The result of incorrect abscess treatment

Case 1

Chloe, a 9-year old Quarter Horse mare, had been diagnosed with two abscesses. She was given "special shoes" ( see below ) that were intended to protect her from the mud which was mistakenly diagnosed to be the direct cause of her abscesses. The shoes had actually compounded the problem and as a result the poor horse could barely walk by the time that she ultimately came to my attention.

right front, glued on shoes
left front with glued on shoe
lateral view

 

The shoes were not only glued to the hoof capsule but screws were also used, unintentionally causing new portals of entry for bacteria. Abscesses, or in this case horn-maceration, is caused by Fusobacteria which can only increase in the absence of air. The first picture below shows how the shoe trapped the bacteria in between the horn and the shoe. The second picture shows the exact source of the Fusobacterium, the remains of droppings which were left on the hoof and then hastily covered with the shoe. The perfect nourishment for an abscess. 

The shoe did not address the cause the problem. It simply masked the symptoms.

silicon fills the frog
underneath the shoe fusobacteria trapped
rotten hoof sole

The actual reason that the bacteria could undermine the sole is the deformation of the hoof capsule. The pictures below show how the toe wall flares. The flare causes a stretch of the epidermal lamellae. By restoring the physiological hoof shape with correct treatment, the risk of re-occurring abscesses is significantly minimized.

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newly produced horn layer, trapped under rotten horn
crena, entry for the bacteria
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The bacterium undermined the entire sole and frog. The moment it is exposed to air, the bacterium dies and new healthy horn is produced. The horse walked better immediately the moment it stood on the hoof's newly created bearing edge.

3 days later, sole and frog are protected by a new and harder horn; Chloe is running around on her turn-out without boots. The coronary band of the inner hoof wall becomes decompressed. As a result the hoof capsule can grow back parallel and aligned to the coffin bone.

hoof sole has hardened 3 days later
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1 year later:

Right Front

Left Front

 
1 year later dorsal view
healthy sole 1 year later
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Case 2

The next case suffered from recurring abscesses. We see 3 abscesses in the pictures that broke through the coronet. The thus created gaps need to grow down. The horse was not lame anymore when it got referred to me, but the owner was wondering why the horse got one abscess after the other, only on the same foot. I told her that the hoof shape is crucial in this case as in most cases. The arrows in the second picture show how shifted and distorted the heels are.

hoof with 3 abscess that blew at coronet
uneven heels
lateral view abscesses

The first abscess happened approximately 6 months ago and caused a huge horizontal gap in the hoof wall (picture front view). The bent medial quarter wall causes distractive forces to the side that work against the toe wall. The tubules can’t withstand these opposing forces and are torn out of their bond vertically at the weakest point, exactly where the abscess cut through the hoof wall. The bacteria broke through the coronary band 6 months ago, right where the tubules are being produced. 

Because the connective tissue has been eaten by bacteria, a cavity is left behind between the hoof wall and the dermal lamellae, which must grow out completely. If existing negative distractive forces such as a flaring hoof wall are not being controlled, the condition will not be healed. New bacteria can easily enter into the open gap and infest newly produced horn. The next abscess is on its way. 

4 months later:

4 months later
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4 months later, the newly produced hoof wall grows down straighter. The coronet is balanced as are the heels.

7 months later:

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The horse grows a completely new hoof, different shape and size. The cracks will close up and grow out as well.

 

The transformation of a club foot

Jewel, an 11-year old Quarter horse mare with an acquired club foot that had been incorrectly treated her entire life. Many approaches have been unsuccessfully tried out to "fix" the problem, from nailed shoes to glue-on versions. The result is a terribly deformed hoof capsule with an enormous discrepancy between hoof wall and bone axis, as shown on the x-ray. Jewel has been lame for the last 4 years. At the moment, after only 3 months of Preventive Hoof Care, she is lame-free but still in boots on her paddock. She will soon walk barefoot again. 

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The following pictures show the medial and lateral views. The treatment started early September 2018. Treatment intervals were two weeks. Jewel’s hoof is still in a boot, as the ground where she walks is hard. The area of the sole where the tip of her coffin bone is situated is of course still very sensitive. Her rehabilitation will continue at least another 7 months. She will be dealing with that problem for the rest of her life. 

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after 1 month

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2 months later

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3 months later

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5 months later