So I got a new mare that is having some issues with her front leg. The previous owner was not honest because she had no issues before I bought her.
Of course, may well be. But how do you know this? It is entirely possible she sustained an injury, or an abscess happened on the way home or some such. How much did you check the horse out, put her thru her paces, do any lameness tests before you bought her?
and put her on bute. I will add she was pretty fat when we got her.
Bute can indeed be a necessary thing. But a word of warning, if the horse has gut probs, and especially if it is linked with laminitis(you mention she is fat, so I'm assuming she's very fat), bute, thru exacerbating gut damage/leakage, can actually cause laminitis! There is one reason not to use it unless you're sure & pref under vet's advice.
The vet said it was concussive, not soft tissue, so in the hoof or a joint. Said to leave her on bute for a couple more days and go from there. From there would be x-rays.
What do you/he mean by 'concussive' & how did he diagnose that? And concussive to me would mean an injury from a bash, or hard landing or such, could well be soft tissue. And bute is an anti-inflammatory, so pointless unless there is soft tissue injury, so this doesn't make a lot of sense to me. Of course, only have your words, so maybe total misinterpretation...
He found a spot where an abscess had blown out. He took out all he could but still couldnít get all the dead out without cutting too deep. He said that could be the reason she was hurting is because that was still healing, and could take a few weeks to heal. So we are soaking her foot to get any left over infection and have her on bute.
Warnings here too... yes, farriers & vets often like to 'open' abscesses in the sole to let them drain at the sole. Obviously if this is done, it opens the bottom of the hoof to further infection from outside, as well as possible injury from something poking into the sole. I recently read a report about horses having to be put down for tetanus due to abscesses being opened on the sole & less than sanitary conditions. So, I'd first want a vet to do this, not just a farrier, and I'd be keeping the horse's hoof very clean, treated daily - although catch 22 is that antiseptics also harm live tissue & can retard further growth(I believe this is why many vets believe solar penetration of P3 is untreatable, the sole will never grow back), so special care must be taken not to use anything too strong either. And the hoof must be protected from possible further injury for some time, until substantial new sole has grown over the hole. So... as a rule, for these reasons, I would avoid opening abscesses on the sole, and ensure if that needs to be done, conditions are sterile, horse can be protected, etc.
I've not known of a farrier 'opening up' an already 'been & gone' abscess, but conceivably he saw infected(seedy) tissue, and felt there was enough new sole underneath, or that you could look after & protect it well enough to warrant that. Generally abscesses - if that's truly all it is - aren't painful for long after they burst. Soaking or otherwise treating topically to kill any infection still left is a good move. IF she has more 'active' abscesses though, bute can also suppress the infection without allowing it to resolve. So while sometimes it's necessary, I wouldn't generally advise bute for an abscess.
Iím asking if an old abscess hole thatís already blown out could be what is causing her pain? Especially at least three weeks after the abscess blew out? Or are we looking at something else on the inside that x-rays will have to show? Could that explain why she has gotten so much better over the last couple weeks?
Yes, possible, to the first, but I'd think something else is going on - infection in the hole, further injury to unprotected tissue - was happening if it's the old abscess hole causing grief. Yes to the second, it could well be something else, that may show up on radiographs. Even if it is 'something else' such as 'navicular'(just as example) but it has yet to reach the osteo stage, then, as soft tissue doesn't show on rads, you'll not see it. Rads can indeed show if it's something serious or chronic enough to have caused bony damage/ossification, or if for eg. she has 'foundered'. And she has been 'rested' and on bute, so yes to any of the above, that that could be the reason she is so much better.
As you can see, there are just waaay too many 'ifs buts & maybes' to say anything remotely more than 'ballpark' from the info you've given. If you'd like to check out the link in my signature line & then take & send appropriate hoof pics, we may be able to give you more.
A big difference in treating a foot abscess in the UK and the USA is that if a horse has an abscess, usually found with hoof testers as to what area it is in, the vet/ farrier will scrape the area with a knife and finding a dark mark, will open the sole of the foot to allow it to drain.
I've heard you say they tend to do that in the UK, but didn't realise they didn't do that so much in the US. I thought it was a general thing the world over, that many vets & farriers liked to do. I do agree it is sometimes beneficial to 'dig for' abscesses, but as per above, I think it's generally best not done.
You, Fox, may well have heard the story before, but my first experience(before I knew much about hoof care) with an abscess being 'opened' was my donkey being lame(vet called, came, treated while I was at work) & diagnosed with a solar abscess. I was instructed to change the dressing she put on it daily & he could again go bare in about a week. Donk was still very lame that night. Opened the dressing & found a sole full of craters - looked like a giant wood borer had been there! Apparently the vet had been taught, after using hoof testers to find the painful area, to 'follow a tract' and as my donk was generally sore footed & had little black spots all over his sole, she dug into all of them! And turns out the poor boy had such horrifically & chronically foundered feet(I'd been trusting 'experts' at the time, who told me he was OK) that it was P3 trying to penetrate the sole(!!) that had caused the pain, and the vet had dug heaps through the extremely thin toe sole, which in turn ended up with his whole sole blowing off that foot!! So then he really did need bandaging & padding, as he was walking on flesh!!
And yet, as one point to show opening the sole doesn't stop abscesses at the top, he then blew out a massive abscess at the coronary border at the toe and a smaller one at the heel hairline. He eventually did recover, far better than he'd been in years, but that was the start of a huge 'learning curve' for me, as I learned how to look after him myself.
It seems in the US an abscess is left until it blows at the top of the hook. This can take quite some time. Plus you are working against gravity so makes it hard to draw the pus out.
Doesn't quite work like that. I am well aware that the general belief used to be - and often still is - that an abscess not opened will 'track up' to the coronary border, or wherever else it so desires. But generally if a horse has a solar abscess, it is due to insult to the sole, and unless it is a massive abscess or a whole foot breakdown, it will remain local to that area of the foot. Same with one that happens at the hairline - it is often from a bash to the coronary border, it started there, hasn't 'tracked' from the bottom & won't track TO the bottom either. Unless of course, there is a major capsule breakdown/separation and the infection can go anywhere within the compromised capsule.
Also, re gravity, it is the inflammation of the soft tissue which pushes the crud out, not gravity. Hence one reason why I'd generally avoid giving bute for an abscess - inflammation is the body's natural healing response and can be a good & helpful thing.