Thrush - lameness

[Merrylegs52]

I got an older mare at an auction a couple months ago. Very sweet but NQR at the time. Upon inspection, saw she had a “bad case of thrush” and we proceeded to soak/treat with the “purple stuff” when she got home.
3 weeks in, the surface thrush was gone but she was still unsound - and becoming worse. I called the vet to do an exam + X-rays. X-rays were clean and he diagnosed deep sulcus thrush. Prescribed soaking with iodine and wrapping (after ‘cleaning’ the frog with hydrogen peroxide - ! - did I mention that we are in a “vet. care desert” and that there are no actual horse vets locally. Referral clinic - vet school - is over 200 miles away).
So I kept maresy dry, soaked with 50/50 water/apple cider for a week, and treated daily with Tomorrow (dry cow/mastitis stuff). 1 month later, she is still lame and while the sulcus is not as deep (progress?), there doesn’t seem to be much other improvement.
(She’s been trimmed once since being here as well).

I’ve been reading up on here and on online vet/farrier journals, and I am not finding much in terms of long-term prognosis for severe cases & recovery timelines.
Anyone had a similar experience?
What else could I try?

[fivestrideline]

Could be a bone bruise or really sneaky abscess, or a low soft tissue injury (won’t show up on X-ray). How long have you had her in total? How lame are we talking? And has she improved at all in the lameness?

Depending on her condition, she may just need time to grow everything out. Or you may be dealing with something that needs a more knowledgeable vet to diagnose. Be aware that constant soaking can make hoof issues worse, but packing with epsom salt and doing targeted treatments can help.

[cayuse]

If you want to switch up your treatment and try something “dry” Durvet No-Thrush powder works really well. I used it on my mini that had deep center sulcus thrush that was bad enough to make him sore and it cleared it up in about 2-3 weeks. I had used a variety of other things on him without much luck.

[SimonSays]

These are my go tos for bad thrush. The Equiderma White Line & Thrush Treament and the No Thrush Powder. They both work amazingly well if you use them regularly and stay on top of a bad case. They dry it right up and help harden the hoof back up. Good luck- it’s been an awful wet spring where I live and we’ve been treating quite a bit here. Ugh!

[Merrylegs52]

@fivestrideline

How long have you had her in total? How lame are we talking? And has she improved at all in the lameness?

She’s been here for a little over 2 months.
Lameness is probably a 3.5 out of 5 (obvious at a walk).
And no, she hasn’t improved…

Thanks, everyone for the responses!

[fivestrideline]

@Merrylegs52

She’s been here for a little over 2 months.
Lameness is probably a 3.5 out of 5 (obvious at a walk).

I know you’re pretty far out from good vet care… but that would concern me. I’m not saying it isn’t something like a really bad abscess or thrush, but that’s pretty darn lame for quite some time.

Did you do any blocking with the X-rays? How much of the leg did you X-ray? Also, which leg is this, front or hind? I think you may have something else besides thrush going on - a friend’s horse had a stubborn abscess turn into bone necrosis so call me cautious when these things don’t make progress.

I’m happy to be corrected, but I don’t believe that bute or other NSAIDs will do much for thrush/infected tissue pain (like taking Advil for an infection). Have you maybe tried a bute trial to see if she improves? If she responds positively, that might say that this is something musculoskeletal rather than “just” thrush.

Lastly, did the farrier have anything to say? IME thrush can be rapidly improved with some of the treatments above (also I’ve heard good things about Artimud) and frequent trims. Again, this could just be some gnarly chronic foot infection, but 3.5 for 2+ months is a little worrying to me

[rulex]

You could try a round or two of Cleantrax. But really you need to fight the thrush battle on both fronts, topically as well as internally. I found testing hay and making sure it’s low sugar and has adequate protein made a big difference.

[Merrylegs52]

@fivestrideline

Did you do any blocking with the X-rays? How much of the leg did you X-ray? Also, which leg is this, front or hind?

No, we didn’t block (vet was pretty certain that it was “just thrush”.) But I insisted that we took X-rays of joints (up to the knee) since she is an older mare who’s worked hard in the field previously. Strangely (?), she showed very little signs of arthritis and her joints looked great for her age (late teens).
She had thrush in both front feet. One side seems to be “resolved” - she is sound on it and the frog has filled in. The other front still has a deep sulcus crack (not smelly though) and that’s the one she’s unsound on.

@fivestrideline

Have you maybe tried a bute trial to see if she improves? If she responds positively, that might say that this is something musculoskeletal rather than “just” thrush.

No, but, great idea. I just got some from the vet yesterday, so I’ll be starting a trial this morning.

@fivestrideline

Lastly, did the farrier have anything to say?
[…]
Again, this could just be some gnarly chronic foot infection, but 3.5 for 2+ months is a little worrying to me

Believe me, this is worrying to me as well! Farrier seems to think that it will take 6 months to a year before the hoof has a chance to “regrow”. And he agrees with the proper trimming. That being said, by now the outside of her foot looks great (balance is ok) - the issue (whether it’s “just thrush” or something more) is deep inside. Which admittedly will take time.

Other than X-rays (and possibly blocking), which other type of diagnostic could one ask for?
Getting a whole day off work to get her to the vet school (+ Winter roads in the North) is a bit tricky. So I’d want to make sure we’ve exhausted all we can do locally first.

(and yes, definitely questioning my life choices for moving to an area where one has to “Macgyver” vet care. At least I don’t have to sew up a whole horse’s abdomen with fishing line like the neighbor guy had to do last year…).

Had the chiro out who didn’t see any musculoskeletal red flags from her end. She suggested penicillin to treat systemically in addition to topically. So I got some from the vet yesterday and we’ll try that starting today as well - along with some of the other great recommendations for topical application here! (I love the other Equiderma products, so will definitely try this and I’ve just placed an order for No Thursh dry powder and Cleantrax (that one is on backorder though). Might as well try everything!).

Thanks, everyone!

[fivestrideline]

@Merrylegs52

Other than X-rays (and possibly blocking), which other type of diagnostic could one ask for?

Personally I’d be blocking for sure, should you decide to pursue further diagnostics. That would guide you to a location to dig deeper vs throwing the kitchen sink at her. Heels vs foot vs pastern vs higher up can make a HUGE difference in what you’re looking at. X-rays are great but if you’re dealing with something like a DDFT or other soft tissue problem it wouldn’t show up.

Anyways, the fact that the other foot improved with thrush treatment is encouraging. Keep trying to clear it up, but I’d be thinking about getting blocks and imaging done by a good equine vet at the first practical and safe opportunity, especially if you don’t see improvement very soon.

I don’t know enough about penicillin or the situation to comment on that approach, but that’s not a drug to be used lightly. No matter what, I hope she starts feeling better soon!

[Bonnie2]

If you are in a “vet desert”, the first thing I would do is get a second opinion on the existing xrays. Quality of xrays and experience reading them varies widely! Send them to the expert of your choice. The internet is a wonderful thing!

[Merrylegs52]

@Bonnie2

If you are in a “vet desert”, the first thing I would do is get a second opinion on the existing xrays. Quality of xrays and experience reading them varies widely! Send them to the expert of your choice. The internet is a wonderful thing!

Great idea! How would one go about this? Should I just contact reputable equine vet clinics? or are there vet services similar to “Teladoc”?

[Merrylegs52]

Thanks for the great advice! Much appreciated!

[barnesthenoble]

I agree with everyone’s suggestions to keep looking for a cause, especially a relatively straightforward block to at least isolate it to the foot. In the meantime, I highly suggest Red Horse Products Hoof Stuff. It’s a mix of desitin and some sort of coarse fibers. Pick out the sulcus as best you can, irrigate (I use water/ACV), then pry out some Hoof Stuff and gently push it into the sulcus using a hoof pick to get it deep. The fibers help hold it into deep cracks and provide gentle stimulation to the tissues while helping treat infection. Reapply every other day or so. I usually like to top it off with a smear of Artimud or Field Paste.

If you want to hit it really hard I’d do weekly soaks of White Lightning or Oxine plus the Hoof Stuff.

Really set in infections can take quite awhile to improve and can be incredibly painful. However, I would also be suspect of a deeper cause if she’s that level of lame. It’s possible, though–a deep foot infection can be pretty darn painful! Is she reactive to probing in the sulcus with a hoof pick?

[Merrylegs52]

@barnesthenoble

Is she reactive to probing in the sulcus with a hoof pick?

Yes, very much so!
Thank you for the great advice!

[Texarkana]

Many years ago, I had a resale project horse with foot lameness. I took him to the closest vet school for diagnostics, thinking it was something serious.

Cheapest and most valuable vet visit ever.

His deep sulcus thrush was the problem. And I received the BEST hoof care advice I was ever privy to:

Treat thrush like a skin wound. Do not put anything on it that you wouldn’t put on a flesh wound on your own body.

Things like vinegar, harsh chemical concoctions, strong iodine— they all perpetuate the problem by killing the healing tissue. Even peroxide damages new tissue.

Use a milder wound wash to cleanse the area frequently. Keep it as clean and dry as possible, but don’t restrict movement to do so. Very gently use a tongue depressor to make sure to clean the deep area, but don’t go “digging for gold” as that can also damage the tissue. As for topicals, you want to encourage regeneration of healthy tissue. In my horse’s case, he was prescribed Panalog to get the infection under control. Then I was advised to use neosporin or SSD or even nothing; all of that I was told is better than most of the irritating thrush concoctions sold.

[Bonnie2]

Ideally, speak to your vet and explain you would like a second opinion on the xrays since the horse is not improving. Most vets are fine with this and will recommend an expert and make the contact and send the xrays. If your vet is not the helpful sort, contact a vet school or clinic that you respect. Explain the situation and have your vet forward the xrays. Second opinions on xrays are a very common practice for equine vets.

[fivestrideline]

Reactivity to the hoof pick sounds like this could be gnarly thrush after all! At least in part. The degree and timeline of lameness still concerns me, but maybe it is “just” thrush!

Good point @Texarkana, sometimes we try to aggressively get after something like this and accidentally make it worse. I wouldn’t use anything caustic but definitely try to keep it clean. Maybe the next trim will be able to clean out the foot a bit more too!

[barnesthenoble]

This definitely makes me more suspect of “just” thrush then! I agree with Texarkana re: nothing overly caustic. Any of the reallt gnarly stuff like Thrushbuster, Koppertox, etc kill the bacteria but also the new tissue so you never grow more foot. I’ll use 25% ACV/75% water to irrigate but you can also use dilute chlorhexidine if that’s available to you. I also agree not to dig–I try to remove what I can easily with a pick, then use a spray bottle to irrigate it. Much less damaging to tissue.

I feel like a broken record but I really can’t recommend the Hoof Stuff enough for cases like this. It’s basically diaper rash cream and carpet ?? Fibers. Super gentle but sticks in cracks amazingly well and provides gentle stimulation. Doesn’t get washed out the way neosporin or SSD will. Plus I try to avoid antibiotics when possible, since resistance is becoming such an issue. Neosporin is basically useless now according to my vets and my doctors. SSD is more potent but requires a prescription for me now. I have yet to need prescription meds to treat thrush with my approach, but there’s a first time for everything!

Good luck with your girl.

[RedHorses]

I did Pete Ramey’s daily treatment of triple antibiotic ointment mixed 1:1 with clotrimazole antifungal, delivered via catheter tipped 60cc syringe to the bottom of the sulcus, with a cotton ball stuffed in on top. Repeated until the cotton ball wouldn’t stay in the hole. I dragged the old cotton ball through the groove as I removed it, to clean it out before the next application.

One of the problems with the deep thrush is that after you clear the thrush, it leaves a nice little condominium with a vacant sign ready for the next lot of thrush to move in. Ongoing preventative treatment until there’s no deep hole left is key.

[Merrylegs52]

@Texarkana

Treat thrush like a skin wound. Do not put anything on it that you wouldn’t put on a flesh wound on your own body.

This is great! Thank you!
I agree that the products I originally used as recommended by the vet were probably way too harsh and killed everything - including the “good” tissue.