Lameness in forelegs

[helenhunterlivestock]

I own a 17 yo, 16hh, Dutch Warmblood / Hackney gelding. He has had a long career as a carriage horse, and until recently competing Nationally across the country. He has been intermittently lame since November 2011, on his off fore, and is short and "pottery" in his stride. Tradionally a very active horse, even at rest in the field, initial diagnosis was laminitis. An abcess erupted through his frog within a few days, and he became sound again, until 10 days later when a further antibiotic injection was administered as slight lameness on the off fore was noted, but no further pus was seen. He has been on field rest, stabled only when the weather dictates since this time.
Following lameness for the last 2 weeks, he is now on 2 sachets Danilon, twice daily, and is still "pottery" and short on the off fore, locomtion of all legs is reduced. If this dose is reduced to 1 sachet, twice daily, lameness is pronounced. Blood tests revealed a raised insulin level, further tests for Cushings have proved negative. Glucose levels are all within normal ranges, so Laminitis also discounted.
He is currently being fed 400gms D&H Safe and Sound, 400gms Alfalfa-A with Oil, twice daily, receives a heaped (mineral) scoop of local feed company branded all purpose mineral balancer and 2 half mineral scoops of same company branded digestive enhancer. Large haylage net when stabled at night. This feed regime has not changed, other than the inclusion of digestive enhancer in the last 2 weeks since October 2011.
Horse remains bright and perky throughout all this. No flexion tests conducted so far.

 

[rhino]

Antibiotics for a sub solar abscess?

If it was my horse I'd be asking for some more diagnostic work - 4 danilon a day is a hell of a lot for a horse to be on long term without knowing the cause.. At 17 elevated insulin levels are not hugely unexpected, so I would really want to know what was causing the lameness.

I would be wanting nerve blocks to identify the area of concern, and take it from there.

 

[cptrayes]

Giving antibiotics for a foot abscess often results in the abscess "going to ground" and failing to come out properly, that is why they are normally contra-indicated for foot abscesses and it is a surprise that your vet prescribed them.

The two doses of antibiotics may have done this with your horse, and the continued use of anti-inflammatories may be preventing the abscess from breaking out of his foot properly.

I would now be asking for xrays to make sure it is nothing but the abscess, and provided that it is, taking him off all meds and letting this abscess make its way to somewhere where it will either release itself or can be cut an exit hole. Yes, he will be crippled lame until it does, but the alternative is this dragging on lameness that can result in deep infection in the foot.