Post Abscess Lameness - thoughts?

Looking for some help/advice on post-abscess lameness… sorry for the length…

Background: I have an older, TB gelding who is known for having pretty awful feet. Through a great farrier and some feed through supplements, we have been able to get his feet better, though there is still a huge issue with how slow (and I mean SLOWWW) his feet grow. He is shod in steel all the way around and has been for the past year (previously have used steel, aluminum, and even glue ons when he totally destroyed his hoof walls). Steel have by far been the best this past year as we have dealt with far less issues and shoe losses.

Of course I jinx myself, and while I was across the country for work, I get a text from the barn letting me know that he twisted the front left shoe and they had brought him in (He lives out almost 24x7 to keep him moving/active, plus he hates being locked in a stall). To be fair, he was about 5.5 weeks from his last shod and just about due to be done again. A quick call to the farrier, and he is en route within 30 minutes (did I mention how great my farrier is?!) Thinking he would quickly nail it on and all will be well, I jinx myself again. Farrier calls to let me know that my horse stepped on the clip when he threw the shoe. He did a pretty thorough look over his foot and was fairly sure he only hit the outer hoof wall and not any soft tissue. Horse was deemed to be pretty sore and put back into a stall.

The thrown shoe happened on Wednesday, I fly home Thursday, head straight to the barn from the airport to assess the situation myself. Pull him out of his stall and still very sore (3-legged lame). Also a lot of heat and swelling in the lower leg. Take him out to graze, cold hose his leg, stuff him full of treats + some bute, and come up with a plan to hit the tack store first thing in the morning for some magic cushion before heading back to the barn. Make it back on Friday mid-day and horse is doing shockingly well (I’d say 80% better). More grazing, cold hosing, 1g bute, back in the stall, and leave feeling relieved. Jinxed for the third time. Go back on Saturday and horse has gotten worse. Not as 3-legged as before, but worse. Starting to suspect abscess, I soak with Epsom salts, pack with a poultice, and diaper/vet wrap/duct tape (horse has abscessed before so luckily I am well-versed and have all supplies on hand and the soaking/booting system down pat). I didn’t throw him outside as I wasn’t completely sure it was an abscess (know movement can help it) so he stayed in. Sunday – back to 3-legged lame and has all symptoms of an abscess. Soak, re-wrap and boot. Monday I talk to the farrier who unfortunately can’t make it until Wednesday AM. I continue the soak/wrap method a put him out Sunday night to get him moving.

Farrier makes it out Wednesday, pulls the shoe and carefully starts digging. Luckily (!!!) he is able to find the abscess (easy since it was exactly where the clip hit and he expected it to be) and boy did it drain. Ran hoof testers on the rest of his foot to check, and all seemed well. Farrier left the shoe off and instructed more soaking to full drain it and then wrap it to keep it clean/help it dry out. He was out of town for 4 days, but assumed it would take at least that long to fully dry out, so recommended I just keep wrapping. Horse gets progressively better over the next few days as abscess drains. Saturday I put him out for awhile with his foot wrapped, and again Sunday night he goes out. Farrier comes back Tuesday, puts the shoe back on as well as re-does his other feet. Reports that he might be a little sore since the shoe has been off, but that he was putting full weight on it as he does his other feet and seems to be on the mend. I go out to see him Friday (away for work again that week!) and he is 90% sound. Over the weekend he stays about the same, maybe up to 95%. Free lunged him and saw just the slightest head bob sometimes.

So here we are today, it has been a week since he was fully re-shod and back to living outside. I went out this morning to check him again and he is still slightly off (I took some videos just need to figure out where to upload). Its very slight and not accompanied by so much of a head bob, but a little more noticeable on tighter turns. Is this normal?? Am I just being impatient? In the past once the abscess has blown/dried out and a new shoe was on I’ve had a sound horse. Maybe this one was bigger and he is still experiencing some residual soreness? Should I be worried that something else is going on? Again, apologize for the novel (and yet another abscess thread! :))

I would say normal.

I have gone through this (stepping on clip injury) 2x, first time took 6 weeks until sound and the second time took 4 ish. Animalintex is great for drawing out abscesses, I would use that right against the sole under your wrap.

I would say normal too. Don’t you just hate wrenched shoes!!!

He could also still have a little general soreness in his leg/shoulder/back from when he wrenched it.

Sounds like your horse just needs more time. My boy can take weeks to be sound after an abscess. He may have a tender spot on the hoof that still needs to heal/toughen up a little more.

Thanks! Makes me feel better - he’s getting older and I’ve been super neurotic about every little ding/scrape/off-step.

I’ve added a video … sorry it isn’t the best - he was clearly annoyed to be out trotting around the indoor at 6:30am and really just wanted to roll (hence the rooting)!

I am a worrier. I would worry that your big abscess involved the coffin bone. It might then need IV antibiotics and to be opened up to drain more. I would get the vet out and get an x-ray.

It’s too bad your farrier didn’t have you call the vet to take X-rays while the clip was still in his hoof. There is no way he could tell from looking at it how deep the clip penetrated and what structures might have been damaged. I hate clips for this very reason.

I’m also surprised he didn’t advise hosing, squirting a disinfectant into the puncture, politicing (even a paste made from Epsom salt would have worked) wrapping and keeping the foot clean.

Best bet now would be to have the vet out for some X-rays, preferably using a radio-opaque material in the puncture. Farrier didn’t suggest a vet either?

Unfortunately the farrier did not find the clip in the hoof, so would not have been able to have the vet out to take x-rays. The farrier did clean the spot out as well as possible and squirted iodine where the clip had hit before putting the shoe back on. When the farrier came out the second time to remove the shoe and dig out the abscess, I did the standard soaking, packing, and wrapping for a week until the abscess hole had dried out and was clean. I soaked with epsom salts/hot water and then packed with the green epsom paste (can’t remember the name) and continued to use iodine to keep everything as clean as possible.

The horse now has all 4 shoes back on. The clip had hit pretty close to the outside hoof wall so the farrier didn’t think it was close enough to soft tissue/coffin bone, but did recommend keeping an eye on it if things did not progress. This horse is know for being pretty sensitive (read: big baby) to any injuries and tends to have a slower healing process. I hope to wait a few more days to see if it resolves, but if not will consider having the vet out for x-rays. Thanks!

Sounds like you’ve done everything possible given the circumstances.
Good luck with this. Puncture wounds anywhere in the bottom of a hoof can take a long time to heal and go south quickly.

Did your farrier suggest a hospital plate? Might be easier for you.