Gas pocket on toe of hoof on MRI -- nervous mom

[Sarahmz]

Hi There,

My horse had an MRI due to some intermittent lameness that showed up as a 3/5 lameness on the day of a pre scheduled vet exam. No previous hoof issues.

MRI showed a gas pocket by the toe (as well as some other incidental findings that we treated with PRP but that wouldn’t cause acute lameness), we were told to treat for abscess and put the shoe back on. The horse was hand walked and poulticed – and was sound without the shoes on the morning the farrier came. The horse was then shod, and was then off on that same foot. The next day he was better, I’d say 75%. I tack walked him all week being careful to watch for heat and any bad steps. Yesterday, the hoof was hot, with some swelling, and I trotted him and he was very lame. We pulled the shoe and you could tell was more comfortable (skilled groom pulled the shoe and said he was sore on a nail on the outside, near where the gas pocket was located on the MRI). Soaked and packed.

Our primary vet lives in a different state and will look at him with our farrier in one week (when he is due to be reshot). At this point, I’m a bit nervous to drive more nails into the foot. Our farrier is quite skilled and I trust him – I just feel that something is creating discomfort with the shoeing. I’m mostly looking for some reassurance and some thoughts on what might be happening. Maybe the gas pocket is a bruise (hematoma?) and that whole area is just tender and needs to rest? Or maybe it is an abscess that that perhaps the nail is “pushing” on the gas pocket… or just that we put the shoe on too soon and that we still need to be treating the abscess aggressively? It’s just so strange that he’s sound without the shoe.

I don’t know. At this point I’m wondering if I should pull his shoes for 3 months and send him to an excellent rehab facility that is just up the street where he can spend a lot of time walking and healing. Unfortunately, they won’t turn him out (despite having beautiful grass fields) because he’s a playful horse and they don’t want him ripping up his feet. My farrier doesn’t recommend leaving him at our existing barn without shoes which I agree with. I know I’ll know more on Monday, but thank you for allowing me to express my worries and am hopeful to hear of other’s experiences.

[BrookdaleBay]

Something very similar happened to my horse last winter. I was bringing him back into work after a case of cellulitis and in a moment of exuberance, he overreached and bruised his heel. He presented with heat in the hoof and 3/5 lameness, and he just about fell over when hoof testers were applied to his heels. He’s older, so negative flexions are his normal now, so the vet had us treat him for an abscess. Over the next couple days, he became more and more sound, so the vet agreed to have the shoe put back on. As soon as the shoe was back on, he was sore again. The farrier suggested waiting a couple days, just in case he was tender from the hammering of the nails, but he never improved.

The shoe was pulled again, poulticing resumed, and once again he became sound. Shoe back on, walked off lame, and this time the farrier pulled the shoe immediately. He applied the hoof testers and horse was still reactive, especially on the inside heel. The farrier did some digging with his knife and that’s when the bruise was uncovered. My horse has thin soles and the farrier didn’t want to leave him without a shoe for too long, so he made the suggestion to try a z-bar shoe, to take the pressure off the inside heel. He was coming back to shoe the rest of the barn the following week, anyway.

My horse wore a hoof boot for turnout for the week, and I continued poulticing withEpson Salt poultice. The z-bar shoe went on and stayed on for two shoeing cycles until the bruise healed, and it hasn’t been an issue since.

[Sarahmz]

Thank you so much for taking the time to respond. I’m really glad you found the solution and that it hasn’t been an issue. My horse (unfortunately? fortunately?) has no reaction to hoof testers. I suspect that a deep bruise could very well could be the case – except the gas pocket on the toe is a bruise rather than a true abscess (pus in the foot).

The problem is, I’m a bit “spooked” to put anymore nails into my horse’s hoof at this point and am considering pulling his shoes and giving him a break (which he hasn’t truly had, not with pulled shoes, anyhow). My sense is that’s what my horse wants, but we’ll see what the vet recommends when he comes on Monday.

Turns out there’s so much truth to “no hoof no horse!”

[BrookdaleBay]

Being spooked to put more nails in the hoof is totally understandable, and I was quite nervous myself to put him back in a full shoe even after the bruise grew out. If your horse has good feet, pulling his shoes to give him time to rest and heal sounds like a good plan.