Diary of a Chronic Abscess

is this finally The End?

While I was in Dublin, the LSH kept going with hot-tubbing and poulticing Aero's foot (he's a saint, really, it's not like he's not busy with work).

There was plenty of gunk coming from the spot at the back of the heel initially, but then it slowed down.  He wasn't very happy with it, and described it to me over the phone.  There was a swollen area at the back of the pastern, just above the spot, and the spot itself had glossed over and was looking red and shiny, like (sorry for grossness) a big spot, ready to burst.

I rang Dave-the-Vet and filled him in on the story so far.  He was reluctant to diagnose over the phone, of course, but he was concerned that having gone on so long, there could be some infection in the bone, or at the very least, the infection could have underrun the sole.  He offered to call up, but I knew the LSH was crazy busy with work, so I said we'd wait until Monday.  This abscess has gone on so long, another couple of days wasn't going to make a difference.  We decided to cut the PHW wraps off, though, and focus our poulticing on the place where the chunk of hoof wall had broken off as well as the spot on the heel.

When I got back from Dublin, I was keen to see how it all looked.  Much the same, is all I can say, although there was indeed a soft swelling just above the heel.  There wasn't anything being drawn out on the poultice through the broken hoof wall, and there was a small amount of mostly serous goop coming out at the back of the heel.  On Monday morning, I took the poultice off and trotted Aero up.  Still lame, but not hopping lame.  I left his hoof uncovered and waited for Dave to arrive.

He watched Aero trot up a couple of times, confirmed the lameness and then set to work with hoof testers.  After some squeezing, he eventually pinpointed a small area of response, on the sole just inside where the hoof wall was broken off.  He started excavating, very conservatively, I have to say, but after trying two different approaches - first through the sole and then through the side where the chunk is missing - he still hadn't "struck oil."

His feeling was that we were probably at the end of it, and our poulticing efforts had been successful.  However, when I pointed out that we were leaving for France in less than six weeks, he suggested that I take Aero over to the clinic for Xrays, which would show if there was a generalised area of infection in the foot, and more importantly, if the pedal bone was infected.

I'd either end up with peace of mind, or we'd have six weeks to start a treatment and see it through - surgery and curetting of the bone being the worst possibility, in my mind anyway, until I made the stupid mistake of asking is the bone infection ever so bad that they have to euthanase the patient.  Crap.  What a stupid thing to ask.

So next morning, I boxed Aero over to the clinic.  I confess that the thought crossed my mind that if things were really bad, this might be the last time I took him anywhere, but I quickly dismissed it and tried to stay positive.

The two other vets, John Jr and John Sr, the founder of the practice, were there to meet me.  I trotted Aero up - he was quite excited being in a new place and he trotted smartly beside me.  Sound.  His blood is up, he's excited, so he's not feeling anything through the adrenalin, we said.

I trotted him up.
I trotted him down.
I turned him in a tight circle.
I trotted him one last time - barefoot, downhill, on concrete - 100% sound.

Well!  Bloody horses!  Half an hour earlier, I'd brushed away a tear, thinking I might be leaving him there!

Myself and the vets had a chat.  Initially, they spoke in terms of putting a shoe back on, but when they heard I was trying to go barefoot, they were very supportive, and talked in terms of hoof boots instead of metal shoes.

John Sr suspected there was a layer of false sole, caused by the infection, so he told John Jr to trim away a good deal of sole and to tidy up around the hole where the hoof wall had broken off.  Given Aero's history (they all remember him, he was quite the conundrum for the summer of 2007) and the looming deadline (5.5 weeks!) they agreed that Xrays would be a good idea, just so we'd know for sure that things were going in the right direction.

The hoof was trimmed and we trooped into the treatment room for Xrays.  John Jr knows Aero very well - six years ago, he lay on the ground behind him for half an hour, stitching both of his back heels after a hunting injury, with no sedation, just a shot of local - and I felt a glow of pride in my little horse's temperament when he said to the attendant vet student "There's no need for sedation, this guy is very quiet."

Aero posed beautifully for his shots, but, best of all, there was almost nothing to be seen - just a teeny fuzzy area, at the side where the infection had eventually broken out.  John Sr peered at it for a while, and finally pronounced it acceptable - in his opinion, it was where the infection had formerly spread inwards, but was now cleared up.

So the seemingly endless rounds of poulticing and hot-tubbing are over.  The advice is to keep it dry, so no paddock turnout for the foreseeable future (the weather forecast is as bad as ever).  I'm to scrub out the hole in the hoof wall two-three times a day and put iodine into it and I have to put his boots on, to protect the foot when he's turned out in the arena or when he's being worked.

Work?  He's back in work?  Yippee!