Abscess leading to bone infection, surgery the next step, any experiences?

[Moonberry]

Hi All,

On my previous thread about a loading issue I received some invaluable help which I was very grateful for, and we were doing really well with lots of repetition. Until a mystery lameness struck..

Finally abscess erupted out of his heel bulb, but despite lots of hot tubbing / poulticing / all the usual just would not clear. Cue vet visit and the start of antibiotics, a sample taken to grow a culture and an x ray which confirmed a small amount of infection had got into the back of the pedal bone. Vet was happy to continue with antibiotics, however another 2 weeks in, no real improvement it is pretty clear they are not having much, if any, effect. Horse is a bit lame in walk, sound in flat out gallop (apparently we can still gallop around the field), and absolutely hopping in trot, it is now pretty clear he needs to go in for the surgery to remove the infected bone. This is booked for Wednesday.

Has anyone got first hand experience of this sort of surgery? I'm terrifying myself with the risks of the G.A, the risk of coming round, the box rest /rehab, everything really. Feels worse that I have made this decision for my sons horse, although it's clear there isn't really an alternative and I can't continue to leave him in pain without taking decisive action.

Not even entirely sure the purpose of this post, other than needing to write it all down somewhere, I am not normally an anxious soul but this is really bothering me. even if everyone could just keep their fingers crossed / send vibes for a good outcome that would be a start!

 

[meleeka]

Mine had antibiotics which cleared it. I can’t remember the name but it wasn’t licensed for use in horses and is one that’s used where others have failed. She wasn’t a candidate for surgery so that was the only option.

I think I’d be guided by your vet. Doing nothing isn’t an option, so it doesn’t sound like you have much choice.

 

[horseman1985]

I have not met with such situations, so, unfortunately, I cannot help with advice. Any surgery is always stressful. I just want to wish you an easy operation and a quick subsequent rehabilitation! Please write us how it will go. God bless you

 

[Starzaan]

I have rehabbed quite a few horses from this surgery and it’s a fairly easy process albeit generally slow. The biggest things to remember for rehab are a lovely DEEP bed, keeping everything as dry and clean as possible, and get the feeding right - all these are vital. If you can, try to learn some lymphatic drainage massage for the legs from your veterinary physio - that will make a huge difference.
I have horses in for rehab following GA about once a week. It isn’t something to be frightened of - the same as with humans, there’s always a risk but veterinary hospitals are so well equipped to deal with horses coming round etc that there’s no need to worry.

My inbox is always open if you’d like to chat further about it. ?

 

[ycbm]

Yes I've ridden a mare which had it done with no complications.

Everything crossed for you both.
.

 

[Moonberry]

I have rehabbed quite a few horses from this surgery and it’s a fairly easy process albeit generally slow. The biggest things to remember for rehab are a lovely DEEP bed, keeping everything as dry and clean as possible, and get the feeding right - all these are vital. If you can, try to learn some lymphatic drainage massage for the legs from your veterinary physio - that will make a huge difference.
I have horses in for rehab following GA about once a week. It isn’t something to be frightened of - the same as with humans, there’s always a risk but veterinary hospitals are so well equipped to deal with horses coming round etc that there’s no need to worry.

My inbox is always open if you’d like to chat further about it. ?

Thank you for taking the time to reply in such detail, definitely helped put my mind at rest a bit. He’s horrible at being stabled and stresses badly but we’ll get there. I may turn the field shelter into a stable with slip rails on the front so he has a better view but we’ll see how he gets on. I’ll certainly look into the massage, that’s really interesting.

 

[Moonberry]

Yes I've ridden a mare which had it done with no complications.

Everything crossed for you both.
.

Thank you. Reassuring to hear some success stories.

 

[Quigleyandme]

Good luck. I hope it all goes really well for you and your horse. X

 

[Elf On A Shelf]

We have 2 that had this on the yard. Whilst both returned to racing (one actually only has half a tendon in his foot as the infection attacked that too.) Neither are 100% sound. They would not pass a trot up for any other equine discipline.

 

[Bonnie Allie]

We have been through hell and thousands for this exact surgery. I have a few lessons learned that might help you.

Pain needs to be managed really effectively. Your horse will be in significant pain post op for quite some time. Ours was not weight bearing on the surgery hoof even though she was on pain meds and she developed mechanical laminitis in all 4 feet and we were within an hour of pts.

In our box in addition to effective pain meds we had rubber matting, soft wood pellets and shavings to keep her comfortable.

The pain meds ripped her gut apart and she got a severely inflammed gut, was not getting enough nutrition as a result which impeded her healing.

Vet #1 put a hospital plate on the surgery hoof which was a massive PIA to take off daily and clean wound. Vet #2 removed it post the laminitis episode and we went to quality bandaging instead.

The vet who did the surgery was a great surgeon but useless thereafter.

If I had my time again, I would take the horse to a vet rehab centre post surgery get her pain, nutrition, gut managed to get her through healing faster.

We are 10 months down the track and whilst the surgery has healed, her feet are a mess and her immune system is still strengthening.

Make sure your vet practice can assist post surgery or find someone who can.

My biggest learning is if you are concerned about the way the horse is healing or you think the pain is not being managed well enough get another vet. Don’t wait like I did believing Vet #1 knew what he was doing.

Oh and soft ride boots were a godsend. I wouldn’t dick around again with heart bar shoes.

 

[Hormonal Filly]

No advice on the actual surgery but my gelding has GA and coped much better than I’d of ever expected.

Good luck for the surgery x ?

 

[Fieldlife]

We have 2 that had this on the yard. Whilst both returned to racing (one actually only has half a tendon in his foot as the infection attacked that too.) Neither are 100% sound. They would not pass a trot up for any other equine discipline.

I didn’t realise race horses don’t need to be fully sound. Doesn’t not being fully sound make them slower?

 

[Elf On A Shelf]

I didn’t realise race horses don’t need to be fully sound. Doesn’t not being fully sound make them slower?

It's a mechanical lameness in the end rather than a pain related one. The vets trot them up and video them at the start of the season and then every 3rd race they get trotted up again to make sure they get no worse. It didn't stop either horse winning ans being placed in their races.

 

[Moonberry]

Good luck. I hope it all goes really well for you and your horse. X

Thank you x

 

[Moonberry]

We have been through hell and thousands for this exact surgery. I have a few lessons learned that might help you.

Pain needs to be managed really effectively. Your horse will be in significant pain post op for quite some time. Ours was not weight bearing on the surgery hoof even though she was on pain meds and she developed mechanical laminitis in all 4 feet and we were within an hour of pts.

In our box in addition to effective pain meds we had rubber matting, soft wood pellets and shavings to keep her comfortable.

The pain meds ripped her gut apart and she got a severely inflammed gut, was not getting enough nutrition as a result which impeded her healing.

Vet #1 put a hospital plate on the surgery hoof which was a massive PIA to take off daily and clean wound. Vet #2 removed it post the laminitis episode and we went to quality bandaging instead.

The vet who did the surgery was a great surgeon but useless thereafter.

If I had my time again, I would take the horse to a vet rehab centre post surgery get her pain, nutrition, gut managed to get her through healing faster.

We are 10 months down the track and whilst the surgery has healed, her feet are a mess and her immune system is still strengthening.

Make sure your vet practice can assist post surgery or find someone who can.

My biggest learning is if you are concerned about the way the horse is healing or you think the pain is not being managed well enough get another vet. Don’t wait like I did believing Vet #1 knew what he was doing.

Oh and soft ride boots were a godsend. I wouldn’t dick around again with heart bar shoes.

Sorry to hear you have had such a tough time of it, and thank you for your very candid reply. It’s definitely helpful to understand the bad as well as the good. Hope your horse is now well x

 

[Moonberry]

It's a mechanical lameness in the end rather than a pain related one. The vets trot them up and video them at the start of the season and then every 3rd race they get trotted up again to make sure they get no worse. It didn't stop either horse winning ans being placed in their races.

This is really interesting! Definitely learn something every day!

 

[Northern Hare]

Good luck MB, I hope all goes well with the surgery, and that your horse recovers well. ??

 

[Spottyappy]

I can’t help with that particular surgery, but from the GA pov, we had a mare admitted for an op (at the RVC) under a GA a couple of weeks ago. We actually collected her home the next day! Which was abit daunting as I wasn’t expecting her out so soon, but she was fine. She was on pain relief for a week.
I think GA has come on a long way in recent times- obviously, it is still a risk, but it seems less than a few years ago, thankfully for us all.

 

[foxy1]

My horse had this surgery a few years ago now. The most difficult part was the daily bandage changes once he came home ( he was in vet for 2 days) which had to be done to keep the foot meticulously clean.
He didn't have a hospital plate or bar shoe, but I think this will depend on which bits they have to remove.
The bandage was 3x layers of vet wrap, duct tape and gamgee as he was very good at wearing through the top layer!
He did fully recover from the foot surgery, although had a whole host of other unrelated health issues that got him in the end

 

[Starzaan]

Another thing to add is learning how to do the best kind of foot bandages. I’m very happy to talk you through the process - after so many years of rehab work I’m very proud of my ability to dress or poultice a foot and have no horses ever wear through or pull off their dressings ?

 

[CPayne]

Another one here. Had surgery in June. He stayed at the hospital for nearly a week. Hospital plate for the first 2 months changing dressing every two days initially, then twice a week. For the first week to ten days he needed to be sedated to change the dressing, he turned in to a fire breathing dragon. I think the pain and being at the hospital were very stressful for him, he’s an unbacked baby. It still took two people to change the dressing after that though with the bolts, spanner, iodine swabs etc. Luckily it was dry when we brought him home so he was allowed a small outdoor pen next to my 29 year old. We used Woof poultice boots when he was in the pen. I cut some rubber matting to go over the hospital plate/bolts and vet wrapped that over before putting on the Woof boot. He did rip a few boots, but he was much happier being able to go out. We are now about to do hopefully the final shoeing with pad as the hole has nearly grown down and forward to the wall. I have a full photo diary so if you would like some pictures PM me. I found the size of the hole after surgery quite shocking and obviously initially you can see the pedal bone where they have scraped it. Vet happy that he can be backed once out of the shoe and doesn’t expect any issues from it. He may however find other ways to never be a ridden horse!

 

[Moonberry]

My horse had this surgery a few years ago now. The most difficult part was the daily bandage changes once he came home ( he was in vet for 2 days) which had to be done to keep the foot meticulously clean.
He didn't have a hospital plate or bar shoe, but I think this will depend on which bits they have to remove.
The bandage was 3x layers of vet wrap, duct tape and gamgee as he was very good at wearing through the top layer!
He did fully recover from the foot surgery, although had a whole host of other unrelated health issues that got him in the end

Thank you for the info. Sorry to hear about the bother health issues ?

 

[Moonberry]

Another thing to add is learning how to do the best kind of foot bandages. I’m very happy to talk you through the process - after so many years of rehab work I’m very proud of my ability to dress or poultice a foot and have no horses ever wear through or pull off their dressings ?

That’s very kind of you and I would really appreciate it. I put by bandaging as only marginally better than average ?

 

[Moonberry]

Another one here. Had surgery in June. He stayed at the hospital for nearly a week. Hospital plate for the first 2 months changing dressing every two days initially, then twice a week. For the first week to ten days he needed to be sedated to change the dressing, he turned in to a fire breathing dragon. I think the pain and being at the hospital were very stressful for him, he’s an unbacked baby. It still took two people to change the dressing after that though with the bolts, spanner, iodine swabs etc. Luckily it was dry when we brought him home so he was allowed a small outdoor pen next to my 29 year old. We used Woof poultice boots when he was in the pen. I cut some rubber matting to go over the hospital plate/bolts and vet wrapped that over before putting on the Woof boot. He did rip a few boots, but he was much happier being able to go out. We are now about to do hopefully the final shoeing with pad as the hole has nearly grown down and forward to the wall. I have a full photo diary so if you would like some pictures PM me. I found the size of the hole after surgery quite shocking and obviously initially you can see the pedal bone where they have scraped it. Vet happy that he can be backed once out of the shoe and doesn’t expect any issues from it. He may however find other ways to never be a ridden horse!

Bless your poor boy, so young as well. I’m quite worried about the stress for him. He loves out in our little herd 24/7 so this is going to be a real shock to him! Thanks for such a detailed account. I’ve been doing what you shouldn’t and Googling and the size of the hole after the surgery looks terrifying!

 

[Orangehorse]

I hope all goes well. You definitely need to have a good talk to the vet about the prognosis and what the nursing requirements will be.

 

[Season’s Bleatings]

Not this kind of thing but my big horse (17hh ISH) had a GA in June for a tendon op, I was more scared of the GA than anything else. But he came through it just fine. Best of luck to you & your horse

 

[PinkvSantaboots]

My mare had a pedal bone scrape in 2013 they actually did it standing up under sedation in her stable, I watched the whole procedure it's not for the faint hearted they drilled a hole through the sole then remove the infected bone but it took about 25 minutes.

Before the vet started he padded her other front foot as a prevention for laminitis she was pretty uncomfortable that night but was well dosed up on pain killer and was weight bearing on it by the next day, she did have a heart bar shoe and surgical plate fitted on it so I could flush it twice a day myself with iodine.

She had the operation end of December and was out in the field by March the hole does shrink fairly quickly really it is amazing how it just closes up and her recovery was fine although she hated box rest and chewed a huge hole in her stable door.

 

[Moonberry]

Well, a short update, he’s due to go in tomorrow for the surgery but I’ve had a call from the vet who would be operating to say she thinks he needs to have an mri to determine prognosis before surgery as she believes that the infection is likely to have spread to the soft tissue / surrounding structures. Her prognosis was very very bleak, so many many tears here today, and now feels like we are just counting down time to the worst for our beautiful boy ?

 

[Spottyappy]

So sorry for your update, and hope the MRI gives better news once it is done,

 

[Bonnie Allie]

Well, a short update, he’s due to go in tomorrow for the surgery but I’ve had a call from the vet who would be operating to say she thinks he needs to have an mri to determine prognosis before surgery as she believes that the infection is likely to have spread to the soft tissue / surrounding structures. Her prognosis was very very bleak, so many many tears here today, and now feels like we are just counting down time to the worst for our beautiful boy ?

im so sorry to hear this, however it sounds like your equine practice is exceptional and preparing for all possible outcomes. In addition if they are doing MRI first they can be truly honest with you about some of the challenges in recovery if you go ahead with the surgery.

I wish my first vet practice had been more thorough as ours had soft tissue damage as well which is where we had the challenges in pain management.

A bright note on our 10 month ordeal, our patient was feeling so good yesterday she jumped out of her strip grazing. Only 90cm but she gave it a 3 stride run up, cleared it by quite a margin and then set off down the laneway at a very brisk trot. Our dear old girl is 23 and I couldn’t be happier knowing she is well enough to jump out.