Hoof Abscess Goes South

My 12-year-old Thoroughbred gelding, Sterling Story, suffered four months with what my vet and I thought was a hoof abscess. He was retired from the track as a 6-year-old, and I have ridden him in dressage and as a trail horse since. He is that one-in-a-million people-loving horse that has bonded with me as my true friend. I ride him on the average of five days a week to keep him fit and focused.

It was with great dismay that I noticed lameness in his right rear leg in August 2004. I had come out to ride early and found him in his paddock not wanting to move. When I did coax him in, he was almost hopping on three legs. I called my veterinarian, R. N. Schwyzer, DVM, who came right away. He examined Story and found no fracture, but an increased digital pulse (on the back of the pastern). He used hoof testers to locate a sole abscess, then cleaned the foot and used a hoof knife to look for any area that appeared to be draining, but could not find the suspected pocket of pus. The treatment was Bute and soaking his foot for 20 minutes three times a day in a warm Epsom salt solution. I kept an Easyboot on between soakings to try to keep things as clean as possible. He was better the next day from the Bute, but still too lame to ride. Three days later, my vet returned and found a thin dark line on the sole near the toe and pared out a small pocket of pus. He bandaged the foot with a poultice for three days and expected that I would be able to ride him in three to five days.

About a week later, after we had done some easy walking in the arena under saddle, an area on the coronet band "blew out" and drained. More foot soaking was in order, and I again adjusted his feed to suit his lessened exercise routine.

After each soaking, I applied the prescribed poultice and the Easyboot. About two weeks after the first abscess broke through the coronet, a second one broke in the same foot. For the next few months, Story would intermittently get sore enough for me to call my vet. He would usually find and pare out a small pus pocket, and we would soak some more. We thought each episode would be the last.

In December, my vet decided to X ray Story's foot. What showed up was evidence of a gas line extending from the sole near the toe up to the coronet. The tip of the coffin bone showed deterioration and remodeling. The fuzzy bone border and the pitting of the bone were classic signs of osteomyelitis, a bacterial bone infection. The gas line was produced by the bacterial waste products.

We were referred to our nearby equine hospital for surgical debridement of the infected bone. The surgeon gave me the option of doing the procedure under general anesthesia with Story on the surgical table, or with Story standing and tranquilized. Because of the financial difference, the standing procedure was more appealing to me. As Story was prepped for surgery, the farrier prepared a hospital plate to protect the foot and allow the area to be treated post-op.

The surgeon placed Story's foot on a stand and pared out the toe area of the sole to the level of the bone. She then took a culture of the infected bone so an appropriate antibiotic would be selected, and she removed any bony area that was soft. She checked the coffin bone with X rays to be sure the debridement was complete. The wound was packed with Betadine-soaked gauze and the farrier applied the hospital plate. Story was hospitalized for the next two days so that pain and antibiotic therapy could be managed. We were sent home with two weeks of antibiotics and instructions to change the dressing daily.

Story was walking comfortably as soon as we got home, and in a matter of a week was quite sound. The hospital plate was on for four weeks as the sole area dried and filled in with granulation tissue. This keratinized into normal, healthy sole. My farrier removed the hospital plate at four weeks post-op and set regular shoes. We were out on an easy ride with our friends that afternoon!

I have learned plenty about foot care from this long experience. We are now back to full fitness and getting ready for our spring schooling shows, healthy from head to sole.

About the Author

Kimberly Peterson, DVM

Kimberly Peterson, DVM, is an AAEP member and assistant professor in the Department of Veterinary Technology at Morehead State University in Morehead, Ky. Her husband, Eric, is an equine practitioner, and their family lives in Lexington.

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