abscess · farrier

When it rains, it pours: back in front shoes

So Tristan had chiropractic work on Friday, after much angsting on my part and carving room in the budget for it. He felt much more free through his neck on Sunday, so I was glad I did it.

Then on Monday afternoon, the barn manager called. The farrier was there, and wanted to talk through Tristan’s right front foot.

Yes, that right front. The problem child. It’s been over five years since it first started causing problems. If you’re new to that saga, start reading the abscess tag. Here’s the foot progression collage. Short version: he had a stress fracture of the coffin bone that separated, got infected, abscessed, and had surgery, and that foot has never been quite right since.

It’s always grown slightly wonky, thanks to the scar tissue from the original injury and the abscess insult to the coronet band. Well, the farrier was telling me over the phone that over the last few months it’s been resulting in a mechanical instability at the toe – not due to bad balance, but rather to the way the foot itself was growing. That had now resulted in some separation at the white line, a bacterial infection, and a growing crack.

I knew the crack was there, and had already planned on talking it through with him, but I also thought it could be dug out with a normal trim. Joke’s on me, nothing about that foot is normal.

Verdict: he needed to get it totally dug out back to healthy foot, stuffed with artimud, and then…back in front shoes for stability and protection.

Whooosh goes the money out the window. See, my budget is pretty tight, and it’s built around him being barefoot, which, 95% of the time, has been a realistic projection!

Alas, not for the next few months.

So here’s the foot all dug out.

It’s tough to really tell, but that’s a decently deep hole. The good news there is that the farrier really thought it was better than his worst fears.
Tris also got hot shod for the first time, this farrier’s preference. New farrier from the last farrier who did shoes on him – anyone remember when Tristan had to get sedated for shoeing? Yeah. Good times. Thankfully, I distracted him with peppermints and he did not put a foot wrong the entire time. GOOD PONY.
Next step, artimud and dental putty.
Farrier said “if you want bragging rights, your horse’s foot is so round that I have to use the draft horse pad.”
Then, the shoe. Sigh.
GOOD PONY. So well-behaved.
I was grumpy but resigned (also freezing cold, it was 40 degrees and I am not yet acclimated to winter) but then I got on…and we had our best ride in WEEKS. He was forward, he was cooperative, he was loose.
Fine, pony. Fine. Have all the money.

abscess · adventures with the vet

Limbo Lower Now

So, let’s recap.

Tristan comes in lame with a blown up RF. Yes, the problem foot.

Vet diagnoses abscess, and we go into full-blown neurotic mode: wrapping and poulticing for a week, with SMZs for that week. Wrapped constantly after that. X-rays are taken and minutely examined.

Two weeks later, it still doesn’t seem quite right, and he is just not using that leg as he ought.

Two days after that, the vet comes out and he longes perfectly sound. Vet says keep on keeping on.

One week after that, he gets his feet trimmed all around, and the farrier is iffy about the foot. He thinks the abscess goes deeper, and it’s not done yet. He takes out more foot to try and chase down the poor hoof quality channel, and then fills the hole with putty.

Five days after that, aka yesterday, I went out to the barn and had a come to Jesus moment with myself.

When Tristan first came in lame again, and it was an abscess again, I was not in a good place. I was by turns terrified, depressed, and foolhardy. I couldn’t settle on a way forward, so I bounced between options. I felt nauseated and anxious whenever I thought about it, imagining a repeat of that terrible 9 months that ended in surgery. I couldn’t believe this might be starting all over again.

Uncharacteristically for me, I backed off. I followed the vet’s instructions to the letter, but did not go above and beyond. I immersed myself in other things – work, the new house, training the dog.

In a way, I let Tristan down. I don’t mean to say that he wasn’t meticulously cared for. This is hands-down the best barn I’ve ever been at for noticing things and maintaining horse care. They are truly extraordinary, and I’m grateful for that every day. I haven’t worried even for a moment that they would not be on top of things. Trust me, I realize how lucky I am to feel that way!

But I didn’t do anything extra for him, either. I would go and pet him on the nose, re-wrap his foot, and bug out. When his shipment of new vetwrap got waylaid and delivered to the barn owner’s house instead of the barn, I sort of shrugged and trusted that it would arrive eventually. It did, but in the meantime I got dangerously low on wrapping supplies and honestly almost ran out.

I hosed off his hind legs when he spent a few days sleeping in his own pee, but not until weeks later. I just hosed them off, I didn’t scrub them down to help the skin out like I should’ve.

I didn’t really groom him, other than a cursory brushing and one or two sessions with a shedding blade.

I honestly can’t remember the last time I cleaned my tack, which is a good way to fill downtime. It’s been at least 9 months. Maybe more. (I’m sorry to all of you who just cringed!)

I didn’t really hang around the barn, either. I was completely surprised when the horses arrived back from Florida, because I hadn’t been chatting to people daily. I was surprised when the grain room relocated to its new (better, more organized) location. things have been passing me by.

As you can see, I haven’t been as on top of blogging as I’d like to be.

So yesterday, I tried to get my head back in the game. I gave myself permission to move on with a minimum of self-loathing.

I groomed Tris thoroughly, until he shone, and instead of a quick re-wrapping I carefully picked out any tiny bits of shavings with my fingernails, tested the white line and the sole, examined everything. I used my hands on him in addition to the grooming tools, feeling his body for any new bumps or irregularities – you know, the basics. I used to always follow the brush with a hand to constantly update my mental reference points on his body, so I would know what’s new.

Then I put his halter on, and we walked and walked around the fields. I figured the grass would be less abrasive on his duct tape bootie, and that I really needed the exercise too. He dove for grass for the first few minutes, but then he was clearly so happy to be out and about. It was quiet and peaceful and sunny and it felt good – if pathetic – to feel the burn of hiking up the long gallop hill. Tris licked and chewed, and dropped his head to stretch out over his back as we went up.

It was only about a 20 minute walk, but it was good for both of us.

The vet will be at the barn for other horses tomorrow, and she’ll jog him out so we can continue to keep an eagle eye.

In the meantime, I’ll keep with the handwalking, I guess. Keep on keeping on.

abscess

Never mind

I went out yesterday afternoon and curried Tristan, and fussed over him, and reinforced the toe of his duct tape boot with some more tape.

Then I jumped on bareback, intent on repeating Sunday’s ride: 30 minutes of walking, plus some loosening up.

Within a few minutes I got That Feeling. You know the one.

The barn manager was teaching at the same time, and I asked her to watch him. “Is he sound?”

Long, long pause. Too long, as we walked on.

“No.”

We agreed between us that he wasn’t in tons of pain – he wasn’t head-bobbing, or obviously favoring that leg.

He just wasn’t landing right on it. He wasn’t using the leg the way he should’ve. Guarding it, maybe, just a bit.

I jumped off, led him back to his stall, put away his tack, went back to my car, and cried. A lot.

Then I called the vet, who will be out today or tomorrow.

sigh.

abscess

Momentum

I rode my horse yesterday!

Just for 30 minutes at the walk, but it was enough to get him loosened up, to ask for some acceptance of the bit, to do a few tiny leg yields and to reassure me that he has not forgotten everything.

the actual cutest.

He felt sound. At the same time, however, his duct tape boot split at the toe, after just 30 minutes. So I am not sure if we can do anything more than walk around for a little while until he can have that foot open again.

I re-wrapped. There was a slight sheen of moisture inside the hole. I can’t decide if it was drainage or the last bit of saline from the last time I wrapped it that just didn’t evaporate. So this time I rinsed it with saline and then dried it with a cotton swab, then packed the hole with gauze and added more gauze on top of that. I’ll ride again today and rewrap and then we’ll see.

I also groomed him for the first time in, um, about three weeks. I’ve been that busy, discouraged, tired, whatever. He was under a sheet the entire time. So yesterday it was in the low 70s for the first time since early October and he was nekkid and I thought oh my God my horse looks like a homeless ragamuffin.

That is my size 8 Ariat Terrain for sizing purposes. That pile is halfway up my shin. o.O
He was so happy, leaning into it. He had clearly been itchy. I’m the worst horse mom ever. But I fixed it, so that has to count for something. I’ll go again today and scrape more off, and ride again, and maybe, maybe we will start to get back on track.
I’m staying in touch with the vet about the toe, and right now the plan is to wait until midweek next week when the farrier comes. We’ll have him trim the toe (which is long, and I think putting some pressure on the open area), and see what he thinks. 
We discovered while riding that there is a new banner in the arena and that Tris is apparently one of the new mascots for the local university riding team. He was used in one of their shows once and was apparently such an exemplary citizen that he offered up a polite, balanced canter when one of the walk-trot riders put his heel too far back. Ha.
I laughed and laughed. L-R that’s Skip, Tristan, Portia (I think? too many grays!), and Prince. They don’t travel for IHSA yet so I think they had a limited number of photos to choose from, and apparently Tristan’s beggar-face made the cut.
So, spring. Even with all the insanity, hope is returning.
Spring in the foreground, winter in the background.

abscess · adventures with the vet

What the Vet Found

Apologies for the delay – the last few days have been very full and I have not felt much like self-discipline. See also, the frozen pizza I had for lunch.

So, the vet came out on Friday, and we got to work figuring out what the heck was going on with Tristan now. (As mentioned previously, he was lame with a badly stocked up RF leg.)

We walked him out and he was still lame, though not falling-down three-legged lame as he had been on Wednesday and Thursday. The vet had me walk him in some small circles, and then brought out the hoof testers. Immediate strong positive…right where we didn’t want it to be.

Next step, looking at the foot itself. The vet cleaned the bottom of the foot off, and then began carefully paring away at the toe. There was still a nasty defect at the white line from scar tissue; she cut that out and almost immediately saw a spiderweb of cracks underneath it.

I was super nervous about cutting away that foot that we worked so hard to grow, but she was being incredibly careful. She’d cut just a little bit, then clean it out. She went back to her truck and got a dremel to keep the edges smooth and pare just a tiny bit at a time. She followed her instincts about where to trim, and slowly but surely the cracks faded out until there was one, and then with one last tiny paring – pus welled up.
Abscess. Again. Some more.
I was a bit discouraged, I admit. The vet, even though she’d expected it, was somewhat resigned. We talked options. I brought up the idea of a regional perfusion of the limb, ie, get whatever is in there the hell out NOW. She got what I was saying but said that she felt that was too aggressive right now, and was really very painful for the horse.
We kept talking while she got out her equipment to x-ray, because of course. That foot, seriously. We couldn’t take any chances.
Thank God, the x-rays came up clean. In fact, the coffin bone looks pretty darn good. I’ll put them up here in another day or two when I pull them from the flash drive. You can see the abscess drainage hole, but it’s tiny.
Vet used a needle to get betadine way up into the crack, and then did a final cleaning up with the dremel.
If you click on this photo, you’ll get a blown up version. Look within the pink of the sole, that’s within the betadine stain. Now look just off center, to the left: there is a tiny black pinprick. That’s the drainage hole.
If we can keep this draining freely, and keep it clean, we should be ok. Tris is on sulfa antibiotics for a week to be neurotic, and I am poulticing every day for a week with sugardine, then wrapping the foot for 3 weeks after that.
ready for battle.
It’s been a few days, and a few things are evident. First, he and I remember our foot-wrapping dance very well. After one brief heated discussion, he’s stood patiently and quietly, and my hands have remembered the motions. Second, he’s practically sound again, thankfully. We seem to be on the right track.
So, I am obviously bummed that this is another setback, that it’s still related to that initial disaster in his foot (2.5 years and counting!), and that I can’t ride and get him legged up and back on track for the spring like I’d planned.
But I am glad it’s not what it could’ve been. His leg was so hot and fat I was worried he had done something truly dire to a tendon or ligament.
Just wrapping. I can wrap. And waiting. I’m getting pretty good at that, too.
abscess · adventures with the vet

Frying pan, meet fire

So, as I mentioned yesterday, the barn manager let me know that Tris came in from turnout with his RF fetlock swollen again and quite lame.

Last night at midnight, after getting back from my 15 hour workday with a program in another part of the state, I checked on him.

RF was swollen and hot from fetlock to knee. No definition to the tendon sheath. Three-legged lame.

Fuck. Everything.

I paced, and checked it again, and paced some more, and finally left the barn. I couldn’t cold hose, since it was still going to be below freezing overnight and the hoses wouldn’t run. I didn’t have ice, and it was midnight – I couldn’t get any. I thought briefly about liniment, but that felt like flicking drops at a fire, and I didn’t have any Sore No More – only Absorbine, which I kind of hate.

While I was driving home, I formed a plan that I carried out this morning. After about 5.5 hours of sleep, I returned to the barn. I stopped for iced coffee and a bag of ice on the way, and when I got to the barn filled a gallon bag with ice, added a little water, and wrapped it on to his leg with a snug polo wrap.

He was turning up his nose at his grain – he really hates his new bute – but chowing down his hay and happy and cheerful otherwise. I was struck by how much his leg looked like it did back when he had his first abscess. You know, the one that started the year of misery and vet bills and surgery and rehab.

On the one hand, of all the personal nightmares I do not want to revisit, that one is pretty high on the list.

On the other hand: if it isn’t an abscess, there is something very, very wrong going on in his fetlock. That has all sorts of possibilities that I don’t want to think about right now.

The silver lining is that I am so maxed out on stress with the house and work that while I am worried and upset and stressed about this, I am not quite freaking out. Yet.

Barn manager, who I am nominating for sainthood as soon as I can figure out the paperwork, is negotiating with the vet right now for an appointment today or tomorrow for Tris as well as another horse in the barn. She’ll pull and periodically re-ice through the day today, and I left it up to her discretion whether to put him in standing wraps otherwise.

Onward, I guess. I just wish I knew where.

abscess · blog hop · surgery

TOABH: Costly


What has been your horse’s most expensive injury to date? Let’s exclude maintenance things, like hock injections and the magical monthly package of MSM. What single episode blew your savings or left you boiling ramen? If you want to get technical about it, time is money, too.


hahahahahaha.
 
ha.
ha.
I’ve covered this at length in the blog, but for newcomers, here’s the short version. In August 2012, Tristan blew his first ever abscess. It was really bad. He blew at the coronet band, and then at the toe, and then a few weeks later midway down the hoof. Cue 6 months of NQR; he would almost come sound, and then he wouldn’t. On and on. In March, he had surgery to remove the cause of the abscess: a bone chip from his coffin bone that had become badly infected, as well as portions of his coffin bone that had died from infection. Upon recovery from that surgery, which took months (if we’re counting the time back to normal hoof status), he came sound and has been ever since, though I would not call him 100% recovered – he still has to wear front shoes to keep that foot stabilized, because it is still not growing evenly enough to stay balanced barefoot, 2.5 years later.
Here’s what I call the foot progression collage: photos taken at monthly intervals from initial abscess to final recovery.
And here’s the post where I broke down and tallied up every penny I spent on that injury and what it went towards (three sets of x-rays, supplies, surgery, umpteen vet visits, specialty shoeing, the whole nine yards). So, to answer the original question: $6,100.08, which does not include lost opportunity costs or even begin to approximate time.
If you’re really feeling in a reading mood, check out the abscess and surgery tags. Dozens and dozens of update posts there.