Posted by Marta on October 24, 2003 at 15:40:54:
I'll try to be concise about this problem which has been going on since July.
Previously sound thoroughbred mare, attended week long eventing clinic in early July, doing advanced level jumps on hard ground. Shod with pads due to flattish feet. Threw left front shoe one day, and reshod by clinician, who was trained as farrier. Threw R front shoe next day and reshod again. went extremely well at clinic, with no suggestion of lameness.
Came home, had several days off, came out of stall looking 'stiff', gave a gram of bute in pm , and again in am, went sound. attended Pony Club 'b' test, jumping 3'6,lunged, some cross country, hard ground- very sound.
Two days later, came out of stall lame in L front. Oddly, no heat in feet, no digital pulses, all joints and tendons fine. Vet saw, and could find nothing. Blocked L front foot, went sound in L, but also lame in R front! Blocked R front, and went sound. A few days later, x-rays done to rule out navicular- no pathology found! examined with hoof testers- no reaction to pressure anywhere, frogs, sole, walls included. Large heel cracks present in bulbs of heels- working diagnosis, bruising of both front feet, plus or minus soft tissue infection in heels. Treated with soaking, cleaning heel cracks rigorously, one gram of bute/day and rest. Dramatically better on small bute dose, but not quite sound. Over time, this gradually resolved, and the horse went sound. Competed at the prelim level
( 3'6) at 3-day event, and went extremely well- no suspicion of lameness.
3 days after show, came up dramatically lame in L front foot, with heat, increased digital pulse. We felt that this was probably an abcess, possibly secondary to being close nailed by clinician at eventing clinic.Soaked foot, bandaged and poulticed with animalintex, and after three days blew huge absess with a lot of pus out the coronet band ( leaving 1 1/2 inch exit wound). Much sounder, but not quite sound. Treated by soaking wound, and maintaining cleanliness for 3 days, as horse gradually became sounder. We stopped treating the foot, as the wound appeared to be healing well, and the horse was almost sound. The horse then gradually became more lame- the vet saw, and felt that the exit wound had become secondarily infected, and prescribed 5 day course of oral anitibiotics. The horse gradually improved, to the point of trotting nearly sound on concrete, and being lame in the turns both directions, then became increasingly lame again. Vet saw, and prescribed higher dose of antibiotics, over a longer course. Again, the horse responded, becoming increasingly sound, but deteriorating after anitibiotics were stopped. Throughout, we continued to treat the foot by cleaning the heel cracks, which are almost resolved, soaking the foot in warm water and epsom salts 2x per day, and keeping it bandaged and clean. The horse then blew small abcess out bulb of heel, close to crack, and proceeded to become more sound. She was reshod, and the farrier found old bruising in the R front, which would fit with our theory about initially bruised feet. She also identified corns in both feet, R worse than L.
The horse has currently improved to the point where she is almost sound, and is being handwalked on the theory that this will increase the circulation in her feet, and aid in resolving the infection. She appears sound at the walk and trot when going straight, and somewhat lame in the turns both ways. Undersaddle though, you can feel that she is not quite sound on the concrete at the trot.
My questions:
-is there a possible diagnosis which we are overlooking, or does all this fit with an abcess due to shoeing?
-if the horse does not progress to being sound, what might the next steps be?
-Our farrier is a bit concerned that her heels are slightly contracted ( not very much), and is wondering if egg-bar shoes will help support her heels. ( long term, I am reluctant to have her event in egg bars, as she is short backed and long legged, and pulls shoes as it is.)
- any suggestions about how we could have handled this better?- thanks- Marta