PEDAL BONE INFECTION - REALLY REALLY LONG POSTING!!!

Helen71

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Hello,

Just thought I would share my tale of woe with you all. Bear with me this is a long story and still not over yet – you might want to get some supplies!!!

I have owned Tango a gorgeous, kind, spooky 17hh Dutch WB gelding 7/8th aged 18 yrs for nearly 8 years now. He has always been sound except for a few cases of pus in foot.

June 2007 he picked up an old nail whilst out hacking (we were only 5 minutes down the road from home) the rusty old roofing nail went into his off-hind hoof through the sole at an angle, near the frog (approximately an inch in). I pulled the nail out and he was happy to stand and put weight down on the affected foot. There were a few drops of blood, I called my local vet on emergency duty and he advised to poultice it and call again if he got worse.

I poulticed and tubbed the foot and kept the foot wrapped up in vet wrap and tape to keep it clean. 3 days later he was slightly sore so I called my farrier and he came out to investigate the hole and released some pus, I continued to poultice and tub the foot and there was some improvement for the next couple of days and he was happy to walk and bear full weight on the foot.

Over the next weekend he was obviously more uncomfortable and only walking on the toe of the affected hoof. I called for my local vet to come out. He removed the shoe and pared the hoof along the route of the nail and took the frog away, down to its core. He then had a course of antibiotics and danalon. The foot was kept clean and wrapped up, I continued to tub the foot.

In the next week x-rays were taken and the path of the nail seemed to show that it was very close to the pedal bone but had not make contact.

Two weeks later the farrier came and put the shoe back on to see if it would encourage him to stand on the foot. This did help and there was some improvement. For the next week he was beginning to gradually use more of the foot to walk on (but not full use) and was bearing more weight on the affected foot when standing and resting.

A couple of weeks later I was away, whilst I was away he became very sore and the farrier came out again. There was a little bit of pus and the foot was foul smelling (may have been due to the wet weather and foot wrapping). He was kept in overnight and no dressing was put on – the hoof dried out and he showed improvement – but was still reluctant to use the foot.
Upon my return from holiday (not a great holiday did too much worrying and thinking) there was no improvement from when I left. He was reluctant to put the foot on the ground and use the full surface of the foot when walking. He was losing condition fast and fed up.

I asked my local vet to refer me to a vet clinic I used to work at and I got him up there a week later. He went in for surgery the next day and had two pieces of pedal bone removed and all the infection that had built up was scraped out. The poor chap having all that in his foot, I felt awful. The vet seemed to think that the nail may have caused the fracture when it first went in and then infection set in.

So we were all hoping for a good recovery. 4 days later I got a call from the vet and he said that he was not happy with how he was recovering and he would have to go under again to have a cast fitted to cover his whole foot up to just below the hock. The concern was that as so much pedal bone had been removed that there was not enough support for the coffin joint. What a nightmare. All was ok and he actually coped very well with the cast and became very comfortable and was able to come home after a few weeks once he had finished all his medication. What a relief to bring him home and set about pumping some feed into him, he had lost so much weight in hospital!

So he was on full box rest at home for another 5 weeks, I was able to lead him out to the lawn for some grass which kept him going. I spent most of the summer picking grass for him just to keep him interested in food.

Finally the time came when we could go back to the clinic for the removal of the cast, I had not seen his ‘naked’ foot for nearly 2 months. When the cast was removed everything looked pretty good and promising. An x-ray showed that the bone had healed well and looked quite dense. He had a hospital plate (shoe) fitted and I took him home again for more box rest. This was as a caution as it was difficult to tell how damaged the deep digital flexor tendon would be at the point it connects with the pedal bone.

After another 4 weeks of box rest I could start walking him out at the end of October, by this time he was getting too difficult to lead out for grass so it was very exciting and new for him to be walking out on the roads and seeing the sites again. For the first two weeks of walking he was being very good whilst he did not have a full set of shoes on. He was obviously a bit tender with just his ‘slippers’ on so I arranged for him to be shod all round. This really set him alight and for the first time I led him out after that he was a nightmare. The plan was to start riding him after 4 weeks of walking and when we were up to half an hour. But having 17hh of horse rearing up and his hooves dangling above your head it really is too dangerous. Even with a chiffney and an attempt to pin him down with side reins and chambon! So the next morning I decided to get on him and see how he was, he was an angel (helped by the wet weather – he hates the rain) how good was it to be sat on him again, even if it was for 15 minutes of walk. He seemed happier with that arrangement.

So we were getting up to 40 minutes of walking a day and things were going good. Then on a particularly windy day he was being really spooky so rather than battle with him and get him upset and worse still damage his leg, I led him past the scary flapping plastic. He was really scared and just as we got past, a gust of wind caught the plastic and it flew up. He spun around and reversed sharply and then made a grunt/squeak nose. I thought then ‘what have you done’?. But he seemed ok so I got on and carried on. A couple of days later he was not right and on tip toe again on the dreaded white foot. Typically it happened at the weekend! I was convinced it was pus in the foot, I called the vet, but we could not find anything and he was no more sensitive than normal.

So we put it down to bruising of the affected area or tendon or maybe he had done something worse. He went on a course of danalon for a week and he seemed ok on that. I kept walking him out gently; typically he had a crazy day and blew up so I shouldn’t think that helped matters. I eventually weaned him off the danalon and he was ok but not 100%. So we have been on another course of danalon for the past week and FINGERS, TOES and HOOVES CROSSED (PLEASE) he seems to be ok all be it a bit stiff to start with.

Thank the lord for insurance!!! I don’t know what I would have done had I not been insured. I am insured with Petplan and have up to £5000 for vets fees which has nearly run out. So I have recouped all my premium money for the past 8 years that I have been paying out for insurance.

I would be really interested to know if anyone else has had similar problems particularly DDFT problems. As the damage is likely to be deep in the hoof there is no possible way of scanning it and I can’t justify forking out for an MRI. So I have to treat the matter with extreme caution and see how we get on.
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Well done if you made it to the end of this VERY, VERY long posting!!!
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Blimey what an odyssey! My PF had a foot infection that went up into the pedal bone- I tubbed and poulticed but she was never quite right. Fortunately my vet agreed to x-raying her and referred her to Rossdales where it was treated very quickly. The gunky mess was scraped out and a metal plate fixed to a circular shoe. She came sound straight away, and the hole filled in gradually (had to pack the hole twice a day with iodine-soaked swabs. Since then she's been fine. Got some fascinating xrays!
Hope your horse recovers soon!
 
God don't they make us worry!

Sorry i have no experience of this sort of injury but your horse is very lucky to have someone as dedictaed as you to take care of him
 
What a nightmare. I was reading it all, thinking, is this going to have a happy ending or a sad one? I'm glad things are tentatively heading in a positive direction. You're right, only an MRI scan would tell you exactly how things stand in the foot, and my horse had one at a cost of just over £1000, so it depends how far you are from your £5000 limit, but Petplan do pay out in full for MRI if you have sufficient cover at the time.

I'm sure a lot of us can identify with all the problems of leading out a horse that is on box rest, and have the scars to prove it.

It would be nice to hear an update at a later stage as to how your horse progresses.
 
My horse did much the same in a virtually identical situation to the one you had. He too wasn't lame when I pulled the nail out. However I phoned my vets straight away and they wanted him in.

Within a couple of hours he had been admitted so they could X-Ray to see how far the nail had gone (luckily not too near the pedal bone), and he was kept in for 3 nights for intravenous anti-biotics.

Luckily he came home and was fine. My insurance didn't cover it as I have a £500 excess, and it didn't quite come to that (but almost!).

Good luck - fingers crossed that things improve for him. Maybe your vet would give you a mild sedative should you ever need to start riding him after box rest - my friend had to sedate her horse when she started to exercise him again after a stifle operation.
 
My God what a nightmare I totally understand the problems of walking in hand after box rest. Please accept a big hug from me because I know exactly how you feel.
My walking in-hand marathon has also expanded my calf muscles so just when I have run out of money and can sit on the boy I have broken the zip on my leather riding boots and my Ariat boots have split from tramping up and down for an hour twice a day.
A very good friend got a fracture of the shoulder blade from her walking in hand experiences.

Since starting ridden work I have only been bucked off once so am riding with my fingers crossed now.
 
I was just at aveterinary clinical meeting during the week where one of the top Iirhs equine surgeons was giving a tutorial (to long qualified vets) on tretment of distal limb injuries. He dealt with injuries similar to your guys and said in his experience of extensive infection of the pedal bone 4/5 were never "useful" again - I found that to be a phenomenal amount of horses that never recover! He did say that infection of the attachment of the DDFT was the primary cause for the permanent/intermittent lameness these horses were left with. I tuelly hope your boy continues on his road to success.
I second those who said you should get some sedative to in hand walking or starting back under saddle if you predict he will be very fresh. Just remember to only use a very small amt. I have used approx a centimetre of a tube of sedalin when starting to walk a point to pointer out under saddle follwing 4 months of box rest.
 
I have my fingers crossed for you - ours didn't make it
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Before he came to us, he'd got a piece of wire embedded deep in his foot but it wasn't detected for a long time and he was seriously ill with an infection. The tough cookie pulled through and was sound for a while but when broken to work the lameness reappeared. His owners turned him away for twelve months but didn't do enough and he was pts age 5. A lovely pony with a lot of promise. However, this was a front hoof. A horse with a rear pedal bone fracture I knew came totally sound. No infection though.

I wish you good luck. He sounds much loved and at 18 retirement isn't a ridiculous option as long as he is comfortable.
 
oh blimey - some sad stories there.

I'm sticking with it and we started handwalking the end of October. After 2 weeks he was getting fresh and it was getting silly to lead him so i got on and he was very good. After a couple of set backs (i think he may have bruised or sprained the tendon) we are still walking and up to about an hour a day and fingers crossed he seems ok.

I am taking things really slowly as i don't want to put all this work in and not get a positive outcome. He was on danalon over xmas as he was not 100% but i took him off this on sunday (week ago) and he has been ok since.

Hopefully i can think about adding trot at the end of january. He is being very good but gets frustrated at times and has a leap and a buck. He took my by suprise today and did a massive stag leap over a puddle. He is funny that he will always jump into water but never walk through a puddle.

He is in really good nick for his age so hopefully i can keep him going. He likes to go out and about and see what is going on.

Interesting what Glenruby said about 4/5 horses not pulling through. I used to work at a vet clinic and we had one horse come in with wire in his foot which reached the navicular bursar, we got him through surgery etc and it was a long haul but i think he pulled through.

I'd already decided about sedating him a tad when i turn him out, just to take the edge of him. He will just want to roll and roll and roll but rear and buck each time he gets up. He is due his vacc and teeth in a week or so, so i will speak to the vet then about it.

Thanks for your thoughts and i'll post an update soon - hopefully a positive one!
 
Yes, the 4/5 each pulled through surgery and early post-op treatment, but failed to become fully sound again. I know most of the vets there were surprised to hear it, but the surgeon did say that its impossible to compile complete records of success/failure as each case has so many variables - horse's metabolism, age, size, immune system, location of infx, spread of infx, associated structures etc.

Fingers crossed for your guy. xx
 
What a story and congratulations to the OP - you have really worked very hard to get your horse back on the road again.

VERY interesting about the recovery rate, though. It is always those little words that the vet says - "Is the horse insured for vet's fees." Makes you think.
 
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