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Equine

No Foot, No Horse

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By Dr. Garrett Metcalf, DVM

There is a wise old saying no foot no horse and that is absolutely true. Horses of all breed, discipline and size must have good healthy feet or they will suffer poor performance, chronic pain or worse succumb to diseases of the foot. There are several medical conditions that require surgical treatment within the hoof wall of the horse and this article will highlight the most common conditions that require surgical treatment and specialty farrier care.

Foot Abscesses –

Foot abscesses are a very common issue that nearly every horse may experience at some point in their lifetime. Abscesses are often minor issues that can be easily corrected by a farrier or veterinarian getting access to the abscess to allow drainage but they can be rather debilitating and sometimes rather serious. Abscesses in general are localized pockets of infection that found its way into the sole or white line of the foot. These abscesses often form because there is some structural abnormality of the foot, trauma that led to bleeding under the sole or improper hoof care that has led to abnormal forces being applied to the foot and of course the old hot nail. For example trimming of the foot without relieving enough sole pressure can lead to overloading the sole and in turn sole bruising setting up for an abscess. Other common abnormalities of the foot that leads to abscessation are laminitis and club feet. These two conditions can cause tearing and stretching of the white line and allow bacteria plus moisture to enter deeper into the foot which in some cases can further destabilize an already unhealthy foot, leading to a life threatening situation.  Deep abscess that go untreated for days or weeks can continue to invade and dissect through tissue planes leading to larger abscesses. These large abscess sometimes require surgical intervention to keep them from spreading and to eliminate the abscess all together.

Pedal Bone Osteitis

Pedal bone or the coffin bone is a very unique bone compared to others in the horse. The coffin bone is a rather porous bone that has intimate attachment to the foot capsule and sole. The bone and the hoof tissue has a very high amount of blood supply rightly so because of the vast amount of metabolic rate energy it uses to keep the foot supplied with nutrients. Whenever the hoof is diseased or compromised from laminitis or infection the blood supply can be compromised as well spelling disaster. The disaster that can ensue from these conditions is an infected portion of the coffin bone or sequestration of bone. Bone sequestrums are when bone lacks blood supply and is also infected by bacteria that thrive off of dead tissue. Bone sequestrums are generally rather treatable conditions because once removed the bone can heal but the coffin bone is not the same as other bones in the horse. The coffin bone lacks an outer soft tissue coating called periosteum. Periosteum is a very robust membrane outside of almost all bones that provide blood supply and support healing with progenitor cells and stem cells. The uniqueness of the coffin bone without this important layer leads to poor healing, a more delicate blood supply and makes is more prone to infectious insults.

Treatment of an infected piece of the coffin bone requires aggressive steps in order to prevent spread and destruction of the rest of the coffin bone.  Further spread into the coffin bone can lead to further damage to the blood supply to the bone and hoof as well as weakening the bone to the point of fracture under the weight of the horse. Aggressive surgical debridement or removal of infected tissue and bone is the first required step to reduce the amount of infection present in the foot. Secondly is aggressive antibiotic therapy using local delivery methods and systemic routes of administration. Local antibiotic delivery is by means of antibiotic beads, pastes or ointments and by means of regional limb perfusions. Regional limb perfusions are 20-30 minute treatments where antibiotics are delivered to the affected limb via blood vessels in that limb. The antibiotic is held in the limb by a tourniquet above the application site to allow higher concentration of the drug to enter the target tissue or region of the limb. Lastly is proper support of the remaining hoof while still maintaining access to the infected areas to allow local treatment. This step cannot be overlooked and requires the work of a talented farrier to make it possible.

Quittor

Quittor is a chronic deep infection within one of the collateral cartilages of the coffin bone. The collateral cartilages are attached on both wings of the coffin bone and are often referred to on x-ray films as side bone. Lacerations, puncture wounds, trauma and abscesses of the foot can lead to infection of the collateral cartilage. To most people quittor doesn’t sound like a big deal and seems like it would be easily addressed with a few days of antibiotics but that is not the case. This infection deep in the foot can be like a smoldering fire that cannot be put out until the infected cartilage is removed. The diagnosis is usually straight forward because there is often a draining tract with swelling, heat and proud flesh centered over one of the collateral cartilages. The difficulty lies in finding and removing all of the infected tissue not to mention that you have to go through the hoof wall to get there. A hoof wall resection or a window cut in the side of the foot is often needed to access the infected tissue, allow drainage and local treatment at the same time. Quittor can be rather difficult and sometimes require multiple surgeries in order to get the infection cleared up. After the hoof wall resection is made often a specialized shoe will be needed to help protect and keep the foot stable until the hoof grows out the defect in the hoof wall.

Keratoma

Keratoma is a benign tumor like growth that arises from the hoof wall or laminar tissue of the foot called keratin. Keratin is what makes up our hair and nails. This growth continues to expand between the foot wall and the coffin bone leading to pressure necrosis and damage to the coffin bone. This abnormal keratin tissue is usually located at the toe region of the foot and is thought to be triggered by trauma to the hoof tissue. The most common signs of a keratoma are reoccurring foot abscesses in the same location and same foot, plus lameness that are localized to the foot. X-ray, CT and MRI can be used to diagnose keratoma formation within the foot. Often the keratoma is well formed enough to be seen with x-ray but sometimes advance imaging is necessary to make the diagnosis.

The only treatment and cure for a keratoma is surgical removal through the hoof wall. This requires a hoof wall resection with either an oscillating saw or drill bit to removal the hoof wall without damaging the coffin bone. A keratoma has an often distinct appearance by this off white crumbly type tissue that is often easily removed from the surrounding healthy hoof wall. After surgical removal a specialized shoe is needed to protect the foot and allow access to treatment of the surgical site to prevent infection.

Coffin Bone Fractures –

There are many different patterns or ways that a coffin bone can be fracture and some are more serious than others. To keep it simpler we break them down into articular or non-articular meaning do they enter the coffin joint or do they not.  Non-articular coffin joint fractures generally are much less serious and can be healed without major surgery. Often times non-articular fractures are stabilized with a special shoe and casting tape placed around the foot to make the hoof itself the “splint” for the coffin bone nestled inside the hoof wall.

Articular fractures of the coffin bone are a much more serious problem because of the damage that is done to the coffin joint. A fracture into any joint is a serious threat to the health of the joint and requires surgical reconstruction as soon as possible to keep the joint from developing crippling arthritis. The trouble again with any surgery on the foot is that the bone is inside the foot making it difficult to access. There are techniques to place screws into the coffin bone through small hoof wall resections to allow stabilization of coffin bone fractures. It does require the right fracture pattern and location to make this surgical treatment a plausible option.

Street Nail

A street nail surgery is used to treatment of deep penetrating injuries that occur at the frog or sole that leads to infection of the bottom of the coffin bone, navicular bone and closely related surrounding soft tissue structures. Street nail procedures are often needed when a metal object such as a nail or screw penetrates and infects the one of the vital structures of the bottom of the foot. This window allows flushing of the synovial structures and removal of damaged/infected tissue. This procedure success is greatly improved with the use of an arthroscopic camera placed in the navicular bursa or coffin joint depending on what area the puncture wound involves. The arthroscope allows better visualization and more thorough flushing of debris and infection out of these tight spaces.  Again this surgery cannot be successful with the application of a special shoed called a hospital treatment plate shoe that allows access to the bottom of the foot while keeping the foot clean and protected.

As you can see there is a pretty clear pattern to these hoof conditions: infection and the need for specialized farrier care. In order to be successful in treating these conditions the veterinary surgeon and farrier must work hand in hand to provide the best care for the horse. Although performing surgery on the foot of a horse is challenging and sometimes limited, it is often possible to have successful outcomes with a variety of different conditions.

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Equine

From a Kid’s Horse Point of View – Western Housewives

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By Summer McMillen

As the land starts to thaw and cowboys and cowkids everywhere are gearing up for spring there is one specimen in particular that is dreading the coming season. And that is ponies. Or more specifically, kid horses.

Let’s look at life from the kid horses point of view for a second.they have the winter off. They’ve gotten to enjoy some much needed R&R in the back pasture. Their hair has gotten long and so have their hooves. They’ve spent the winter feasting on native grasses, alfalfa, and the occasional bucket of grain when it’s was especially cold.

They’ve gotten to wonder aimlessly while the real work horses were still being caught for essential tasks. The most work these kid horses have had to endure the last few months were being tied to the arena fence to get the cockleburs brushed out of their tail.

Yes, life has been calm for these kid horses. But, there is a season for everything and the season for being used and abused is fast approaching.

My own children all share a little pony they affectionately call “Rubble.” He is a certified welsh pony that is as tall as he is wide and is as passive as he is…not. They spend summers riding him bareback. And when they aren’t riding him bareback they are riding him fully saddled. Tiny little bit in his mouth being yanked in every which direction.

The little fellow takes everything in stride. But I can feel him starting to resent me from the back pasture already. Every time I carry him some feed he gives me a look that just screams “please keep all three of your children away from me forever please.” I laugh at him and tell him he doesn’t mean it and then he runs away as fast as he can. It’s a special bond.

Kid horses are funny like that. We entrust them with the lives of those most special to us. We saddle them up and throw the little cowkids on them and assign them small tasks like moving 200 pairs to a new pasture or, holding the herd while dad doctors wheat cattle. More often than not, the young partners get their job done. Sometimes in unlikely ways.

Last summer my daughter hopped up on Rubble bareback and was going to trot down the road and get our mail. A simple and harmless task I thought. I was proud of her for taking the initiative. I was also proud of her when I looked out the window, saw the little pony start crow hopping with excitement and the unassuming 8-year-old being catapulted in the ditch. Instead of crying she climbed back on. Tenacity, I thought. That’s what kid horses are good at teaching.

A few months later I was watering all our geldings. The three kids whom I raised, better known as the three amigos, were all harassing the little pony. My youngest son decided it was his turn. He climbed up on Rubbles back as proud as a peacock.  But, he couldn’t help himself. He wanted to look that pony in the eye. So he starts leaning. Farther and farther until he leaned all the way to the ground. Lost a boot in the process. Instead of rushing to his side I waited for the tears. He was only two years old at the time after all. Instead his face was filled with glee. Joy, I thought. That’s what kid horses are good at teaching.

My middle boy is afraid of heights. So mounting a horse has been tough for him. When we introduced Rubble, I wasn’t sure he could even manage his height. After a little encouragement he donned his chaps, boots, and hat with a turkey feather in it and mounted the little horse. In a matter of five minutes the little cowboy had rubble trotting around the arena with his hand in the air and his spurs in his neck. (Gently of course.) Confidence builder, I thought. That’s what kid horses are good at teaching.

While, most of the time kid horses are a nuisance. Eating all our alfalfa and requiring special horse shoes to function properly.. they are more often than not a priceless gift. Teaching the ones we love most how to have tenacity, joy, and confidence.

While the ponies in our life may love their time off in the winter you can’t convince me that they don’t love their jobs in the spring. Even if it’s just a little bit. When that little cowboy shoves a bucket of grain in their face after a job well done together, the ponies head sits a little higher and so does that little cowboys hat.

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Equine

Foot Abcesses in Horses

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By Garrett Metcalf, DVM

A foot abscess is a common occurrence in horses throughout the year, with wet weather often contributing to an increase in cases. These abscesses can cause significant pain, lameness, swelling, and overall misery, making it important to address them quickly and manage pain to keep the horse comfortable. There are various methods used to treat foot abscesses, and this article will outline techniques to evaluate and treat them as efficiently as possible.

A foot abscess is a localized or sometimes diffuse infection trapped between the sensitive and non-sensitive laminae within the hoof capsule. Abscesses may develop spontaneously due to everyday stress and environmental factors that allow bacteria to penetrate down to the sensitive tissues. Other causes include penetrating injuries to the sole from nails, sharp rocks, or even thorns. Poor hoof care and misdriven shoeing nails can also lead to abscess formation. Common sites include the white line, where the sole and hoof wall meet, and the bars of the heels.

The level of lameness caused by a foot abscess can vary, but it often results in visible discomfort at the walk and can even cause non-weight-bearing lameness. Swelling that begins at the foot and moves up the leg may occur, particularly if the abscess migrates and ruptures at the coronary band. These cases are often referred to as “gravel” abscesses, which are simply abscesses that find the path of least resistance and exit at the coronary band, creating a draining tract. In some cases, especially involving a hind foot, the horse’s movement may appear so abnormal that it mimics neurological issues, confusing owners and veterinarians.

Diagnosing a foot abscess begins with a lameness exam. Most affected horses will be visibly lame at the walk, though in some cases a trot may be necessary to detect the issue. Regional nerve blocks can help confirm that the pain is originating from the foot and not another part of the limb. Horses with abscesses often show an increased digital pulse and, occasionally, noticeable heat in the foot. The bounding pulse is due to inflammation and is most easily felt just above the hoof near the ankle. If the horse is shod, removing the shoe is often necessary for a thorough exam. Hoof testers are useful in identifying the most painful area, and horses with abscesses are typically reactive to pressure. Cleaning out the foot with a hoof knife is important for exposing any defects or tracts in the sole or frog. Often, a dark spot or line will lead to the source of the abscess.

There are multiple ways to treat an abscess, and opinions vary widely, but my preferred approach is to open the abscess as soon as possible. This provides nearly immediate relief for the horse and allows the infection to begin resolving. A sharp hoof knife or loop knife is a reliable tool to open the abscess and create drainage through the bottom of the foot. Allowing the abscess to drain from the sole reduces the risk of a gravel abscess and makes it easier to treat the area with topical poultices. After opening, it’s important to bandage the foot both to draw out remaining infection and to keep the area clean.

A large baby diaper makes a simple, effective bandage. It’s absorbent and fits the hoof well. Secure it with layers of Vetrap, duct tape, and Elastikon, or place the hoof in a medicine boot to keep it protected. Poultice choice is often based on personal experience and availability, but the goal is the same — to draw out infection and prevent contamination. Products like Magna Paste, an Epsom salt-based poultice, are effective, as is a homemade mix of sugar and Betadine. There are many other options, but whatever product is chosen should be safe and offer antimicrobial properties.

In some cases, an abscess may be difficult to locate or open. Soaking the foot in warm Epsom salt water can help soften the hoof and encourage the abscess to rupture or become easier to identify. Pain management is also helpful while waiting for the abscess to surface. If the abscess continues to recur or proves difficult to treat, radiographs can help evaluate the hoof’s internal structures. While most abscesses don’t show up on X-rays — since the fluid is the same density as the hoof — they may be visible if gas is present within the abscess. Radiographs are especially important in cases of puncture wounds, to ensure deeper structures like the coffin joint or navicular bursa aren’t involved. In cases of penetration, it’s best to leave the foreign object in place until X-rays are taken, which helps determine the extent of the injury and what structures may have been affected.

While preventing all foot abscesses isn’t always possible, good hoof care goes a long way. Regular trimming on a consistent schedule helps maintain healthy laminae and prevents stretching of the white line, which can allow bacteria to enter. Careful shoeing practices, including proper nail placement, can further reduce the risk of abscess development.

Foot abscesses are painful, frustrating, and often sudden — but with proper diagnosis, drainage, and aftercare, horses typically recover well and quickly return to soundness.

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Equine

The Pull of the Barn

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When I was younger, I saw plenty of old Westerns. They were fun to watch, but one part always stressed me out. Inevitably, a cowboy would get shot or thrown from his horse, and while the cameras stayed on the fallen rider, I worried about the horse. Would it wander around lost on the prairie, never finding its way back? The truth is, most horses know exactly where home is. Turn one loose, and it will drift toward the barn. Ride one out, and the trip away from home feels steady, but the return picks up pace the moment the barn roof comes into sight. We even have a name for it: barn sour.

Horses are prey animals, and survival has always depended on familiar ground. For a domestic horse, the barn means food, water, and the company of the herd. Ethologists (scientists who study animal behavior) point out that horses are quick to learn patterns. When hay and grain appear in the same place every day, that spot becomes magnetic. Over time, repetition lays down mental trails as clearly as cattle wear down physical ones in a pasture. What appears to be stubbornness is actually instinct. The barn equals safety, and safety equals survival. Riders from cavalry days to modern ranches have written about horses quickening their pace on the way home. And though the land changes, that pull never does.

People are not so different. We all have barns in our lives — comfort zones we gravitate toward, routines that steady us. They serve a purpose. Like a horse standing at the gate, we lean on safe ground when life feels uncertain. But the pull can also hold us back. A horse that refuses to leave the yard never discovers what lies beyond the fence, and the same is true for us.

That balance shows up in history too. Old cattle trails once served their purpose, guiding herds north and helping to build economies. But when railroads and fences changed the landscape, those well-worn tracks became ruts. Progress required new paths. Our own habits work the same way. Some keep us grounded. Others only circle us back to where we started.

When I see my horses drifting toward the barn, I think less about impatience and more about instinct. They are drawn to the familiar, and so am I. The barn matters. It is the anchor point, the place of rest. But the pasture matters too, because growth is waiting outside the gate.

Those old Westerns had it right in at least one way. The cowboy’s horse was never going to wander off aimlessly. It would head back to camp, back to the barn. That simple truth still plays out in every pasture and arena today. Horses know where home is. The question is whether we will let the pull of our own barns keep us tied too tightly, or whether we will use them as a base to step farther into the wide-open ground ahead.

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