Pus, deep bruising, still lame, when to go to MRI ?

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cyearsley

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My boy went lame initially 11th Jan, found a bruise, shoe off, back on, sound for three days, lame again. Given short course bute, no improvement, taken to vets, xrayed and nerve blocked and seemed to confirm that it was in the foot (vet suspected deep bruising). Back on bute for 10 days, has been off bute now for 2 days and now lame in walk and trot (before only lame in walk). Have now placed on box rest as was out with a boot on (awaiting bruise to heal but protecting the foot) but now due to increased lameness think box rest is probably wiser. Initially was no heat in foot but now is slightly more warm than the other foot.

As have already had xrays, nerve blocks etc, the only next place to go is MRI, if I take him this week or next, this will be four-five weeks from initial lameness, am I being impatient by pushing to MRI now or should I wait for old father time? My farrier is coming again Monday to have another look before we go back to the vet.

Am worried as lameness appears to be worse but no pus has popped out, if it's bruising it appears to be getting worse and after over four weeks I just want to know what's wrong ? Can pus really appear after a month or so, how long can some bruising take to heal? Is it acceptable to move to MRI when your horse is still lame after only 5 weeks or should I wait longer and be patient? Any ideas or suggestions welcome! Thanks in advance
 
Sounds simple but have you tried removing the shoe and poulticing the foot to see if you can draw anything out?

Has the farrier had a good look and a dig around the foot - especially near the heat?
 
My elderly cob went through the exact same thing over a 4 week period. He is retired and had his shoes removed. He began faltering walking over gravelled track to paddock so he was put in a paddock over a short flat walk. He became worse. Farrier hoof tested him and cut a hole but no pus, only blood came out and he became increasingly lame. I got the vet last Thursday who cored out a deep hole but approx 2 cm further down than where we initially thought. Pus bubbled out. I have poulticed him for 3 days and got a fair bit out. He is certainly a lot happier and hardly lame. However, as he's got heat in his heel to the outside and is still v tender on the turn I think I'll get the vet to open up and see as I'm sure there was pus oozing out cleft of frog.

In conclusion, after 4-5 weeks I think the infection had time to accummulate and was looking for a way out, hence the lameness til he could not put his foot to the floor.

I would get your farrier or vet out again and then if there is no sign of pus discuss the next option with your vet. An x ray may all that is required if the vet thinks there is any infection deeper seated.

Hope he comes right soon.
 
The farrier took the shoe of and both he and the vet couldn't find any pus a month ago and there was no heat either, they didn't want to remove the shoe again as bruising was diagnosed and I guess the shoe protects the foot. Now there is heat and lameness worstening, I have everything crossed that the farrier will find pus tomorrow. Xrays last month concluded nothing broken but am worried about soft tissue damage...thanks ever so much for your advice it's much appreciated and to hear what other people have been through definately helps. Thanks again
 
Shantor, you've made my day, pus can appear after a month, gives me some hope and made me feel more positive, had a tendon injury last year so really hoping not soft tissue damage - thanks again!
 
Has the vet not prescribed antibiotics? if it was an infection then Antibiotics should clear it up. I had a deep seated abscess, the farrier dug a hole, the pus came out - we poulticed for 5 days. he was sound, about a week later he was lame again - farrier came out and dug another hole - huge thing, about 2 inches along the foot and in deep - pus oozed out. But he recommended I get antibiotics as it was possibly deep seated and although we could keep poulticing he felt that it may continue to bubble under the surface. A strong course of Antibiotics, 3 days hot and 2 days cold poulticing and he was sound. We had to pack th hole as it was so huge, then have his shoes back on and that was it.
 
I have got one that has got deep bruising, and after nearly six weeks he is just coming sound now, although can still be a little sore on gravel. I spent two weeks hot poulticing because my vet thought it was an abscess, but when no pus came out she decided it was bruising. My vet was going to xray it, but as he started to improve she decided not to.
I have another who has an abscess, have been hot poulticing for four days now, with lots of pus coming out, and he is improving rapidly.

Hope things improve soon.
 
Bosworth, no the vet has not prescribed antibiotics as was diagnosed as deep bruising, recommended 10 days of bute as an antiinflammatory but now off the bute the lameness has got worse which didn't think it would do with bruising? Farrier coming tomorrow and if nothing obvious, going back to the vets. Was hoping that maybe was pus in the foot but guess will just have to wait and see. Thanks again
 
Could be an abscess looking for a way out, only the bute stopped it forming, so it is now a sub-solar abscess. I had something similar - lame, poulticed, sound, then lame again, over several weeks (and horse was also given bute in the first week). In the end the vet suggested X rays, just to make sure that there was nothing broken.

On the X ray the vet could see where the infection had tracked round the foot, hence the on-off lameness. She had to sedate him to find the infection, and there was never much pus that came out.

Horse is just recovering from another abscess, (2 years on) and again, virtually no pus came out. This time he didn't have any bute and although it took time and 4 vet visits to find, and a big hole in the foot, it did resolve in a lot less time. When the vet finally found the source ("did you hear that?" when it exploded outwards) he did have 5 days antibiotics.

I would go for the X rays to see what is happening, personally.
 
Don't think I would get an MRI done yet , they are so expensive and Xrays would show if there was an infection. I would also be tempted to treat it as an infection with Anti biotics. If it was deep bruising it could take several weeks to come out but I would not expect it to get worse over time.
 
Whether to push for an MRI this early or not depends on your insurance situation. If your insurance are happy to pay and if your farrier can find nothing then I'd push for one but only because of my experience. My TB has been constantly diagnosed for the past two/three years with deep bruising - treatment of box rest and bute - always came sound after approx two weeks. However, December 06 he failed to come sound, x-rays suggested possible arthiritis of coffin joint. Treatment of cortisone injections, bute, box rest and slow rehab. Over the next nine months two more vets visits for 'deep bruising' before finally Christmas 07 we got him MRI'ed. No arthritis, instead he has chronic wear to collateral ligament, progosis was guarded but he's slowly coming back into work and looks sound.
If your insurance will pay I'm always one who believes why wait. I'd ask your farrier's advise because in my opinion they are far more knowledgable about bruising - mine could never find a bruise or pus.
Good luck and I hope your farrier finds some pus. *fingers crossed*
 
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