Re: Hoof puncture

["Michelle Fink" <michrowe@frontier.net>]

I wanted to reply about the infected bone.  I have not updated my site
regarding my mare lately, but we did radiographs and found septic osteitis -
an area where the anaerobes had invaded the bone.  It's on the front of the
coffin bone in one spot (it's called focal lysis).  I thought it was the end
of the road for my mare, and started trying to make some very hard
decisions.

Then someone on RC had posted for a friend about non-septic osteitis, and
eventually the friend and I got in touch.  She sent me an abstract from
Dartmouth about septic osteitis.  The article was printed in a respected
English vet journal, after several emails to London, a kind lady at the
journal faxed me the article.  The researchers found that by opening the
hoof and removing the dead bone, they were able to save most horses, and
most return to a performance level.  Most of the horses studied were sound
after 3 months, despite the duration (sometimes YEARS) and degree of their
lameness (my mare is 4/5 lame).  The article was a turning point for me, it
gave me hope when all I felt was loss.  I asked my vet to go in and remove
the dead tissue from the coffin bone.

He had done his own consulting about the surgery through CSU and his surgeon
friends, and was ready to do the work.  He resected her hoof (made a 1" x 2"
window), and he found a spot of dead, black sludge on the coffin bone.  He
cleaned it, and cleaned a tract that the infection had made toward the point
of the frog and opened the sole at that point to allow full drainage.

She was truely miserable for about 3 days.  She ate, but not well, and she
faced the back of her stall.  Her whole foot was blocked for the pain.  Then
her appetite picked up, and she has returned to snarfing up all of her food
(6 qts. Eq. Sr., free choice hay, lots of beet pulp, oil, etc.).

An important finding has been through HorseShoes.com.  A vet there has
followed our case (Dr. Jon Cohen is a SAINT in my book!), and he suggested
that we look into PMMA beads.  They are a bead made from a readily available
veterinary material that the vet can make up and impregnate with
antibiotics.  So my vet took cultures from my mare and found that the
anaerobes are susceptible to CPCH (I think).  He mixed the right dose of
antibiotic powder into the plastic to make the beads, adds the special
compound, and voila you have beads that will release their antibiotics for a
long period of time.  Much, much, much better than soaking guaze with
antibiotics!  They use the beads for people in septic fractures, hip
replacements, etc. with great success.  In fact, they can put them in and
leave them in place as it heals, if needed.  My mare has these beads packed
into each drainage tract (there are now 4 tracts - 2 on the sole, one at the
coronet band, and one at the resection).  The beads are working really,
really well.  Her open tracts are granulating beautifully, the openings are
finally staying very clean (no evidence of further infection), and when
washed there is only a little blood and no pus (GOOD).  Also they are not
tender, she is finally healing up.  He only has to open the surgical
bandaging and change the beads every 4-5 days.

This is not to say that we won't find more pockets, or that we may not have
re-infection.  There may be more battles, but we seem to be winning the war
(finally).  I wanted to share this with all of you who are interested,
because we are doing some work that a field vet may advise you not to do.  I
was told by a couple of field vets that my horse should not be put through
this, that she would be in misery for weeks, that she would not likely
recover.  My research lead me to believe otherwise, and it became very
important to find a progressive and aggressive vet.  At this time, there's a
fighting chance that I will have a sound mare in the end.  My mare has not
given up, and I have not given up on her.  Hope has not been easy to come
by, but love for my horse has kept us going.

Thanks all, happy trails to you & your equine buddies -

m (& Sarena, who has never given up)