Assumed Abscess That is Now a Lump on his Coronet Band

[hj.eq.xc]

I would love any and all ideas for what this might be or what I can do to help this resolve as I am kind of lost at this point

The history:

At the end of September 2024, my horse came up slightly lame left hind, vet visit and x-rays of foot and hock showed nothing but the hoof testers indicated an abscess point by the medial caudal area by the bar and hoof wall. My vet tried to get the abscess to drain with the hoof knife but despite what turned into significant exploration, there was very minimal drainage, like a tiny trickle, and he remained sensitive to the hoof testers in the same spot and still just as lame. We got the standard protocol of soaking with warm water, epsom salts, and betadine, and wrapping with a soaked AnimalIntex pad and changed daily. Also included SMZs 14, 2x a day for 7 days due to mild swelling in the limb. There seemed to be improvement in comfort despite no drainage and there was no hole that needed to be sealed over and I stopped wrapping after two weeks per vets instruction.

A few days out of the wrap and then his leg swelled up and he was SIGNIFICANTLY lame and started to run a bit of a fever (102.4 F) so I had the vet out again. We did more hoof x-rays which showed nothing, he was still reactive to the hoof testers in the same spot. My vet tried to establish drainage again by further hoof knife digging but nothing opened up. Gave him some banamine, started a course of Bute and SMZs, 14 tabs 2x a day for 10 days, and commenced hoof soaking and wrapping again. Fever was gone in a few hours and I continued to monitor temp 2x per day. Comfort did not improve for about 4 days, eventually improved slightly and the lower leg swelling decreased a bit. At this point he was still not putting his heel down at all. About a week in on this round of Bute and SMZs and his temp dropped to 95.4, had a very tucked up abdomen, was very tight in his body, lethargic, not eating/drinking normally, eventually came around in the afternoon and nibbled hay, vet advised continue monitoring and to stop Bute which I did and do two tubes of UlcerGuard over the course of a few days and things improved. Digital pulse still strong in foot.

Beginning of November he was walking better but still trotting lame, reactive to hoof testers, no drainage could be started with hoof knife, blocking the foot did not remove all lameness but slightly improved it. No drainage evident on any poultice pad that I had been wrapping and changing and soaking from the start of this. Slight increase in soreness and swelling around the pastern. On Nov. 8 he developed a significant bump on his coronet band that was sensitive to the touch. I wrapped a warm Animal Intex pad on the bump as part of the wrapping routine and the vet came out a week later. The pad on the bump increased it in size. When the vet came out he was almost 100% sound, no longer reactive to hoof testers. The following week I applied the hoof wrap with the pad on the coronet band, no longer needed to change wrap and could leave the foot bare by Nov 20, applied a topical drawing salve on the lump from that point and stopped using AnimalIntex pads on the lump. Vet came out again Nov 27 to ultrasound the lump and saw nothing, nothing on the ultrasound and nothing on the x-rays. His lameness seems to go on and off, some days looks 100% sound, some days appears a bit sore.

Fast forward, Dec. 16 and the bump opened and appeared to be draining (he did another round of antibiotics as he cut his nose the next day and needed stitches and went on Uniprim for about a week) and since then it has alternated being open and draining and then kind of scabbing over but then opening again. Initially, it was bandaged over but the wrap wasn’t lasting in his turnout, so I was cleaning it with betadine and spraying it with the AluShield aerosol bandage spray. A week ago, I stopped that and have just done nothing to it and let it do its thing. His comfort level continues to ebb and flow, some days he is more comfortable and other days he isn’t. We have the all clear to start riding again but I am not comfortable with that because of how some days he is comfy and others not, so I have been doing 10min hand walks as tolerated the last few days and seeing how that goes before gradually increasing the time.

My vet has said in all his years of practice he has never seen any abscess behave this way. I was thinking that it may be a thing that is in his foot but nothing showing up on X-ray or ultrasound is strange.

If you have come this far, thank you, I feel like I am in a holding pattern and frustrated where it isn’t getting any better and my horse isn’t 100% comfortable/sound and I have no idea where to turn or what to do or if I should keep doing nothing. I know it sounds very human but I feel like there should be something I can do to help him. I had hoped that starting the walking would help expel it more rapidly but I’m not sure its making a difference

I would really value any ideas if anyone has dealt with anything like this, if anyone has any ideas on what I could do to help move this along or any wisdom to share I would really appreciate it. I have attached some pics in chronological order to the best of my ability to show what it looks like for reference.

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[Sdel]

I can only see the first picture, but I have seen a similar thread before. A bump that kept opening up and draining periodically and moving around some. I do believe that eventually a splinter or thorn came out of the wound and it finally closed up permanently after that.

[hoopoe]

horse on a farm I was at went through something like this and it was a largish wood splinter that finally migrated out the cornet. Not known how it got in, possibly through heel bulb. The horse was a pasture pet so not regularly ridden, just led to pasture each day

[Foxglove]

Went through a six month saga with a hoof abscess similar to your story. Repeatedly opened up on the coronet band. The vet and shoer discussed resecting hoof at one point, but they concluded (and I clung to this) “This is a healthy horse. He will heal.”

We Xrayed and probed and did everything possible.

In the end, after six months, the horse healed and is fine now, with no evidence of the abscess that gave us both so much grief.

[NancyM]

Keep soaking it, keep “drawing” it. The use of antibiotics before it has managed to expel whatever is in there may be the reason why this has not successfully resolved. The pus is trying to flush whatever is in there OUT. Soak it in epsom salt baths, and cover with a drawing poultice. Good luck.

[Obsidian_Fire]

I viewed all your pics. I agree that something may well be in there, somewhere, trying to make it’s way out. It might be in a different spot than where you’ve taken any images.
Have you run any bloodwork, especially when he’s had a fever?
The fact it wants to drain, starts to close off, then drain again, makes me think that keeping a drawing poultice on it, and maybe hot hosing, would be a really good idea.
Walking, IMO, is a good thing. It keeps blood flowing and that’s what you want.
On the days he’s uncomfortable, where is the ‘ouch’? Still in the hoof? Or the leg? I’d be suspicious whatever “it” is, is moving around.
Definitely a head scratcher.

[RedHorses]

I would poultice wrap it, probably with animalintex, after hot compresses. If you can’t keep a wrap on him in turnout, I suggest you level up your wrapping skills. What kind of conditions is he out in, and what was your failed wrapping protocol?

[NaturallyHappy]

I agree w continuing to soak and wrap. Gorilla tape and elastakon (sp?) can really help a wrap hold up in turnout.

[hj.eq.xc]

we haven’t run any bloodwork, the fever was a one off with the bad lameness flareup but still, running blood wasn’t discussed but we did talk about a tetanus booster but he gets the vaccine regularly in the spring so the vet didn’t think it necessary. Walking does seem to help open it, especially since I like to do road hand walks to see something new and interesting and I live in a very quite area so its pretty safe but the harder ground may be beneficial, it may not change at all. On days where we haven’t been out, it seems to close up a bit more then reopens more vigorously the day after a walk. I think that’s generally the pattern so far. The ouch is definitely in the foot, he holds it resting as he would with an abscess and postures like an abscess and touching the bump is a definite no from him. His ouch days are all roughly the same level, not showing significant or varying pain or lameness and more looking uncomfortable. If it is something like a thorn, splinter, piece of wood etc, and it is slowly migrating out, maybe as it moves somedays its position is more painful?

[hj.eq.xc]

wow, thank you for the pictures, i’m glad your horse healed so well and it all turned out fine. I also keep telling myself that, he is a strong, healthy horse and I know the body is really very capable of healing within reason without our interference in trying to help, but as I am sure everyone with horses understands that feeling of feeling like there must be something you can do to help it heal faster, better, etc. but I guess sometimes doing “nothing” is doing what is right, I did add probiotics after the antibiotics were finished and have added j-herb to help increase circulation so that may help his body expel what is going on, thank you for your input!

[Kyrabee]

Could it be ultrasounded? If it is a splinter or thorn would it even show on x-ray?

[hj.eq.xc]

the wrap that he walked through was done by the vet, unfortunately my hoof wrapping skills have gotten excellent (in all humility) this year, ask me how lol, and typically do the standard duck tape boot situation over the poultice, cotton and vet wrap and then reinforce the sole of the boot with a gorilla tape layer and that has proved indestructible in turnout, when he walked through the boot I was hesitant to rewrap for a couple reasons, firstly, I was considering that something was trying to be expelled and putting a pressure wrap over the opening would be counterintuitive and secondly, allowing the hoof the freedom to flex and function improves circulation in the lower limb/hoof and would help the body expel whatever is going on. His hoof changed shape a lot with how long it was wrapped through the fall and the soaking making it very soft and I am hesitant to start moving that backwards as it’s finally starting to come back to its normal shape. That said, I did have an idea about using some of the Equifit leg sock things to cut a band to put around the coronet band and hold on a drawing poultice without wrapping the hole hoof, Im not sure how that would stay if it goes down the hoof enough, but it might be worth a go?

[hj.eq.xc]

we did give it an ultrasound, because I don’t think a splinter or thorn would show on Xray. Initially, we were hoping to see evidence on the x-rays of an abscess draining tract or pocket to see if we could get a clear answer or if we could see something in the hoof. the ultrasound didn’t appear to show anything, I couldn’t say whether my vet targeted the viewer looking more laterally or down into the hoof from the location of the bump, I’m more experienced with x-rays than ultrasounds but he said he saw nothing

[JB]

@hj.eq.xc

I was thinking that it may be a thing that is in his foot but nothing showing up on X-ray or ultrasound is strange.

Replying before I read the rest of the replies, but I had one like this. Not the coronet, but an abscess that didn’t behave like an abscess beyond a few days. Xrays showed nothing.

It wasn’t until 2 weeks later that I was cleaning his foot to pack and wrap - again - when I saw it:

A stick. He’d shoved a 1.25" long twig into the back of his frog.

Wood doesn’t show on xrays.

Now, off to read other replies LOL

[Foxglove]

@hj.eq.xc --I know the frustration of doing nothing. My horse was in such pain! He’d hop around on three legs (the abscessed hoof was on his left hind). I asked my vet if he could use better pain relief medications (heroin, morphine, Fentanyl) —Vet said no because all of those, despite being difficult to buy in the amount a horse would need for pain relief would depress his digestive system and cause colic or depress his respiration and cause pneumonia, etc.

Just keep remembering, your horse is healthy; it will get better. (we did discount canker --cancer type of the hoof, but that was a suspicion at one time). We never found out what caused the abscess --nothing ever showed up on xrays except the infection pocket.

[trakehners]

@hj.eq.xc

That said, I did have an idea about using some of the Equifit leg sock things to cut a band to put around the coronet band and hold on a drawing poultice without wrapping the hole hoof, Im not sure how that would stay if it goes down the hoof enough, but it might be worth a go?

My horse is the king of monster abscesses that take a month to open and always migrate out via the coronet band. What I’ve found to be most useful is actually an Easyboot (I have the Trail II). I’ll either wrap the whole foot or just the coronet band (with drawing salve or Epsom salt poultice underneath), duct tape it, then throw the boot on. The only time it hasn’t held the wrap on was when my horse and his then-pasture mate decided to stage their own running of the Kentucky Derby in their (very muddy) field and removed all shoes (except one), bell boots, and hoof boots in the process.

It may seem like overkill but I have a pair of Easyboots courtesy of my horse’s couple-year phase where he was throwing shoes left and right and I have more than gotten my money’s worth out of them on both that and the abscess front. My wrapping skills are quite good (our farrier wants me to teach a class on how to do it properly, lol) but the hoof boot goes a long way toward keeping the wrap on and holding up for as long as I need it to. In my experience you just need to make sure you catch the wrap under the heel a bit if you’re only doing the coronet band so it doesn’t ride up but you can avoid wrapping the whole foot that way.

[ghst13]

Another option to consider if it doesn’t resolve on it’s own… My horse has a similar looking abscess (never figured out what caused it) but in a totally different place (along the tendons above the hock) and it kept draining and and reforming over and over. When it closed over he would be non weight-bearing. After several weeks I finally took him to a vet hospital where they debrided it and found dead tissue was acting as a foreign agent that was causing it to reform. My local vet had been unwilling to debride because of the proximity to tendons but the hospital had the procedure done quickly with local anesthesia.

[TWH_Girl]

I was going to suggest taking the horse into a hospital or clinic where a debridement can be done by equine surgeon. Especially if there is a foreign body in there.
Not sure if they would recommend a CT or MRI first. That’s what I’d be doing at this point though. Otherwise these can take a very long time to work through.

[hj.eq.xc]

I have been toying with the idea of whether it would be worth going to a clinic where better tech can get a better look and hopefully resolve this if this is still status quo in the next couple weeks but its hard to know when sinking $$$ is going to be better than hanging on just a bit longer and if after sinking the money there is no guarantee there would be any reward other than being told to just wait it out

[TWH_Girl]

What if you sent X-rays, ultrasound and pictures in advance to see if the clinic/hospital could review the case and give an idea what options they would have? They might be able to let you know if you should take him in or let it resolve in its own. It certainly isn’t unheard of for a stubborn nasty abscess to require surgery though.