Hopping lame but not an abscess

[acw295]

Interested to hear what people might think might be responsible for this. Background-23yo Welsh cob x mare. Semi retired, in light hacking work. Aways slightly fat despite careful management as a potent laminitic (although no history).

Hopping lame from field on LF suddenly on Saturday, abscess type lameness. Has had bute and poulticing all week, no worse but no better. Has seen vet once and farrier twice, not really reactive to hoof testers, strong pulse in the LF only. They’ve all had an unsuccessful dig for abscess.

She has a history of tenosynovitis in all legs, and had ALS in LH in 2017. Also had a splint fracture in LH 2012. The LF tendon sheath seems like it always is, bit swollen but there’s no heat anywhere. She has got slighly dropped fetlocks in front this year though and she is a bit long in the toe/underun heels which farrier has been trying to support (only shod in front).

X-rays are booked. Assuming it’s not an abscess that’s hard to find, or laminitis (vet and farrier thinks not), what do you think it’s more likely to be? Google suggests anything from pedal fracture to DDFT. I’m trying to to panic but feel sick with worry.

 

[shortstuff99]

Could there be a puncture wound somewhere, even if it is very small?

A puncture wound made one of mine look absolutely crippled.

 

[ycbm]

It could still be an abscess, especially as she has been given bute, which will have stopped it developing and eating its way to the surface or somewhere easier to find. Bute isn't usually recommended for abscesses, for that reason.

I hope you find it's something simple.
.

 

[OrangeAndLemon]

Mine did the same. No reaction to hoof testers. No heat or swelling anywhere, no cuts, no injuries. Vet said most likely was that he'd booted a wall and broken something but as the wall was still there without a scratch on it we discounted that one. He had bute to make him more comfortable because he was non weight bearing so in a lot of pain. (No temp or change to heart rate or respiration)

It was dermatitis. The swelling and scabs didn't appear for another day or two.

 

[brighteyes]

My TB was the same. Hopping lame, very hot leg and foot but nothing at all to see. Zilch. Farrier came and dug a bit - nothing. Completely sound a couple of days later.

 

[meleeka]

Mine was similar and was an abscess. Hot tubbed twice a day and eventually did burst through the top.

 

[acw295]

X-rays don't appear to show anything, vet going to have a really thorough look at the images back at the vets but as far as he could see on the yard (very sunny conditions so not optimum for looking closely) there was nothing obvious. No sign of anything broken, nothing there shouldn't be (eg no sidebone etc) and pedal bone looks normal where it should be. Nothing degenerative.

Completely unreactive to hoof testers, nerve block confirms definitely that pit's the hoof only (trotted up sound when blocked).

So box rest and bute for 10 days and see what happens. Hope is an abscess will come out at the top somewhere - worse case it's a soft tissue in hoof job. Vet said he can't 100% rule out laminitis but given it's just the one hoof and no reaction to testers it's unlikely - but the bute and rest won't hurt if there is any chance it's that.

Ho hum - off to juggle work, toddler and now a box rested pony. Thank god for lovely YO's - I know they get a lot of stick but mine is lovely and helps no end (for free!)

 

[PSD]

If it’s an abscess the bute will prolong it surfacing.

 

[fankino04]

A friend's horse was like this last year, never got to the bottom of it but was fine after 2 days box rest and Bute. Mine was hopping on Tuesday morning and only mildly lame by the afternoon ( she's still not 100% but vet said not worth interfering as whatever it is is obviously getting better or if an abscess will suddenly get worse and deal with then). Bloody horses!!

 

[ihatework]

I wouldn’t rule out abscess yet.
But if crippled I would to be safe assume laminitis. Even if it’s just soft tissue in the foot immobility on a deep surface won’t hurt. Keep the foot poulticed too, right up over coronet (which is where it will burst if digging isn’t locating it).

 

[acw295]

She's non weight bearing without the bute and vet more worried that spending too long like that will give us other issues. She's absolutely crippled - we took it down to 1 bute mid week for the farrier to take a second look and we could barely get her out of the stable as she was on 3 legs. On 2 bute she can take a few steps and will stand on it.

I'm also not prepared to have her in that much pain - it's already been a week and she looks exhausted with it.

 

[acw295]

A friend's horse was like this last year, never got to the bottom of it but was fine after 2 days box rest and Bute. Mine was hopping on Tuesday morning and only mildly lame by the afternoon ( she's still not 100% but vet said not worth interfering as whatever it is is obviously getting better or if an abscess will suddenly get worse and deal with then). Bloody horses!!

We're already on day 7 of box rest and bute and getting no better

 

[pistolpete]

Oh I really feel for you nothing worse than seeing them in pain. Not much to add except straw clutching! Ultra sound? Thermal imaging? I had a splinter last year which was agony. Nothing showed in my X-ray or ultrasound either. Lots of physio when she’s better as compensating going on will be epic! I’d throw a calmer in too if she’s that unhappy. Trinity do a whole range of them.

 

[ester]

Poor girl, frustrating xrays in that you can rule out some of the major issues but be no further forward.

Bute and abscesses is tricky, while the preference is to not bute it can become a welfare concern giving nothing. Presumably shoe is off, are you able to get hold of any boot options as they might keep her more comfortable.

 

[ycbm]

IMO, it would be very, very unlikely that a soft tissue injury inside the foot would cause her to be non weight bearing without bute. If it doesn't surface as an abscess soon, then I would expect your vet to want a second set of x rays, as fractures sometimes don't show up on the first one and have to "mature". .

I hope it's just an abscess but foot fractures often mend easily.
.

 

[Tiddlypom]

OP, I hope that your horse is more comfortable soon.

I know that some horse owners do not believe in giving bute to horses who are potentially brewing an abscess, but leaving a horse on three legs with no pain relief is a welfare issue, which most vets are not happy with.

Treating as suspect lami as suggested above by box resting on a deep bed sounds wise in the interim.

 

[wanderersmelody]

Interesting to follow as my horse the same although he's had a steroid injection and I suspect this has brought on lami as he was non weight bearing on front 2 feet for 2 days, and then it seemed to transfer to behind on RH. He sounds the same - crippled. I got farrier to check for abscess, but nothing showing. He is on 1 bute twice a day and 25 paracetamol twice a day. I am on day 6 of him being like this and last night I padded his back foot with animal wool, a gamgee pad, vetwrap and duck tape and He's improved 30% overnight by comparison in that he can put his foot down and walk around in some fashion. I would also treat as susp lami. My horse isn't your typical lami type at all. He had x ays on all 4 feet a week ago - no rotation of pedal bone and no abscess showing, but he is back tomorrow for more x rays, and assessment, so I will update you on his findings. Fingers crossed for you.

 

[SEL]

I would get a warm, wet poultice on even if you can't spot an abscess.

My old YO was big on poulticing - they practically had to have a dangling leg for him to think it was anything other than an abscess. He was usually right too. He persuaded a fellow livery as a last resort 'well it won't harm' to hot poultice from the coronet band down and wow did nasty gunk come out after a week. We're talking green, smelly and went on for days. Then just as the horse looked to improve it got non weight bearing again and the second abscess burst through the frog.

Vet guessed that a small blackthorn had probably worked its way in somehow and caused the infection. Nothing had shown on the x rays and we never saw anything on the poultice.

I'm going to do my pus dance for you and hope its nothing more serious

 

[Birker2020]

Problems within the hoof can be hard to detect because everything is crammed into such a small area. Xrays will show changes in the bones, but won't show soft tissue problems but an MRI might be the best solution. I know this can be an expensive thing to do and some insurance companies will only pay 50%.

Did the vet rule out a keratoma? It can present as sudden and severe. My friends horse had this and was fine one day and very very lame the next.
Fingers crossed you manage to sort this out.

 

[FFAQ]

OP, any news?

 

[SusieT]

If no obvious abscess she should be x-rayed to check for boney damage. If no boney damage treat as an sbcess for aw eek or two as they don't always blow immediately.
I would strongly disagree with not giving a painful horse bute - the old wives tale about it delaying abscesses has no evidence behind it at all. If you had a giant abscess in your foot you can bet you'd be taking painkillers.

 

[Pearlsacarolsinger]

If no obvious abscess she should be x-rayed to check for boney damage. If no boney damage treat as an sbcess for aw eek or two as they don't always blow immediately.
I would strongly disagree with not giving a painful horse bute - the old wives tale about it delaying abscesses has no evidence behind it at all. If you had a giant abscess in your foot you can bet you'd be taking painkillers.

It isn't an old wives' tale, bute isn't just a painkiller it is also an anti-inflammatory, so it stops the abscess coming to a head. However, of course you can't leave a horse on 3 legs without pain relief.

 

[acw295]

Hi, just an update to say there is no progress, no better and no worse.
I'm beside myself with worry now. Vet back this week to decide on next steps - going to probably mean an MRI.
Still non reactive to hoof testers, nothing from poulticing. We're not far off 3 weeks now.
I feel sick that I am going to lose her like this.

 

[acw295]

Problems within the hoof can be hard to detect because everything is crammed into such a small area. Xrays will show changes in the bones, but won't show soft tissue problems but an MRI might be the best solution. I know this can be an expensive thing to do and some insurance companies will only pay 50%.

Did the vet rule out a keratoma? It can present as sudden and severe. My friends horse had this and was fine one day and very very lame the next.
Fingers crossed you manage to sort this out.

She's not insured any more as she is 23 and had loads of exclusions. I can fund an MRI at a stretch but not easily especially as she doesn't travel without sedation. Luckily my vets has an MRI (Oakham Equine is my local vets).
No mention of a keratoma to date. That's another thing to worry about then

 

[Birker2020]

I feel sick that I am going to lose her like this.

Hey don't say that, I am sure it will be something simple that none of us have thought about.

I do think MRI might tell you the problem though. I don't expect its a keratoma, it was just a suggestion, they are pretty rare but easy enough to deal with.
Sorry you will have to fund this yourself. This is the problem, mine was around 20 when I gave up on the insurance. With six exclusions there was hardly any self harming open to her that would have been covered on the policy.

 

[acw295]

If no obvious abscess she should be x-rayed to check for boney damage. If no boney damage treat as an sbcess for aw eek or two as they don't always blow immediately.
I would strongly disagree with not giving a painful horse bute - the old wives tale about it delaying abscesses has no evidence behind it at all. If you had a giant abscess in your foot you can bet you'd be taking painkillers.

She had xrays - nothing to be seen on those, completely normal. We're on day 19 now.

 

[ycbm]

I'm surprised they aren't going to repeat the foot x rays before the expense of an MRI, it's well known that some fractures take a couple of weeks to show up on an x ray. (I'm saying only the foot because of the strong digital pulse). Soft tissue injuries in the foot don't usually result in "on three legs" lameness.
.

 

[acw295]

They haven't said what the plan is - it might be more Xrays before an MRI. Last visit after first Xrays was to do 10 days box rest and bute and see. I think vet was assuming abscess would appear by then. He said MRI as a last resort as he wouldn't want to do it too soon to find an abscess on there, especially as I am self funding and she doesn't travel easily.

I finding it very distressing to see her in such a state though. We've had straightforward abscesses before with that level of lameness for a few days. But this is just hideous. I know it could be laminitis still but not sure how they'll diagnose that for certain either?
I asked about a Cushings test but vet said levels would be too high with that much pain so not worth doing yet.

 

[acw295]

She nerve blocked sound to that foot too 10 days ago - so it was definitely only that foot and not leg or any other leg/foot.

But she looks crap everywhere now with that amount of box rest with her arthritis and all the compensating so she now just looks bad everywhere. I did put her in the school a few times and she was happier pottering about in there for a few mins while I mucked out. It's very soft rubber surface and very close to her stable. So she seems to prefer soft to hard which obviously supports lami.........
Arrggghhhh. I just sob every time I see her.

 

[pistolpete]

That’s so sad to read. I really hope they find something treatable. Or if not you’ll at least get an answer to why she’s so lame.