Pedal osteitis in unshod youngster

[champagnetaste]

This is a big, 3 yr old horse. An abscess kept recurring, and radiographs show early stages of PO. There is no known foreign body, although something could have penetrated the hoof. Radiographs show a drainage tract, slightly eroded coffin bone tip, and there is a palpable "soft spot" adjacent to the bone.

Is surgery always indicated? I'm pursuing second opinions but would like to hear from others who have experience with PO.

[LMH]

photos of the hooves would be great...if you dare.

[JB]

Digital xrays?

I would be looking for 2nd and even 3rd opinions about the possibility of a septic coffin space.

[champagnetaste]

Thanks -- am in the process of getting a referral to New Bolton. I don't have x-rays but have posted his feet previously, was surprised that the responses weren't too bad. He is now on SMZs and stall rest, with a notch in the front of his hoof. While I can't show the x-rays, the erosion appears to be slight -- we were able to compared radiographs in March (first abscess) with those taken on 7/3 to determine the change.

This may not be enough to go on but I'm sure interested in any general advice or experience with PO.

Thanks!

[champagnetaste]

The thought is that it is non-septic. Radiographs are on their way to NB...

[Dune]

Digital xrays?

I would be looking for 2nd and even 3rd opinions about the possibility of a septic coffin space.

That'd be my concern as well. I'll be curious to hear NB's opinion. Are they suggesting that you shoe this horse?

[EqTrainer]

Draining tract? Soft spot?

Come on now.... I'd be demanding either a debriding or some serious perfusions. SMZ's aren't going to do anything for that one. Sigh.

[BornToRide]

How long has this been going on?

[J.D.]

That'd be my concern as well. I'll be curious to hear NB's opinion. Are they suggesting that you shoe this horse?

what's wrong with shoes in a medical/mechanical diress situation?:confused:

[BornToRide]

what's wrong with shoes in a medical/mechanical diress situation?:confused:Uhm, how would shoes help in this situation? Please elaborate.

[champagnetaste]

His radiographs are on their way to a surgical facility--drainage is a possibility.

He happens to be unshod as he is only 3, but he has been backed and ridden in an indoor with great footing. If he needs shoes he'll get them.

The soft spot could be a pocket of infection or maybe a hematoma from bruising. Would drainage help in the latter case?

[EqTrainer]

? for you. His films are "on the way"? It takes just a few minutes to send digital rads to someone who knows more. When my vet sends film like this for a second opinion she sends them to Rich Redden at NCSU and he looks at them that day. When I had a horse who presented much as you describe, she took them there herself and waited to talk to him. So.. I am hoping this film is digital? Because if it's not it will be much harder to tell what is what and the delay could be problematic. If they are digital I'd be wanting to know what is taking so long! If they aren't, I'd be finding out if you can just take him wherever he might be going and have them do digital film and make a decision then/there.

I don't think the question is, should it be surgically *drained*, unless I am missing something... The question is more likely, does the coffin bone need to be debrided?

FWIW, after my horse had a septic coffin bone he was casted rather than shod. Shoes would not have protected the big missing chunk of toe wall. Casting certainly did and he was able to be turned out in the spring with all the wet and slop with no problem.

[champagnetaste]

But they were overnighted. They should be there now.

I think there is a feeling that this is non-septic, FWIW. I don't think any obvious sequestra were noted.

Thanks for your replies.

[Patty Stiller]

Uhm, how would shoes help in this situation? Please elaborate.Uhmmmm lets see.... .let me count the ways....maybe protect the already damaged coffin bone solar margin from further damage? Or maybe add a hospital plate to cover up the hole they may need to make in a the surgical clean up ? or maybe protect the probably thin sole from more trauma? or maybe ease breakover all around the foot to reduce stresses on the bone and surrounding soft tissue structures? or maybe help hold a genetically weak foot together?
Or how about this one ....... help this lame domesticated horse that does not have the rock solid 20mm thick sole of a feral mustang ?

[Patty Stiller]

His radiographs are on their way to a surgical facility--drainage is a possibility. usually, if there is no bone fragment, drainage of a sole abscess or hematoma would only requires a small drain hole and should resolve quickly. He happens to be unshod as he is only 3, but he has been backed and ridden in an indoor with great footing. If he needs shoes he'll get them.GOOD.
The soft spot could be a pocket of infection or maybe a hematoma from bruising. Would drainage help in the latter case?If there is a hematoma from a bruise then a little drain will relieve the pressure quickly, and the small hole created will heal fast as well.

AS well if the radiograohs reveal a very thin sole, you may consider that this horse may need to be in shoes for protection and prevention of further incidents such as this.

[champagnetaste]

When the vet came, she met the farrier and they looked at him together. He now has bar shoes that have a little makeshift pad that inserts into the toe area (which is now notched). I've been sticking icthamol into the notch with cotton, taping it, and booting it with a soft nylon boot. And he is on stall rest w/handwalking until further notice.

I didn't say he was "shod" b/c I consider this more of a medical situation.

[champagnetaste]

What kind of post op care is involved in each of these?

[champagnetaste]

Maybe they'll help...
It's the right front, you can see a tract. This was taken after 10 days of a non-breaking abscess. At the time he was on turnout and I assumed it had broken while he was in the field...
http://picasaweb.google.com/barnhelp/Radiographs#5317483222843258770

Oh, he has a different farrier now, and a lot less toe.

[besttwtbever]

I had a horse with pedal osteitis. We did a lot of things to make him comfortable but nothing ever made him totally sound. He wore bar shoes with pads and seemed pretty good with those. At the time we didn't have money for expensive treatments so I searched the internet for some alternatives.

One website I went to said to turn the horse out barefoot in a rocky paddock. I personally thought this sounded cruel but I thought I would pass it on to you. It said that after a while the foot would get tougher and the sole would get thicker.

I asked my vet about this and he said it was worth a try. We never actually did it as I ended up selling him as a trail horse to some very nice people. I know this is not a lot but hopefully it helps.

[EqTrainer]

Did the vet tell you to stick icthammol up it?

[Patty Stiller]

One website I went to said to turn the horse out barefoot in a rocky paddock. I personally thought this sounded cruel but I thought I would pass it on to you. It said that after a while the foot would get tougher and the sole would get thicker.Round smooth river rock can indeed toughen a sole.as can asphalt or concrete, but but There is ZERO proof that the sole will get thicker ,and doing that to a horse with existing pedal osteitis is a good way to destroy the bone further.

[champagnetaste]

Yes. But the hole is not really draining or open. Why do you ask?

[EqTrainer]

Round smooth river rock can indeed toughen a sole.as can asphalt or concrete, but but There is ZERO proof that the sole will get thicker ,and doing that to a horse with existing pedal osteitis is a good way to destroy the bone further.

I agree w/this. If you were wanting to try something like this, pea gravel would be a good option as it at least increases circulation without causing pain.

Icthammol - odd choice, JMO.

Edited to add - the xray view is not ideal to tell much of anything about the front of the coffin bone. Do you have any more?

[Dune]

what's wrong with shoes in a medical/mechanical diress situation?:confused:

Re-read my post, I never said anything was wrong with shoes, just asking a question. In fact, I was wondering why a hospital plate hadn't already been put on this horse. (my initials aren't BTR, so don't get so jumpy, JD:winkgrin::lol:)


Uhmmmm lets see.... .let me count the ways....maybe protect the already damaged coffin bone solar margin from further damage? Or maybe add a hospital plate to cover up the hole they may need to make in a the surgical clean up ? or maybe protect the probably thin sole from more trauma? or maybe ease breakover all around the foot to reduce stresses on the bone and surrounding soft tissue structures? or maybe help hold a genetically weak foot together?
Or how about this one ....... help this lame domesticated horse that does not have the rock solid 20mm thick sole of a feral mustang ?

Right on. :yes:

When the vet came, she met the farrier and they looked at him together. He now has bar shoes that have a little makeshift pad that inserts into the toe area (which is now notched). I've been sticking icthamol into the notch with cotton, taping it, and booting it with a soft nylon boot. And he is on stall rest w/handwalking until further notice.

I didn't say he was "shod" b/c I consider this more of a medical situation.

I *thought* there must be some missing information, thanks for clueing us in.

Did the vet tell you to stick icthammol up it?

I'm sorry, but how many people can you say *that* to?? (without getting a strange reaction, that is) :D

[champagnetaste]

Icthammol made sense to me (a non vet) from the perspective that a) they believe it is non-septic and b) there is a soft spot adjacent to the hole, but they don't want to poke around that close to the pedal bone. There is a teensy hole that they can squeeze a tiny bit of liquid out of in the soft area -- I'm assuming it's a pin prick.

Here's a bit of black humor. He's shod, padded, and booted, and being hand walked. He now hates me handling his foot, and last night, after applying the nylon boot, he jerked his hoof away from me. I was done, so I let go. Maybe that surprised him -- he hoof fell hard on the concrete floor.

This has gone on two weeks and it feels like a second full time job. And It's barely even begun. And to watch him drop that foot onto the concrete like a stone, and hear that crack on the concrete after everything we're doing to protect him! I just about started bawling.