Possible puncture hoof wound-need my friend's advice

[ducks4you]

HELP ME!!!
My poor little 4 year old QH, "Buster". (All 1,000 15'3hh of him.) I "adopted" him at the end of March, and I just got his back left hoof mostly healed (from an absess that he had last February, before I brought him home--still there is a 1/2 inch chunk that needs to grow out.) Now, yesterday, the farrier pared away a 2 1/2 inch long, one half inch wide deep soft spot on the bottom of his right hind hoof, that looks to have a small puncture in it. He's almost healed up from a rope burn just above this on the pastern--had him tied too long a few weeks back.
I should mention that he's been very reluctant to let me pick up his back hooves. I never dig at them, but who can fight a horse when he doesn't want to do something?
Right now, he is stallbound. I took him off of the trailer, and used the hose nozzle to clean the bottom of his hurty foot. I let it dry while he grazed some grass, then treated it with Nitrofurizone, and covered it with a baby diaper secured with duct tape to his hoof. As of this morning he had full weight on it, and seemed pretty happy in his stall. (My stalls have 1/2 inch rubber mats.)
I'm interested in how you may have treated such an injury. A long time ago my (previous) Vet pared away about an inch to inches of the bottom of a hoof to find an absess. I kept it clean, bandaged with a diaper, and my horse recovered. There was no puncture.
A few years back, I had a horse go through a very old gate in my old fencing (now replaced.) The hole was 3 inches deep in a muscle, and my Vet had me treat it by mixing 1/2 iodine, 1/2 water, flushing the wound with a syringe, then packing it with Nitrofurizone. Darn if it didn't heal completely with no proud flesh, on an old horse. BUT it wasn't on the bottom of a hoof.

Without blaming anyone, I'm wondering if this was an old absess recurring. :/ In my 25 years and about 30 horses, this is my third absess. I guess he could have landed full force on piece of gravel, but I have combed my property, and after 10 years, I believe it's metal free.
I JUST want to completely heal him up, because I intend to keep this horse.
BTW, my farrier suggests light work with an easyboot, would be okay, and I think it's probably necessary to keep him from going stir-crazy.
ANY ideas are appreciated, friends!!

 

[michickenwrangler]

Make sure he is UTD on his tetanus shot, which you probably already have done.

I would soak the hoof in some kind of drawing poultice like epsom salts, slippery elm bark, peroxide or something like that to help draw out an infection.

I would do whatever I could to keep it as clean as possible. That is going to be the big concern.

Hope he gets better!

 

[patandchickens]

What did your farrier think -- recent puncture wound, or (what it sounds more like from your description) an abscess that has drained thru the sole or maybe was just getting *ready* to drain?

If it is an actual recent puncture wound, that is a significant issue, you want to make sure horse is good'n up-to-date on Tetanus and then poultice the bejeebers out of the foot for at least a few days, have xrays done if lameness returns/persists. Punctures can be pretty serious sometimes.

OTOH what is much much much more common, and very often presents like what you describe, is a sole abscess that has drained or at least gotten close to draining. This is a different situation, and usually no big deal. Unless your farrier thinks there is more in there waiting to get out, or unless he thinks it went deep enough to afffect inner structures (doesn't sound like it), you probably don't have to do very much at all at this point other than try to keep the foot dry and clean. Like, no standing around in mud. If the horse is still sort it is worth poulticing for a couple days just to try to draw any further stuff out, but if he is at least 95% sound then honestly there's not usually any point in it.

When you poultice, I would not suggest nitrofurazone (nor peroxide honestly). Better choices would be ichthammol or animalintex or an epsom salt gel. Ideally wrap it on in such a way that it does not chafe or bind but can stay one for at least 24 hrs before replacing the wrap; but if you are not practiced at doing that kind of poultice wrap, at LEAST try to get the poultice wrapped on there for a few hours at a time several times a day, if the thing actually needs poulticing.

Good luck, have fun,

Pat

 

[michickenwrangler]

BTW, there's a drawing substance called Tenda-Hoof that is formulated for hoof injuries. A lot of distance riders use it for stone bruises and the like. I've used the sister product Tenda-Bow as a tendon/leg poultice to good effect.

To Pat
I know peroxide causes proudflesh but is there a reason it shouldn't be used on a hoof?

 

[patandchickens]

I know peroxide causes proudflesh but is there a reason it shouldn't be used on a hoof?

It just doesn't really 'draw'. Certainly not comparable to ichthammol or actual drawing-poultice type preparations.

Pat

 

[LauraM]

When you poultice, I would not suggest nitrofurazone (nor peroxide honestly). Better choices would be ichthammol or animalintex or an epsom salt gel. Ideally wrap it on in such a way that it does not chafe or bind but can stay one for at least 24 hrs before replacing the wrap; but if you are not practiced at doing that kind of poultice wrap, at LEAST try to get the poultice wrapped on there for a few hours at a time several times a day, if the thing actually needs poulticing.

I agree.

I know peroxide causes proudflesh but is there a reason it shouldn't be used on a hoof?

It just doesn't really 'draw'.

Also, I'd like to add that it can actually do more harm than good. The bubbling action of peroxide can push debris further up into the hoof.

I would also soak the hoof in warm epsom salts at least twice a day for 20-30 minutes at a time.

 

[ducks4you]

Thanks, all!
I was offline yesterday, else I would have written back sooner. Right now, he's back in his stall, with foot wrapped in a disposable diaper, which is secured with duct tape, to the horn, of course. I was home yesterday, but I had to let him out of the barn. We had an excessive heat warning, with a top heat index of 112 degrees F, and since he's not limping, I thought that a good breeze to keep his heart rate down was more important than keeping him inside. Sometime before the end of the day, he tore the bottom of the diaper loose.
Regarding your comments, I almost think my Vet should look at this, now. I agree that proudflesh on the bottom of a hoof is almost an oxymoron. Nobody would care how it looked, and it will most certainly grow out, anyway.
These are really good suggestions, anyway. I can't help but think that this is an absess that I didn't know about, but had never really healed. My other two horses in the herd don't have any hoof concerns. Yes, my shelter needs cleaning, but I've closed it off to them--they have a 3-way surround of 15-20 foot pine trees in my south pasture--there is ALWAYS shade somewhere there.
VERY FRUSTRATING!!!
I'll need to call around to see who carries ichthammol or animalintex and epsom salt gel (didn't know it came in a gel.)
I'll keep you posted. Poor little guy. He loves his herd. The three of them travel everywhere together in their 4-acre turnout.

 

[w c]

Proud flesh on the bottom of a hoof is a very big problem, in fact. Friend's horse cut her foot while we were trail riding(broken off t post sticking out of the ground one inch or a large shard of glass, can't recall which it was), it got proud flesh protruding from the sole and it was a terrible mess taking months to heal. proud flesh can also protrude from the hoof wall causing just as serious a problem.

In the past a great many very irritating products were used on wounds. It's now understood that irritation of tissue causes proud flesh, so there has been a trend away from products that irritate healing tissue. Products like peroxide and similar ones cause irritation of tissues and proud flesh. Grit, sand, and even friction can encourage proud flesh. That's why my vet has us scrub injuries out thoroughly with yellow soap once, and then keep them clean and dry with bandaging that is not so tight or restrictive it causes friction, yet keeps the wound clean and dry.

Over the years vets have gone back and forth on the poulticing, soaking and the like for hoof and foot issues. Quite a few will tell you that while poultice substances are assumed to have some disinfecting action or antibacterial action, most in fact do nothing more than create a moister more bacteria-happy environment near the wound and don't allow secretions to drain and clean the wound.

Quite a few vets you talk to will take the attitude that antibiotics don't get into the hoof very well, and that there's no point in giving oral or injectable antibiotics. Then there's the more modern vets who feel if even a little gets in there, it's better than having a huge infection get going.

Quite a few lamenesses from nail pricks or nail binds (farrier induced), are not infected, at least for a little while, LOL, and some of them may come right without antibiotics.

It is very important to make sure one knows what's going on in there. With some obviously severe puncture wounds a vet will take a quick xray with the thing still in there so he can see what it's hit.

If a horse has a hoof puncture I keep him in a clean stall. I don't feel it's worth risking getting the injury infected. If he's hot he can have a fan. if he's lonely he can have a PPC (personal pony companion). If he's restless he can get some Happy Medicine and go Night Night.

All hoof abcesses are not due to stepping on objects such as broken off posts or nails.

Quite a few of them are due to pressure from shoes that have remained on the foot for too long without being removed, the hoof trimmed, and the shoe reset.

If shoes are left on too long, they eventually will cause what's called a corn (permanent bruise). These can even drain and rupture, working their way down to the sole or up through the foot to the coronary band. If it ruptures at the coronary band it's called a quittor. Such corns (chronic pressure based abcesses) make draining tracts and all the diseased and damaged tissue must be surgically removed, what a mess.

 

[ducks4you]

Thanks for the advice!!
UPDATE: Buster was stalled briefly, and bandaged. Then, we had a horrible hot, dry spell. I made the decision to turn him out, rather than have him overheat while I was at work. You see for almost 2 weeks straight our temperatures were running close to 100 degrees F, and our dewpoints were almost at 80 degrees F, with, ironically, no dew in the morning, as is usual for the swamp that we live in (the whole state of Illinois is technically a swamp! )
I kept monitoring this injury and watching him move. He isn't lame, I see no evidence of a puncture, and after riding him lightly 3 times in the last week, he is ready and willing to move out. The spot, 1/2 inch wide and 2 inches long is ever-so-slightly soft, and has hardened. I am sure that he'd go lame on it riding on gravel, but not on dirt.
I was glad to know of the methods suggested. Has anybody used Vetricin on this or any other injuries?