Please look at x-rays [Archive]

Derby Lyn Farms

Jan. 29, 2010, 04:19 PM

I posted about my mare on here before. Finally got the x-rays emailed to me. Feel free to comment.

The mare stepped on a nail. Nail was taken out, she was treated with antibiotics (along with soaking and keeping it clean). She was abscessing at the coronet and the heel from this. The nail went in at the tip of her frog (the point). It was about 3/4" long. Antibiotics weren't strong enough so we switched. She was re-shod and still had abscesses under her shoe.

One vet thinks its infected still. The other says its boney fragments breaking off from it fusing. Both vets (different clinics) both agree that the coffin joint is fusing.

My question is in the first film. I just emailed it to the vet so I don't have her response yet. I circled the area on it. What do you think this is?

The foot in question is her Left front. There is a pic of her right to show what the left is suppose to look like.

http://i104.photobucket.com/albums/m171/arcticcielo/friday.jpg

http://i104.photobucket.com/albums/m171/arcticcielo/Fridaysx-rays001.jpg

http://i104.photobucket.com/albums/m171/arcticcielo/Fridaysx-rays003.jpg

http://i104.photobucket.com/albums/m171/arcticcielo/Fridaysx-rays004.jpg

lindsay_aggie

Jan. 29, 2010, 04:38 PM

It looks like air, right? Did she abscess in that area? I am interested in your vet's opinion because I am not a vet and just guessing of course. Sorry about your horse.

McVillesMom

Jan. 29, 2010, 07:52 PM

Agreed that there are a lot of osteophytes (arthritis) on both P2 and P3, which will eventually fuse.

Also agree with lindsay_aggie - that sure looks like gas density to me in your circled area. Not a place that you should be seeing gas. I'd be pretty concerned that there's still infection in there. Hopefully I am wrong :)

Derby Lyn Farms

Jan. 30, 2010, 12:04 AM

Thanks for your replies. The vets haven't really told me what to do with her yet. Yes both clinics say the joint is fusing and there is tons of arthritis in there now. She still has abscesses under the shoe, AND she lost weight when this first happened and has not gained it back. She is usually a very easy keeper. That makes me think infection still.

Rodawn- the first link I listed is a front view. On the right side of her coffin bone there is a small black spot that I circled, sorry the circle isn't very dark.

Derby Lyn Farms

Jan. 30, 2010, 12:07 AM

I am hoping to find a way to make her as comfortable as possible, and none of the vets seem to have any advice for me on that yet. Kind of losing hope.

I asked about another round of stronger antibiotics and they told me its not going to do anything at this point. I see it that I don't have anything to lose at this point.

Fharoah

Jan. 30, 2010, 12:59 AM

What about planting blue beeds antibiotics under the skin?

Meadow36

Jan. 30, 2010, 09:23 AM

Derby Lyn - I'm only in my first year of vet school, but I agree with the ringbone possibilty and also something like calcification possibly going on with the collateral ligament of the navicular bone. I'm confused how this all happened from a nail?? Seems like the stuctures in question are much higher up. This looks really painful; I'm so sorry you are going through this with your mare. :(

If this were my horse, I would ask my vet about sending these rads out for a consult to a radiologist - in small animal medicine the consult is usually only about $100 - and well worth the information. Pet Rays is one company that does this; also the vet school in your state may have a consult service, just call up and ask.

Edit: I just saw the part where I think the nail went in. The antibiotics probably cannot penetrate this area. Have you tried packing with ichthamol or sole pack to keep drawing the infections out? I would also be continuing the soaks. Good luck!

animaldoc

Jan. 30, 2010, 09:54 AM

Bluey

Jan. 30, 2010, 10:05 AM

Is the horse lame now? Looks like this happened at the end of October?

The first thing I worry about with a nail in the foot is that the nail may have gone into the navicular bursa and caused an infection there.

It's actually more useful to leave the nail IN and take a radiograph to see where it penetrated. If it is in the bursa, then a surgery needs to be done to open up the bursa and flush it out.

These types of injuries don't always have a great prognosis......

Exactly, "a poor prognosis" is what our vets told us, when we had a horse come up from weekend turn out with a long nail a long ways thru the navicular bursa into the bone on a hind foot.
He was dead lame all along, even under heavy pain medication.

He was treated aggressively for five weeks, in consultation with TX A+M specialists, when enough is enough the vets said and he was euthanized.:cry:

The nail had been pulled out by the trainer that found it, he was being used for lessons at a friend's riding center, so for the x-rays, a needle was inserted in the nail track and it helped determine where and how deep it was.

The vets said many horses do fine with aggressive treatment, but in ours the nail went in so far, it was, as I already quoted, "a poor prognosis".:(

I hope your horse will do fine, many do.:yes:

Dalemma

Jan. 30, 2010, 10:13 AM

Was this a rusty nail?

My vet's horse stepped on a rusty nail and after the intitial recovery........she continued to abcess on and off for about a year......they figured a very tiny piece of the rust stayed behind and the foot continued to abcess until it was expelled.

Dalemma

Derby Lyn Farms

Jan. 30, 2010, 01:34 PM

Rodawn-thank you for all the useful information. The hole is closed up now and has actually moved (grown out) towards the hoof wall. I have her on hoof supplements, and I can really tell they are making her hoof grow like crazy. So I am not sure if your soaking treatment would work since there is no openings where the hole was. However, it will work for the abscesses under the shoe, but I am going to have the shoe removed again and left off. I do have one of those medicine boots that I kept on her until the hole was completely sealed. I soaked it with epsom and betadine.

I actually showed this to my own orthopedic surgeon. He obviously doesn't know much about a horses anatomy, but he said the coffin bone looks like it is pretty weak and deteriated from the infection. He said it is definately severe arthritis, and obviously he would have no idea what ringbone looks like. It is funny that I am getting so many ringbone responses, other friends have also said that, when none of the vets have even mentioned that.

I will ask about the antibiotic beads. It was a rusty nail, and I told the vets it was. Actually it was an old old nail from out in the field somewhere. There was no nail head on it, it was bent and twisted and basically just a short piece of metal that was at one time a nail. She is utd on tetanus and was at the time. I worry that it is rust or dirt up in that pocket.

I have a friend that went to vet school but never finished. He said arthritis, ringbone, and he thought it was foreign debris in that hole. He talked about getting the exact measurements of that "air pocket" and drilling a hole to it. He is not my vet, just a friend, so no final decisions will be made on his sole opinion.

She is still lame. I started her on bute again this week. I don't like to keep horses on bute. I want to see if the bute takes away any of the limp so I can estimate her pain. I am not sure if the limp is all from pain, or the fact that it is fusing and there is limited mobility.

Supposedly the films were sent to a vet in FL and all he suggested was doing the operation where they insert a metal plate on the joints to fuse them.

I understand no matter what happens, the prognosis is poor. I won't let the mare live her life in pain and if I have to I will have her euthanized. I just don't think that I am ready to make the decision to euthanize her yet since I haven't recieved any real answers, diagnosis or treatments. The vets have not even suggested euthanasia when I have asked. I have used both vets in the past, and they have both put horses to sleep for me. They will tell me when its time to euthanize without hesitation.

Thank you everyone for your suggestions! I am looking for any and all opinions on this, so keep them coming. I will take all this to my vets and discuss it with them further.

I have not heard back from the vet yet on the "air pocket" and might not until Monday, but I am going to call them right now to make sure they got the email.

foggybok

Jan. 30, 2010, 08:12 PM

I actually showed this to my own orthopedic surgeon. He obviously doesn't know much about a horses anatomy, but he said the coffin bone looks like it is pretty weak and deteriated from the infection. He said it is definately severe arthritis, and obviously he would have no idea what ringbone looks like. It is funny that I am getting so many ringbone responses, other friends have also said that, when none of the vets have even mentioned that.
.

Both your vets said it was fusing, that is actually what low ringbone is. They probably just didn't call it ringbone. You can have mild ringbone, where there is just a mild response around the joint, or severe ringbone like yours where the joint actually begins to fuse.

There is quite a bit of reaction at that joint. The coffin joint is meant to have motion, so horses with that much reaction are likely to be very sore. And yes, even when fused, she will have an abnormal gait, since she will lose the motion in that joint.

Best wishes for your horse!

ivy62

Jan. 30, 2010, 08:58 PM

Androcles

Jan. 30, 2010, 10:05 PM

She was re-shod and still had abscesses under her shoe.

One vet thinks its infected still. The other says its boney fragments breaking off from it fusing. Both vets (different clinics) both agree that the coffin joint is fusing.

Could you be specific what the actual current problem is?

Are you saying that this appears to be a problem still, that the hoof continues to abscess? Because there were abscesses under the shoe? That does not mean they are recent or current abscesses.

The area circled doesn't look like anything really.

I would be concerned with that thick ridge of hoof wall 1/3 of the way down the wall and the wall it is 'folding onto' the wall below it. Hard to say but does that part of the wall date from the time of the accident, IOW did it grow out that odd way from whatever was happening after the nail was pulled out?

That is some significant ringbone on that leg and probably more of an issue than other things. The two feet are trimmed very differently, if this has been the case for a long time it's no wonder she developed such bad ringbone. The LF should look more like the RF, without all that excess underneath the coffin bone and in front of the toe - I would try and have it trimmed better, and maybe even remove the shoe during the recovery to allow the abscesses to drain out and be done with.

Meadow36

Jan. 30, 2010, 10:22 PM

Could the infection have moved into the bone? Osteomyeolitis is bad..even in people...Even IV antibiotics do not work but if your up for it HBO does a wonderful job...If it needs to be cleaned out, the sooner the better...
Good luck

Yes I think that is the problem ... you can see the navicular bone is very "spongy" looking compared to the one on the right ... I'm assuming this is why the vets are saying the antibiotics won't work. The problem is she has extensive remodeling of the other joint besides the nail issue so she's getting hit with multiple problems, unfortunately.

I am curious, was she sound before the nail incident?

HD2008

Jan. 31, 2010, 10:04 AM

Pockets of gas within the hoof wall suggest current infection, but if there is currently no open draining tract from the bottom, then you may not get any drainage unless it ruptures from the coronet. If your vet or farrier can find a tract and relieve the pressure from the bottom so that gravity will help it drain that would be best.

Sometimes with such a severe problem (the nail, which by the looks of the "after-effects" went all the way to the navicular bursa), will continue to cause problems for a long time. When a the navicular bursa is infected (and it can communicate with the coffin joint) you get secondary reaction from the bones on either side of the joint and then secondary arthritis between those bones P2 and P3 (or the short pastern bone and the coffin bone). Arthritis in this joint is commonly known as low ringbone (ringbone is just a layman's term for it). Once the arthritis is started, there is no stopping it.

If the coffin bone itself was also infected, then the bone will remodel throughout and is usually more brittle then previously. However, little fragments seen away from the bone may not be fragments off of the bone as you can get calcified areas of infection (the body is trying to wall it off) - you must look at the edge of the coffin bone to determine if the fragments actually came from the bone (you should see pieces missing) or if they are just areas of calcification.

The arthritis may be one source of your mare's pain. Usually it is a weight bearing lameness - anotherwords they are lame, but they'll walk on it. If she is not weight bearing -or just barely weight bearing, then infection is more likely.

Regional perfusion therapy is typically performed if severe infection is suspected, but at this point most of the damage is already done. Now the question becomes - is there just a secondary sole abcess or are the joint and bone still infected? The grade of lameness and how it's changed may help you determine that with your vet.

SquishTheBunny

Jan. 31, 2010, 12:51 PM

Send to a radiologist - you would be amazed at how many vets skip this step on cases like this.

Make sure the radiologist is board certified. There are MANY bone processes that are often misdiagnosed.

Get their opinion, they will also often recommend courses of action.

And personally, I would go quality over quantity in this case. I know I may get flamed a bit for this but bute, surpass, adequan, legend....all can help relieve some pain but are temporary minor reliefs.

Derby Lyn Farms

Jan. 31, 2010, 01:35 PM

Androcles-I do not know exactly what the problem is with this mare, except she stepped on a nail and this is the result. She has abscesses under the shoe, but not anywhere else anymore. I am hoping to find a way to make her comfortable, or would just like an answer as to what to do with her.

This mare has NEVER took a lame step in her life. Never any issues prior to this, and I would think the right foot is an example of what her left use to look like.

I think the reason each hoof looks different is b/c the left has a bar shoe and she is not wearing down that toe. She is more weight bearing on the right and has worn that toe down. The reason she only has a left shoe on is b/c she would not stand on the left foot to put a shoe on the right. If I remember correctly the farrier could not trim it that well. This time around she will be shod on both fronts since she now can stand on the left.

The ring on her hoof that you are seeing did start with this injury up near the coronet. It has grown out that much since the injury. I associated it with more of a stress ring then anything.

I am not looking for a quick fix that will only be temporary. I do not want her depending on bute or any other arthritis medicine just to live each day. I will keep her on supplements no matter what, but if it comes down to it I will euthanize her before making her live a life on bute. The only reason I am trying her on bute now is to see if I can get an estimate on her pain. She is happy, eats, kicks, attacks, runs from the back of the field, runs me over, and basically anything she wants. Its really hard to tell with her if she is in a lot of pain b/c she is a tough one. One of my tb mares would have died from drama by now.

I am going to read up more on ringbone. I have never dealt with it so I guess I had better get to it.

I have asked about osteomyelitis, b/c obviously that may be the case. When I ask the vet they say yea sure it could be that, but pretty much say tough luck. When I took her in for these films they tried to draw fluid out of the coffin bone area to see if it was still infected, and all they got was blood b/c of all the bony formation going on.

foggybok

Jan. 31, 2010, 01:56 PM

I am going to read up more on ringbone. I have never dealt with it so I guess I had better get to it.

I have asked about osteomyelitis, b/c obviously that may be the case. When I ask the vet they say yea sure it could be that, but pretty much say tough luck. When I took her in for these films they tried to draw fluid out of the coffin bone area to see if it was still infected, and all they got was blood b/c of all the bony formation going on.

This is not typical ringbone, but is ringbone secondary to infection. When you read, look at "low ringbone", the prognosis is generally poor, especially at this severity. Also google infected coffin joint or navicular bursa.

When you say they checked the coffin joint to see if it was "still infected", do you mean they determined there was an infection in the coffin joint and not just an abcess from the nail? There is a huge difference between the two. From the x-rays, it certainly looks like it. As a previous poster mentioned, it looks like the navicular bursa was penetrated by the nail, with the infection spreading through the coffin joint. I'm sorry to say, but this generally is a very poor prognosis.

I'm not sure it's worth sending off x-rays anwhere, the issues are pretty obvious.

How the horse responds is going to depend on the horse. Some tolerate more pain that others, but in general, this is a pretty painful condition. When it becomes completely fused, she may have a little more comfort, but her gait will likely be abnormal

You probably need to just see how she does, and if the time comes when she is no longer happy, you can make your decision.

Best to you and your horse

Androcles

Jan. 31, 2010, 03:13 PM

Androcles-I do not know exactly what the problem is with this mare, except she stepped on a nail and this is the result. She has abscesses under the shoe, but not anywhere else anymore. I am hoping to find a way to make her comfortable, or would just like an answer as to what to do with her.

When you say "this is the result" what is this that you are referring to? What problem are you trying to solve? The abscesses under the shoe? As I said that may not mean much of anything, just old abscesses that are coming out. When you say you want to make her comfortable, what discomfort is she showing?

I think the reason each hoof looks different is b/c the left has a bar shoe and she is not wearing down that toe. She is more weight bearing on the right and has worn that toe down. The reason she only has a left shoe on is b/c she would not stand on the left foot to put a shoe on the right. If I remember correctly the farrier could not trim it that well. This time around she will be shod on both fronts since she now can stand on the left.

The right foot looks fine. In fact it looks great. So, I would try to trim the left foot similar to the right foot. In fact I don't know why you are aiming to put two shoes on since the RF looks good as is. Maybe you should leave shoes off till she gets thru whatever rehabe is required.

The ring on her hoof that you are seeing did start with this injury up near the coronet. It has grown out that much since the injury. I associated it with more of a stress ring then anything.

In the xray it looks like a lot more than a 'ring'.

I am not looking for a quick fix that will only be temporary. I do not want her depending on bute or any other arthritis medicine just to live each day.
I would start with trying to get a better trim on these feet.

I have asked about osteomyelitis, b/c obviously that may be the case. When I ask the vet they say yea sure it could be that, but pretty much say tough luck. When I took her in for these films they tried to draw fluid out of the coffin bone area to see if it was still infected, and all they got was blood b/c of all the bony formation going on.

Maybe there is nothing there to draw out, and blood came out because blood vessels were pierced.
It looks like she could be in pain from bad ringbone, and severely unlbalanced feet (compared to each other) like wearing a high heeled shoe on one foot and a sneaker on the other.

Meadow36

Jan. 31, 2010, 05:12 PM

Derby -

For comfort - I'm not sure any of the joint supplements are going to work here; but of course it's worth a try. If there is an infection in the bone or bursa, you aren't really going to have much luck relieving that pain. You can try injecting the coffin joint and the one above it, if you haven't done so already. That might be your best bet from a comfort level.

Derby Lyn Farms

Jan. 31, 2010, 06:20 PM

The results are what is shown in the films. As I said before about her hooves, the reason they look the way they do is b/c of her circumstances, and I don't think I need to write it again. These films were taken right before she was due for a trim again, so her hooves have been trimmed since these films were taken. She is getting shod about every 5 weeks. I don't think she is off b/c of her hoof trims, I think the reason she is not sound is from what is going on inside.

These are not the only set of films I have. The other vet took some that were not digital and not as helpful, and I don't have computer access to those.

I just wanted to get some thoughts on what this was that was going on in her. Especially the little air pocket. Can't get a hold of the vets until Monday. The vets I am working with don't seem to have much experience with this type of injury, so just wanted some opinions from people that may have.

Your opinions and thoughts have been helpful. Would a blood test show an infection or osteomyelitis? If there is an infection that cannot be fought, and will only get worse with time, I don't want to experiment on this poor girl with a losing battle. I understand she will never be riding sound no matter what happens, but your thoughts have made me understand better how she will feel and the outcome. If she can live her life comfortably then I would like to make that happen. If not then other arrangements will be made.

Androcles

Jan. 31, 2010, 08:55 PM

The results are what is shown in the films. As I said before about her hooves, the reason they look the way they do is b/c of her circumstances, and I don't think I need to write it again. These films were taken right before she was due for a trim again, so her hooves have been trimmed since these films were taken. She is getting shod about every 5 weeks. I don't think she is off b/c of her hoof trims, I think the reason she is not sound is from what is going on inside.

Especially the little air pocket. Can't get a hold of the vets until Monday. Would a blood test show an infection or osteomyelitis?

The xrays show really bad ringbone and a very mismatched pair of feet. No feet should be this mismatched at the end of a cycle, they would have start out this way at the time of trimming/shoeing. The air pocket is not significant.
It is normal for the foot to try and abscess out necrotizing tissue, too large to be resorbed, that was damaged by invasion by a foreign object. And the process is slowed down by the foot being shod. It doesn't necessarily mean there's an infection and the symptoms you give don't point to one, so why the obsession with finding an infectioni? You could help this mare's comfort level with a good trim and addressing the ringbone.

Derby Lyn Farms

Jan. 31, 2010, 09:09 PM

Not really obsessing with the infection, but surgery to fuse the coffin bone is not an option if she does have one. You don't want to introduce foreign material to her body if there is an infection, and as far as I am concerned infection has not been completely ruled out yet.

ivy62

Feb. 2, 2010, 04:36 AM

Regarding the treatment if it is osteo..HBO is wonderful..and proven to work in humans. If they are up for it read about..Also, if you want to check blood flow how about a venogram? (sp)

lightlee

Feb. 6, 2010, 04:46 PM

Why don't you post your x-rays on the farrier forum and get their expert opinion? I can't imaging that stepping on a nail would cause all of the arthritic changes in the left foot. Perhaps these changes existed all long but were not detected until the nail incident. Your horse looks like is conformationally built very upright in the left foot, perhaps club footed, and has overun heels in the right.

Derby Lyn Farms

Feb. 6, 2010, 04:53 PM

Thomas_1

Feb. 6, 2010, 04:54 PM

I'd strongly recommend you post here to get professional evaluation and opinion:

http://www.horseshoes.com/forums/index.php?

foggybok

Feb. 6, 2010, 08:59 PM

Thank you Rodawn. Its helping me a ton for you to explain all of that. I will keep you updated.

I do believe this started with the nail, and is a result of the infection. There is obvious hard boney type swelling around the coronet area that was never there before. She is lame now, where she never was before. I, myself, am having a hard time understanding why a nail would do this.

Unfortunately, it's not all that uncommon. A simple nail can often progress to the damage you see. All the damage on the x-ray is secondary to the initial infection. Likely the nail punctured the bursa or coffin joint, leading to the infection. This same result came be seen after punctures in any joint.

I am sorry for you and your horse, I hope she can be comfortable

Androcles

Feb. 6, 2010, 11:34 PM

Unfortunately, I, too, am wondering if your horse could be in the throes of osteomyelitis which is just nasty to deal with in people, and even more so in horses.

Osteomyelitis - - - When a bone becomes infected, the soft, inner part (bone marrow) swells.

Unique to the entire mammalian kingdom, the equine coffin bone is the only bone to not consist of bone marrow on the inside, reflecting the unique functions it performs.

EqTrainer

Feb. 7, 2010, 07:46 PM

In a nutshell, this is why we all preach very aggressive treatment for horses who have stepped on something and driven it up into their foot. Not saying, OP, that you haven't done what you were told to do, obviously you have been.

Some questions for you. Have they done venograms? Has the foot been perfused on a short cycle? Has your horse been on IV antiobiotics for this?

The amount of pain that you say your horse is in makes me strongly suspect that she has an active infection. Curious about how she was treated, hence the questions.

Derby Lyn Farms

Feb. 10, 2010, 10:33 AM

EqT- none of that was done. I have learned the hard way that the vets in the area are not aggressive. I lost a foal 2 years ago to a vet (I no longer use) that was not aggressive enough.

It was like pulling teeth trying to get antibiotics for this mare. I try to trust my vet(s) opinions. I am willing to go to another vet, and I have had several recommendations all willing to help me, but don't have experience with this. I do not need another vet to take x-rays and point out the problem, I already know that. I need a vet that is going to be aggressive and actually do something for my mare.

My opinion, she was not treated correctly or aggressively. I did what I could and kept it clean and soaked. I have never dealt with something like this, but it doesn't take a vet to realize that if it keeps abscessing then it is still infected somewhere.

mickeydoodle

Feb. 10, 2010, 10:55 AM

As an orthopaedic surgeon (for humans) I would say the x-rays show the results of a septic (infected) joint, with cartilage distruction (that is what arthritis is by definition) and osteomyelitis. All that bone around the joint is the body's reaction to the infection- in the infection some bone dies, the body makes more bone (fluffy looking, imature bone as on the x-rays) and you get the ugly picture on the x-ray. The bone is not "chips" nor "fragments" it is reactive bone. In humans, the joint does not fuse, and the only way to treat the infection is to cut out all the bone that looks infected, (sometimes this may require an amputation) followed by 6-8 weeks of IV antibiotics. Antibiotics alone will not fix osteomeyelitis (except rarely in children) it requires surgical intervention. Even then, no one is considered completely cured, bacteria can hide out in the tiny spaces of bone, and suddenly flare up years later.

I agree that the circled area looks like gas on the x-ray. I would worry about a gas-producing bacteris, like some streptococci, or a facultative anaerobe. Rusty or not, the nail drove germs into the tissue, often these are nasty bugs.

Sorry, to a human doc's eyes it does look like a grim prognosis.

If I were in Michigan, I think I would take her to the vet school at Michigan State.

EqTrainer

Feb. 10, 2010, 07:35 PM

I am sorry I just realized you followed up on this.

I don't say this easily or randomly but if my horse had been mismanaged this grossly I'd be calling my lawyer.

At this point I agree w/Mickeydoodle and take her to MSU. They will be able to give you a definitive diagnosis and treatment and if nothing else that is something you will need to move forward w/an attorney.

I am very sorry to hear that your horse was not treated properly for this. I had a colt who had a septic coffin bone, it was treated very aggressively and he is 100% fine... my vet and the surgeon who gave the second opinion on the films were right on it and I know he is fine because of their diligence. My heart truly goes out to you.

Derby Lyn Farms

Feb. 10, 2010, 09:00 PM

I am at my wits end with these vets. I actually showed these x-rays to my orthopedic surgeon, thanks mickeydoodle! Sadly I have had more informative information with my orthopedic surgeon and you then my vets! Seems like you guys have dealt with this situation more often.

In my past experiences with MSU I have not been happy with them. Wish I could hear more positive stories from there.

Waiting for culture results and I will decide what to do then. I was told there is a good clinic in Ohio, but I am not sure how good a trailer ride would be for her. It would be atleast a few hours.

Just made another post about ethyl alcohol injections in the horse care forum. The one vet did suggest going in there and fusing the joint with a metal plate, but that won't do her any good if she has an infection already. My dad has osteomyelitis in his arm, and they actually removed part of his bone in his arm. About 3 years ago it came back but he is ok.

What type of test is done in horses to determine if it is osteomyelitis? Will the culture for the abscess tell that or is there another method?

Derby Lyn Farms

Feb. 10, 2010, 09:07 PM

Regarding calling a lawyer: I lost a colt that was septic due to mismanagement in 2008. I KNEW the colt was septic, the vet came out and insisted he had just been stepped on. Unfortunately I lost that colt after about $5000+ in vet bills. I did speak with a lawyer regarding that, and I do have a case. However, the cost would not be worth it for me to hire a lawyer. This was with a vet that I have used forever and that I trusted. I have not used them since then and never will again. The other vets I am working with now are completely different vets. If I sue all the vets in the area I am going to have to haul the horses 2 hours to get coggins tests;) I just don't believe it is worth the time and cost to hire a lawyer. I live and learn, but unfortunately at the cost of my horses. I am asking for opinions on vets in Michigan, so I can have a place to haul my horse in case of a serious medical emergency. They are so old school with everything around here and they just don't realize that I want to help my horse.

mickeydoodle

Feb. 10, 2010, 09:19 PM

I am so sorry for your situation. The culture cannot prove nor disprove osteomyelitis. The culture shows germs are there in the tissue, not thqt they are specifically in bone. The only proof is on a pathological slide- that is cut the bone out, section it, put it on a slide and look at it under the microscope. In osteo you will see dead bone, PMN's (white cells that show up to fight infection) chronic inflammatory cells (lymphocytes) etc. In humans one can do an MRI with fat-suppressed technique (a setting of the software and the magnet) to look for osteomyelitis. I have no idea if the vets have looked at this, written papers, etc.

However, all of the above aside, the x-rays strongly (very very very strongly) suggest osteomyelitis. If you do not like MSU, the nearest place for a University type opinion is Ohio State, or you could come to KY- Hagyard/Davidson or Rood/Riddle.

GatoGordo

Feb. 11, 2010, 01:06 AM

I'm very sorry you're going through this; it is so stressful when you are getting conflicting or inconclusive input and you just aren't making progress. I wish you and your mare the best of luck.

I'll be another voice in the crowd saying that you should ship her to a referral clinic and get a second opinion from a surgeon. If there is an infection in the bone, navicular bursa, tendon sheath, or coffin joint, you are going to get nowhere by treating her on the farm, and you and she are just going to keep suffering. You can ask your farm vet to block her foot before the trailer ride, but I think that in this case the temporary increase in pain for the trailer ride is thoroughly justified by getting an actual diagnosis and definitive treatment (or euthanasia if they give you a grave prognosis). Any attempt to fuse the joint is not going to fix the problem if there is infection.

As to the poster who mentioned surgery not being an option for the coffin bone -- yes, yes it is, and usually quite successfully, although the prognosis is probably more guarded when it has been going on for so long. :) For an infection of the palmar surface, the hoof is sterilely prepped, a window is opened in the sole with a hoof knife (after triangulating with radiographs the day of the surgery) and the bone scraped until the infection tissue has been debrided. Repeat rads are taken and more debridement done as necessary. The horse has to be bandaged or wear a hospital plate for several months until the sole grows back over, but this is a fairly common way of addressing an infection from stepping on a nail or a sequestrum from a solar margin fracture of the coffin bone. I know a vet who blocks the foot and does it standing for small, uncomplicated cases. Things get more complicated if the joint and/or bursa are involved, though.

Not a vet, just a vet med geek (and worked for equine vets).