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!

Diary of a Chronic Abscess

If a picture is worth a thousand words, what's a video worth?

This is Aero, turned out in the arena on Aug 8th, wearing a plastic bag over his hoof, protected by a Cavallo Sportboot.  Later that day, all four feet were the same temperature (warm) and the digital pulse in both forefeet felt the same.

Two days before, there was this on the poultice :

Not much, but it was something and my fingers are crossed once again that this might be the end of it.

I'm off for two days to run the Silver Spurs finals.  Hope our youngsters are inspired by the Olympic glory achieved by our nearest neighbours!

DIary of a Chronic Abscess

This started off as a reply to all the comments on the last post, then I came to the conclusion it would merit a post in its own right.

First of all, thanks for all the comments and good wishes, everyone.

I've no happy "poultice full of snot" story to share yet.  The pink spot on the back of his heel is still there but seems less soft.  There is a small amount of black stuff coming out where the poultice meets the top of the PHW wrap - I'm not sure if this is a little bit of thrushy goop coming from his frog or if it's old black pus working its way out from the bottom.

Right now, I'm still tempted to rip off the hoof wrap, unplug the hole and really go after it for a couple of days.  I'm reluctant to head down the antibiotic route for two reasons, the first being that I've never found them to help with hoof abscesses before.  Years ago, we had a similar protracted abscess story with our little pony Rosie which the Vet initially treated with penicillin, after opening the abscess.  Ten days later, he was back and ended up removing literally half her sole to try to get it to drain again.  Apparently antibiotics kill the infection, but the pus and dead bacterial matter is still in the foot, only now it's no longer liquid so it's ten times harder to get it to drain.

The other thing which is making me think twice about antibiotics is Aero's history.  We spent the entire summer of his seventh year treating an infection in his right foreleg - we think he picked up a thorn during his first ever event.  He won the event, but lost the rest of the season while we went through a seemingly endless cycle of poulticing, medicating, resting, bringing slowly back into work, leg swelling up again.  He had three courses of different antibiotics and in the end the Vets and I all agreed they weren't helping and the thorn was going to have to come out by itself.  What eventually got it out was a garlic poultice, but that was very severe and actually burned him like a blistering agent (some of you might also be old enough to remember blistering!) and I'm really reluctant to do that again.

I'm going to keep up the soaking and poulticing for the next day or two, but on Thursday I will assess where we are and I may revisit the antibiotics idea.  I'm hoping to turn him out in the arena for a while each day (movement would help), but we've just had yet another night of torrential rain and unless it clears up really well this afternoon so that the arena dries out, he's going to have to stay in all day.

The other thing I'm trying to do is to get my hands on a bottle of a homeopathic treatment "Hydropathics Chronic Abscess."  It's worth a try, especially since he has a history of his own immune system not working too well.

I'm off to boil the kettle and soak the Animalintex now...

Diary of a Chronic Abscess

(Also know as Aero's Diary)

I diligently soaked Aero's foot in a Cider Vinegar solution for two days, then the Clean Trax solution arrived in the post and I settled down to treat Aero with it on Thursday morning.  I decided to soak his foot for an hour this time, so we settled down for the long haul, Aero munching on his hay net, Dylan waiting patiently outside the stable door and me playing Sudoku on my phone, while making sure Aero didn't move around and risk pulling the soaking boot off.


After the hour was up, I carefully followed the Clean Trax instructions and bandaged a plastic bag onto his foot, leaving it there for a further 45 minutes "to allow the vapours to permeate the hoof."  Ok, so, job done.

I kept him in overnight and checked him the following morning.  It looked good - the abscessed foot (left front) was no longer noticeably hotter than the others, the glands in his throat seemed to have reduced and most importantly, I asked him to trot for a few strides up the drive towards the yard and he seemed ok.


Cue Saturday morning.  This was the day I was going to check him out fully - I actually felt I would jinx his recovery if I trotted him up properly on Friday, so I decided to give him an extra day to improve once I thought I'd seen some improvement.

I touched the heel of the left front.  Hot.  I touched the heel of the right front.  Much, much cooler.  I held the palm of my hand over the front of the left hoof.  Definitely warm.  I held the palm of my hand over the front of the right hoof.  Definitely cool.  Once again, the glands in his throat were up.  Once again, he was lame at walk.  Once again, back to the drawing board.

It was time for some reflection.  I came to the conclusion that I screwed up big time the day the chunk broke off his hoof.  At that stage, I should have poulticed the hole left by the break for a couple of days and I should then have kept his foot as clean as possible, ie bandaged and protected from dirt and re-infection for as long as it took - probably weeks.  Instead, I took the "Ah, sure it'll drain away by itself in the field" approach, and turned him out into my paddock.  This might have worked if we were having anything approximating a normal summer here, but with the huge quantities of rain we've been having, large tracts of my paddock are under water.  Because of this, Aero has had no choice but to slosh around in mucky water, and instead of the infection in his foot draining out, more dirt and infection worked their way in.  When I thought about it, if the Hoof Stuff packing material and PHW resin wrap allow moisture to flow out, then it follows that bacteria and infection can flow in too.

My initial reaction was to cut off the PHW wraps, clean out the hole where the break occurred and start poulticing and bandaging from scratch.  I even went out and bought a sheet metal snips just to cut off the wraps!  Then when I brought Aero in from the paddock and scrubbed his foot, I noticed a soft pink spot at the back of his heel.  Could I focus on this point and get the abscess to break through?

I shelved the Snipping plan for the moment, pulled out the Davis boot and started hot-tubbing with salt water.  Then I applied an Animalintex poultice, bandaging it onto his hoof and protecting it with one of Flurry's Cavallo Sport Boots.  I was hoping to find the poultice full of pus that evening, but no such luck.


Hot-tubbed again with the Davis boot, applied the poultice again.  Same story on Sunday morning, a disappointingly clean poultice.

Lather, rinse, repeat.

Please let it end soon.

Aero's Diary

Unfortunately, this has turned into "Diary of a Chronic Hoof Abscess."

As expected, a chunk of Aero's hoof wall sheared off, just the day before Anja the AEP practitioner was due to call.

The missing chunk.  You can also see where the abscess broke through at the coronet

I cleaned it and soaked his foot in a bucket of Epsom salts, but it is quite badly damaged and you can see that the weakness continues upwards through the hoof near the heel.

You can see the crack continues up the hoof wall

The good news, though, is that any pus should be able to drain away quite easily now, but the bad news is that being so open, it's very susceptible to re-infection.

When Anja called the next day, she tidied up the break, cleaned the opening and stuffed it with Hoof Stuff, which is made from honey, Zinc Oxide and cotton wool.  It adheres to the cavity, aids healing, allows drainage and acts as a barrier while the hole is growing out.  Hope it works!

Crevice cleaned and stuffed, the screws are to hold the resin bandage in place 

Aero was clearly still very sore on this foot, and our conclusion was that the sole is having to carry too much weight because there is no hoof wall at that point.  She felt that putting him back in PHW wraps would benefit him and help to support the weakened hoof wall, while at the same time allowing normal circulation to continue, allowing the hoof to breathe and enabling me to soak it or Clean Trax it as necessary.

All wrapped up

Initially, he has been very sore, not quite on three legs but not far off it.  There is still significant heat in this foot, centred at the heel.  I am planning to Clean Trax it just as soon as I get my hands on a bottle (tomorrow hopefully) because I suspect that the solution I used last week was gone off - it's supposed to be kept in the fridge, but that bottle had travelled around France with us for four weeks.

I've also been reading up about abscesses on various forums.  The current thinking really seems to be "let it drain by itself" and to use Epsom Salts or Cider Vinegar (a new one on me) in a solution to soak the foot.  Having already spent a week soaking his foot in Epsom Salts, I think I will try the Cider Vinegar this time.

Any other suggestions will be gratefully received.  It is so hard to see him in pain all the time, he's a sweet boy and he doesn't deserve this.

Aero's Diary

...or more foot trouble.

It's been a busy week, with visitors, unpacking, emergency vet visits and hospital visits (not me).  Every day, I said "I will ride Flurry tomorrow and lunge Aero to see how he looks." Every day, something came up and Flurry remained unridden, Aero remained unlunged.

I was determined to do stuff with them on Friday.  While I was skipping out the paddock on Friday morning, I watched Aero moving around for a good while.  He looked ok walking, but at one point himself and Lilly had a little trot around and he was definitely lame - not hopping, but definitely lame.  I was pretty disheartened - this has been going on for weeks now.  I was back to thinking X-rays and serious veterinary investigations.

I was filling the water trough a little later on, and Aero came over for a chat.  I glanced down at the offending foot - what was that?

Goop running down from the coronary band near the heel - yippee!

I was now happy that it was indeed "just an abscess" and not navicular or some other horrible foot issue.  The abscess had finally burst, and now I had to to my level best to get as much pus out of his hoof as possible.  Forget about riding plans, it was time for some hot-tubbing, so the red bucket was filled with hot water and Epsom salts and Aero and I spent some quality time standing in the sun, while the stray pup (now named Dylan) lay in the shade of the old trailer and watched us.  I am his universe, he can't bear to leave my side, which is very sweet, but given his complete lack of horse sense and general ungainliness, he's something of a liability around the horses.  Peace reigned, though, Aero was his usual tolerant self, and Dylan was content to lie still so long as I didn't wander off.

Once I had finished hot-tubbing, I studied Aero's hoof.  There's a disturbing fissure in the wall of his hoof on the side where the infection came out.  It runs from the sole upwards, and almost looks as if someone was trying to saw a piece off.

I suspect that ultimately, a large chunk of wall will shear off here, presumably due to the abscess.

I put a poultice on the back of Aero's foot, wrapped it up and put one of the Cavallo Sport boots on to protect it.  I was going to bring Pepper in to keep Aero company overnight, but Flurry volunteered for companion duty - he came straight up to me when I went down to the paddock!  The two boys settled well, there was very little calling back and forth to Pepper and Lilly in the paddock overnight.

In the morning, there was a small amount of black pus on the poultice - I'd have been happier with more!  Anja had advised using Clean Trax to completely disinfect his hoof now that there was a small opening on it, so Aero got to stand in the stable for an hour, with a big blue bag on his leg, but first, I finally got to ride Flurry!  OMG, I was stiff!  OMG, he was stiff too - or maybe my stiffness was reflected in him.  I rode for about 45 minutes - it's a start!

Then it was Clean Trax time.

Flurry was very curious at first,

and made faces at the smell

but he eventually got bored and stopped watching.

Finally, we were finished and both boys could go out again.  Aero possibly looked a little less lame as he trotted off - I have my fingers crossed that this is the beginning of the end of the foot saga, but I suspect that fissure is going to cause some trouble.