Treatment of severe, chronic thrush

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Goldking023

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My horse has recently been diagnosed with severe deep thrush causing lameness on at least 3 feet, the 4th right hind is currently recovering from an abscess which he gets frequently. He has always had chronic Thrush that has not responded to treatment and as he has become lame from it my vet believes his hoof conformation does not allow enough circulation to his frogs to withstand the infection and therefore it has progressed severely. He is 14, barefoot and lives outside in a very dry paddock with great drainage however despite all paddock maintenance I cannot completely eliminate the potential of him standing in urine and poop. His feet are picked out daily and we are currently trying to control the infection with iodine soaks. My vet has suggested that I put 4 bar shoes on him to support his feet. After doing a lot of research I have found a lot of people in this situation did not see expected results from this treatment. The kicker here is that my horse was also diagnosed with severe kissing spine last year and so far has not gotten better with injections and rehabilitation. he is not a good candidate for surgery due to how severe the kissing spine is and his pelvis conformation is incorrect and untreatable (right side sits lower than the left). I was currently in the process of assessing options with my vet when the thrush issue developed. I just want to hear what others would do in this situation. I feel like I am riding the line of prolonging an inevitable decline as all treatment options I have been offered for this horse seem to be failing or lacking promise. I would like to hear if anyone has had success in treating chronic, severe thrush to give me hope that it would be worth it to then continue finding a solution for his kissing spine? Before asked- he is unsound under saddle due to the kissing spine and struggles to lay down. I have had his feet and legs xrayed and there is nothing alarming to contribute to unsoundness or any real justification for why he is prone to thrush aside from having very poor feet and thin soles. I have had his diet reassessed many times and have not had any luck in adding supplements such as biotin, copper and zinc to support his feet.
 
Iodine is quite strong for repeated soaking.

I'm not a fan of soaking frogs which are already soft and mushy and rotten.

I would make sure you or your farrier has removed ALL flaps, pockets and hidey holes from the frogs, and keep removing them as often as possible.
Next SCRUB the frogs as clean as you can, but if it is truly all awful, deep thrush, then you will need to be gentle, but still thorough, in the central sulcus. Use a strip of towelling soaked in very dilute Hibiscrub and floss. Be careful because it could be quite sore.

The gold standard IMO would be Pete's (UK) goo, which is sudocreme and copper sulphate powder. I buy zinc oxide powder, CuSO4 powder and tea tree oil, and mix to a thick paste with water. (about 1tbsp CuSO4 to about 250g ZnO) . Or just buy Red Horse field paste. What ever you use, apply deeply to every crevase. I mix cotton wool fibres in to my paste for this, or you can buy the Red Horse Hoof Stuff which has fibres in it, and pack in to collateral grooves. I'd be wary of packing fibres in to the central sulcus if it is really badly compromised - jsut pack loads of the paste in.

Repeat once a day until it starts to improve, then every couple of days. Hopefully you'll be able to stop scrubbing and just give a good stiff brush off, and apply the paste.

Also, figure out why he got so bad - he obviously won't be heel loading now his frogs are sore, but he should have been, which should have stimulated a strong healthy frog, whatever his environmental conditions. Why is hs hoof confomration so bad? If he's NPA or flat footed that will need to change. It may be the kissing spine? Can you post decent photos of hooves from the sides and underneath?
 
Some pictures of his feet may help us here.
With it affecting all four feet I would wonder about an immune problem, the environmental he lives in or his diet. I would be adding a broad spectrum multivitamin to the feed.
Reduce all starch and sugar in the diet as much as possible.
Consider antibiotics if actual infection present.
Apply daktarin or clotrimazole antifungal cream to the frogs liberally and apply nappy and hoof boot to keep it dry when outside.
Other potions to try would be red horse field paste, manuka honey, tee tree oil, neem oil, coppertox, silver feet thrush buster, copper sulphate mixed with sudocream, keratex hardener and tetramycin foot stray.
Bed in a large dry shavings filled stable to dry the feet when they are not wrapped.
If he's miserable though it might be time for him.
 
Cragrat said:
Iodine is quite strong for repeated soaking.

I'm not a fan of soaking frogs which are already soft and mushy and rotten.

I would make sure you or your farrier has removed ALL flaps, pockets and hidey holes from the frogs, and keep removing them as often as possible.
Next SCRUB the frogs as clean as you can, but if it is truly all awful, deep thrush, then you will need to be gentle, but still thorough, in the central sulcus. Use a strip of towelling soaked in very dilute Hibiscrub and floss. Be careful because it could be quite sore.

The gold standard IMO would be Pete's (UK) goo, which is sudocreme and copper sulphate powder. I buy zinc oxide powder, CuSO4 powder and tea tree oil, and mix to a thick paste with water. (about 1tbsp CuSO4 to about 250g ZnO) . Or just buy Red Horse field paste. What ever you use, apply deeply to every crevase. I mix cotton wool fibres in to my paste for this, or you can buy the Red Horse Hoof Stuff which has fibres in it, and pack in to collateral grooves. I'd be wary of packing fibres in to the central sulcus if it is really badly compromised - jsut pack loads of the paste in.

Repeat once a day until it starts to improve, then every couple of days. Hopefully you'll be able to stop scrubbing and just give a good stiff brush off, and apply the paste.

Also, figure out why he got so bad - he obviously won't be heel loading now his frogs are sore, but he should have been, which should have stimulated a strong healthy frog, whatever his environmental conditions. Why is hs hoof confomration so bad? If he's NPA or flat footed that will need to change. It may be the kissing spine? Can you post decent photos of hooves from the sides and underneath?
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We started by scrubbing the frogs but my horse honestly will not tolerate it as his feet are so sore currently he will not stand and becomes dangerous. Hes on bute and previcox but is not making a huge difference. My vet also has informed me that it has progressed too much for topical creams to be of any help however i am willing to try that if my horse allows. we previously were treating it with thrush buster but it has progressed to this point anyways. My vet has not indicated why it has gotten so bad beyond suggesting he needs softer footing such as sand to live in and engage his frogs - this is not an option for us unfortunately. No vet or farrier has ever mentioned a flat foot or NPA. Im not an expert but NPA looks possible. is this something that needs shoeing to fix? Images attached, poor photo of his sole as i need another person here to pick it out currently.
 
Metronidazole tablets ground into a paste poulticed on, and box rested cured my horses thrush. Then replaced with iodine and sugar paste poultice to help harden things up. (Vets advice).

Wish you lots of luck.
 
no idea about KS but for thrush cleanliness is the key to getting rid.
To treat clean the feet twice daily not just with a hoof pick but clean right to the bottom of the grooves and right to the bottom of the central sulchus which from what you have described will be a very deep and very sore split.
Clean the grooves by putting a cloth on the bottom of your hoof pick and get right down to the bottom, pressing hard (being careful if he is sore) and get it totally dry and clean. For the central sulchus do the same but you will have to start with something like a cotton bud very gently. You could slide a piece of material in and draw it through.
Get them totally clean twice a day.

Then soak in copper sulphate solution for about 15 mins a foot. Try this say 3 times with a couple of days in between soaks.

pics would help
 
Do you have his feet trimmed? In an ideal world, the hoof should hit the ground either flat or heel first, depending which gait he is in. The frog should then 'kiss' the ground with each step. If his heels are too high, this won't happen. If his heel area is very sore, then he will be throwing weight forward onto his toes. Unless the frog is making this sort of contact with the ground, it will be nigh impossible to eliminate thrush, as the circulation in the frog is compromised. Take a look at Pete Ramey's Hoof Rehab pages on thrush, and be prepared to use boots and pads to cushion the frog and provide gentle stimulation. I struggled for years with recurring thrush, and finally started to make some headway when I asked the trimmer to bite the bullet and lower his heels. She trimmed out all the crappy frogs, lowered his heels, and he went into boots and pads for gentle exercise. Red Horse Field Paste also comes highly recommended.
 
How old is he, is there any possibility of Cushings which could be making him more susceptible to infections. I find the blue terramycin spray from the vet good at clearing up thrush.
 
Gloi said:
How old is he, is there any possibility of Cushings which could be making him more susceptible to infections. I find the blue terramycin spray from the vet good at clearing up thrush.
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This. If there is a problem with his general immune/metabolic system you will struggle to get on top of the thrush. I would discuss blood tests with your vet to see if you can find the root cause and stop the thrush constantly reoccurring.

If I had a horse that struggled to lie down, and there was little chance of fixing that problem, I would being saying goodbye.
 
Interestingly since KS surgery my mare hasn’t had thrush, although hers wasn’t severe I treated it with the antibacterial and antifungal hoof spray from the farming section, it’s purple but cheap and seems to do the job.
 
Gloi said:
How old is he, is there any possibility of Cushings which could be making him more susceptible to infections. I find the blue terramycin spray from the vet good at clearing up thrush.
Click to expand...
He’s 14, my vet mentioned it, we will be testing in the fall when my vet office has access to lower cost tests. She says unlikely given his age but will be worth it to rule out
 
HopOnTrot said:
Interestingly since KS surgery my mare hasn’t had thrush, although hers wasn’t severe I treated it with the antibacterial and antifungal hoof spray from the farming section, it’s purple but cheap and seems to do the job.
Click to expand...
I am suspecting the KS and feet issues are closely related, compensatory movement from one exaggerating the other. Unfortunately I haven’t had any luck rehabbing his KS and not a good candidate for the surgery
 
So sorry to read this.

I, like others, would be putting to sleep at this point. Thrush aside, a horse that cannot lie down and get back up would be enough for me. The thrush on top would be the final push if I’d not made the decision before.

It sounds like a full body metabolic issue is going on here.
 
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