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  1. #1
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    Apr. 15, 2011
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    Default Need Advice on Deep Hoof Bruise

    Hi everyone, I am relatively new here. I have a 8yo OTTB gelding that I adopted right off the backstretch one year ago. I decided after not riding for nearly 20 years to find a retiring racer that really needed me, and I did just that. We are a great team and competing in hunt seat equitation under saddle and over fences.

    In mid October my boy grabbed his shoe while we were working indoors and he nearly fell. Came up lame instantly on LF. He has remained on and off lame only at trot now for six weeks. Vet and farrier are working together and have done many diagnostics to rule out coffin bone issues, etc. Diagnosis entire time has been bruise/abscess. However, heat has gone way down and abscess never popped. So we stopped treating as abscess and are poulticing and hand walking.

    FINALLY, two nights ago my farrier spotted a "red dot" near where be grabbed shoe and opened it. Blood came out and a red bloody hole appeared. Farrier said "we've found the deep bruise". He said he thinks there is more there but wants it to emerge on its own. It took six weeks for this bruise to come to the sole. Vet and farrier are saying to clean with iodine twice daily, wrap with animalintex to protect foot and keep clean. Hand walk only for circulaiton (no running around in field) and bute for 4 days. Then we re-evaluate.

    My questions are:

    -- Now that we can actually see the bruise, what happens next? Does it just shed off on its own? today the hole looked the color of the rest of his sole, unlike when we found it.
    -- Does finding it mean that "the end is near" as far as him being "off"?
    -- Since we have found and exposed the bruise, does that mean it's not going to abscess?
    -- Anything else I should be doing to support his recovery?

    I appreciate any advice. This has been a long process and although I am relieved we have finally found the culprit, and am not sure what to expect now.

    I would attach a photo but it seems we cannot do that here.

    Thank you!



  2. #2
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    Feb. 21, 2009
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    Default

    If you upgrade your membership you can upload pictures (it costs money) However, I would suspect more likely the bruise is not even the issue but rather the horse injured a ligament inside the foot when he wrenched on the shoe. Impar and collateral ligament injuries are VERY hard to accurately diagnose without an MRI. And an impar ligament would block out with the same diagnostic heel block that a heel bruise would.

    In other words definitively ruling out a coffin joint injury or impar ligament without MRI is hard if not impossible.
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  3. #3
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    Apr. 15, 2011
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    I didnt say it was a heel bruise. Its near the front of his hoof, near the toe. Really large red bloody bruise from hitting himself.

    My understanding is that deep bruises are well known to cause lameness until they eventually grow out.



  4. #4
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    Jun. 17, 2001
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    Add one of the better hoof supplements with biotin and other ingredients known to speed growth-it needs to just take care of itself. As it grows out it should push out the damaged tissue. Just like a bruise on your fingernail. The faster the hoof grows out, the closer you will be to him returning to soundness. But it will still be awhile yet.

    6 weeks is not that long, I fought this for 3 months with another 8 weeks for it to completely grow out on one I had just bought (mid 5 figures). $$$ in diagnostics. Fortunately, never had another problem once that cleared, still have the horse 10+ years later.

    I would follow the treatment advice of the vet and farrier who actually know and have been working with the horse and have seen the diagnostics you have done.

    They seem to benefit from excercise once they can get around without too much trouble/pain. The hoof flexes with movement and that seems to help it grow as well as work the crap out of it. Just keep it soft and clean-wrap to keep dirt out if you have to. But if you hand walk in your arena or on clean, dry ground or grass and stay out of the mud, it is OK to leave it open as long as you check and clean when you are done walking. Needs to be in a clean dry stall as well or wrapped.

    Patience my dear, patience. He should be rearing to go by early spring (figuratively speaking).
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.



  5. #5
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    Apr. 15, 2011
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    Default

    Thanks, Findeight. Once the actual bruise was visible, how long until your guy pushed the damaged tissue out?

    Also, can you recommend a hoof supplement to speed growth?

    I am hand walking him in a soft indoor arena as much as possible. SOmetimes I just let him walk around on his own with his bandage on. I am using a diaper over a foot with vetwrap. It gives him extra cushion and stays clean and dry.

    When on his own, he rolls and sometimes canters around, completely sound. Today he trotted and he was SOUND, however, he is on bute so that is likely masking it.

    Just going to keep wrapping and hand walking as it grows out.



  6. #6
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    Well Farriers Formula is probably the standard but pricey, proprietary and marketed only by the manufacturer (or was then anyway). I used that one.

    Later was able to get something called "Shoers Friend" from Smart Pak, must be out there elsewhere, pretty darn cheap and very effective, has most of the same stuff as the FF. Good growth rate and very healthy foot.

    JMO but feel that diet and supplement (if and as needed) to grow a healthy foot on a healthy horse is the best way to avoid abcesses and excessive bruising or speed healing when they do occur. That has been the case with mine, all of whom improved drastically in both bruising and holding shoes...but we are talking the better part of a year to grow that good hoof completely.

    How long did mine take (girl BTW)? Well she was pretty much off with it for about 60 days until it started to show on the sole then on and off for another 4 weeks or so. Never had any drainage from that one (we had a few too many abcesses elsewhere that quickly drained and cleared the first year I had her).

    So about 3 months with at least some soreness. I rode her sometimes during the later part of that 3 month period, just in the arena. Vet suggested it, she was sound to walk so we walked for about 30-45 minutes maybe 3 times a week. It really helped keep her moving and that thing geeting good circulation to pump it out. Kept her happier too.

    We put the shoes back on after that first 90 days when she started having more good days then bad and she went back to light work and turnout. Back to full work at about the 5 month point.

    I could still see traces of that dark spot 8 months later...but she really never had any discomfort or tenderness after the shoes went back on. No idea why she came with crappy feet in that price range...and do NOT believe that TBS have bad feet as a breed trait. No excuse.

    Horse had very few problems after the first year, even when she stepped on the nails from an occasional pulled shoe-if it did bruise/abcess it cleared in a week or less. Once we grew a good foot.
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.



  7. #7
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    Jan. 14, 2005
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    Aiken SC / Fay NC
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    Had the same situation as the OP.

    Used www.equicast.us as an alternative to a boot, and a biotin supplement as one of the posters above suggested. Took about a month, then he wasn't off at all.

    Then the barn called me one day saying he was dead lame. Took off cast, and sure enough, abscess had finally "popped". Cleaned, disinfected, recasted, and was good to go in several days.
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  8. #8
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    I didnt say it was a heel bruise. Its near the front of his hoof, near the toe. Really large red bloody bruise from hitting himself.
    OK sorry I missed that it was a hit at the toe. Most shoe pulling and near pullibng is a from a grab hit at the heel.
    My understanding is that deep bruises are well known to cause lameness until they eventually grow out.
    The resulting bloody STAIN (the hematoma)grows out. In a sole that is usually four months or so. However generally by the time the stain from the bruise is grown out far enough to see, (a few weeks to a month ) the pain from even a deep bruise is resolved unless there are complicating secondary problems such as an abcess.
    You can just shoe and pad him and if he is then totally sound then there ya go.... it is just a stubborn bruise. And the pad can be taken off the nest shoeing .
    But if a pad does not fix it ,because has been quite a long while for a bruise to heal internally I might be re-checking for other issues that resulted from the force of the shoe grab and stumble. (as I mentioned before)
    You said they ruled out coffin bone issues so I am assuming there were Xrays to rule out:
    1) a fracture of the extensor process of the coffin bone,
    2)or a small chip in the coffin joint somewhere,
    3)or a solar margin fracture on the edge of the bone under were the bruise was?
    Sometimes a small fracture will not even show up on an X ray at the very first. But as it starts to set with a fibrous union a few weeks later it WILL show up like a little gap in the bone that was not there the forst Xray.
    A bruise as extensive as this sounds like could have a little tiny solar margin fracture underneath.
    As well the same thing aplies to collateral ligament injuries and impar ligament injuries as I said before, because of the forces of the stumble and they cannot be visualized without MRI.

    So my approach would be first shoe with a pad and medicated sole packing underneath (magic cushion) and see if the lameness goes away completely. With the pad it if it persists I would be asking for more diagnostics .
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  9. #9
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    Jun. 10, 2001
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    i agree with patty. this sounds like a soft tissue injury not a hoof bruise. those can be difficult to diagnose due to location.
    http://www.eponashoe.com/
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  10. #10
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    With my mare, vet and farrier preferred to pull the shoes until she was back to some degree of soundness-we were having all sorts of crappy foot issues, not just the bruise. Getting tired of following her picking up shoes with not much left to nail to. Blocks and pictures showed no structural problems...niether did the almost 900 PPE (in 1999 dollars) from 8 weeks earlier.

    But she got pads in front with medication on the affected foot pad when the shoes went back on. OP might want to discuss that option with her farrier...might make that horse alot more comfortable and useable in a shorter period of time. Beats the diaper booties if deemed appropriate.

    But I don't think 6 weeks if diagnostics have been done and were negative and a good farrier is involved indicates it is time to assume the worst. Especially if that hoof is not as healthy as it could be and not growing too much-not that unusual when they come from less then ideal backgrounds. Long as there is a continuing, gradual improvement she should be OK. If not, agree something else is going on.
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.



  11. #11
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    Apr. 15, 2011
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    Default

    Patty, the diagnostic xrays were taken at one week, and again at 3.5 weeks, with no change. Does that help?



  12. #12
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    There is not, and has never been, any swelling or heat anywhere above the hoof. The only lameness has been very slight at the trot. Undetectable at the walk. The heat in hoof is 1/5, and sometimes nothing.



  13. #13
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    Jul. 18, 2009
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    My mare was off for weeks, then months with severe bruising to her hoof/sole. When months started to roll around, I pushed for further diagnosis.

    It turns out she had injured her DDFT WAY deep down in her foot, very difficult to see with ultrasound. Weeks upon weeks and still lame for a bruise unfortunately meant that while there was bruising, that was not my main issue.

    This happened in December 2010 for me. It took until April 2011 for the vet to find the tendon injury. She was still lame as of June 2011, so I pulled her shoes, turned her out, and bred her. Last I heard, she was looking sound and happy. I'm hoping to find a sound mare in June 2012.



  14. #14
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    When my farrier exposed the bruise and called in the vet to see it, she said she could not imagine a horse having a bruise like that and not being "off". The farrier agreed. Given all that, and that I have diligently done all prescribed and even more, I am not going to jump to the worst case scenario. I'm going to let it grow out, continue to hand walk, and see where we are.

    Agree with the pads and magic cushion. However, both vet and farrier said bruise to "open and raw and bleeding" to close up in a pad right now. They prefer to let more growth occur, then add pads for ongoing protection.

    About three weeks ago he went suddenly from "off" to dead lame, and a very tiny slit opened in the coronary band, exactly above where this bruise is. Then he was 98% better. But the last 2% still there. We think he blew a teeny tiny abscess but not enough to clear out the bruise.



  15. #15
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    Patty, the diagnostic xrays were taken at one week, and again at 3.5 weeks, with no change. Does that help?
    Yes definitely because a small solar margin or extensor process fracture would have been visible by the second set.

    I would go ther padded shoe route and see what happens, then IF it persists consider that it is likely a soft tissue (ligament) injury.
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  16. #16
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    dead lame, and a very tiny slit opened in the coronary band, exactly above where this bruise is.
    AHA! A sole abscess that tracked up underneath the hoof wall. Sometimes a small slit is all you will see when they open.
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  17. #17
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    Patty, do you think the bloody bruisy area growing out now is the rest of the abscess that didn't really "abscess"? We expected him to get better after the tiny slit opened and he improved. But he remained a tiny bit off at trot. Don't you think large bloody bruise in toe can keep him off?

    Now that it's coming through sole, do we just wait for it to slough off?



  18. #18
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    Not Patty but it seems reasonable that what you are seeing is the bruised tissue itself-not all of it goes to an abcess, in my case none of it did.

    It will get trimmed off as it grows out, usually does not slough off by itself. Alot of what you see is no longer painful, once it grows past a certain point it just does not bother them any more even if you can see it. Sounds like yours is getting to that point but he is still going to be tender on it some days. Like I said, patience.

    Maybe time for shoes and pads soon too. if he was always shod and has been without for 6 weeks and only on soft ground, he may still be a tenderfoot.
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.



  19. #19
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    Quote Originally Posted by SaratogaTB View Post
    I didnt say it was a heel bruise. Its near the front of his hoof, near the toe. Really large red bloody bruise from hitting himself.

    My understanding is that deep bruises are well known to cause lameness until they eventually grow out.
    My horse stepped on the clip of his shoe he'd just pulled off with a hind, and the vet was out after 6 weeks of lameness when I was getting worried. He said he expected it to be about 2 more weeks, but if he wasn't ok then with pads we'd do more diagnostics to see if we could find another problems. At 8 weeks he was pretty much sound, and we put thick wedge pads on him since he had also eaten up a lot of his heel. He was 100% sound at that point with the pads, and next shoeing we went down to more traditional pads, then we waited until rainy season was over to remove those so his hooves would harden up in the dryer footing. My vet said especially with the TBs with sensitive soles, 8 weeks nearly to the day is the standard for coming back in most cases.

    Given the vet has seen your horse I wouldn't be jumping to conclusions either, because it really just sounds like a bruise and abscess trying to heal.
    My horse is a dressage diva so I don't have to be.

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  20. #20
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    The hole near toe in sole that the farrier exposed and was bloody has now been treated for 4 days. It's completely dry and normal looking, not sensitive and hard like the rest of sole. Farrier said he thinks there is more bruising yet to come out. How does he know that?

    Also, he is on bute which ended last night. I've been letting him loose in soft indoor, and yesterday he trotted on his own and was completely sound.

    I know that bute will mask soundness, but how much? Is it a good sign if bute can make sign? Meaning, if it was something more serious involved, bute likely wouldn't mask, right?



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