Help! Abscess, to poke or not to poke !!...

gracenarchie

gracenarchie

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Hiya,


Advice needed please .....Gracie has a hoof abscess, she's had one before so I know the drill but this one is about to burst out the bulb of her heel and its a big one, the bulb literally feels sqishy like when you get a blister on your heel and it fills with the watery stuff!... sorry I know its early, hope I havent ruined anyone's brekkie :-) !!! I am now not sure weather to make a tiny puncture in the bulb and then clean it as usual or just to continue puolticing and let it find its own way out?
thanks v much
J
 
i wouldn't do it yourself- keep poulticing and get your farrier to have a look if it hasn't come out in a day or two.
 
Thanks, I was heading that way but wanted a second opinion, have re-poulticed this morning and hopefully should be out within the next 24 hours,

thanks again guys :-)
 
I would just carry on with what you are doing. It's taken nearly 5 weeks for mine to burst out. Luckly he wasnt hopping lame just day one unlevel then sound etc. Had vet out and he didnt want to dig nor did the farrier. Im just hot tubbing and poulict once a day. hope it doesnt take that long for your's to come out.
 
just an update, I re-poulticed yesterday morning and it did seem like it was ready to burst, went up last night and it had erupted on coronary band at the back, quite gross really but i was just so pleased it was out, Gracie seemed in better spirits immediately and after being kept in for 72 hours, I just thoroughly cleaned and dried it then a good squirt of purple and put her out. went up this morning and its as if nothing happened!!! she's totally fine and the eruption spot is starting to dry up and heal already, will keep a close eye for the next few days but hopefully thats it over with.
thanks again for all the replies
 
gracenarchie said:
just an update, I re-poulticed yesterday morning and it did seem like it was ready to burst, went up last night and it had erupted on coronary band at the back, quite gross really but i was just so pleased it was out, Gracie seemed in better spirits immediately and after being kept in for 72 hours, I just thoroughly cleaned and dried it then a good squirt of purple and put her out. went up this morning and its as if nothing happened!!! she's totally fine and the eruption spot is starting to dry up and heal already, will keep a close eye for the next few days but hopefully thats it over with.
thanks again for all the replies
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Don't let it heal over!!! Keep squirting an antiseptic like hydrogen peroxide in it for at least another four days. If it heals at the top before it is ready you will have all sorts of horrible problems while it brews again, possibly deeper and worse. Stick a needle-less syringe in it as far as it will go and squirt hard to blow the yuk up and out.

Be warned, too, that in time, possibly about three months, she is likely to shed the whole of that heel. If her heel bulb was squishy but it actually burst at the coronet, then it has under-run the entire quarter of her foot at the back. Don't panic, it'll grow again quickly and doesn't usually cause any problem, but it might be a shock!
 
you might want to warn the op that sticking a syring in the abcess may well cause her to get kicked so wear a hat!
I would have it poulticed for the next few days to draw out any remaining gunk, wouldn't remotely consider squirtin hydrogen peroxide into it as that kills off good cells too, and have no idea why you would put 'purple spray' on it!
 
Although this sounds to have now opened up, please don't anyone ever stick syringes in an abcess.
At the very least you will get a violent reaction, and it's always best to poultice and get your farrier or vet out for experienced advice.
Just because it's now open doesn't mean all is well, sometimes there can be "pipes" inside to other pockets of infection, so keep tubbing it and ensure the horse has an up to date tetanus injection. If it doesn't rapidly improve get your vet out, it might need a course of a-b.
The mind boggles at the thought of inexperienced owners on here sticking syringes into what will be very painful areas, so please don't always take the advice on here as Gospel..
 
I don't think cptrayes mentioned anything about a needle - just a syringe to flush the area out with saline......
 
Hi, yikes! thought the worst was over!
since second post have actually re-poulticed again while she was in the stable during the day just to put my mind at rest that it was all out, and was pretty clean in the morning, i.e. no gunk.
will just keep a close eye on it, only used the purple spray as she was put out in field for the night to keep any nasties out of the wound, thought that would be ok as was re-poulticing (hot) on the next morning so would not be "sealing in" any remaining bacteria/abscess.
thanks again for the advice
 
I didn't mention needles either, but if anyone attempts to open an abcess with a blunt syringe end they will get kicked into touch..
I think we all have to remember not everyone on here is as experienced with wound management (just read a few of the questions to realise that) and any advice has to be very clear and not be misunderstood.
My concern was not the advice after the thing had erupted, more if anyone thought they could make it burst by sticking a syringe in it.. Plus unless the syringe was sterile they may introduce bacteria into the wound doing it.
Perhaps just suggest the farrier and vet for advice because after all, we can't see the problem can we...?
 
No-one is talking about opening an abscess with a syringe!!! The abscess is open and if you read the posts it was already open when I gave my advice, but I think you missed a few in between the OP and mine. If you are pumping an antiseptic in that you have loaded into a syringe, then don't you think the syringe will have been disinfected itself by what you put in it???

There is an open wound on the coronet which will get bigger over the next few days as the coronet dies away and the bit above starts to grow new horn down. An abcess draining from the coronet is not draining well - it can't - it's uphill to the hole. If it reseals there can be big trouble with possible infected bones inside the foot. This is espectially likely to happen if the hole seals while the horse is on antibiotics. The antibiotics can suppress the infection enough for the hole to heal, but not enough to kill it completely, and it can brew again. I've known of two cases like it with friends whose horses had to have their feet cut open to get a deep seated infection out. I believe that it is essential to flush it out and pumping an antiseptic firmly into the hole is the only way you can do that. I have never had a horse react in any serious way to having the nozzle of a small plastic syringe inserted into a hole in a coronet band or heel, but if I had I'd do it anyway. The risks of not clearing that infection are too high to be a bit squeamish.
 
I would be syringing and continuing to poultice too CP. I also read it that you meant syringing now it has broken out. I always have the odd sterile syringe hanging round they have a variety of uses :).
 
It's not squeamish..it's advising op not to get her head kicked in-so wear a hat if doing anything of the sort.
Flushing with saline will be perfectly adequate, and allow the lining of the wound to begin healing rather than prolong the healing time by stripping the layers of good cells off with the bad.-But that's just my opinion
OP-the essential thing is-get advice from the vet/farrier, as any of us could be talking out of our backsides, and they are qualified professionals who will know what to do.
Good luck with it.
 
SusieT said:
It's not squeamish..it's advising op not to get her head kicked in-so wear a hat if doing anything of the sort.
Flushing with saline will be perfectly adequate, and allow the lining of the wound to begin healing rather than prolong the healing time by stripping the layers of good cells off with the bad.-But that's just my opinion
OP-the essential thing is-get advice from the vet/farrier, as any of us could be talking out of our backsides, and they are qualified professionals who will know what to do.
Good luck with it.
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Agree totally with SusieT. Always wear a hat when poking around a foot abcess!

An abcess that comes out through the coronary band CANNOT drain properly and must be poulticed until NOTHING comes out. Agree that flushing with disinfectants will only delay healing -saline will clean the channel and encourage proper healing!

And advice on an internet forum is only a stop-gap measure until you can consult your vet/farrier!!
 
JanetGeorge said:
Agree that flushing with disinfectants will only delay healing -saline will clean the channel and encourage proper healing!
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Hydrogen peroxide is sold in Boots as a treatment for use in human adults and children on open wounds. If it prevented open wounds from healing it would not be on sale on the high street with those directions on the bottle.

The bugs which cause foot abscesses in horses are anaerobic bacteria which are prevented from growing if you can get enough oxygen to them, and that's what hydrogen peroxide delivers, as does purple spray. It is extremely effective at flushing foot abscesses and does not prevent healing at all. I have treated every foot infection my horses have had in 35 years with it and not one of those abscesses has ever taken more than six days to have the horse back in work, usually only three to four. The only one I ever had recur was one I failed to flush for four days because it looked OK after two. I never made that mistake again.

What hydrogen peroxide does do is stop a badly draining foot abscess from becoming a deep rooted foot infection. I have never had a horse object in any serious way to it being done, I do not even tie mine up to do it, and from their reactions I would say that it appears not to even sting on a flesh wound, where I also use it, never mind deep inside the foot.
 
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I've had to 'flush' out an abscess that burst through the coronet band with hydrogen peroxide (10 vols) This was under instructions from the vet and the horse didn't mind at all although his coat went a bit orange where I didn't wipe the stuff off.
On a slightly different note, I'm personally not entirely sure that letting an abscess run its course is the best way to go; I waited for AGES for an abscess of PF's to burst and poulticed like mad to no effect. In the end she had to have her foot cut open at Rossdales (I have fascinating x-rays on photobucket if anyone would like to see :p) and part of her pedal bone scraped out as the infection had tracked upwards into her bone. That said, most abscesses do resolve themselves in a very straight-forward manner.
 
YIKES!!! 10 vols is 30% - 10 times as strong as the solution for wound flushing. How interesting that's what your vet used. I buy 10 vol and water it down by 10 and my skin turns white if it splashes on me neat.

PF did your horse have any antibiotics while you were waiting for it to break out? I am always interested that of the ones I know of where people have had big problems, they were treated with antibiotics.
 
Oooh, maybe I'm not remembering the proportions correctly; it was AGES ago! I don't remember it ever going white on my skin...
Vet said there was no point in giving ABs whilst the infection was still in there. PF did get ABs once the infection was out, and the hole in her foot was packed with iodine-soaked swabs. She had a plate on her foot for a while. I don't think my other neds had ABs for their abscesses as they were very straight-forward.
 
Here you go...
First x-ray; you can see where vet has been trying to dig out pus and you can see bubbles of pus up along the wall

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From the top... From this angle you can see that the pedal bone has been affected

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After all the yuck has been dug out. Apparently the tip of her pedal bone was like cottage cheese... niiiiice


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And with her speshul shoe on. The plate was bolted onto this

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Thanks Pf. How long did it take to complety heal up?? Mine I think is tracking around the wall it has came out in the wall and frog. The vet didnt think the pedal bone was at risk as he wasnt hopping lame and didnt want to dig at it. This has taken nearly 5 weeks of him being unlevel the farrier didnt think it was one as he came out on two different times and he showd no signs. It only burst though last sunday and now it's greyisg colour so shouldnt be much longer before dry nappie!!
 
PF was only about 2/10ths lame; a lot less than ther other horses when they had their abscesses :( As soon as the pus was out she came sound and was able to go out with her plate and a duct tape boot on it. When the hole was small enough, she could have a wide-web shoe, I guess it was a couple of months... she actually went out to Argentina as soon as she was able to have a proper shoe on and finished her rehab out there.
 
OMG! Look at the damage to the pedal bone! It's been eaten :-000000 It looks as if you were very lucky to get away with that one.......
 
Scary, isn't it? Luckily my vet took my concerns seriously (you know how you just know something more sinister is going on?) and sent her to Rossdales where they very quickly got to the bottom of the problem.
Incidentally I never used the peroxide on her :)
 
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