Hoof injury leading to Pedal Osteitis

Street_Skill

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Hi all,

I've already written this thread out once but log in timed out and I lost it!

Anyway, I've never posted before but am in need of some advice an opinions on how to get hooves to grow. It's long, but here goes.....

On the 28th of February I transported by 6 year old TB to his first jumping lesson in the trailer. Everything went well and he loaded without problems to come home. I had been travelling for about 10 minutes down a fairly major A road doing 50mph when he started thrashing about in the trailer. This is really unusual as he is a brilliant traveller (being an ex-racer) and you normally never hear a peep out of him. My friend looked through the rear window to see him right in the front of the trailer-in the part that you would walk through to unload down the front ramp. I took me a little while to find somewhere to pull over safely, but when I did I realised that the breast bar must have come down (don't ask me how, I have asked myself that every day and I still don't have an answer) and fallen round his feet causing him to panic. He'd ripped both his back shoes off and there was blood everywhere, dripping out of his feet, on the floor, up the walls, on his leadrope, literally everywhere. There was nothing I could do by the side of the road apart from push him back into the stall, put the breast bar back, carry on and phone the vet on the way home.

When we got back I hosed and hosed the feet until the vet arrived, but he'd basically created a "wound" for want of a better expression at the toe of each of his back feet where the wall of the hoof and sole were no longer attached. The blood was just running out of both hooves, but my vet was brilliant and gave him painkillers, antibiotics and bandaged his feet. Fast forward 7 days and I still had a horse that was in incredible pain (I'd had two emergency call outs in this period for pain relief as he was shaking and sweating and couldn't bear any weight on his hind feet) which I was struggling to manage. I was also having trouble stopping the bleeding. My farrier came to see him with a view to casting the feet in special bandages to stabilise them and to kick start healing as whenever he was weight bearing the wall and sole were moving destroying any new tissue that was forming. Unfortunately Ted (my horse) had developed an abscess by this point in the left hind which was the worst out of the two so my farrier was unable to do anything. After another 3 days the abscess had erupted out of the coronet band and Ted looked like a hat rack-he had lost so much weight and was not eating due to the pain. I was tearing my hair out by this stage for several reasons-I couldn't get enough pain killer into him (despite mixing it in Greek yoghurt!), my vet seemed to disregard my concerns (although in her defence she was newly qualified and is not my usual vet) and I just couldn't see how it was all going to heal without some form of shoe to hold it all together. I made one final desperate call to my vet (thankfully my usual on). She took one look at him and agreed with me-he needed a referral to Newmarket Equine Hospital.

Ted spent 10 days at NEH during which time they stabilised him, got painkillers into him, put him on a broad spectrum antibiotic and started getting him to eat again. They also x-rayed him which revealed by some miracle that there were no fractures. After 2 or 3 days he had a pair of reverse shoes fitted to take the pressure off his toes and they greatly increased his comfort. He also had his feet soaked, cleaned and dressed every day. I collected him on 19/03 with instructions to change the dressings every day and keep him on complete box rest. My vet was happy that he would eventually make a full recovery. He finished the bute about a week ago, and seemed much brighter and happier, eating me out of house and home. The discharge from the infections had reduced significantly and his coat was looking much brighter. He is starting to change it and it was no longer flakey and scabby like it was when he was first discharged. I took him back on 08/04 for further x-rays, a trim and a new set of reverse shoes. Sadly the x-ray showed that Ted had developed Pedal Osteitis (demineralisation and reabsorption of the pedal bone) in both hind feet. The left is worse that the right, but when viewed above there is grey semi-circle of demineralisation across the middle of the pedal bone. His chances of making a full recovery have now gone back down to 50/50 and basically if he loses the lower portion of the pedal bone he is a gonner. All I can do now is support him nutritionally and keep changing the dressings and keeping it all clean. The rest is down to him-he needs to grow some foot and connective tissue/blood vessels and I need to keep my fingers crossed that he readopts the pedal bone and doesn't reject it!

The worst bit is that we just don't know what is going on in there. There may be more demineralisation to come, or we may be over the worst and coming out the other side. He has obviously grown new tissue in those feet as when he was first admitted the pedal bone could be seen in the hoof cavity. That area is now completely full of new tissue. He goes back to NEH on 4 weeks for another trim and more x-rays. He was a bit sore after the debridement of part of his sole and new shoes, but is now picking up again and eating, well, like a horse. We will know more then, but in the meantime I just wanted to know it:
1. Anyone had any experience of an injury like this? What happened and how did you cope?
2. Any tips (feeding or otherwise) to get hoof to grow?

Thanks for reading this marathon, and thanks in advance for your help.....

I'm going to try and attach some photos that I took this morning so you can see what I'm talking about.



 
I'm so very sorry that your horse has had such a terrible accident.

I can't see the photos, can you try to post them again?
Can you post the x-rays?
 
Im guessing that the infection caused an osteomilitis. It can happen sometimes when a foreign body punctures the sole and touches the bone. in your case it sounds like the clip of the shoe. Do not despair, im sure the vets have got all bases covered. We quite often have to remove sections of the pedal bone at the toe when they have problems (kerotomas or infections) and they do just fine after.The key will be to make sure the bone is free of infection and the inlamatory conditions treated.
 
Thanks both for your replies.

Faracat-I thought that might happen! I will try again but think I might have limited success. I'm trying to post from Skydrive if you have any tips?! The photos are saved to my hard drive.... I don't have access to the x-rays unfortunately.

A Guilding-From what I can gather (it was all a bit of a daze on Monday to be honest!) the vets thinks that it is non septic Pedal Osteitis caused by the trauma of what happened in the trailer, and the infection is secondary, rather than the infection causing the demineralisation if that makes sense?! :confused: The grey area of demineralisation is a central band horizontally across the sole of the pedal bone as you look at it from below. Thanks for your advice-I'm keeping my fingers crossed and the kettle on for all those warm salty foot baths to keep infection at bay! :)

I will try and post pictures again....
 
Thanks both for your replies.

Faracat-I thought that might happen! I will try again but think I might have limited success. I'm trying to post from Skydrive if you have any tips?! The photos are saved to my hard drive.... I don't have access to the x-rays unfortunately.

A Guilding-From what I can gather (it was all a bit of a daze on Monday to be honest!) the vets thinks that it is non septic Pedal Osteitis caused by the trauma of what happened in the trailer, and the infection is secondary, rather than the infection causing the demineralisation if that makes sense?! :confused: The grey area of demineralisation is a central band horizontally across the sole of the pedal bone as you look at it from below. Thanks for your advice-I'm keeping my fingers crossed and the kettle on for all those warm salty foot baths to keep infection at bay! :)

I will try and post pictures again....
We use sugardine, works well. I did one today that got caught in the walker, cut it out and tacked a shoe on, I was in two minds as to whether to put a reverse shoe on it but put a normal one on it. the sole and wall juction had separated, you could see inside the foot, I did photo it but the button pushers take great delight in jumping on me if I put any pics up.
 
A Guilding-Thanks for that. I'm currently Bandaging Animalintex onto the weeping areas but will Google Sugardine and see where I can get hold of some.

Victoria1980x-Yeah, it's been awful. I've been sitting up with him until 1am at times it's been emotionally and physically exhausting. He's such a gentle soul, he really doesn't deserve this.
 
Always check with your vet before taking random advice from the intertweb, sugardine is just sugar mixed in a saucer with iodine. spoon it on and vet wrap it up, Im sure if you ring vet tomorrow they will say good idea.
 
Thanks for the explanation-I'd never heard of Sugardine before but the name makes sense now! You read my mind about running it past my vet first-you're right about random advice from the internet, especially as I'd never heard of it! ;) Thanks again for your help :)
 
Thanks for the explanation-I'd never heard of Sugardine before but the name makes sense now! You read my mind about running it past my vet first-you're right about random advice from the internet, especially as I'd never heard of it! ;) Thanks again for your help :)

Let me know how you get on.
 
My mare had pedal osteitis in one foot a few years ago - seemed to be linked to a foreign body abscess, though we never did find the foreign body. My vets said that the only treatment was to remove the infected bit of bone, so she had surgery under general anaesthetic. It was successful, and she has done well in dressage since. I would have a very frank talk with the vets who took the x-rays that showed demineralisation - if there is still infection there, presumably it either needs to be physically removed or you need an aggressive course of antibiotics. Any external preparations will help external infection, but not infection in the bone.
I have to say that in hindsight I might have decided to PTS - my mare developed laminitis as a result of the anaesthetic (although I think it may also have been linked to subclinical Cushings, which is now clinical) and so her recovery wasn't straightforward.
 
Soloequestrian-Thanks for your reply, it's reassuring that you managed to get your mare through it. Your mare sounds very similar to one I had a few years ago-developed an abscess which I couldn't shift, ended up with septic Pedal Osteitis and an operation. Looking at the piece of bone they took out of her foot you could clearly see an indentation like the pointy end of a nail, never did find it though! Surgery is certainly on the cards for Ted, although having spoken to the vet on Monday (and from what I can remember!) it really depends on whether he rejects the damaged parts of the pedal bone and how much he rejects. If he rejects the whole lower portion from the demineralisation down then she wouldn't be able to operate as he would lose about 50% of his pedal bone. In that situation then PTS is going to be the only way to go. She thinks that the Pedal Osteitis was caused by the trauma of thrashing about in the trailer, rather than the infection which occurred as a secondary thing after ripping his feet open. The x-rays would certainly support this as the line of demineralisation neatly follows the tear in his sole. Frustratingly I think it's just a waiting game and trying to find a good hoof supplement to encourage him to grow some foot! Off to work now to try and take my mind off it! :)
 
I've been away from this for a while but I did ask my vet about topical applications for the exposed part of Ted's feet. She said no to this so I have not put anything on it and have been continuing with the salt water soaks. The amount of pus being discharged has decreased and the right foot is drying up and appears to be trying to heal. The granulation tissue is now massive in the left foot and when the dressings are off it hangs down below the line of the hoof. He seems to be getting more sore the larger the granulation tissue gets so I'm hoping that this is down to the pressure on the sole from the large amount of granulation tissue and not further demineralisation of the pedal bone. He's back on Wednesday for further x-rays and another shoeing so fingers crossed.....
 
Don't have any advice, way beyond anything I know.

But just wanted to wish both of you all the best and sending hopes for a good outcome as well as sympathy.
 
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