Odd lameness present before & after abscess...(also on main board)

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RoughcutDiamond

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Bit long winded I'm afraid but wondering if anyone has had any similar experiences.....

..Davie had a few weeks of intermittently just not "feeling right" through September though never lame, just couldn't putmy finger on it. Around 24th Oct came in from field lame with heat/swelling in left fore...wondered if this was the culmination of the"off" feelings so cold hosed etc etc overnight and when no change next day got vet out. No response to hoof testers, lame on left rein but visibly worse on right rein (but lifting head when left hoof landing). Nerve blocked left hoof, left rein a tiny bit better, right rein still awful. Vet (who was leaving practice that week) booked him in for x-rays/scans the following week. Box rested from that point.

5 days later leg filled, pony obviously very sore so called vet out (she has since managed Davie's investigations). Explained all the above, she did hoof test again with no reaction but decided to cover all bases, take shoe off and poultice in any case....did hoof test again and found abscess under shoe. Had a dig and the pus came pouring out, thick, black and smelling worse than any other abscess I've witnessed. So x-ray appointment cancelled whilst we poulticed and got abscess dried out.

Vet was out to yard on Monday so I got her to check things over and we popped him on the lunge only to find the lameness still present as it had been originally . We've spent the last 2 days at the clinic. Left leg nerve blocked up to mid cannon with a vast improvement, then really thorough x rays and scans (inc of right leg for comparison). Everything came back absolutely clear which from one point of view is great but it means we still don't have a cause. There is the option to block the fetlock joint and the tendon sheath but Davie has (since the abscess) a recurring oedema in the affected leg which goes down after a short walk and vet didn't really want to risk rying to nerve block through the swelling. Last option would be a bone scan.

In the meantime the suggestion is that the abscess may well have been building for several weeks (perhaps accounting for the "not right" feeling) and therefore the internal bruising/swelling it caused may just take time to come right. I am waiting on a detailed e-mailed plan of action from vet but broadly speaking it seems we are going to go for getting the shoe back on (sole packed and hoof floated as farrier sees fit), then try a strict exercise programme prob starting with 10 mins walk in the school daily.

Obviously I am glad his musculo-skeletal aspects have had a clean bill of health but am still anxious.......has anyone had similar experiences, or does anyone have any ideas??

Sorry is so long - Maltesers and a dram of Baileys all round!!
 
To be honest I am stunned at the amount of investigation which has already taken place into a horse which has a hole in his foot and a shoe off. Does he also still have a shoe on the other foot, so he has one leg longer than the other too? It is barely two weeks since you exposed a huge abscess which had been brewing for at least five days and possibly the best part of two months. I would have expected your vet to wait until the shoe was back on and the horse given time for the newly shod foot to settle before doing the investigations which have already been done, but that's why insurance is now so expensive that I can't justify paying it for three horses :(

Depending on just how lame the horse is, this seems like far too early to be worrying to me, it's par for the course for a large foot abscess that's been weeks in the brewing to take a couple of weeks to settle again, especially if it's got a bleedin' great hole in it.

Good luck with it, and let us know if it's something extra to the abscess when you've got the shoe back on.
 
Interesting PoV....it's so hard when you have to put your entire trust in someone else because you don't have the knowledge yourself! I try to learn what I can from other horses health issues as Davie hasn't needed a single Danilon in the 4 years I've had him so this is all new. Yes, he still has the other shoes on (and it had occurred to me that I would be awful uncomfortable walking about with different length legs for 2 weeks...).

He was assessed as 1/5 lame on left rein and 2/5 lame on right......to me he obv looks bloomin awful but prob not to the vet/more experienced eye?

Thanks for the good wishes, will keep board posted.
 
If the hole is on the inside edge of the left foot, I would expect that lameness pattern. Try not to worry too much, I think your vet has escalated far too soon personally, but as you say, you have to trust people you pay to give you their best advice. It still sounds to me like the abscess should be to blame, and as if it is not yet completely finished with, even though it's not showing on xrays. Good luck with the shoe going back on. Hold your concern until it's been back on a couple of days.
 
Yes, hole IS on inside edge of left foot! The original site dried up a week ago after 6 days poulticing. There is still some swelling daily in his fetlock and slightly higher up the leg which disappears when I pop him in a neighbours stable for mucking out and he fidgets about playing with buckets etc or I take him out for an in-hand graze....makes me wonder if there is a secondary abscess brewing somewhere although nothing showed on the x-rays (I understand gas tracks can be identified but can pus???). Asking about the consensus is that vet has escalated quickly but, being selfish, it has given me some peace of mind that all the structures in the legs and feet are sound.
 
It sounds to me as if one of two things is going on. The first is that the abscess may not be finished, but if the vet cut the size of hole that vets often cut, and given how long it was poulticed for, then it's unlikely. The second is that the abscess had already been brewing for so long that it tracked upwards and was about to blow at the coronet.

If this is the case, and I think it is likely, then you need to understand that there may be a strip of an inch of more wide of laminae which are dead, from his sole to his coronet. Without a shoe, levering at this lack of attachment will cause considerable pain when he is on the right rein and putting weight on the inside of his left foot. Until a shoe goes back on to stop that leverage, he's going to be very unhappy. I'm guessing he'll be fine once the shoe is back in place.

Let us know, won't you?
 
cptrayes has hit several nails on the head! Abcesses are often preceded by slight lameness - usually a stone bruise. The abcess builds up and it may well spread sideways, or travel up the white line. Vets tend to be a bit conservative on cutting out an abcess - and often miss a secondary area of infection. Even if that HASN'T happened, just being one shoe on and one off is enough to cause some inflammation and soreness.

It can take several weeks (at least) for a horse to be completely sound after an abcess!
 
An update......farrier out last Friday - packed hole and put shoe on and said he was happy for normal turnout to be resumed. Vet preferred walking for a week beforehand but with my shift work this was going to prove very hard so I took an informed decision (seeing as all scans etc were clear) and he has been turned out for a few hours each day. Brought him in tonight, walked him for a while then popped him on the lunge. Seems 100% sound on left rein :) and there is only an almost imperceptible nod on the right which, going by you CPT would be consistent with recovery from the abscess site.

Interestingly I had a recommended "back man" out last Saturday - Davie's coccyx was out, estimated for 3 months and might show up as intermittent lameness on forelimbs....which is exactly how all this started and the timeline fits too. Didn't give the guy any info prior to treatment. Pone certainly looks better along his back tonight than I think I have ever seen him. Perhaps the abscess was a red herring....

Thank you all again for your advice and opinions. Going to bring him back into work very slowly and carefully just to be on the safe side. xx
 
I've also had a horse with a sacroiliac issue (unlevel tuber sacrale) present with inconsistent front limb lameness over several months, so that fits.

Good news that your abscess looks fixed. My horse with the tuber sacrale strain evented afterwards with no issues, so hopefully the rest from having had the abscess will have sorted that out too.

Thanks for letting us know. Hope all goes well from now on.
 
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