Abscess, swollen leg, advice please!

[hj.eq.xc]

One week ago (Sunday) my horse became suddenly very lame on his front left. He was fine in the morning but in the afternoon I noticed that he was quite lame. In checking him his leg was swollen slightly up to about 4 inches above the fetlock with slight heat. In response I gave him 2 scoops of bute in his feed and cold hosed his leg for 20 min as well as shutting them (2 best friends) in a smaller turnout area. Initially I was thinking a nasty fly stomp on harder ground. I wanted to see how it responded so I waited until morning. Pain/limping was better in the morning, I gave him bute in AM + PM feed and cold hosed for 20 min twice that day. Tuesday morning he got more bute, another 20min cold hosing and I called the vet.

The vet came out in the afternoon, discovered an abscess by his heel and drained it. After he drained the abscess he put the hoof in warm water and epsom salts. Obviously, the water got very dirty as the hoof and leg was not cleaned prior to dunking. Then he proceeded to dunk a hoof poultice in the dirty water and then he put it on the hoof and wrapped it up telling me to leave the wrap on for at least a day and if it held up leave it on for another day; take him off bute, do not cold hose, do not use ice boots. The dirty poultice was a red flag but I trusted the vet so I followed directions. Hoof tenderness was improved with the draining and the first 24hrs after didn’t change much otherwise so I was feeling hopeful. Thursday morning I noticed increased inflammation with the swelling up to the bottom of the knee joint. I contacted the practice and was told the vet would drop off SMZs. So, he dropped off SMZs without seeing my horse with instructions of 12 tablets 2x a day for a week, again told not to give bute or ice boots/cold hose and continue to rewrap hoof (to be clear I do not dip poultices in dirty water). He got SMZs Thursday night and Friday morning. Friday midday, the swelling is significantly worse and well over the knee. I contacted the vet again and was told to give one scoop bute in AM and if he’s still sore next week maybe an X-ray. I was not told how many days he should get one scoop of bute and the vet still has not seen my horse since he came out to drain the abscess on Tuesday. (yes I could ask him out but he is very busy and its just “do the treatment and let me know”) I gave him bute Friday evening, Saturday morning and Saturday afternoon. I was making up feed and automatically added the bute in the PM without thinking about it but I figured it wouldn’t hurt so I left it in. Sunday morning he got one scoop bute and showed swelling improvement and Sunday afternoon looked better still, not no swelling but much better. I reached out Sunday to get clarification on length of doses for bute and if the vet should come back out to evaluate. Monday morning, another scoop of bute, and now Monday afternoon, the swelling is getting worse again and up around/over the knee. I should also add when I removed the vets poultice wrap the foot smelled horrid, like the worst thrush and there was black nastiness around the white line and frog. I soaked his hoof in epsom salts and added tea tree and eucalyptus oil to help disinfect further. Subsequent rewrapping that I have done of the hoof does not show any of the nasty smell or blackness. As of now, Monday evening, I have not heard from the vet.

I have concern over the possibility of the initial dirty poultice the vet wrapped on introducing a nasty infection into the recently drained abscess hole and the overall non communicative aspect, in having to chase the vet for a reply and to clarify instructions. I still don’t know how many days I should be giving bute or wrapping the hoof and I am concerned that a bigger problem is being masked especially with the resurfacing of the swelling, the bute is the only thing that seemed to do anything for the swelling, the SMZs only made it worse and on less bute (one scoop a day) the swelling is coming back. I feel a bit ignored by the vet and that the situation is not being handled properly or with enough concern as it is not improving and to the contrary apparently getting worse. Am I being an overreactive horse owner? Is this normal? Please help and let me know your thoughts, I will clarify anything I can. Sorry for the long post.

[Long_Time_Lurker]

Is the hole used to drain the abscess still “open” or has it closed? Sometimes it closes over while the abscess has not completely drained or healed. If it drained a lot and was foul smelling the first day it should probably not have stopped draining in a day or two, but gradually lessened over a week or so. If it is getting worse there is still infection inside, or another problem too, but probably still or again an abscess that needs to be opened and further drained. And/or there may be more “pockets” of infection that have not been opened. Is there a vet hospital you can haul to for evaluation and treatment by a lameness specialist? There is a treatment called Clean Trax that can be used to get medication way up inside the hoof to any additional pockets. If you haven’t used it before you probably need help/guidance from someone who has. Here is a link:

https://www.centaurforge.com/Clean-Trax/products/69/

[Scribbler]

@hj.eq.xc

One week ago (Sunday) my horse became suddenly very lame on his front left. He was fine in the morning but in the afternoon I noticed that he was quite lame. In checking him his leg was swollen slightly up to about 4 inches above the fetlock with slight heat. In response I gave him 2 scoops of bute in his feed and cold hosed his leg for 20 min as well as shutting them (2 best friends) in a smaller turnout area. Initially I was thinking a nasty fly stomp on harder ground. I wanted to see how it responded so I waited until morning. Pain/limping was better in the morning, I gave him bute in AM + PM feed and cold hosed for 20 min twice that day. Tuesday morning he got more bute, another 20min cold hosing and I called the vet.

The vet came out in the afternoon, discovered an abscess by his heel and drained it. After he drained the abscess he put the hoof in warm water and epsom salts. Obviously, the water got very dirty as the hoof and leg was not cleaned prior to dunking. Then he proceeded to dunk a hoof poultice in the dirty water and then he put it on the hoof and wrapped it up telling me to leave the wrap on for at least a day and if it held up leave it on for another day; take him off bute, do not cold hose, do not use ice boots. The dirty poultice was a red flag but I trusted the vet so I followed directions. Hoof tenderness was improved with the draining and the first 24hrs after didn’t change much otherwise so I was feeling hopeful. Thursday morning I noticed increased inflammation with the swelling up to the bottom of the knee joint. I contacted the practice and was told the vet would drop off SMZs. So, he dropped off SMZs without seeing my horse with instructions of 12 tablets 2x a day for a week, again told not to give bute or ice boots/cold hose and continue to rewrap hoof (to be clear I do not dip poultices in dirty water). He got SMZs Thursday night and Friday morning. Friday midday, the swelling is significantly worse and well over the knee. I contacted the vet again and was told to give one scoop bute in AM and if he’s still sore next week maybe an X-ray. I was not told how many days he should get one scoop of bute and the vet still has not seen my horse since he came out to drain the abscess on Tuesday. (yes I could ask him out but he is very busy and its just “do the treatment and let me know”) I gave him bute Friday evening, Saturday morning and Saturday afternoon. I was making up feed and automatically added the bute in the PM without thinking about it but I figured it wouldn’t hurt so I left it in. Sunday morning he got one scoop bute and showed swelling improvement and Sunday afternoon looked better still, not no swelling but much better. I reached out Sunday to get clarification on length of doses for bute and if the vet should come back out to evaluate. Monday morning, another scoop of bute, and now Monday afternoon, the swelling is getting worse again and up around/over the knee. I should also add when I removed the vets poultice wrap the foot smelled horrid, like the worst thrush and there was black nastiness around the white line and frog. I soaked his hoof in epsom salts and added tea tree and eucalyptus oil to help disinfect further. Subsequent rewrapping that I have done of the hoof does not show any of the nasty smell or blackness. As of now, Monday evening, I have not heard from the vet.

I have concern over the possibility of the initial dirty poultice the vet wrapped on introducing a nasty infection into the recently drained abscess hole and the overall non communicative aspect, in having to chase the vet for a reply and to clarify instructions. I still don’t know how many days I should be giving bute or wrapping the hoof and I am concerned that a bigger problem is being masked especially with the resurfacing of the swelling, the bute is the only thing that seemed to do anything for the swelling, the SMZs only made it worse and on less bute (one scoop a day) the swelling is coming back. I feel a bit ignored by the vet and that the situation is not being handled properly or with enough concern as it is not improving and to the contrary apparently getting worse. Am I being an overreactive horse owner? Is this normal? Please help and let me know your thoughts, I will clarify anything I can. Sorry for the long post.

First I’ve never had a vet out for an abscess. I’ve always just soaked and poulticed myself. My observation is that abscess tends to resolve even if untreated (say on a pasture horse where you only notice the abscess tracks at the next trim). But it does seem to resolve faster with care

I don’t involve a vet because I don’t want them to cut a hole in the sole, which requires a hospital plate or similar for several months until the sole grows out.

Without a hole cut, the abscess will seep out the heel or frog (ideal) or burst out the coronet (not so great) but won’t leave a hole in the sole that needs antiseptic care

I do pick the hoof before I soak in a saturated Epsom salts solution, and I do soak the Animallintex or similar in clean water, and I do wrap to keep it together, but not with the care I’d take on an actual open wound. While the abscess is draining, the movement is more from inside to outside

Bute may slow the process, and in my experience doesn’t do much for serious abscess pain. I understand oral antibiotics are not very effective because there is so little blood flow to the hoof.

Abscesses may also get worse before they get better.

There likely is some point at which I myself would call in a vet to make sure there was nothing seriously wrong, like a foreign object or a crack in the coffin bone. Fortunately I haven’t been there yet.

I’ve been very lucky to have few medical issues with horses under my care, but the combination of barefoot horses and wet weather paddocks, especially wet summer weather, has caused enough abscesses that I feel like I know the drill now. As kids we had shod horses and kept them in dry stalls, and I never even heard about abscesses.

Anyhow if you don’t trust this vet, call in another vet.

If it’s your first abscess, the speed it progresses, the leg swelling, the insane amount of pain, all can be very alarming. But in the majority of cases it’s not a serious ailment and will resolve on its own timeline. So the vets office likely doesn’t share your concern to the same degree.

[trubandloki]

Oh, I answered this same question in the hunter/jumper forum.

Dirty water happens when you soak a hoof, no matter how much you try to not have dirty water.

Bute is typically not used for an abscess.

Stocking up is pretty common for a horse not moving. It is typically worse in a leg with an injury.

[trubandloki]

@Amberley

I think OP is right to be concerned.

I am never going to tell someone to not call their vet. I am a firm believer in I would rather pay for a vet call I did not need than not have paid for one that I did need.

So I agree, that calling the vet and having an in person appointment is a very smart idea.

I personally have seen swelling/stocking up above the knee on a horse on stall rest.

But again, for sure call the vet.

I am not going to assume that because the vet gave medications that it means a certain diagnosis.

[DiamondJubilee]

Both my farrier and vet will not create a hole to drain and abscess. They both stated (at separate times) that there is a greater risk of infection if a hole is created. I have always just soaked and then poulticed for an abscess with a hoof wrap. I like them to go out through the day to walk around to help speed up the process, and I know it can be super painful for them, but movement is best.

I thought one of my ponies was foundering one day as he just wouldn’t walk out of his stall at all. In both fronts. I had the vet out that day and took xrays of his feet and low and behold it was a big abscess in one hoof, even though he presented in both fronts. The vet said they almost never show up on xrays and this was his 3rd time ever seeing it in his 20 years of practice. But he would not dig into the hoof and wanted me to soak it and poultice it and turn out. I felt horrible as it took weeks for it to burst, but it did and it was instant relief for him. I didn’t see any swelling of his legs though. It did burst out his toe when the farrier came to trim him so that helped in the end.

I don’t have much advice on swelling as I’ve never seen that with an abscess, but as others have stated, it could be from many things - infection, cellulitis, being in a smaller enclosure or ?. I’m thinking the vet was thinking the abscess got infected which is why they prescribed sulfa/trim. Jingles for your guy!

[hj.eq.xc]

the hole appears to be still open, thank you for the link!

[hj.eq.xc]

To be fair, when it turned out to be an abscess, I felt like it was a waste of time, it was because of the sudden and intense soreness and lower leg swelling and heat I wanted to be rather safe than sorry. My boy is barefoot as well and has been for ages and this is his first abscess with me (over 3 years together now) Thanks for your input!

[hj.eq.xc]

He is out 24/7 with a run in, his “restricted area” is about 100 or so feet by about 200ish feet, the property is not set up for truly restricted rest at the moment as work is being done on it so he moves around a lot, following the vet draining the abscess his lameness decreased significantly and was only like a 1 for a few says and seems almost fine as far as that goes now but still with the swelling in his leg

[Scribbler]

Movement is good for an abscess.

[Alex_and_Bodie_s_Mom]

When my horse gets an abscess, it can be this bad and the worst one he ever had took 3 weeks to resolve.

I personally would rather have the abscess pen in the sole, not the coronet band. Alex has permanent hoof damage from that. I know others will disagree with me on this.

The other thing that occurs to me is founder. I had a mare who foundered, and her first presentation of symptoms was exactly like this. It’s worth getting x-rays just to make sure there isn’t a massive infection inside the hoof.

[hj.eq.xc]

So far the working plan right now is continuing treatment as he is through Friday, if the swelling has not gone away in a couple days the vet will be out to recheck where I assume X-rays and maybe ultrasound imaging will occur to see what’s going on in there. I’m planning on going for x-rays more than likely anyway but see what he says with hands on the horse. Part of me still feels like an idiot because all in all the swelling isn’t THAT bad but it is enough and not going anywhere. I am curious to see what happens to the swelling off bute but that won’t be until Saturday it’s looking like at this stage.

[Kyrabee]

The one abscess I have dealt with with my mare was swelling, swelling and more swelling.

She initially was maybe 2/5 lame with a bit of swelling on the outside her leg…hoof to fetlock. After several days when nothing changed I took her to the vet. I thought she was pissy with the hoof testers but his verdict after exam and radiograph was she had ‘sprained’ her ankle. I did 3 days of bute per vet directions and she was better. So, I chose not to go to the barn day #4 and when I showed up the next day she was only touch weight bearing and her leg was stovepipe swollen from hoof to above the hock. I wondered what in the heck she had blown? We hobbled her into the barn and got her in cold water. When she was done soaking, I was palpating her leg and got down to her heel and it was blazing hot.
Boom…abscess. I came the next day and it had broken out the coronary band at the heel. She quickly came sound but it probably took 3 weeks for the swelling to resolve. She was massively swollen before the abscess popped.

[hj.eq.xc]

Thank you for sharing this! Did you return to any level of ridden work while the swelling went down if she was comfortable on it or did you wait until it was all gone completely before riding again? He is starting to seem a lot more comfy and has started to trot and canter in turnout a bit. I think something spooked him once but he has just decided to go off trotting occasionally in this last day but there is still some swelling in the leg and I was wondering how you handled it!

[Scribbler]

@hj.eq.xc

Thank you for sharing this! Did you return to any level of ridden work while the swelling went down if she was comfortable on it or did you wait until it was all gone completely before riding again? He is starting to seem a lot more comfy and has started to trot and canter in turnout a bit. I think something spooked him once but he has just decided to go off trotting occasionally in this last day but there is still some swelling in the leg and I was wondering how you handled it!

If the swelling is caused by an abscess but the horse is sound, I would feel free to ride lightly. However I would stay alert to the possibility there is still a little tenderness in the foot, especially in any movement that loads that foot, like lateral work.

[hj.eq.xc]

Thank you! Yes, I have hoof boots for him which I used frequently while he transitioned to being barefoot and I think it would be a good idea to use those as we ease back into ridden work. I am hoping to get the vet out Saturday or Monday, today was his last day of SMZs and tomorrow his last day on Bute so I am hoping for some good reactions on his part as he comes off meds and heals. Keeping fingers crossed!

[Kyrabee]

Well, unfortunately I was more crippled than her . I had had foot surgery and was non-weight bearing on my right leg. However, I would have gotten her back to light work a week after she came sound. That may have moved that swelling out sooner.
Luckily, it was oddly dry (March) and since it came out at the coronary band, it had to heal by benign neglect (which it did uneventfully). I did get it soaked once but just couldn’t manage what I needed to do on one leg.

[hj.eq.xc]

Wanted to add a question on to this for answers and opinions. My horse still has swelling and heat in leg (although it is more mild, not raging), hoof is still being wrapped (I have heard I should not be doing the soaking and wet poultice wrap for more than 3-5 days after the abscess drained? Is this true ?) I texted the vet on Friday asking for directions on what to do going forward now off meds (I was instructed to continue treatment of meds and poulticing through Friday earlier in the week), how long the hoof should be wrapped with an updated pic of his leg and can he please come out ASAP but I haven’t heard anything. Is it normal for vets to not respond on the weekend? It’s just that at this point we are going into the third week struggling with this now, I know some abscesses take some time but I am concerned that the reason for the lack of healing is that there is something more serious going on (obviously). To clarify, any instruction has taken place via text, he has not been out to see the leg/hoof since Tuesday, the 9th when he drained it.

[Scribbler]

I would not consider long running abscess a reason to pay weekend rates for an emergency vet visit but again, if you feel you don’t trust the vet, you should get a new one.

[hj.eq.xc]

ya, this is a good point that I need to remember. I am also conscious that I don’t want to be THAT client for the vet to deal with. I have always dealt with vets via boarding barns so I am learning the etiquette if you will of being a direct client as I go with this but of course my frustration and concern (and overthinking) over it not getting better isn’t great when I feel like I can’t do anything for him (and of course any day now I will go out to his whole leg ballooned up and massive fever and laminitis and bone infections etc etc…)