Hoof Abscesses and Bute - Yay or Nay?

[Goldenstar]

Because it reduces the inflammatory reaction reducing the pressure that helps the abscess drain .

 

[blitznbobs]

Nobody "wants" their horse to suffer. It's not cruel if it shortens the pain.

I realise I'm questioning a doctor here, but surely inflammation is the normal response to infection?
.

It it but tbh drugs don’t get into an abscess very well at all its why antibiotics dont work on an abscess it is an encapsulated collection of pus. The anti inflammatory action of bute is not going to stop the inflammatory process much and certainly wont stop an abscess bursting.

Its very very old fashioned in human medicine to withhold pain killers to quicken an illness or improve a diagnosis because it is considered cruel to the patient(aka not supported by evidence base). There is an oldish adage in emergency medicine a a b c which stands for analgesia airway breathing circulation which is a little tongue in cheek but highlights the importance of analgesia befoee all things. Indeed it does improve movement and I wiuld suggest movement in a foot abscess is going to encourage bursting more than a mild anti inflammatory would stop it. Of course if your farrier can get a knife in it all the better…

 

[ycbm]

How will it stop the infection tracking down? Does anyone actually know?

It's my understanding, which I have just checked and has been researched, that the liquid produced by inflammation is corrosive. This should mean, I think, that it will eat through healthy flesh to the easiest exit.

 

[ycbm]

This question is never going to be resolved without research but there's no profit on that for any drug company so no driver to do what would have to be a pretty hefty study.
.

 

[BronsonNutter]

I have been told the reverse, on this forum by a vet, that they are rubbish anti inflammatories but good at pain killing. In my experience, it's good at both. Maybe not the best at either, but good at both.

I'm not sure if you've mis-read me or mis-typed, as you've just said that the other vet agreed with what I said, rather than the reverse

Problem is bute slows the whole process of the abcess bursting down so you run a real risk of the abcess becoming septic etc.

An abscess is a bacterial infection, therefore is septic already. I've never seen a horse (yet) develop septicaemia (infection in the blood, if that's what you're meaning by septic?) from a foot abscess, but I have seen a horse develop contralateral limb laminitis and need to be PTS as their pedal bone has fallen out of the sole of the opposite foot, due to being non-weightbearing lame for so long because of a foot abscess the owner 'wanted to burst of its own accord' and gave no bute to.

So I'm firmly team bute, sorry guys. There is a study on reducing mechanical pain vs inflammation reduction, and some unpublished research regarding inflammatory markers reduction (or lack of) in NSAIDs and various other drugs, but none so far specifically aimed at foot abscesses as far as I'm aware.

 

[Taliesan]

Thank you for your replies everyone - your viewpoints have made for some really interesting reading.

I have my own knives anyway, but when my trimmer came out at the weekend she could not see anything at all that would warrant creating a hole to help it track out. Given the heat at the coronet band, and where abscesses have historically burst out in his feet (back of the heel bulbs below the hairline) it is not somewhere I would want to start poking around.

I also agree wholeheartedly that, if I can remove or reduce the pain for him, then I would do it without hesitation. However, if the argument is "reduce the pain and have the discomfort go on for longer / possibly become more serious" or "leave him without painkillers and it will resolve more quickly with a lower chance of long term issues" then it becomes much more tricky as there is no perfect choice. (That is assuming he is not hopping around on three legs and is still able to walk about, albeit in limp mode. If he was on three legs and unable to stand on it then I would give bute so he was able to put weight on the affected foot and encourage the abscess to burst faster.)

At the moment he is not buted as he can walk on that leg 95% fine and the lameness is minimal.

The point about laminitis is a fair one, but the heat is only in one foot and there are no pulses. So I am fairly confident at this point that it is not laminitis.

 

[spotty_pony]

How will it stop the infection tracking down? Does anyone actually know?

I’m sure it’s due to the fact the Bute tries to remove the inflammation and the horse will show up as being ok before it is. The pus builds up and it isn’t noticed that it has got worse until it’s more serious. I know a horse that was on Bute permanently as he was an older boy and when he got an abscess it burst out at the coronet band.

 

[PinkvSantaboots]

Vets actually prescribe paracetamol for laminitis and some other things now which is just a pain killer so why would it not help for an abcess to relieve pain?

 

[spotty_pony]

Vets actually prescribe paracetamol for laminitis and some other things now which is just a pain killer so why would it not help for an abcess to relieve pain?

Because it prolongs it bursting. Once it’s burst there is no pain as the pressure is relieved.

 

[ycbm]

Vets actually prescribe paracetamol for laminitis and some other things now which is just a pain killer so why would it not help for an abcess to relieve pain?

This is a good point and paracetamol isn't anti inflammatory, so it could be a really good option for foot abscesses. Good thought!

 

[Tiddlypom]

Because it prolongs it bursting. Once it’s burst there is no pain as the pressure is relieved.

That pain relief prolongs the bursting is a widely believed old fashioned myth amongst horse owners which I also used to buy into. I have since been put straight by my vets.

Allowing an animal to continue unnecessarily in pain is an ethical issue. Movement helps the abscess the burst, so pain relief is actually going to encourage the horse to move which will burst the abscess more quickly.

 

[ycbm]

That pain relief prolongs the bursting is a widely believed old fashioned myth amongst horse owners which I also used to buy into. I have since been put straight by my vets.

It isn't the pain relief that is believed to prolong the abscess, it's the reduction in inflammation.

The problem is that there are vets who support both arguments, they aren't all on one side.

Movement helps the abscess the burst, so pain relief is actually going to encourage the horse to move which will burst the abscess more quickly.

Which is why the paracetamol suggestion above sounds like such a good one, and one I would use in future.

 

[Tiddlypom]

I'd certainly be asking my vets what pain relief they currently recommend for a suspected abscess.

What I won't do is go back to the old fashioned ways where I was ticked off by a farrier for calling him in too soon to look for a suspected abscess. 'Best to wait til the horse in on three legs and dripping in sweat' he said .

 

[PinkvSantaboots]

This is a good point and paracetamol isn't anti inflammatory, so it could be a really good option for foot abscesses. Good thought!

It is so bitter its hard to get into alot of horses, but it's a good marketing opportunity for someone to produce a more palatable solution like Danilon.

I gag taking paracetamol it's horrible.

 

[southerncomfort]

I'd certainly be asking my vets what pain relief they currently recommend for a suspected abscess.

What I won't do is go back to the old fashioned ways where I was ticked off by a farrier for calling him in too soon to look for a suspected abscess. 'Best to wait til the horse in on three legs and dripping in sweat' he said .

I've seen a horse looking exactly like that.

It was shaking with pain and incredibly distressed. The owner refused to give any bute until she couldn't get it out of the field as he refused to move.

Owners want to do the right thing but sometimes a bit of common sense needs to be deployed.