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Antibiotics For An Abscess?

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  • Antibiotics For An Abscess?

    About one month ago a pony at the barn where I board came up lame. The owner dithered. The pony appeared to get better but then was lame again. There was noticeable heat in the left front foot, some heat in the other, and swelling in the lower left leg. Finally after about two weeks from the initial lameness she popped an abscess out of her coronet band. The owner soaked for a few days and the pony seemed to be better.

    This Monday morning I went to the barn to feed and the pony would not come in from the field. In fact she wouldn't move. When I tried to coax her she almost went down. She had a temp of 101.9 and her heart rate and breathing were elevated. The owner had the vet out who said she has another abscess brewing in the same place and just to soak her and wait it out.

    As of this morning it still has not popped and she's still dead lame. I've seen quite a few abscesses and know that they are extremely painful but this is by far the worst.

    My question is then when do you begin to suspect that the abscess is moving up into the leg. Do you ever administer antibiotics as a preventative? Do the swelling in the leg and the fever indicate complications or are they not that unusual?

    We asked the vet about antibiotics and she said it wasn't necessary. When we asked about possible infection in the leg, she said it was extremely rare and that she could x-ray the coffin bone but since she is going to be back Saturday to do teeth they could do it then if the pony hasn't improved.

    If it were my pony I think I would have to get a second opinion as I have heard of cases where abscesses were fatal. It just seemed to me that the vet was not taking an aggressive enough approach. Is it really that rare for the infection to move up into the leg?

  • #2
    An abcess nasty enough to cause a fever would have me calling for xrays immediately.
    Patience pays.

    Comment

    • Original Poster

      #3
      Originally posted by Melissa.Hare.Jones View Post
      An abcess nasty enough to cause a fever would have me calling for xrays immediately.
      That was my thought too but the vet said that the fever was probably just from the pain.

      Comment


      • #4
        Originally posted by EAY View Post
        That was my thought too but the vet said that the fever was probably just from the pain.
        I'd be looking for a new vet if mine told me that! The swelling in the leg could be from the horse not bearing weight on the leg because of the abcess but the swelling AND a fever could mean cellulitis and/or infection.

        We're actually dealing with a similar chronic abcess right now (minus the swelling and fever) with a boarder's horse. It's been going on for about two months and we've finally convinced the owner to radiograph the foot--the only abcess that I've seen take this long to resolve was one secondary to a coffin bone fracture.

        Good luck!
        Originally posted by EquineImagined
        My subconscious is a wretched insufferable beotch.

        Comment


        • #5
          I would definitely have x-rays taken of the suspected abcess[hoof]. If left untreated there is a chance of infecting the coffin bone and that can be a death sentence.I don't mean to be gloom and doom ,but if that infection is extensive and aggressive antibiotics may do nothing at this point. I would be callling the vet back in a.s.a.p.

          Comment


          • #6
            I'm one of the ones who's horse died as a result of a "simple abscess." If we'd been proactive and cultured the whole mess earlier and had her on appropriate antibiotics via an approriate delivery system we might have saved a really nice mare.

            If nothing else, if the horse is in enough pain that it's temp is that elevated, the poor creature needs to see a vet and be on some kind of pain management protocol. If it was mine, I'd start with banamine and work down to bute or equioxx.

            And yes, I'd be springing for the x-rays on Saturday.

            Comment

            • Original Poster

              #7
              Originally posted by atr View Post
              I'm one of the ones who's horse died as a result of a "simple abscess." If we'd been proactive and cultured the whole mess earlier and had her on appropriate antibiotics via an approriate delivery system we might have saved a really nice mare.

              If nothing else, if the horse is in enough pain that it's temp is that elevated, the poor creature needs to see a vet and be on some kind of pain management protocol. If it was mine, I'd start with banamine and work down to bute or equioxx.

              And yes, I'd be springing for the x-rays on Saturday.
              The vet's attitude seemed to be that a serious complication was so rare as to be next to impossible, whereas I as a lay person tend to expect the worst (and hope for the best).

              Again, the pony is not mine and I have no say in her care. I do use the same vet practice for shots and other regular care so I do have an interest in their competence, and in this case I disagreed with her approach and wondered whether I might be overreacting.

              I'm also worried about the pony. She's very sweet and it's terrible to see her suffer like this. She is on bute, and in fact the 101.9 temp was one hour after 1 gram.

              Comment


              • #8
                Abscesses that open at the coronet band are a bear to heal. It sounds like the original abscess walled over and a new one is brewing. The owners for certain need to keep soaking the hoof (or keep a soaking bandage on it) to get the abscess to open again. If they did not the first time, when it opens this time, they should flush the site twice daily for 3 or 4 days with a betadine "tea" and then once daily for probably another week so the dang thing heals from the inside out.

                Until this ones open up again and drains I have been taught NOT to give antibiotics. When antibiotics are given at this stage the abscess could subside only to reoccur once again- the infection needs to drain first. I would ask my vet about giving the horse bute for now the theory being the horse might then be comfortable enough to walk around and this could help speed up the process of getting the abscess to blow. Once it has blown open, then give antibiotics, especially since this one isn't healing on it's own.

                Good luck.

                Comment


                • #9
                  I agree with previous posts. I would get proactive, xrays, pain meds, soaking, etc. If there is a more serious situation going on, waiting around could be a disaster.
                  www.Somermistfarm.com
                  Quality Hunter Ponies

                  Comment


                  • #10
                    I just lost one to an infection that started as an abscess. He had one abscess that appeared to resolve, then he went lame again about a week or two later. He started out lame but without swelling, but eventually swelling and cellulitis developed. I took him in for surgery to clean out infection in the coffin bone, so it was a terrible shock to find that the infection had mostly bypassed the coffin bone and had attacked the navicular bone and tendon sheath instead. He couldn't be saved. It was heartbreaking to lose a beloved gelding to what started as "just" an abscess.

                    If the pony was mine, I'd definitely get radiographs. I would not start antibiotics unless I knew what I was dealing with.

                    Comment


                    • #11
                      Everyone is assuming another abscess. Since this is a pony and it's fall, I'd want x-rays to rule out laminitis/founder. Pronto. The longer the delay in providing support if it is the dreaded "F" word, the less likely a good outcome. I'd have this pony on the styrofoam protocol like yesterday. Can't hurt, might help.

                      Antibotics are rarely effective for hoof abscesses. Not enough of the drug gets to where it needs to be, even when the antibiotics are given IV multiple times per day. However, since the pony's temp is elevated antibiotics may be in order since there is the possibility of some systemic disease brewing (although it would be rare, IMO, to be caused by a hoof abscess).

                      No blood work done either?

                      Comment


                      • #12
                        My experience has been what SLW said.

                        You say the vet is coming out on Saturday and will do X-rays then. It is now Thursday. Do you think you will get the vet out sooner than Saturday at this point anyway?

                        I assume the owner is actually soaking and wrapping this time instead of just waiting for it to do something on it own?

                        Comment


                        • #13
                          Originally posted by EAY View Post
                          We asked the vet about antibiotics and she said it wasn't necessary. When we asked about possible infection in the leg, she said it was extremely rare and that she could x-ray the coffin bone but since she is going to be back Saturday to do teeth they could do it then if the pony hasn't improved.

                          If it were my pony I think I would have to get a second opinion as I have heard of cases where abscesses were fatal. It just seemed to me that the vet was not taking an aggressive enough approach. Is it really that rare for the infection to move up into the leg?
                          The vet is probably calculating (correctly or incorrectly) that the owner does not have the funds or the willingness to pursue aggressive treatment.

                          One of my friends is a first time horse owner and has a horse that has a really bad xray on one foot and is chronically unsound. Friend went to like, three different vets to get help and to see if the horse could be servicable for light work or if it needed to be retired, which was likely to end in euthanasia sooner rather than later because, well, you know.
                          Everyone's reaction was basically, "Well, it limps."

                          I come along and I am like, "Well, what about maintenance? Are joint supplements an option? Are joint injections an option? What about Legend or Adequan? What about a daily bute regimen? Or Equiox? Isoxsuprine? Last resort can we block it? Anything?"

                          None of the vets had mentioned ANY of these options to her.
                          Probably if they were looking at a valuable show horse with a resume at a fancy barn they sure as mcshizzle would have, but this is a pleasure horse in a low-key pleasure barn.

                          Finally after my friend relayed my ad nauseam pestering questions all, "Well my friend was wondering about...", the Great Lightbulb dawned in one of the vet's heads and she prescribed a gram of bute once a day.


                          Horse has been servicably sound for pleasure riding ever since, and Friend did not have to retire and eventually PTS her mare.



                          And none of the vets even MENTIONED bute.


                          OP, if it was my horse I would not accept that response from the vet for an answer and if I had to drive it four hours to Cornell to get an answer TODAY I would drive it to Cornell. It is clearly more than just a usual abscess and "well let's give the problem another 48 hours to take hold because I can't be bothered" is not an acceptable answer.

                          OH THERE I GO DEMANDING GOOD SERVICE AGAIN.

                          Is anyone else tired of the fact that you basically have to go to war all the time to eke competent service out of paid professionals these days? They can't just come up with, 'You know, let's hit this fast and hit it hard,' as part of doing their job, ON THEIR OWN?
                          The Noodlehttp://tiny.cc/NGKmT&http://tiny.cc/gioSA
                          Jinxyhttp://tiny.cc/PIC798&http://tiny.cc/jinx364
                          Boy Wonderhttp://tiny.cc/G9290
                          The Hana is nuts! NUTS!!http://tinyurl.com/SOCRAZY

                          Comment


                          • #14
                            I would be speaking to another vet immediately. My horse, before I owned her, almost died from an abscess. Similar to yours, dead lame and it also blew out part of her coronet band. She was able to be saved but my instructor was really contemplating putting her down there for a bit because my mare was so bad.
                            *Wendy* 4.17.73 - 12.20.05

                            Comment


                            • #15
                              Originally posted by meupatdoes View Post


                              OH THERE I GO DEMANDING GOOD SERVICE AGAIN.

                              Is anyone else tired of the fact that you basically have to go to war all the time to eke competent service out of paid professionals these days? They can't just come up with, 'You know, let's hit this fast and hit it hard,' as part of doing their job, ON THEIR OWN?

                              We don't know exactly what transpired between the vet and the owner of said pony.

                              I for one find I receive much better and more appreciative attention from a professional when I treat them with dignity and respect. Demanding or telling them how to do their job pretty much shuts most of them down. Have I ever been upset or second guessed them? Sure, who hasn't. But I ask again and outline my thought process. Why is always a good question.

                              Comment


                              • #16
                                Originally posted by Just Wondering View Post
                                We don't know exactly what transpired between the vet and the owner of said pony.

                                I for one find I receive much better and more appreciative attention from a professional when I treat them with dignity and respect. Demanding or telling them how to do their job pretty much shuts most of them down. Have I ever been upset or second guessed them? Sure, who hasn't. But I ask again and outline my thought process. Why is always a good question.
                                OP reports that she ASKED all the questions about antibiotics and xrays, the vet basically shrugged and said "meh," and the pony is still standing there crippled with a temp and despite her increasing concerns the situation has been tabled til Saturday.

                                OF COURSE be polite first.
                                OF COURSE be respectful.

                                But when you have been polite and respectful and you are still getting "Meh" for an answer, and the pony is still sitting there crippled and spiking a temp, and the little voice in your head is increasingly saying 'something ain't right,' at some point it is OK to feel entitled to demand better service. And if not from that vet then from some other vet.

                                Do you think the people who own Totilas would put up with this crap?
                                The Noodlehttp://tiny.cc/NGKmT&http://tiny.cc/gioSA
                                Jinxyhttp://tiny.cc/PIC798&http://tiny.cc/jinx364
                                Boy Wonderhttp://tiny.cc/G9290
                                The Hana is nuts! NUTS!!http://tinyurl.com/SOCRAZY

                                Comment


                                • #17
                                  Originally posted by meupatdoes View Post

                                  OF COURSE be polite first.
                                  OF COURSE be respectful.
                                  Does that include yelling or is that something you do special for us?


                                  You might note that the OP is not the owner of the pony so really it does not matter what the OP says or asks the vet to do. It is up the owner.

                                  Comment


                                  • #18
                                    OP, how competent is this vet? For some reason I don't get a pretty good vibe from your description regarding to this vet, especially the part she declared high temperature was caused by pain. I'm not a vet but I think a higher "heart rate", not higher "temperature", could be caused by pain. To me, a fever indicates some kind of infection, which will cause pain, not the other way around.

                                    I know my vet would have done a lot more.

                                    Her dismissive attitude is most alarming. When a horse has a fever, something needs to be done, even if that something means to wait it out, but that decision needs to be based on the level of elevation, some lab works, and careful calculation or rewards/risks.

                                    You aren't the owner so I don't know what you can do, but in your shoes, I might suggest to the owner to seek second opinion. If she was willing to soak hoof every day as you said, she is concerned about her horse, and your advice might just save her a lot of grief in the future.

                                    Comment


                                    • #19
                                      Originally posted by trubandloki View Post
                                      Does that include yelling or is that something you do special for us?


                                      You might note that the OP is not the owner of the pony so really it does not matter what the OP says or asks the vet to do. It is up the owner.
                                      Thank you. Those were my thoughts too.

                                      Unless OP was present for every vet visit or phone call, words in a conversation are rarely recounted word for word. We all know one word added or missed can change the entire meaning.

                                      Vet is looking at said pony on Saturday. Nuff said.

                                      Comment

                                      • Original Poster

                                        #20
                                        I was there for the vet appointment and did talk with the vet about the case, so it is not that I got this second-hand. And as I do sometimes use this vet, I need to know if she is competent. Another thing that concerned me was that the vet did not ask the owner to monitor the pony's temperature. I have three horses so I have had my share of abscesses and always find them stressful and want to learn what the signs are of complications, as I know they can be fatal.

                                        The owner is not one to spend a lot of extra money on her horses but she has had horses her whole life and has made the effort to soak the pony. She has also been concerned that something else might be going on but she's definitely not one to be shipping the pony to a clinic, and if there were a choice between surgery to save the pony or euthanasia she would choose the latter.

                                        The good news is that the second abscess has started to drain and the pony is feeling much better. She still has quite a bit of swelling in her leg and some heat so we're still worried that she's not out of the woods yet. The farrier was out today and looked at her and agreed that it was a particularly bad abscess and had the potential for complications.

                                        The vet will be out Saturday, so hopefully if she still has swelling and heat she will go ahead with the radiographs just to make sure nothing else is going on.

                                        Comment

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