Treating an abscess- NOT HOOF

[Dramapony_misty]

So, my lovely pony mare has had a scrape on the inside front pastern for a while. Started off that the hair was gone and it was a little scaly. I assumed that she had one of her less-graceful moments in turnout and caught herself with her opposite front hoof. It seemed to have been a long time healing (stayed sort of hairless and scaly) but not getting worse. No heat and no pain/lameness.

Fast forward to this morning when I see that she has re-opened it and has some blood oozing down her pastern. No biggie, I can handle this…until I start cleaning it with a betadine solution and poking around. Turns out that as I massage it, blood and puss (clearish mixed with the blood…not yucky color) start coming out of the opened part (hole is about the size of a pinkie finger tip). I massage and rinse it out as best as I can to get the junk out, slather it with some icthammol and wrap with a sterile pad and vet wrap. The leg is slightly warmer than the other, but almost not noticeable.

Anything I’m missing in this treatment? I can find tips for treating hoof abscesses all day long, but not for non-hoof ones.

And I will say that I sent this story via text to my vet and am waiting for a reply right now.

[khall]

Flush with dilute nolvason solution to help it heal from inside out.

[Calamber]

You did the right thing with the ichthammol, I would not flush under the skin with anything but saline at this point.

[JBD]

Hopefully whatever was in there came out when the abscess blew. If not, your treatment should help it come out. After that its just a regular wound, hydro and treat with whatever your vet says.

[merrygoround]

I’m glad you notified your vet, They may want a course of antibiotics, just on case.

[findeight]

Vet may also need to go in and clean it out and have you keep it open for a few days to completely flush it and allow that inside out cleaning and healing. It’s not a complicated procedure, tranq and a local plus maybe 5 minutes to probe and clean out. Imagine antibiotics too but not that expensive or traumatic. But I would persue that and not assume it’s completely cleaned itself out.

[Dramapony_misty]

Thanks all…It is definitely still draining so that is a good thing. The drawing salve seems to be doing its job quite well.

I haven’t heard back from the vet so my guess is that it isn’t a super-emergency. I did have my phone with me tonight and took a picture of it unwrapped for the evening treatment so I will be sending that tomorrow.

[J-Lu]

I would opt to flush the abcess with 0.9% saline, not water, if possible. If you have a scale that can weigh small amounts, you can make your own saline solution. Alternatively, go to someplace like Whole Foods that sells a) salt and b) has small scales to weigh things with. Do you have syringes hanging around? 5cc to 10 cc? I’d flush the wound pocket directly with saline and betatine or saline and chlorhexidine. It the wound is “pinky sized”, I’d flush many times a day so it heals from the bottom up rather that surface down (seals in bacteria). If you are wrapping the pastern, consider a gradient wrap. Soak a few 2x2 gauze with betadine/saline, put that on the wound. On the back side of that, put several dry gauzes - as the fluid drains from the wound it will wick out to the dry gauze and facilitate healing. When the pocked starts to fill in, I’d use triple-biotic ointment.

Let us know what your vet says/does, and good luck for your pony!

[Dramapony_misty]

The water “flushing” I am doing is just a surface flush (like squeezing a washcloth saturated with warm water on her leg just above to wash away any ooze that has come to the surface). Getting in there a bit more with some hydrogen peroxide in a syringe. I know that using peroxide too much can injure healthy tissue but I figure (maybe wrongly…let me know) that it is more important to get the crap out of there so then the healing can start.

I didn’t think of layering pads, though that makes total sense. The first (and right now only) layer is a non-stick sterile pad. I will grab some gauze at the store on my way home today.

[horsepoor]

The only non-hoof abscess I have dealt with is one on the jaw, and that was a nasty mess that my vet had to work on almost daily for awhile as the horse was a particularly difficult one and had to be sedated for treatment. Thank goodness for insurance paying the vet bills on that one. The vet ultrasounded to look for anything in the wound/abscess first and then we flushed daily with (something – might have been a chlorhexidine solution?) through a tube inserted into the wound. Then applied good old ichthammol to draw anything out – that was such a treat to have black goo on halter, stall front, everything after all this was done. We did not bandage as the area was impossible to do so. I think he was on antibiotics too, but now I can’t remember. I’d certainly discuss it with your vet, even if they don’t feel it is urgent enough to see immediately, as they may want to start meds. Good luck. Mine took forever… hope yours is quicker!

[Dramapony_misty]

I heard back from the vet who (after seeing a picture of what I was dealing with) said I should basically continue to do what I’m doing, though suggested using Animalintex instead of the icthammol and gauze pads. I will be getting some tonight.

Otherwise, unless the drainage starts changing into nasty colors or the area starts getting hot and painful, just keep on keepin’ on. Pony seems to be fighting the infection pretty well on her own.

[rcloisonne]

I for one would never use vet wrap on a lower leg injury without wrapping the leg with cotton sheeting or some other type protection over the pad first. Doing so is asking for a bandage bow.

Also wouldn’t use a facecloth to clean the wound. Most facecloths are loaded with bacteria unless they’ve been boiled. A 60ml (cc) syringe of sterile saline for flushing works well. Keep the syringe clean by flushing with betadine or novalsan before and after use. You can get sterile saline at any drug store. 0.9% saline is much less caustic to tissue than peroxide, betadine, or novalsan. Peroxide is especially damaging and no longer used to treat infections by top wound clinics in the U.S…

[RedHorses]

When I have to deal with deeper wounds like that I hot compress daily for one day longer than I’m getting crap out of the wound. Clean, compress, bandage (Animalintex is good, but I usually use plain white sugar) and repeat every day.

I have discovered a few secrets to effective hot compressing. Use a big towel folded thickly (like 2’x4’ folded into 1x1’) as it holds more water and retains heat longer. Just squeeze out the dripping water as more water retains and transfers heat longer. Don’t unfold it when resoaking. When resoaking, wring it out and soak it again before squeezing out the dripping water and reapplying to the wound. Use a nearly full personal pail of water as hot as you can stand to keep your fingers in. Again the large volume of water retains heat longer. Compress for no less than ten minutes, but compress as long as you are still getting crap out of the wound. If your towel was is thick enough and your water hot enough you can do ten minutes with only two resoakings (even in temperatures below freezing).

Yes, I have done this too many times.