Please read help!!! Anybody who has treated an abscess on the withers

[ihearttbs]

My TB gelding was bitten on the withers by another gelding 4 months ago. His withers became swollen and eventually an abscess burst. When it first occurred, it was so bad that my gelding wouldn’t reach his head down to graze and I had to hang all of his hay up high. Under supervision of the vet, I spent an entire month going out every day and flushing the wound with hydrogen peroxide (not an easy task) and applying topical antibiotic. He was also on excede shots that the vet was giving him. The vet also opened the drainage hole wider. Come a month later it starts to close up but messily. A few weeks later, it reopens. I have a different vet come out- they take x-rays: no bone chip. Culture it, it is not brucellis so not fistulous withers. They continue with the excede, prescribe him an oral antibiotic, and I continue flushing the wound with a sterile salt water/betadine solution this time followed by topical antibiotic.

A month later, he seems completely healed. Abscess has healed cleanly. I wait 3 weeks and the vet gives me the OK to start riding him lightly. Everythings great. I go out of town for 2 weeks (during which point he’s not being ridden) and he has a blanket put on him because its -10 here. I come back and the abcess has reopened. It seems very shallow and small compared with previously and he doesn’t seem to be in too much pain, but I have no money left after $2000 down the drain, and I’m emotionally exhausted from having to basically traumatize him by flushing the wound every day.

I don’t know what to do. Do you think at this point it could go away on its own and it was just because of the blanket? Should I be worried that this might require surgery? Lastly, do you think it would make it worse to start riding him lightly if the saddle is not touching the sore and riding doesn’t cause him pain? This upcoming summer was going to be one of my last seasons competing him (not that I’ll have the money for it this summer), and having lost 4 months is a big deal because he gets stiff when he’s not in work Final question, for anybody who has read this novel I appreciate your patience: I haven’t asked for a dime from the owner of the horse that bit him. However, I’m pretty upset that she didn’t offer to pay, especially because she mischaracterized her gelding (new to the barn) to both me and the barn owner as an extremely passive gelding (not the case, he has gone after multiple of the horses and has actually now been kicked off the farm by bullying). Do you think it would be fair to try to contact her and ask for money?

[TrueColours]

IM no vet, but the rule of thumb is to NEVER use peroxide for flushing after the initial application as it does kill off good tissue.

Ive dealt with something similar a few years ago as a neck injury. Horse got bitten badly on the neck and the area where the bite mark was, was about the size of a dime or maybe a bit bigger but with a ton of swelling around it. Vet came and made a cross on that area with a sterile scalpel and said it needed the least amount of resistance necessary to open and drain and as it started to open, I needed to flush - constantly - with nothing but warm water under a lot of pressure (which I did with my thumb over the hose opening so I sprayed inside - hard!). I flushed that wound out probably 10-15-20 times a day and each time I did, the hole got bigger and bigger and more and more junk and dead tissue and pus came out and then I’d put furacin on and I had ripped up an old bed sheet, punched holes in it and got some elastic like you would use for underwear waistbands and threaded that through and tied it on like a cape to keep flies and dust out of it. Then an hour later back in again to flush, reapply the furacin, put on a new cape and wash the old one, etc.

The original wound went from dime size to about twice the size of my hands as it opened and drained and just when I thought I had a handle on it, more goop would come out and I would take a step back instead of forward. I could actually hook my fingers underneath the neck muscle and once I actually softly pulled that muscle out towards me and flushed underneath it, the remaining debris that was trapped in there came out and the final healing began. At that point the wound did start to close but I was also relentless in that hourly regime of flushing to make sure as it closed absolutely nothing was left in there that would aggravate the healing and cause a secondary abcess to form later on. We were also using SMZ’s throughout - I think probably 3 or maybe 4 weeks in total from what I can remember?

Mine healed with no further complications at all and my total cost because I did everything myself and really didnt need the vets out at all past the initial consulation as there were no more complications, was maybe $200.00 - $300.00 in total

With any of these kinds of wounds, the relentless and thorough flushing is absolutely key. It simply cannot heal from the inside out any other way

Good luck with your guy …

[ToTheNines]

I am not a vet. I have not seen your horse. I am only going to comment that I have VERY successfully used sugar (yes plain white table sugar) to pack “wet” deep wounds. You might look into this. Seems like gentle flushing as the above poster described, then pack with sugar, might let it heal faster.

[Laurierace]

I would send him to a clinic for a workup.

[merrygoround]

If you are close to University of Pennsylvania’s New Bolton Center, I would go there. It is not Penn State;)

Also, you have here another non-fan of peroxide. And I also dislike Furacin. Peroxide is caustic, and Furacin has a reputation for slowing wound healing.

[rcloisonne]

You say the wound was cultured. Was the pathogen(s) determined? Did the culture include “Sensitivity” which means exposed to various antibiotics to determine which are effective? There are a number of pathogens that are resistant to ceftiofur (Excede), including quite a few genera of staph and pseudomonas.

I am also very surprised your vet recommended flushing the wound with hydrogen peroxide. It is very damaging to healthy tissue so impedes healing. Most vets recommend flushing wounds with sterile saline several times a day now a days.

So sorry you’re going through this and that things are tight. It’s hard to know what to do when you’ve spent thou$ands, are still having issues and running out of funds. However, if there’s any way to swing it, I’d have to agree with the other posters and send him to a university clinic. They’ll run the right tests and be able treat the wound several times/day. Many will allow you to make payments.

If that’s not feasible, be sure to ask your vet to run a culture & sensitivity. There’s a chance the antibiotic you’ve used is ineffective. And please stop flushing with peroxide if you’re still doing that.

[ladyj79]

Does a giant shoulder abscess count? Probably not, but I did what my vet told me which was twice daily extended flush with water, then flush with betadine/water solution from a big syringe. And antibiotics. Mine was cultured as according to my vet it was the worst thing she’d ever smelled, but cultures came back with nothing exotic. We didn’t use smzs, I think tucoprin, and I used until wound was closed, which was probably more like six weeks.

Flush, betadine/water, antibiotics.

[beowulf]

I am no vet and don’t pretend to be one, but it’s my understanding that using peroxide and or betadine on a healing abscess is different than it is on say, a laceration. Peroxide and betadine are good for anaerobic areas, which are often what abscesses are after they blow.

FWIW, a very reputable vet in our area had us flushing out one of our gelding’s shoulder injuries for weeks. He came in from the paddock with a giant hole in his shoulder - it looked like someone had taken an icecream scoop and scooped out muscle, fibrous tissue and tendon - IIRC, you could see bone with flexion. No idea how he did it, and it healed beautifully without a scar. But it was hard to convince him to let us do it…

In regards to the OP, I am not surprised the hole reopened. That type of injury takes months to heal completely, and it is in an area susceptible to a lot of pressure. Blankets place a great deal of weight on the horse, particularly on the wither and across the shoulder/neck. If I were you I’d call your vet and ask what to do - most vets don’t charge you for a “consultation”. If they want to come out, it sounds like a good idea to let them, even if you just spent so much $$ for his recovery. I would avoid blanketing and saddling for a couple weeks…

[ihearttbs]

The initial vet, who is actually a very reputable vet with Buckeye Equine in Burton, OH, recommended flushing with hydrogen peroxide. He is also the vet who ended up charging me the bulk of the money that I spent. He knows that I’m tight on money, and even though I told him that I could give the excede shots myself, he went out and charged me a farm call to give the horse the excede shots. He also told me that he would stop by and look at my horse for free since my horse is across the street from a farm he goes to 3x a week. He ended up charging me the farm call/appointment fee for that. He also kept bundling (expensive) supplies that I could have bought for less elsewhere into my fees. Needless to say I switched vets. The pure hydrogen peroxide was extremely painful to my horse, and because of it he has become extremely difficult to treat (anticipating a lot of pain even with the sterile salt water solution). I think the vet may have been right in prescribing it for the first week or so after the abscess burst, but he should have been clear to switch to a sterile salt water solution after that as the hydrogen peroxide impedes regeneration of healthy tissue.

That is really good to know about some of the pathogens being immune to excede. However, he was also on topical antibiotic cream and a 30 day course of oral antibiotics that I believe the 2nd vet determined to be a good one for the particular pathogen found. I cannot remember the exact name- it was bacillus something.

As for right now, the wound has closed up again cleanly- He doesn’t seem to be in any pain , even when I touch it, and before it was closed up nothing was draining out of it when I flush it. So I’m hoping it was just a superficial opening. It does still seem to have a little bit of necrotic tissue/proud flesh. Do you think I should try to get it opened up again? I’m also consulting my vet, who said not to, but I just wanted a second opinion. Thanks everybody for your help!

[csaper58]

What you are dealing with is Fistulous Withers. There is lots of info on the web, you can also search fistulous withers/chronicle of the horse, and get links to other posts on the subject. Hope your horse is better soon.

[NancyM]

OP, I know you said this has been cultured and NOT found to be fistulous withers, but is does sound like fistulous withers. If it breaks open again, I think I would have it cultured again, just in case. Don’t just continue on the assumption that the original vet work done was correct. If it doesn’t break open again, then is was just a nasty infection, and has drained and healed adequately now.

We had a case of fistulous withers many decades ago. At the time, it was thought to be “incurable”. But ours did get cured. It took a year of antibiotics to do it. I do not know the details of the treatment used as I was very young when this went on, but was told at the time that the antibiotics were injected for that long to gain success with the treatment. Good luck.

[ihearttbs]

It is not fistulous withers thank god…both vets cultured it and no brucellis was found…have done a lot of research on the subject and true fistulous withers is always associated with brucellis.