Serum from bruising causing same pain as abscess?

[Wagtail]

Many of you will be aware of the troubles I have had with my mare since she was diagnosed with Cushings induced laminitis, and all the heartache and struggle we have had since then. She seemed to have turned a corner when I put her on chaste berry, and was enjoying many days out in the paddock with her grazing muzzle on and staying sound. However, on Sunday she got her muzzle off and I was wrapped up in other problems so did not realise until it was time to bring her in. As she had been on a bareish paddock and the weather was cold, I didn't worry too much, especially as she walked into her night time sand enclosure perfectly sound.

However, on Monday morning she was on three legs. Poor thing could not put her left fore down. I thought that this was it. I would give her plenty of danilon (3 sachets throughout the day) and if there was no big improvement by the following morning would call the vet out to PTS. So I organised the vet for the following morning and had the most terrible day. However, she seemed sound on all the other feet and there were no pulses in them and so I wondered if it was an abscess. I decided to bring her in from the sand and poultice. Within an hour she was visibly more comfortable and so my hopes were up. The following morning she was very comfortable indeed, and not resting the foot at all. There was no pus on the poultice, but I could see serum coming out of a line near the toe and so reapplied.

When the vet arrived she said that she didn't think it was an abscess, but instead bleeding and bruising from past bouts of laminitis, and that this could put the same amount of pressure on and cause just as much pain as an abscess. I was wondering if anyone else had come across this before?

She is almost sound today and happily trotting around. Vet told me to continue poulticing for a couple more days. She also dug a bit of a hole near the toe to aid drainage.

What a rollercoaster of emotions this is. I cannot begin to describe how much personality this horse has. I have never known it before or since. When I was talking to a livery about possibly putting her to sleep, she was incredulous. Saying the mare is 'larger than life' and how happy and well she looks. I told her that if she can't be a horse then she will be PTS no matter how much I don't want to do it. But when someone is standing there trying to persuade you not to do it, it make you feel heartless.

Anyway, for now she is happy and very much being a horse.

 

[ihatework]

Inflammation within a fixed solid space (i.e. the hoof), yes it will have very similar presentation to abcess.

 

[cptrayes]

There's little difference between what you describe and a laminitic abscess except that the laminae were already so degraded that the white line leaked immediately instead of serum building up. So I doubt if this is a bruise, but yet another laminitic attack causing laminar swelling which is very painful whether draining or not. The toe is a dead giveaway for me, it's where one of my lami sensitive horses blew on his worse foot after concussion and it's my impression that the laminae die there first.

 

[Wagtail]

There's little difference between what you describe and a laminitic abscess except that the laminae were already so degraded that the white line leaked immediately instead of serum building up. So I doubt if this is a bruise, but yet another laminitic attack causing laminar swelling which is very painful whether draining or not. The toe is a dead giveaway for me, it's where one of my lami sensitive horses blew on his worse foot after concussion and it's my impression that the laminae die there first.

So in your opinion is this the beginning of the end?

 

[amandap]

When the vet arrived she said that she didn't think it was an abscess, but instead bleeding and bruising from past bouts of laminitis, and that this could put the same amount of pressure on and cause just as much pain as an abscess. I was wondering if anyone else had come across this before?

Yes, I've heard of so called sterile abscesses which is what your vet describes. Any leakage that causes build up of pressure in the hoof capsule will cause pain. Pressure in the hoof I think is a bit like tooth abscess... no where to go in a sealed structure with little capacity to expand so the pressure builds.

 

[cptrayes]

So in your opinion is this the beginning of the end?

I'm sorry Wagtail, but I would certainly put her down. Not everyone would be with me in that, but I would, myself, prefer to be absolutely sure that she was not in pain ever again, than wondering from day to day as I woke up whether she would be lame again today

I'm not there with your horse, I don't know her, and there is no way that I would criticise you for making a different choice. I just feel so sorry for you, on top of the gelding too.

 

[glenruby]

Seroma formation at the point of the pedal bone is relatively common in severe laminitis cases. Unfortunately, in my experience it has usually not been worth dealing with due to the pain and suffering the horse inevitably endures. It is not necessarily the end though - just that in my cases we have accepted that the laminitis is still not under control and the decision has been made to ensure there is no more suffering. I do know of cases where drainage occurred quickly and as the relief is instant the horses have been given the chance to continue treatment (sometimes successfully).

 

[Wagtail]

Thanks everyone. Sensible and intelligent advice as always.

 

[pines of rome]

I lost my lovely welsh/arab due to laminitis and a seroma, we battled with it for a long time with lots of ups and downs, but in the end it could not be resolved and he was suffering, so I had to let him go!
He was only 12 and I loved him dearly, but my vet said it was time to call it a day! He blocked his foot out so he could have a final hour out on the grass in the sunshine before we let him go, I was so pleased to see him happy for that hour. A very sad day!

 

[Wagtail]

I lost my lovely welsh/arab due to laminitis and a seroma, we battled with it for a long time with lots of ups and downs, but in the end it could not be resolved and he was suffering, so I had to let him go!
He was only 12 and I loved him dearly, but my vet said it was time to call it a day! He blocked his foot out so he could have a final hour out on the grass in the sunshine before we let him go, I was so pleased to see him happy for that hour. A very sad day!

I am so sorry to hear this. So young as well.

This is the first time my girl has gone lame on just this one foot. It is more often worse in the other fore, and always low grade, nothing like we had on Monday. She is back in the field now without her poultice and her boots and is looking very good.

However, if this thing keeps recurring then I will PTS.

 

[pines of rome]

Glad to hear she is better atm, I still wonder about an abscess as my boy kept going on and off lame on one foot for ages, I thought it was lami, vet said no, did not think abscess either, had xrays done which showed a very small chip to his pedal bone but not significant enough to produce the three legged lameness which he was showing by this time!
So the vet investigated his foot further which revealed it was actually an abscess after all!

 

[Wagtail]

I keep thinking that too. My girl has had spells of LGL for nearly two years now and never once had three legged lameness like she did on Monday. In those two years she has never been diagnosed with an abscess, yet I have suspected a grumbling abscess in both front feet from time to time. Vets said no. But laminitis is renowned for causing abscesses. Also, despite having what I though was LGL for two years on and off, she has no typical laminitis rings or deformity of any of her hooves. She is on the light side of good condition wise and her bouts of LGL do not seem to relate to anything she has or hasn't eaten. Apart from last Sunday when she got her muzzle off. So I am wondering if it really is laminitis at all now that she has her cushings well under control with prascend and her weight is good. I am wondering if it is grumbling abscesses caused by the initial laminitis?

 

[melbiswas]

This sounds very similar to what was happening to Ollie this time last year.
Suspecting an abscess the vet dug out at the toe (unilateral hind limb lameness) and got fresh bleeding which he attributed to lami/ bruising. This eased his pain temporarily and then it came back with a vengeance, shifted from one foot to another etc. This went on for about 3 weeks.
The conclusion was a background of Cushings with ? abscess and fresh bleeds. Poulticing and hot tubbing did not result in the satisfying eruption of an abscess at any point on either side.
It appears that you can have both bleeding and an abscess from earlier bouts at the same time if he was correct. In our case this gave severe lameness ( hardly able to weightbear).
He was a real character too, and very tough. It was clear to us when he had enough.

 

[Wagtail]

This sounds very similar to what was happening to Ollie this time last year.
Suspecting an abscess the vet dug out at the toe (unilateral hind limb lameness) and got fresh bleeding which he attributed to lami/ bruising. This eased his pain temporarily and then it came back with a vengeance, shifted from one foot to another etc. This went on for about 3 weeks.
The conclusion was a background of Cushings with ? abscess and fresh bleeds. Poulticing and hot tubbing did not result in the satisfying eruption of an abscess at any point on either side.
It appears that you can have both bleeding and an abscess from earlier bouts at the same time if he was correct. In our case this gave severe lameness ( hardly able to weightbear).
He was a real character too, and very tough. It was clear to us when he had enough.

That's so sad. You obviously made the right decision for him. I know my girl's time is limited. She is happy and comfortable ATM but I know I will know when she has had enough. That will be her time to go. But I am unable to do the deed while she is trotting around the field having a good time, making a nuisance of herself at every opportunity. I understand what people mean when they say to let them go when they are really well and happy, but personally, I would not want to go if I was well and happy. I would only want to go if I was in pain or very unhappy. But obviously, it is important that any suffering is not prolonged. Timing is the crucial thing here.

 

[melbiswas]

I have to agree with you, Wagtail. I could not have PTS if he had been like that. His pain was very severe, with periods of slight improvement that made me persevere for too long.

I meant to convey in my post that it seems you can have both abscesses and fresh bleeds/bruising if it is a chronic problem, if my vet was right. It made for confusing management as we were hot-tubbing and poulticing and on bute and then antibiotics! It was all a bit of a mess.

 

[Wagtail]

I've had a terrible morning. After my girl being really good the past two weeks, she was hopping lame again this morning. There was no reason for it, she had not got her muzzle off once in the past week, and was sound as a pound last night. I rang the vets saying that it may be time to PTS. Vet arrived within a couple of hours. But from being hopping lame only minutes earlier, she actually walked in from the sand only 2 tenths lame. Vet hoof tested and there was obvious discomfort but also oozing of pus/serum from a hole in the toe. Vet said that the walk in on a hard surface had obviously relieved the pressure. He said that she had no active laminitis, but that it was an abscess most likely brought on by the sudden rain. He said she was obviously now quite comfortable, bright and perky and certainly didn't need to be PTS. So from thinking I was saying goodbye, I am back to poulticing. It really is an emotional rollercoaster! She is back out in the field now with her boots on over the poultice and doesn't look lame at all.