Cyclic

Leo has officially been 'off' for two weeks now.  After many conversations with my trainer, assistant trainer, farrier, friend's farrier, and my vet (via phone), we decided that it was time for a lameness exam.  My friend's farrier took a look at him today and noticed that he was extremely sensitive at the base of the frog/along the heel, and that although it could still be that an abscess was about to blow out, it wasn't very likely that that was the case.

pictured: a horse that is about done with these foot soaks

The vet and I were prepared to go the route of blocks and x-rays, but it turned out that they aren't necessary at this stage.  The lameness exam came up with nothing for the right front; flexion was all negative, and he wasn't sensitive to palpation along the tendon.  The hoof testers were brought out, and he was reactive - again - at the base of the frog and along the heel.

Summary of how we were both feeling at this point

Dr. G dug around in the creases a little bit and came to the conclusion that thrush, not an abscess, was likely the cause of the continuing lameness.  We established a timeline.

• Leo comes up lame.  The ground at this point is quite hard, and has not been turned to mud by a stupid amount of rain.
• Leo hoof tests positive in the sole of the front right hoof.  Abscess is assumed.
• Foot is soaked daily and packed with poultice
• Leo remains on turnout and the obscene rains begin, turning the world into mud
• Farrier looks at Leo, confirms that there is a sole bruise and a soft spot that may be an abscess trying to pop.
• Foot is soaked daily and packed with magic cushion
• It rains forever
• Leo is still lame

Basically, he had a stone bruise that could have abscessed but didn't, but the treatment of the bruise/potential abscess, along with a shit ton of rain and mud, created a perfect environment for thrush to potentially grow.  And.  It turns out that even with regular soaking, when you pack a hoof with super sticky material and then combine that with mud, it doesn't get completely clean unless you scrub.  So it may look normal...and then you scrub the shit out of it with betadine...and then you see, well, this.

left is from yesterday, post-soak; right is today, post-scrub

How did we not smell this darkness brewing? We aren't entirely sure; again, two farriers, two trainers, myself, and several friends have all looked at this hoof over the last few days/weeks, and none of us noticed.  My theory is that the magic cushion, which is extremely pungent, masked the thrush stink.  I still feel somewhat awful about NOT NOTICING, but if you look at the left-hand photo, it really doesn't look like there's anything unusual to see.  And thankfully, Trainers K and A have dealt with A LOT of thrush in the last year, and have a ton of product recommendations and treatment advice - as does Dr. G.  

Leo's swamp pasture

Unfortunately, the vet noticed something else during her lameness exam.  Although we were pretty sure that the RF was the culprit, she wanted to check his other three legs to make sure that what was presenting as RF wasn't actually compensation for another issue.  And Leo flexed positive, stifles and hocks, for both hind legs (although the RH was worse).  He was sore in his back as well - something that is definitely new; I noticed it yesterday evening when I was grooming him and was planning to talk to Trainer K about it but then the vet ended up coming out today anyways so I talked to her about it instead.

#sorrynotsorry, Ma

The two lamenesses seem to be unrelated, but the backsore and soreness in the hind joints could potentially be from trying to stay off the RF.  We discussed options - blocks and the like - and decided that since the hind end wasn't at all significant, to begin conservatively.  Leo will be on a course of bute, he'll see the chiropractor the next time that she comes out, I'll try to find a massage therapist to come work on him, and we're starting him on Ichon.

Dr. G thinks that once the thrush clears up in the RF, he'll go back to normal - the lameness we've been seeing during the last few weeks has not been hind-end related.  She believes that the preventative hind end maintenance will keep Leo happy and healthy for a while, and that the time has not yet come to pursue actual joint injections; the hind end is a 1/5 - not lame, just sore.  

She wants me to start riding him again, working on strengthening exercises at the walk while he stays in a stall for the next few days (it's still super muddy out so we want to keep his foot dry!), and then working back up to jumping once the thrush clears up and he's sound without bute.  If the thrush clears and he's still not sound, we'll start blocking that foot and taking pictures to find out what's going on.  SO PLEASE CROSS YOUR FINGERS THAT IT'S THRUSH because the other options for these symptoms are pretty scary. 

In essence, a foot bruise led to thrush, which may have led to my horse becoming extremely back/hind end sore.  It's a lameness cycle, and it sucks.  But hopefully we've gotten it figured out.