Keratoma - Your experiences please

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Flame_

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My young arab has just had a keratoma removed. He's home and has to have a bar shoe put on, bute, his dressing changed every day and box rest, with my vet coming in a few days and hopefully he'll be able to tell me a bit more. They didn't have to remove his hoof right up to the coronary band, but its still a good, deep chunk. I've no previous experience with keratoma and I'd just like to know a bit more, like possible problems to watch out for. Also are horses usually on total box rest until the foot has re-grown or does controlled exercise get introduced at all?

Sorry, I'm a total numpty about this problem and would just love a bit more information if possible please.
 
There's someone that posts in competition riders just had this op on one of her horses, I saw it on fb first though, her page is called shoestring eventing. It was interesting as I have never heard of it before, can't remember her username but I'm sure if you do a search you will find it.
 
I have only assisted as the farrier in a few keratoma operations, but the first thing that I was made aware of is the necessity to think of the opposing hoof, we found it very necessary to make sure the hoof was supported and balanced as it is now taking more weight, in the case of the patient being barefoot it was always easier due to the frog having more contact, although when the horse in being kept in there is always the increased chance of the frog weakening, so be vigilant.
In the case of the apposing hoof being shod (why?) then I would recommend a well fitting hart bar
As for the offending hoof, as long as all the problem tissue has been removed the hoof can get on with the process of naturally healing and growing new and healthy tissue.
Do remember that although box rest can be the best way to effect good management, you do not want to create a situation where when the horse is allowed out you have a sudden increase on leverage, concussion, and mobility on all the new tissue that has been produced.
So as soon as it is possible I find it beneficial to get things working to the best of their ability in order to lessen the shock.
 
That horse had its op on the same day as mine. :)

Thanks for the replies, its all a help. I'm a bit paranoid I'll do something wrong, the hospital were great but my aftercare sheet was absolutely minimal.
 
Mine has got one and we are waiting for a op date to come though. Hope your's recovers quickly. Im surpise on how many Keretomas I have read about laterly as I thought they were uncommon.
 
Here's Beau's xray. Found out there is a lot more going on in his foot then I knew :(. Which is being dealt with our new farrier. It now explains why we kept getting foot abscess one after another!!!

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Sorry it's huge!!
 
An observation, I've seen many Keratomas when dissecting feet for educational purposes. They seem quite common and not very large physically. I am sceptical as to whether most of these actually cause any problems, given the adaptability of the inner wall and laminae in the equine digit. I'd want to be very sure that it was the cause of pain before I agreed to having one removed.
 
Interesting thread, my horse indeed had one removed on Tuesday you can read all about it to date here. http://www.shoestringeventing.co.uk/keratoma.html

Re the post above I have heard of many being successfully left untreated, my horse got really bad abscesses laterally and as a top class competition animal something has been slightly amiss for the last 2 years I am hoping this may explain some things.
 
Bojangles, I hope you don't have to wait too long, I had a two week wait for the operation. My horse didn't actually have any abscesses and he was never lame but he did foot point so it was bothering him.
 
Flame_ said:
Bojangles, I hope you don't have to wait too long, I had a two week wait for the operation. My horse didn't actually have any abscesses and he was never lame but he did foot point so it was bothering him.
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Me too!!! I have thought about this op for a long time before saying anything to anyone as I wanted to make sure I was happy with my choose.

He have already had a foot abscess that went to the surfure of the Pedal bone and spent a week at RVC for this. Then every 6 months he kept throwing a abscess in same foot same spot vet didnt think anything of it just him being pone to them so didnt go any further.

Luckly we havnt had any in this foot for nearly two year's I just don't want to risk another foot abscess getting near pedal bone!! It wasnt untill I changed vet's and farriers that I was told of this keretoma I did notich the odd shape foot didnt think much of it. The only thing that did worry me was that the outer white line part was streched a lot more to the inside and now it all makes sense!!

There is a lot more that makes sense even more just thinking about every problem we've had I do wonder now is it all due to this keretoma.
 
Oh I don't think it will heal, I think he has to grow it out. Thanks for asking.

My horse is looking a bit brighter in himself as he'd been a bit quiet and off his food over the weekend. Farrier came yesterday to shoe him but couldn't as the section of hoof wall removed was bigger than he'd expected so he's making something up to go on next week. He did explain that my horse needed a heart bar shoe that put extra weight on the frog because there is so little hoof wall down one side of the foot that the pressure of weight bearing could cause what is there to split and collapse.

The actual open bit of hoof is lovely and clean and dry, I'd expected it to look pretty disgusting but it doesn't, so at least that's something. Its going to be a long road.

Have you got a date for your horse's op yet?
 
Flame_ said:
Oh I don't think it will heal, I think he has to grow it out. Thanks for asking.

My horse is looking a bit brighter in himself as he'd been a bit quiet and off his food over the weekend. Farrier came yesterday to shoe him but couldn't as the section of hoof wall removed was bigger than he'd expected so he's making something up to go on next week. He did explain that my horse needed a heart bar shoe that put extra weight on the frog because there is so little hoof wall down one side of the foot that the pressure of weight bearing could cause what is there to split and collapse.

The actual open bit of hoof is lovely and clean and dry, I'd expected it to look pretty disgusting but it doesn't, so at least that's something. Its going to be a long road.

Have you got a date for your horse's op yet?
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Sorry that is what I meant just worded it wrong. Glad all going well. Any photo's of it?? No still no date yet :(
 
Sorry no photos, I keep thinking I must take some but I just need to pull my finger out and do it, my YM's taken some. I'll do it at the weekend.

If they keep you waiting ages for an appointment I can give you the contact details for where my horse went if you like, they were very efficient.
 
Flame_ said:
Sorry no photos, I keep thinking I must take some but I just need to pull my finger out and do it, my YM's taken some. I'll do it at the weekend.

If they keep you waiting ages for an appointment I can give you the contact details for where my horse went if you like, they were very efficient.
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Photos would be fab. Im not sure on how much wall will taken out so would be good to see any differents way's

Theres a new person at the vet's who only started this month wants to make sure everything is ok before he op on Thank's anyway just hope it soon.
 
Hi,
My Thoroughbred had a keratoma removed in 2008, he had a v cut in the front of his hoof up to about 1/2 inch from his coronet band. He had a normal shoe put back on but had a metal plate made that would squash the dressing in the front of the hoof. You need to make sure that the dressing is in tight because otherwise the hoof doesnt grow back strong and you get what they call proud flesh, yep it does grow in the hoof I was amazed.

He was on total box rest, and I made a leather boot to cover the entire foot to make sure that no dirt or anything can get in. Even though its bandaged, it is hard to stop the Urine being soaked up which can cause infection.

Our dressing changes consisted of sterilising the floor, then bringing him in, taking off the leather boot, take of the metal cover, which needed a socket rench as it had 4 screws on the base, then removing the plastic tape which is that real hardy black tape that we covered the base of the bandage, remove the bandage, then cotton wool, then gause bandage, all the time trying to keep the hoof off the floor even though it was sterile, only if we could get him to stand on a sterile sheet would we put the hoof down. We then removed the packed in dressing which had tape over the front of the hoof, then had cotton wool, then gause, which was sugar and iodine one day and this cream which for the life of me I cannot remember the name of.

We cleaned it daily with iodine then packed it again. At one stage when the proud flesh was growing, the vet had to cut it out, so keep a close eye, because you dont want that to form.

He also got a bit of a smelly foot so we had this blue sprey that is a disinfectant that you spray all round the hoof even on the wound after a bit.

Mine was on box rest for a long time, however I was allowed to sedate him and take him for a little walk, but had to make sure he was sedated as he is highly strung. This went on for about 6 months before he could be turned out, then he was turned out in one of those rubber boots, to ensure no additional rubbish got in the hoof as its still growing.

He is totally sound now, has to wear pads on his front feed but then he is a thoroughbred and he has always had sensitive feet.

Do not try and rush the recovery, you do not want an infection to get in the hoof as it can travel anywhere and cause a lot of problems. Make sure you keep it as sterile as possible.

My husband was a great help through this as he is a big chap, however trying to hold up half a ton of inquisitive bulk is not an easy task and he ended up getting injured himself, I also received a knee in the head which knocked me out temporarily, so be careful, they get rather bored and it becomes a bit of a dangerous game.

Good luck, they are worth it :)
 
SFreyne said:
Hi,
My Thoroughbred had a keratoma removed in 2008, he had a v cut in the front of his hoof up to about 1/2 inch from his coronet band. He had a normal shoe put back on but had a metal plate made that would squash the dressing in the front of the hoof. You need to make sure that the dressing is in tight because otherwise the hoof doesnt grow back strong and you get what they call proud flesh, yep it does grow in the hoof I was amazed.

He was on total box rest, and I made a leather boot to cover the entire foot to make sure that no dirt or anything can get in. Even though its bandaged, it is hard to stop the Urine being soaked up which can cause infection.

Our dressing changes consisted of sterilising the floor, then bringing him in, taking off the leather boot, take of the metal cover, which needed a socket rench as it had 4 screws on the base, then removing the plastic tape which is that real hardy black tape that we covered the base of the bandage, remove the bandage, then cotton wool, then gause bandage, all the time trying to keep the hoof off the floor even though it was sterile, only if we could get him to stand on a sterile sheet would we put the hoof down. We then removed the packed in dressing which had tape over the front of the hoof, then had cotton wool, then gause, which was sugar and iodine one day and this cream which for the life of me I cannot remember the name of.

We cleaned it daily with iodine then packed it again. At one stage when the proud flesh was growing, the vet had to cut it out, so keep a close eye, because you dont want that to form.

He also got a bit of a smelly foot so we had this blue sprey that is a disinfectant that you spray all round the hoof even on the wound after a bit.

Mine was on box rest for a long time, however I was allowed to sedate him and take him for a little walk, but had to make sure he was sedated as he is highly strung. This went on for about 6 months before he could be turned out, then he was turned out in one of those rubber boots, to ensure no additional rubbish got in the hoof as its still growing.

He is totally sound now, has to wear pads on his front feed but then he is a thoroughbred and he has always had sensitive feet.

Do not try and rush the recovery, you do not want an infection to get in the hoof as it can travel anywhere and cause a lot of problems. Make sure you keep it as sterile as possible.

My husband was a great help through this as he is a big chap, however trying to hold up half a ton of inquisitive bulk is not an easy task and he ended up getting injured himself, I also received a knee in the head which knocked me out temporarily, so be careful, they get rather bored and it becomes a bit of a dangerous game.

Good luck, they are worth it :)
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Thank's for this. I wasnt aware of proud fresh growing there. How did you make the leather boot I think that would be a fab idea too for mine. Did you take any photos thoughout??
 
Thanks for your detailed reply, SFreyne, and welcome to HHO.

All your advice is really helpful. The vets haven't said my horse needs a hospital plate, just a bar shoe so I hope that's because in his case he doesn't need one :confused:
 
Photos of Miyaz's poorly foot for anyone interested. It's not actually that revolting colour, or gammy at all, its just a bit plastered in sugar and iodine.

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Poor boy. He is unlucky, he's not even six yet. :( I hope its sorted and doesn't come back.
 
More keratoma removal photos would be fab, thanks. :)

Miyaz is being so good, bless him, he's really settled and chilled. I think he must still be feeling a bit sore and sad because even though he's generally a mellow little chap, he is a fidgit and gets buzzy when horses come in and out, etc, and he's just standing in his box not bothered.
 
Oh that's good news, don't be :( , the sooner its done the sooner he'll be on the mend! Have they told you whether they're operating under general or local?
 
Flame_ said:
Oh that's good news, don't be :( , the sooner its done the sooner he'll be on the mend! Have they told you whether they're operating under general or local?
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I know just didnt think it would happern this quickly it is for the best like you say sooner he be back out if only it that simply!! I think it's going to be under general.
 
I just thought I'd bring this back up to give anyone who knows my arab an update about him and in case it might help anyone in the future.

Its been four weeks since my horse's keratoma surgery. He's still on total box rest, still on a painkiller (Metacam, IIRC :confused: not bute) and still pointing his bad foot. However vet and farrier are pleased with how its looking and think he might be able to go out in about a month which sounds a bit optimistic to me but great if he is ready.

I took some photos on the day his heart bar was fitted, 22nd February, two weeks post-op.

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Then some more last Tuesday, 6th March, four weeks post-op when farrier came the fill in his missing chunk of hoof wall.

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Farrier cleaned it really thoroughly with hibiscrub before filling it with silicone type stuff which sets to form a replacement hoof wall. I think it looks amazing and I have to say, my farrier is pretty awesome. :cool:
 
Thank's for putting them up. I will take some of Beau today as vet coming to change dressing. I think Beau hole is about the same size as yours. He has got a hosiptal plate shoe on. Im not sure if he will having the fillier stuff put in will ask vet about that too. Luckly he bute free and walking around fine. Im still surpised over this vet happy and so is Beau it's just me panicing yet again!! He is being a bugger to take his antibods and the hoof supplement!! So Im having to syrine it into him which isnt easy as he big and me small!! Tried sugar free jam sandwich, yougut nope wouldnt touch his feed!!
 
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