Bruised sole despite pads

[Birker2020]

Hi I went to get my horse in on Sunday morning to find her on 3 legs, took me ages to get her down to the stable.

Initially because of swelling in leg and past trauma suspected suspensory branch injury but then realised that the pastern was quite swollen and warm so started hoping it was the foot.
Got the emergency vet out as she was so lame and they came and started digging, and digging and digging. Eventually she found a small amount of blood and a little pus but there was also quite a bit of bruising around the outer edges of the foot mainly although some by the frog. This despite the fact she is in a plastic foot pad.

I know the ground has been hard and has made quite a few horses footy or lame but when she went to the vets as we suspected a flare up of the coffin joint arthritis and she has Arthramid I expected her to be sound.

Initially she was coming out of the stable for the first day much sounder than she'd been for a good while but the second or third day she was quite sore, then she was sounder again and was really intermittent, some days she'd be sound, other days not. She had two weeks box rest. Now I'm wondering if she had this bruising all along.

She's now been out a fortnight, skids marks across the field a couple of days ago so obviously messing about over night.

Is it usual to have bruising with plastic pads? Unfortunately they do seem to attract a large amount of soil and then she walks across the yard and you can't hear her shoes on the concrete as the sole is convex with the compaction of the soil from her paddock. This can't be good for her either as this must be pressing on the coffin joint and I wonder if this also causes bruising??

Then yesterday morning the abscess and the bruised sole. The vet said she has very hard sole but it is quite thin and that's why there is bruising but I wouldn't have expected that with the plastic pads.
I'm to ring the farrier and get him to come out on about Wednesday/thursday with a view to putting the shoe back on.

I changed the animalintex poultice this morning and couldn't smell much infection, there wasn't a lot to see to be honest.

 

[Tiddlypom]

Visible bruising in the foot can be a sign of a previous laminitic episode. The bruising takes time to show up, and the laminitis may be over by the time it is noticed.

Thin soles can get bruised more easily without laminitis being involved. The mare in my avatar is prone to stone bruises.

There's a lot going on with your horse, who from what you post has been lame for a long time now. Whether this is a new development or a flare up of an old one may be difficult to determine.

 

[NR88]

I read your post on the sad thread and appreciate that you are having a hard time just now and know that things aren't going well for you just now.

It does seem that you have taken every possible treatment option that you can but have still had a sore and lame horse for a considerable lengths of time.

Some horses just don't ever seem to be able to be gotten right no matter how much money is thrown at them.

I have been a long time lurker, well over 10 years on and off, so I've read some of your previous posts about issues over the years and then your long list of ailments in the vet bill thread. I think its just the one horse you have but I know you've mentioned a mare and a gelding so apologies if I have combined the two and there are seperate issues with each.

I don't know based on the sad thread if you are looking for permission of sorts? Personally I'd have stopped a long time ago. The frequency of the soreness/lamenesses seem to be increasing with less time between episodes and next to no time sound and comfortable. There always seems to be something going on. I had a similar horse where I would fix one issue but helping that made something else come to light and it was a bit of a vicious circle. No one can say that you have not exhausted every possible option numerous times and tried everything.

I hope that you're ok, mentally this constant cycle is exhausting on top of the physical side of caring for a compromised horse.

 

[Birker2020]

Visible bruising in the foot can be a sign of a previous laminitic episode. The bruising takes time to show up, and the laminitis may be over by the time it is noticed.

Thin soles can get bruised more easily without laminitis being involved. The mare in my avatar is prone to stone bruises.

There's a lot going on with your horse, who from what you post has been lame for a long time now. Whether this is a new development or a flare up of an old one may be difficult to determine.

Hi thanks for your response. The vet has ruled out laminitis as she had a cushings test a couple of weeks ago and was on box rest for a time after and when introduced to the paddock was on a postage stamp area. So it's almost certainly not laminitis although I appreciate it can come on very quickly.

 

[Birker2020]

I read your post on the sad thread and appreciate that you are having a hard time just now and know that things aren't going well for you just now.

It does seem that you have taken every possible treatment option that you can but have still had a sore and lame horse for a considerable lengths of time.

Some horses just don't ever seem to be able to be gotten right no matter how much money is thrown at them.

I have been a long time lurker, well over 10 years on and off, so I've read some of your previous posts about issues over the years and then your long list of ailments in the vet bill thread. I think its just the one horse you have but I know you've mentioned a mare and a gelding so apologies if I have combined the two and there are seperate issues with each.

I don't know based on the sad thread if you are looking for permission of sorts? Personally I'd have stopped a long time ago. The frequency of the soreness/lamenesses seem to be increasing with less time between episodes and next to no time sound and comfortable. There always seems to be something going on. I had a similar horse where I would fix one issue but helping that made something else come to light and it was a bit of a vicious circle. No one can say that you have not exhausted every possible option numerous times and tried everything.

I hope that you're ok, mentally this constant cycle is exhausting on top of the physical side of caring for a compromised horse.

Yes I am thinking that I won't be taking this horse into the winter. It is mentally exhausting as its just one thing after another, after another not to mention the constant money situation, I've been paying non stop for vets bill almost constantly for a number of years with only a few weeks break in between each new issue.

But she has a very good quality of life when she is out in the paddock and I'm not just saying that, she will play over the fence, spend hours eating, had no issues getting down to roll or up again in both the stable and the paddock and she is inquisitive, alert, and content. If she wasn't I would have PTS a long time ago.

I just really wanted to know if anyone could tell me why they thought my horse was getting a bruised sole despite pads as this is what I can't understand.

 

[NR88]

Well take care of yourself too.

I would suggest the same as tiddlypom that horse maybe had LGL. Could the medications shes had made her a higher lami risk? Could be spring grass? Thin soles can bruise easily even if they are hard.

Could farrier maybe use something like equipak? I think I have the name correct. It is an injectable gel used with a mesh if I recall correctly. That might be softer than sole to plastic?

 

[Birker2020]

Sorry NR88 I didn't quote your message but no she had no medication as she was given Arthrimed so it contains no steroid as its a polymer which is used. But in any case she was left in for 2 weeks box rest following the procedure to give it the best chance to 'settle' as she does tend to run around and play rather a lot as the skid marks in the grass have shown!

This is the pad that she is in for both fronts, which is why I am really shocked that upon removal of the shoe and pad we could see areas of bruising. Between the pad and the foot is a sticky substance which is put on the pad prior to nailing the shoe on which acts as a barrier and stops anything going between the pad and foot. The previous rubber pads allowed her to house a colony of maggots which were only discovered five weeks later when the vet shod her again.

Thanks for your help, like I say I do think we've probably reached the end of the road but I've just had this procedure which, if it works will potentially give her up to 2 years soundness on both coffin joints and alongside bute will keep her paddock sound so I do really need to see if it works first before I make any drastic decisions.

The bruising has just complicated matters and an abscess which is common due to the unusually wet weather conditions we've had lately doesn't mean I will pts when she has a brilliant quality of life otherwise. I will give the farrier a call and see what he advises going forward.

 

[alibali]

Hi thanks for your response. The vet has ruled out laminitis as she had a cushings test a couple of weeks ago and was on box rest for a time after and when introduced to the paddock was on a postage stamp area. So it's almost certainly not laminitis although I appreciate it can come on very quickly.

Please don't discount laminitis on the basis of the above. It can and does present atypically and Cushing's tests can give false negatives as well as false positives. Also laminitis can have other causes than Cushing's.

I have a pony who got laminitis in winter eating almost exclusively haylage. He was only 3 years old at the time and presented atypically with no pulses or heat, lame only in one foreleg and no pointing foot or camped under stance. It took longer than I'd have liked to figure out what was wrong though thankfully he wasn't too sore with it. Only when I decided to manage as if laminitis just in case did he improve and only when his hoof started to grow out that the bruising and stretched white lines were visible.

He has had it twice since despite very careful management and despite being tested negative twice over several years for Cushing's. Vet finally allowed a Prascend trial and since starting that 3 years ago it has never returned.

Before my experience with my own pony I used to only think of laminitis as the acute, camped under stance from lush grass. Just hoping my own mistake can help anyone reading this spot the signs quicker than I did. Thankfully pony made a full recovery and has lovely concave feet now but only after a steep learning curve by me.

Edited to add, bruising on horses sole could be due to standing on a stone or pressure under retained sole or laminitis amongst other things. But in any of the above bruising is more likely to happen if the laminae are already slightly inflamed by sub-clinical laminitis. Therefore anytime I see bruising on a sole I immediately consider the possibility of laminitis either clinical or sub-clinical.

 

[Birker2020]

Please don't discount laminitis on the basis of the above. It can and does present atypically and Cushing's tests can give false negatives as well as false positives. Also laminitis can have other causes than Cushing's.

I have a pony who got laminitis in winter eating almost exclusively haylage. He was only 3 years old at the time and presented atypically with no pulses or heat, lame only in one foreleg and no pointing foot or camped under stance. It took longer than I'd have liked to figure out what was wrong though thankfully he wasn't too sore with it. Only when I decided to manage as if laminitis just in case did he improve and only when his hoof started to grow out that the bruising and stretched white lines were visible.

He has had it twice since despite very careful management and despite being tested negative twice over several years for Cushing's. Vet finally allowed a Prascend trial and since starting that 3 years ago it has never returned.

Before my experience with my own pony I used to only think of laminitis as the acute, camped under stance from lush grass. Just hoping my own mistake can help anyone reading this spot the signs quicker than I did. Thankfully pony made a full recovery and has lovely concave feet now but only after a steep learning curve by me.

Edited to add, bruising on horses sole could be due to standing on a stone or pressure under retained sole or laminitis amongst other things. But in any of the above bruising is more likely to happen if the laminae are already slightly inflamed by sub-clinical laminitis. Therefore anytime I see bruising on a sole I immediately consider the possibility of laminitis either clinical or sub-clinical.

Thanks for that. The vet did say if she's no better in a few days xrays might need to be taken to see if there is anything else going on but I never asked her why.

I know this is probably a really stupid question but when the vet had her in for Arthramid he said he'd scanned her foot and this was showing that her navicular bursae was inflammed. So would he have been able to see any rotation of the coffin joint on an ultrasound had he looked for it?

 

[Birker2020]

Incidentally I should be careful what I say on here, this is what I wrote on the Colic/Medical Emergency Planning thread only six days prior to my horse developing an abscess.

"I've finally run out of funds after 17 years (Covid has brought most of us to our knees) so I will PTS whatever and whenever the horse cannot stay sound on the current treatment of Arthramid or 2 bute a day. I'd possibly treat for a splenic entrapment a third time if it happened and anything simple like an abscess"

Talk about tempting fate!!

 

[alibali]

Thanks for that. The vet did say if she's no better in a few days xrays might need to be taken to see if there is anything else going on but I never asked her why.

I know this is probably a really stupid question but when the vet had her in for Arthramid he said he'd scanned her foot and this was showing that her navicular bursae was inflammed. So would he have been able to see any rotation of the coffin joint on an ultrasound had he looked for it?

When you say the vet scanned I'm assuming this was an ultrasound scan. My understanding is these are done to examine soft tissue normally and x-ray to examine bones. Then you move up to more expensive imaging methods which can provide more in-depth information.... The ultrasound would not give the correct view to assess if there had been rotation of the pedal bone. Happy to stand corrected though!

Edited to add. It's very hard to give up the fight to get them well when you've put so much time, energy, emotion and money into, sadly I've found this out the hard way myself with another horse. It sounds as if you're monitoring quality of life carefully which is wise. I also think there's no shame in admitting defeat at this stage for your own welfare. I know how much these things can drain from you. Take care.

 

[Birker2020]

When you say the vet scanned I'm assuming this was an ultrasound scan. My understanding is these are done to examine soft tissue normally and x-ray to examine bones. Then you move up to more expensive imaging methods which can provide more in-depth information.... The ultrasound would not give the correct view to assess if there had been rotation of the pedal bone. Happy to stand corrected though!

Edited to add. It's very hard to give up the fight to get them well when you've put so much time, energy, emotion and money into, sadly I've found this out the hard way myself with another horse. It sounds as if you're monitoring quality of life carefully which is wise. I also think there's no shame in admitting defeat at this stage for your own welfare. I know how much these things can drain from you. Take care.

thank you.

Yes I am now informing people that I am thinking of making the decision to pts possibly this winter to 'get it out there'. But I am also going to wait and see if the situation improves, I've spent nearly £1K on this new fangled Arthrimid and really want to see if it makes a difference to her, her hocks are okay, her neck doesn't seem to be causing her any issues lately, her colic episodes are non existent now, I'd got the bute back down to 1 1/2 a day from 2 a day. So if the coffin joints have been helped it will be great, it's just very unfortunate that she's go this abscess and bruising develop.

You are right, I am constantly monitoring her quality of life, I am always watching her rolling and assessing her movement. I won't let her suffer, there is no way I'm going to be keeping a hobbling horse long term. I just wish she didn't have such a young head on her as she causes herself mischief by messing about in the paddock with the horses on either side of her. Even when I poo pick her paddock she insists on circling around me doing airs above the ground, it gets frustrating as I think "you will be sore tomorrow".

 

[ihatework]

It’s obviously a complicated picture but just to say I have seen horses with sore feet (for whatever reason) worsen with gel injection type pads.

It might be worth trying old fashioned leather pads with some Stockholm tar underneath, see if that makes her more comfy.

That’s all irrespective of the underlying cause of the sore feet

 

[PurBee]

My mare is prone to thin but hard soles too. The gelding, her bloodlines, is the opposite - grows plenty of sole, so luckily didnt inherit her soles! Shes got more welsh D blood in her than his arab, so the native blood i think makes her more prone to weight/feet issues.

The mare, easily prone to footiness - mainly from high sugar feeds, ryegrass HAY (not late cut ryegrass haylage), meadow hay heavily herbicide sprayed - that made both horses footy - change in bowel bacteria balance, normally caused by change of feeds.
Whenever the above scenario’s happen - she’ll be footy.

Inflamed feet could mean inflamed everything, including laminar connections. So the hoof wall pressure is rasped off to reduce the pain of the hoof wall - but the horse with thin soles, even if they are hard soles, suffers when walls are brought too low. So padding is essential. Booting is best.
Your farrier has gel pads but had still shod her. So theres still concussive wall action occuring on her hoof walls, and if theyre inflamed that’ll be sore for her. The pad is relatively thin compared to boot thickness. As mud was packing in the gap as you said, and you couldnt hear the shoes, that mud was putting more concussion on her sole, possibly causing the bruising. Mud can pack hard like concrete so equally concussive.
Boots are rubbery...always with ‘give’ in the sole. You can also get pads to put in boots For extra padding if needed.
I got boots for my mare and her gait was immediately different, and her sole is finally changing.
I tried various trim methods and feed changes but ultimately i had to give her immediate thick soles, using boots, for her real soles to be relieved.
With boots, the support is all over, walls, soles and frogs, depending on the weakness of the real foot.

’Retained soles’ - can appear very hard and be thin. They dont shed and keep compressing causing pain. New sole material is therefore inhibited from growing and growing thick soles.
Its hard to detect retained soles but a farrier should spot it. Ask your farrier if retained soles is a possibility with her.

You’ve tried so much, have you tried the booting route? Only suitable if you are there daily to put on/take off - keep them off when stabled...with a thick bed...put them on for grazing?
If on 24/7 grazing being booted the whole time isnt ideal as air flow is restricted in boots and could cause its own issues.....but there are some design of boots that give a thick whole sole/wall cushioning effect yet are more breathable than the design which look like ‘trainers for horses’. They have a cup for the hoof/sole - then a type of ankle bracelet fastening allowing the hock to breathe, back of foot to breathe.
Hopefully someone can suggest a boot design best suited to your turnout regime.

 

[Birker2020]

It’s obviously a complicated picture but just to say I have seen horses with sore feet (for whatever reason) worsen with gel injection type pads.

It might be worth trying old fashioned leather pads with some Stockholm tar underneath, see if that makes her more comfy.

That’s all irrespective of the underlying cause of the sore feet

Well I know from my own experience with sore feet (plantar fascitis, extensor tendonitis and arthritis) that if I wear certain orthotics some are much more comfortable than others and some make me even sorer than before so you may be right.

 

[irishdraft]

Haven't read all replies so sorry if duplicated my horse has those exact pads but he has dental impression material between his sole and the pad . This is a plasticine type stuff it isn't sticky and is quite cushioning I've not had any trouble with bruising and my gelding has a dropped sole on one foot and the soles are extremely sensitive. So maybe a change of material is required.

 

[Birker2020]

Your farrier has gel pads but had still shod her. So theres still concussive wall action occuring on her hoof walls, and if theyre inflamed that’ll be sore for her. The pad is relatively thin compared to boot thickness. As mud was packing in the gap as you said, and you couldnt hear the shoes, that mud was putting more concussion on her sole, possibly causing the bruising. Mud can pack hard like concrete so equally concussive.
.

hey thanks for your suggestion. Yes the gel pad was to absorb concussion, maybe he had already spotted the bruising but had not thought to tell me or maybe this is something relatively new due to the hard ground we had before we got the much needed rain, who knows.

The vet said she had to have shoes, in particular a certain make to stop the inward pronation she has on the one foot which would normally aggravate the coffin bone but the farrier didn't really want to use these shoes and the vet didn't want her to have the pads (which caused complications as I felt piggy in the middle and it was a bit awkward). Really the vet should have rung the farrier but there you go.

I said to the vet that the mud was getting compacted in the bottom of her pad and causing a snow effect (like horses walking on snow). I also said to him what you are saying, that I thought that this would be putting pressure on the sole and in particular the coffin joint (I didn't know about the bruising then) but he dismissed my claims. When the odd stone gets caught in the mud in the pad its even worse. You can see from the photo of the pad in reply 7 that you can easily get a build up of 1/4 of an inch or more of mud.

I just feel a bit frustrated by it all.

 

[Birker2020]

Haven't read all replies so sorry if duplicated my horse has those exact pads but he has dental impression material between his sole and the pad . This is a plasticine type stuff it isn't sticky and is quite cushioning I've not had any trouble with bruising and my gelding has a dropped sole on one foot and the soles are extremely sensitive. So maybe a change of material is required.

Yes that's what the farrier said it was but it feels very sticky because I sometimes feel it at the heel. I wonder if there are different types though. Its a kind of reddish colour as in the photo.
She's had equipak years ago but the first time it lasted 2 weeks and the second shoeing it lasted 3 days!

 

[irishdraft]

Yes that's what the farrier said it was but it feels very sticky because I sometimes feel it at the heel. I wonder if there are different types though. Its a kind of reddish colour as in the photo.
She's had equipak years ago but the first time it lasted 2 weeks and the second shoeing it lasted 3 days!

The material my farrier uses is definitely not sticky he squeezes it out if a tube and then makes a ball of it and then compresses it on foot before putting on pad it could be called magic cushion. Also I see you said mud is getting compacted on pad or under it seems strange I haven't had this happen at all and the horses live out 24/7 .

 

[NR88]

I am afraid I am one of those barefooters; or at least trying to be.

I know that they are a faff but there is a therapy hoof boot that is very soft and supportive. I want to say easy stride or something along those lines. If I recall you can change the depth of the pad.

That might be slightly more forgiving than a pad and if she is pulling or losing shoes this will save her wall from damage nailing shoes back on.

Of course I am definitely not saying to go barefoot and I would shoe if it would help the horse. I just thought I would suggest an option if a shoe and pad combination isnt currently working for her.

 

[Birker2020]

I am afraid I am one of those barefooters; or at least trying to be.

I know that they are a faff but there is a therapy hoof boot that is very soft and supportive. I want to say easy stride or something along those lines. If I recall you can change the depth of the pad.

That might be slightly more forgiving than a pad and if she is pulling or losing shoes this will save her wall from damage nailing shoes back on.

Of course I am definitely not saying to go barefoot and I would shoe if it would help the horse. I just thought I would suggest an option if a shoe and pad combination isnt currently working for her.

I was thinking of asking the farrier could she go barefoot until I decided about PTS this winter (if the Arthramid didn't work and the 2 bute wasn't enough to keep her paddock sound) as she reacted so well to barefoot for the one shoeing cycle (if that makes sense). She's shod every 5 weeks on the dot.

However if she is getting bruising whilst padded there is no way going down the barefoot route would suit her.

I've got a load of lads for induction now so really busy at work, but later on my break I'll show you some photos I took earlier today when I changed her dressing of the bruising and the 'hole'.

 

[Tiddlypom]

It's just whether the shoe + padding is somehow causing the bruising, or whether the bruising is from another cause.

The mare in my avatar is unshod. If she gets a stone bruise, I tub her foot two or three times a day and then turn her out in her Cavallo trek hoof boots which protect her sole. She is comfortable in those, and seems to recover more quickly.

 

[Birker2020]

Walking much better today and seems a lot happier. The hole is on the left, these photos were this morning. There was a bit of gunge on the dressing but not much and no strong smell of infection, barely much at all to be honest. On the last but one photo you can see the bruising I'm referring to - all the black areas especially around the right of the picture where the nail holes are. Will be interested to see what the farrier thinks. Very strange, you can see they are quite deep bruises. The bottom of the pad that fits under the shoe has a deposit of soil in it, this is on the bit between the pad and the filling. Not sure how this has happened. Again I will have to ask the farrier, trouble is he is coming at half ten on Thursday and I will be at work. I hope we can have a phone conversation about it. I will send him the bruise photo now and see if he responds.

 

[ester]

I'd be very reluctant to remove shoes from something with all his issues, subsolar bruising and at this time of year, even more so if I might PTS soon.
How much sole trimming does the farrier do (aware the photos might be misleading on that).
They look pretty flat too?

 

[Tiddlypom]

All the black round the outer edge of the sole is bruising, and not natural colouration?

 

[Birker2020]

All the black round the outer edge of the sole is bruising, and not natural colouration?

The vet said it was bruising pointing to that area on the right. I can't say I've ever really noticed what colour the sole was when she was barefoot to be honest. I will see if I have any photos from when she was barefoot from last year with the check ligament injury when she went barefoot.

 

[Birker2020]

I'd be very reluctant to remove shoes from something with all his issues, subsolar bruising and at this time of year, even more so if I might PTS soon.
How much sole trimming does the farrier do (aware the photos might be misleading on that).
They look pretty flat too?

I'm very rarely present when the farrier is there, he usually helps himself to the horse out of the stable, takes into a quiet place in the yard where he can back his van in and then puts back in the stable when finished. I don't think he over trims, he's a very good farrier, the vets praise him highly and he has many clients who sing his praises, on previous xrays the foot balance was shown to be very good.

I've never had any issues with him although about five years ago my horse had an abscess after about a week following shoeing, and then at the subsequent shoeing had another abscess three days after. Everyone was saying ditch the farrier its nail bind, but the previous six plus years and the following five years never had any issues after shoeing, I think then it was thought to be bruising.

Horse is due to be shod this week anyway which will be five weeks.

 

[ester]

The reason I asked about the flatness of the soles is that if you have flat soles, which are thin, then once you put pads on even without additional mud sticking to them you can have sole pressure that you wouldn't have without the pads, and more pressure than the horse is equiped, hoof wise to cope with.
I would urgently speak to the farrier before he proceeds this week as there may be a better alternative pad and filler wise.

 

[Birker2020]

The reason I asked about the flatness of the soles is that if you have flat soles, which are thin, then once you put pads on even without additional mud sticking to them you can have sole pressure that you wouldn't have without the pads, and more pressure than the horse is equiped, hoof wise to cope with.
I would urgently speak to the farrier before he proceeds this week as there may be a better alternative pad and filler wise.

Yes I think you are right Ester. (you should frame this lol).

But seriously I think that the pads are causing extra pressure and the mud building up in them are causing issues although the vet didn't seem to think so.

The photo of the bruising - do soles normally look like this?

 

[ester]

From the photos the soles look a bit carved to me but I might be seeing lines that aren't really there because they have been poulticed and wrapped. The discolouration in the nail hole region I wouldnt' immediately see as bruising necessarily but in picture 2 and 4 it looks like there is bruising in the white line at the toe to me which would fit with the sub clinical/low grade lami theory (I was going to ask re. cushings testing too but thought he had at least been done some time ago).

Theoretically I do think they should be pretty good pads, but we all know they don't always read the handbook.