Abscess :-(

soloequestrian

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20 year old horse, have had him for 13 years, barefoot the whole time, feet like rocks. He was uncomfortable last Sunday (26th) so had the week off. I rode him in the soft school Friday and he seemed fine so hacked him on Saturday. He was really sore when we got home so buted him up and looked at the foot. Slight crack in hind toe that had a track up into the foot - we dug carefully, got a little blood and he seemed more comfortable. Poultice, bandage and out. This morning he still seemed comfortable so I skipped the bute but tonight he is sore again. More bute, another poultice and back out. He is putting weight on the foot while grazing but very lame walking about. He doesn't seem distressed - still eating everything and flirting with the youngster. My feeling is to bute for the next few days and assuming no downturn see how we go. My husband is more in favour of a vet workup - this would involve an hour's drive and the horse finds it very stressful (he was just there two weeks ago for an eye scan). I'm wondering if whatever caused what I still assume is/was an abscess was direct trauma rather than a foreign body and so perhaps there is residual pain in the foot even if the abscess pressure has diminished. I could obviously be totally wrong though. Any opinions?
 

Pearlsasinger

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Bute is an anti-inflammatory, so is working against the poultice. You need the abscess to come to a head, which the poultice should encourage, the horse needs to keep moving so that the abscess comes to the surface and bursts.
 

soloequestrian

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Sorry, I totally disagree with the views on bute - it keeps him moving which is far more likely to allow anything that needs to 'pop' to do so. An abscess isn't about inflammation, it's either about bacterial reproduction and pus formation or a blood blister. I've had vets advice on this for a previous case and they were absolutely in favour of bute.
 

AmyMay

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Bute is an inhibitor where an abscess is suspected. So unless the horse is absolutely crippled is only occasionally prescribed.

As ever though, farrier then vet if you’re concerned
 
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Pearlsasinger

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Sorry, I totally disagree with the views on bute - it keeps him moving which is far more likely to allow anything that needs to 'pop' to do so. An abscess isn't about inflammation, it's either about bacterial reproduction and pus formation or a blood blister. I've had vets advice on this for a previous case and they were absolutely in favour of bute.


The tissues become inflamed as the pus is forming, just as in the human body. However if you don't want to leave the abscess to come to a head, you need to get your farrier to open it up.
 

soloequestrian

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Thanks for all your replies. The bute will continue - yes, inflammation will follow tissue damage but that's not what will mean an abscess bursts. There is already as much of a track to the possible abscess site as anyone would make. There is both a moral and legal argument for minimising pain in this situation. My real question was at what point do you decide to go down the x-ray route rather than waiting - I've had one who I x-rayed early and the abscess burst the following day through his coronet band. If the x-ray facilities were nearby and/or the horse less of a stress head I would go straight away but with him being comfortable I'd rather not subject him to the added stress.
 

Tiddlypom

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I’m another to say ‘no Bute’. It slows the whole thing up.

Are you wet poulticing, or dry? To draw the infection out, it needs to be wet until the pus has drained out, so tubbing in warm salty water for 20 mins at a time two or three times a day, alternated with applying a wet poultice and turning the horse out to move around.

ETA If in doubt do get the vet in to examine and x Ray if necessary. Whilst they can be ‘broken leg’ lame with an abscess, they can be broken leg lame due to other causes too. Does your vet not have a portable x Ray machine?
 

ycbm

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Thanks for all your replies. The bute will continue - yes, inflammation will follow tissue damage but that's not what will mean an abscess bursts. There is already as much of a track to the possible abscess site as anyone would make. There is both a moral and legal argument for minimising pain in this situation. My real question was at what point do you decide to go down the x-ray route rather than waiting - I've had one who I x-rayed early and the abscess burst the following day through his coronet band. If the x-ray facilities were nearby and/or the horse less of a stress head I would go straight away but with him being comfortable I'd rather not subject him to the added stress.


If you've actually found the abscess there shouldn't now be enough pain to need Bute.

I'm sorry but the legal argument is that both diagnosing this yourself and using a prescription drug without having sought the advice of a vet is illegal.

I'm another that believes suppressing the pain and inflammation slows the development of the abscess because it results in a lower volume of stuff to push its way out. And when it does open or get opened it's likely to be more gunky and more difficult to drain.

.
 

ycbm

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2019 report of research into nearly 500 horses:

https://ker.com/equinews/lame-horses-examine-entire-hoof/



“In terms of treatment, researchers found that antibiotic and nonsteroidal anti-inflammatory drugs, two medications frequently used in horses with infections, could actually be contraindicated. These medications prevent the abscess from maturing, thereby allowing the microorganisms responsible for the abscess to invade surrounding tissues,”



.
 

Sasana Skye

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My BF horse gets at least one abscess every year, in my naivety I asked the vet if they could give me some bute for the pain because my horse was three-legged lame which resulted in a 10 minute lecture on why bute was one of the worst things you can do with an abscess. My first port of call would always be my farrier. Generally farriers are pretty sympathetic with abscesses because they know how painful they are and will make an effort to come to you. The farrier can dig it out and advise usually for a tenner, or advise if it's something beyond their area of expertise. Then I would soak in warm water and Epsom salts, poultice and chuck it back out in the field.
 

soloequestrian

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So the good news is that it has burst out the coronet, so hopefully will clear now. I chatted to a vet this morning and she was quite happy with treatment (that was before it had burst) and didn't want to see him. She said they had a portable x-ray machine if it persisted which I didn't even know was a thing so that would have been very helpful advice if she hadn't told me.
In terms of the article, I note the operative word is 'could' not 'is' and typically I can only read the abstract of one source and nothing at all of the other. I understand the argument for not using antibiotics in this situation but I stand by using bute - I suspect part of the reason the abscess has burst is because the horse kept moving and so there was a pump functioning inside the foot. He would have been much more reluctant to move without painkillers and that's an ethical as well as treatment issue.
I'm not sure the argument about illegal diagnosis and treatment stands either. The medication was prescribed for him originally and he's on a low dose for his eye anyway. The diagnosis was by two experienced stock people. It would certainly be a grey area. The freedom that that part of the law is based on requires 'prompt treatment' but doesn't specify by who, otherwise presumably we'd be obliged to get a vet out for every scratch?
I would just love to know how it actually happened. I suppose it could still persist and need x-rays if somehow a foreign body has got in there?? I can't imagine how that would happen though as his feet are really healthy otherwise....
 

LaurenBay

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Can someone in simple terms tell me why an Abscess can't be treated with bute? I have never dealt with an Abscess before so I am generally curious to know the reason now.
 

9tails

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Can someone in simple terms tell me why an Abscess can't be treated with bute? I have never dealt with an Abscess before so I am generally curious to know the reason now.

YCBM's post above shows why bute shouldn't be used. Call your farrier first if you suspect one, I wouldn't try digging around in a horse's hoof.
 

LaurenBay

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YCBM's post above shows why bute shouldn't be used. Call your farrier first if you suspect one, I wouldn't try digging around in a horse's hoof.

Just to be clear I don't have a Horse with a suspected abscess. I am just surprised that bute is a no no and wanted to know why. Just seen the link, thank you :) you never stop learning with Horses eh?
 

soloequestrian

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So can anyone actually access these source papers?
*Barr, E. 2019. Foot abscessation in horses. Veterinary Record. 184(8):249-250.

**Cole, S.D., D. Stefanovski, S. Towl, et al. 2019. Factors associated with prolonged treatment days, increased veterinary visits and complications in horses with subsolar abscesses. Veterinary Record. 184(8):251.

I'd like to read them to be able to make more sense of this part of the quote above: 'These medications prevent the abscess from maturing, thereby allowing the microorganisms responsible for the abscess to invade surrounding tissues.'

An abscess will drain by the path of least resistance, and I assume the term 'maturing' means getting to the stage of being pressurised enough to start draining.... so any abscess could invade surrounding tissues, no matter what medication was used??
 

9tails

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I think it's safe to say that most of us wouldn't choose to use pain relief for an abscess. But if you feel your way is right then you crack on.

I would prefer a farrier to come out straight away and drain it from the sole rather than let it do its own thing and burst out the coronary band. But that's just me, some people don't want a professional to intervene.
 

Sasana Skye

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So can anyone actually access these source papers?
*Barr, E. 2019. Foot abscessation in horses. Veterinary Record. 184(8):249-250.

**Cole, S.D., D. Stefanovski, S. Towl, et al. 2019. Factors associated with prolonged treatment days, increased veterinary visits and complications in horses with subsolar abscesses. Veterinary Record. 184(8):251.

I'd like to read them to be able to make more sense of this part of the quote above: 'These medications prevent the abscess from maturing, thereby allowing the microorganisms responsible for the abscess to invade surrounding tissues.'

I can access these via my uni alumni account. I did my BA and MSc at UWE so we have access to everything equine related thanks to Hartpury. Due to copyright I can't download and distribute the papers though so they are only available to me electronically. When I get time to read them I could provide a summary if necessary but you would probably want to gather your own impressions so I don't think we can help much.
 

soloequestrian

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drain it from the sole rather than let it do its own thing and burst out the coronary band.

This isn't a choice you can make - the abscess will drain out the sole if you can provide it with a route to do so (or it forms its own path), but to do that it needs to be low enough in the foot to get to without trying to dig through sensitive tissue, even if you are a farrier! If it's too high up in the hoof it has to find its own way out and that is often through the coronary band.
 

soloequestrian

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When I get time to read them I could provide a summary if necessary but you would probably want to gather your own impressions so I don't think we can help much.

Did you mean to quite this rude? If you could look at the papers and give a second interpretation of them that would be great. If you just want to imply that I am not a welcome member of the group that have answered this post ('we') and that I need to be firmly put in my place ('necessary') rather than attempt to discuss points of disagreement then please just don't post! Surely part of the point of the forum is discussion rather than back-turning and although I still don't agree with lack of pain relief this whole thread has definitely made me think about it in more depth than I would have done.
 
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