rays clear. Much foot soaking, then treatment for thrush I probably caused by soaking too long.

Winter 08/09:
Horse ripped off huge piece of frog in turnout. We assumed it had been weakened by the old abcess tissue growing down. Continued treating for thrush as per farrier's instructions.

The frog just would not heal properly. Most of it grew back, but one side had a "blemish" that would seem to be healing, then develop a groove which eventually widened, cracked and would leave a sore oozing spot in the frog. Farrier not worried, advised to keep treating for Thrush.

Feb. 09:
Got vet #2 to check out weird area of frog. He suggested we would have to cut out the part of the frog that wasn't healing, with local sedation and farrier. Theorized that we would need to cut down to new tissue, then allow to heal normally. Farrier thought he could do this without needing to block the foot, and did so. Frog only seemed normal for a week or so, then groove started to develop again.

2 1/2 weeks ago: With vet #2 and farrier, blocked foot and cut out "blemished" looking frog. The bad looking area went up and up, gradually narrowing in to a smaller point. Vet left before farrier had finished, unfortunately the bleeding got so bad farrier had a hard time seeing what he was doing. He did his best, hoped he got it all out. Horse lost half his frog, some sole. Vet's statement: "I don't know what this is, I've never seen anything like this before."

This past weekend had to have vet #2 out to check an irritated eye on this same horse, so asked him to look at the foot at the same time. He felt (as do I) that the area the blemish was is not growing back as is the rest of the sole and frog that were cut out. The area of concern is slightly darker in color, and now spongy while the normal tissue looks/feels good.
Vet suggests we try cutting it out again, this time laying the horse down and using tourniquet to ensure we get it all.

I'm really hoping this kind of thing sounds familiar to someone. The vet did say it didn't look like hoof canker to him, if that helps. Before we do the second procedure I think I will take the horse back to vet #1 for a second opinion. Does this sound like something we should be biopsing? Could it just be damaged tissue from stepping on something that caused the large abcess last fall?

Any suggestions/recommendations? I'll gladly take anything you've got!

[pines4equines]

Pictures would help all...

[Alice]

I've taken some but they really don't show anything well at all. They are not 3-D enough to really show anything, and the darker area is at the moment the size of a pencil eraser.

I'll try again, but I don't think I'll be able to show anything. Hmm, maybe Photoshop could help some how.

I'll get the pics off the camera and work with them.

[easyrider]

I don't know enough to be of any real help in terms of what's going on, but I was surprised when I got to the part where you say the vet left before the farrier finished and the bleeding got so bad the farrier had trouble seeing what he was doing (but evidently continued cutting), and the horse lost "some sole" and the vet had no idea what was going on. I have to say that I find all that frightening. I'd think about getting a new vet, and probably a new farrier as well. I hope you and the horse get some help. I know Ric Redden does consultations.

[Androcles]

Is it bothering him? Maybe you should just leave it alone.

[Chall]

Here are some shots of one persons experience http://www.squirrelwoodbelgians.com/cankercondition.html
The original thread was http://www.chronicleforums.com/Forum/showthread.php?t=186090&highlight=canker
The Coth thread references some people and sites. I would also google and search here for "canker. Good luck.

[BornToRide]

Hmmmm, possible Canker comes to mind, but it could also just be a weak, compromised frog thanks to diet implications and ineffective treatment.

How have you been treating for thrush - what have you used and what does the horse's diet look like?

Are all his other frogs healthy or are they all a bit soft and spongy?

[silver2]

I'd look into canker. If you suspect that's what it is, get a specialist. Vets hardly ever see it these days and most don't know how to treat it.

[CosMonster]

Yeah, hoof knowledge varies a lot among vets and for the less common diseases you're probably better off consulting with an experienced therapuetic shoer, of course you should have your vet present and the three of you should work together if possible. I'm not trying to knock your vet, but hooves are a specialty and most vets focus on the rest of the horse (which is a lot to focus on!). I say a farrier who specializes in therapuetic shoeing just because IME those people have seen so many diseased feet they'll be able to diagnose and treat it correctly, as opposed to many farriers who see mostly relatively healthy feet.

[Alice]

I lightened up a picture, it can be seen here:

http://pets.webshots.com/photo/2002804180105052834PHNuFw

I too, was surprised when the vet before the job was finished. I wish he hadn't, but I think he assumed the job was almost over.

Thanks everyone for the info. For what it is worth, the vet seemed confident it isn't Canker.

I'll be taking him for a second opinion with another respected vet. The vet I'm using probably has a bit more experience than a "typical" horse vet around here, and I've always felt he has good instincts. He's been a member of (I think two?) national teams as an assistant vet at FEI competitions in the past couple of years, so others out there also have a good opinion of him.

FWIW, I've been treating his thrush with topical treatments - Coppersept, Coppertox and most recently Thrush Stop. It doesn't seem to be thrush, no discoloration etc. but we are having a very wet spring. I did board the horse a year ago over the winter, and he did come from the track with a bad case of thrush which took a while to clean up.

[movo]

I'd be thinking that there is some foreign matter waaay deep in there that noone is seeing. Just irritating enough to cause a non-healing area.

I had a similar experience with a horse and (9 months and 2 exploratory surgeries later) it turned out to be a piece of aluminum that was buried very, very, deeply and was not causing any pain.

[ReeseTheBeast]

First thought that came to mind is Canker.

[merrygoround]

Where do you live? What other options are open to you?

Repeating the same RX protocol in the face of past failure doesn't seem like a sensible course of action.

In the NE we have some great veterinary referral centers,NB, Tufts, Cornell, same for KY and TX.

[BornToRide]

FWIW, I've been treating his thrush with topical treatments - Coppersept, Coppertox and most recently Thrush Stop. It doesn't seem to be thrush, no discoloration etc. but we are having a very wet spring. I did board the horse a year ago over the winter, and he did come from the track with a bad case of thrush which took a while to clean up.
Looks more like typical frog weakenss.

The treatments you have used are generally not very effective. I would get a bottle of White Lightning and start treating it with that.

In the meantime I would also investigate to make sure the horse gets all the copper and zinc it needs to grow healthy hoof tissue and not too much NSCs (sugar and starches in the diet) and read this: http://www.hoofrehab.com/diet.htm

Copper and zinc uptake can be inteferred with by any of the following:

Compromised digestive tract (worms, not enough good bacteria, ulcers)
Too much iron in water and forage (interferes with copper and zinc uptake)
Not enough zinc and copper in the forageBest wishes :)

[Alice]

I just got an appt for a second opinion on Saturday, so I'm looking forward to that.

It is a very localized area - would "frog weakness" present in such a manner?

movo - I really think that is a strong possibility. My coach's guess was that was the case.

Thanks to everyone who took the time to respond, I really appreciate it.

I'm about 9 hours from the closest vet university, but I do have 3 vets within an hour that I respect to go to for help. Hopefully the university's services will not be needed...

[BornToRide]

It is a very localized area - would "frog weakness" present in such a manner?
Yes, it is possible.

[2DogsFarm]

Before I saw your photo I was thinking this sounded very similar to what I went though with my senior horse. It will be 2 years this August so I'll try to be brief and still not leave out any details.
First off your photo looks a lot less awful than your description and a lot better than my guy at his worst.
My History:
August '07 - barefoot horse bruised his heel in turnout, when 2 days of bute didn't help he went for radiographs that showed bruised tissue deep in the heel itself. Vet's recommendation was to keep him on bute and keep an eye on it. Lameness never completely resolved and one night when I picked the hoof it bled from the sulcus. Back to the clinic where it was determined he had abcessed from the heel bruise and the abcess ahd blown out the sole near the toe. He was prescribed ABX and I was instructed to soak the hoof nightly in a betadine/epsom salt solution and keep it wrapped with the injured part covered by a gauze pad covered with betadine gel .
September '07 - half of his sole has sloughed off, interior hoof structure is visible and he is 3-legged dead lame. Vet examination shows no infection and sole is regrowing...at a glacial pace. Keep wrapping changing dressing twice a day. Horse gets usual turnout and favors the injured foot.
December '07 - sole has mostly regrown but is considerably softer than the healthy side, still medicating & rebandaging twice a day. Horse is sound for turnout and doesn't seem so off on the "bad" foot.
January '08 - enough sole regrowth for glue-on shoes!!! Horse is moving soundly on all four now
March '08 - reset glue-on shoes. Test-ride in the indoor, walk only - still sound
April '08 - back to keg shoes, horse is sound outdoors at the walk & trot
June '08 - back to barefoot & completely sound, owner collapses in exhaustion

Have you had x-rays done?
I'd hesitate using anything caustic - Durasole, Coppertox, even White Lighning - until you know what is causing the abnormal sole growth.

[Alice]

Good gravy 2Dogs - that sounds like quite the ordeal! Good to hear the horse is doing well now. Poor guy - and poor owner!

I don't think my horse is anywhere near as bad as that! The picture I posted is after the paring away of the weird frog tissue was done - I think about a week later. The sole has never looked to be involved.

X-rays were taken back in the fall, I expect they'll be repeated on Saturday. Both farrier and vet recommended the thrush treatments to toughen up the frog.

Thanks for sharing your experience - I really hope I don't have to go through all that!
My horse has only had a few sore-ish days - like two. Even after getting half his frog pared away. I would guess he would be sore if ridden on harder ground than the indoor arena though.

[CosMonster]

What does your farrier say he thinks it is, or is he stumped too? Has he consulted with any colleagues to see what they say?

I do think it's a good idea to get new vet opinion. The first step to fixing something is knowing what it is. At least that's the ideal. ;)

[Alice]

The farrier was reluctant to say anything about it, he did finally say it might be a damaged area from stepping on something - which in turn would have caused the large abcess.

He was really surprised at how far up in to the hoof the weird tissue went. He tried very hard to dig all he could out, it would have been much better if the vet had put a tourniquet on so he could visualize more easily.

[Androcles]

Looks more like typical frog weakenss.




What exactly is 'typical frog weakness'? Are there some resources to get more info about this condition that you know of?