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Not-So-Speedy Dressage

From Endurance to Dressage

How Qualified Am I?

2/24/2020

 
Last week, I wrote several times about taking care of Speedy's abscess myself. (You can read those posts here and here.) I didn't call my vet. I didn't call my farrier, I did the work on my own. A reader took me to task for performing a procedure that she felt fell squarely under the purview of a licensed veterinarian. 
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A licensed veterinarian.
It's hard to disagree with her. I would ALWAYS rather have a licensed veterinarian perform all of my horses' treatment needs. If he wouldn't mind, I'd love him to show up every day to ensure that Speedy gets his daily dose of Prascend. I'd also like him to look at that weird wound on Izzy's lip. And if it wouldn't be too much trouble, I'd like him to dab some goop on that weird cut Speedy has over his eye. Since I am not independently wealthy nor married to a veterinarian (oh my gosh how convenient would THAT be?), I have to do most of the health care tasks myself. I am sure you do the same.
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Maybe then I wouldn't need all of this.
I guess the problem is that we don't all possess the same knowledge nor do we all have the same level of experience. The procedures that I find easy to do, you might feel are red alerts - something for which a vet should do. I don't even flinch at the thought of doing IM injections; I gave them to myself for several years. In fact, I still do a small, monthly injection for my migraines. Not too long ago, I did a course of B12 shots. Injections are no big deal. Administering something in the vein is where I draw the line. I've never been trained to do that, and I know that it's above my current skill level.
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Also joints - I am not injecting anything there either.
I know my limits. I know what I've been "trained" to do. And if I ever have a single shred of doubt, I pick up the phone and call my vet. Dr. Tolley and I have a relationship that spans decades. From the very beginning, even back to when I was about 8 years old, I've been a hands on owner. Teach me, show me, train me, let me learn ... There isn't a single part of my horses' anatomy that I don't want to understand. There are no procedures that I don't or can't watch. I even assisted when we euthanized my heart mare, Montoya. It broke my heart, but my horses trust me. I couldn't let her face that alone.
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There will never be another like her.
Since Speedy's first abscess in January of 2019, Dr. Tolley has "trained" me to use hoof testers and a hoof knife. He's explained what to look for and how to cut. He knows I am never going to cut too deeply since I am always yelling at him for making the hole too big. I am conservative always. I poultice longer than needed. I take my time when digging into the sole, always spreading it out over the course of days. I want the poultice to do the work for me. I bandage with Betadine longer than he suggests because I am mindful of introducing new bacteria.
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Irrigating an abscess hole to flush out any bacteria.
A friend posted a link to Stone Gate Farm's Facebook page. On it, was a very interesting excerpt from the book, The Essential Hoof Book. After reading it, I felt very justified in my treatment. While my vet didn't do the work himself, it was still performed under my his authorization. I followed his protocols exactly. Speedy saw Dr. Tolley on Saturday. My vet looked over my "work" and said everything looked great and that I should keep doing what I was doing.

The reader who criticized my treatment strategy stated that opening up the abscess was an inappropriate course of treatment. My licensed veterinarian, who has been in practice for more than 30 years, would disagree. Poulticing nearly always helps, but it isn't a guarantee that the abscess will drain. By not creating a drainage hole, the horse will likely suffer an increased amount of pain and possibly even greater damage to the hoof.
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Abscesses hurt.
I think the reader's main objection was that I cut the sole myself. She also seemed concerned that opening the sole created a pathway for new bacteria to enter. Even had I taken Speedy to see Dr. Tolley, he would still have a hole in his foot. Dr. Tolley would have done exactly what I did, but the hole would have been deeper. I was able to make a smaller hole because I poulticed it for a number of days which softened things up.

In either case, there would have been a hole that needed to be packed with Betadine to kill any remaining infection while protecting the exposed, sensitive tissue from further contamination. According to Dr. Tolley, once the abscess is opened and drained, the wound should be packed with Betadine for seven days to allow epithelialization to occur.
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Back when Speedy wore shoes.
So what does all of this mean? Do the treatments that you feel safe and confident doing, but if you feel that something is above your pay grade, call a professional. I use a chiropractor, saddle fitter, farrier, and of course my vet. When I am in doubt, I call one of them. 
AMacG
2/24/2020 05:33:12 am

Farrier here! Quick note to say I know the ladies who wrote the Essential Hoof and they would be quite upset to find that their book has led someone to believe they are justified in opening up an abscess all the way to bleeding corium. Opening up an abscess - this is one thing. But if you hit blood you absolutely went too far, and if your vet hits blood, they also went too far, the sole exception to this possibly being a walled off blood blister in an actively foundered foot within stretched laminae. If you are taking a knife to a hoof you must have an excellent ability to judge depth of sole and know when to stop. And if you don't find the abscess... Don't keep digging. Do your usual poultice and soaking/wrapping protocol, if the abscess is near that weakend area anyway it will find the path of least resistance that you have created for it.

But blood is dangerous. It IS an excellent way to introduce bacteria into the bloodstream to do that. It would not be fun if your small abscess became a rampaging bone infection.

This is not to say you're not qualified to do basic searches for abscesses. I'm sure you are. But for your horse's sake, PLEASE learn where stop before you hit blood. Blood is not an abscess.

Bakersfield Dressage link
2/24/2020 06:31:58 am

I won't disagree with you, AMacG. I never intend to hit blood, ever. In my first post about this abscess, I even wrote that. When I first dug down a bit, Speedy improved immediately, but it wasn't enough. Within a day or so, he grew noticeably lamer. I could feel that the sole was soft enough to dent with my finger nail. I took a tiny bit of sole off and pus flowed. I squeezed all of the soft tissue, and then nicked it just a touch more. That's when it bled. I staunched it immediately with a clean gauze pad and packed it with gauze soaked in Betadine per my vet's directions. That is the first time that I have drawn blood.

Two days later, my vet checked the hole and found everything to be in good shape. I never like to see blood, even when my vet does it. Not that blood makes me ill, but it means the wound is pretty deep.

Every "procedure" I do is one that my vet has shown me or one that he prescribes. In this case, it might not have been what you would have done, and I respect that, but in this case, that's what happened.

Thank you for sharing your expertise.

Megan K link
2/24/2020 05:45:31 am

I'm sorry you felt so attacked you felt the need to write this post. That really wasn't my intent at all. I know you care very much for your horses and want to do the best by them. I've experienced holes in feet go extremely bad and end in euthanasia so I was just concerned. I will keep my thoughts to myself in the future. I'm sorry!

Bakersfield Dressage link
2/24/2020 06:40:30 am

Megan - thank you for sharing. I never delete comments that i disagree with and actually welcome discussions. That is how we all learn. Yes, your post struck a nerve which is why I waited a few days to respond. Your original comment did come across (to me) as very critical rather than concerned. It may be that I simply haven't conveyed frequently enough how often I consult my veterinarian. I never do any treatment or therapy that he and I haven't first discussed.

Please feel free to comment and share your thoughts. We can all learn from one another, and if I can't defend what I write, then maybe I am not making good choices. My intent is always honesty and transparency on this blog. I look forward to hearing your thoughts in the future.

Nat D link
2/24/2020 06:53:13 am

I LOVED your posts on the hoof abscess, and this one even more! This is certainly a touchy topic, and in our barn the farrier and vet DO NOT agree on abscess treatment. The vet cuts holes, the farrier freaks out, and the owners are left wondering what should be done.

I have a young horse who might be predisposed to cushings and has been on a preemptive diet for 2 years (andalusian-easy keeper). But I can expect that one day the cushings might still come, and the abscess diagnosing might be something to plan for in my future. I absolutely cringed at the pic of blood, but I loved your detailed plan of wrapping, treatment, and even heartache.

Thank you for sharing. And for facing the controversy. Lets keep the conversation going!

AMacG
2/24/2020 07:53:14 am

Quick note again from the passing farrier here again to say that abscessing should not be accepted as "normal" in a horse with PPID. If your horse's ACTH is uncontrolled and it is having mild subclinical laminitis, then yes maybe, and also subclinical laminitis can defintiely look like maybe a passing transient abscess or lameness. It is not something to take mildly though or write off as "well he's just abscessing" when he might actually be laminitic. But in a controlled PPID horse, abscessing is NOT normal. My own aged PPID horse has never had an abscess in his life, and of the many PPID and IR horses I do, the IR ones that are not controlled are the most likely to have them.

Bottom line is - if you have a horse that you subject might be prone to metabolic issues, start doing bloodwork NOW. Then you will have a baseline of normal and you can get the jump on anything that might arise in the future.

And if your PPID or IR horse is anscessing repeatedly, run, don't walk, to the nearest vet for bloodwork. Then if that's all normal, assess your trim, your horse's living arrangements. Because something somewhere is wrong.

Bakersfield Dressage link
2/24/2020 09:51:42 am

The reason we tested Speedy's ACTH levels LAST year was because of the sudden onset of abscesses. I've owned him since he was 3; he is now nearly 16. He had never abscessed before last January. His ACTH level came back at 56. He has been on a daily dose of Prascend since then. We tested him again on Saturday, but the results won't be back for several days.

I have to disagree with you on abscesses not being related to Cushing's Disease. The AAEP would also disagree. Infections are definitely a sympton of Cushing's Disease. That's what initially suggested to my vet that we should check Speedy's ACTH levels. Speedy is otherwise quite healthy. His weight is good and he shows none of the typical signs of Cushing's Disease like crestiness or long coat. The AAEP has a short, but succinct article about Cushing's Disease here: https://aaep.org/horsehealth/equine-endocrinology-cushings-disease-and-metabolic-syndrome

AMacG
2/24/2020 10:41:05 am

Yes, infections are possible in an UNCONTROLLED horse. A controlled horse on the correct dosage of medication should not be prone to them. If they are still getting multiple abscesses, then something else is wrong. Though in your case, multiple bar abscesses like you're experienced are probably a result of the overgrown and crushed bars you have going on.

Bakersfield Dresage link
2/24/2020 11:14:57 am

Oh my. And you know this how?

If Speedy's blood work comes back wonky, which my vet doubts, but it's possible, we'll adjust his Prascend. I can guarantee you that his bars are neither "crushed" nor "overgrown." I resent your implication that my vet is either blind or incompetent. I also resent your implication that my farrier, too, is blind and incompetent. Would you honestly expect me to trust the word of a stranger who claims to be a farrier (you - this is the internet after all and people aren't always honest) over the word of a BOARD CERTIFIED veterinarian whom I have worked with in excess of 20 years? My farrier is also quite well respected in this area. Please feel free to comment further, but as for me, I feel that I've said my piece.

Bakersfield Dressage link
2/24/2020 12:28:26 pm

Nat D - I have had that same experience - vet response vs. farrier response. Some years ago, a farrier that I was using at the time, made a mistake and created a hot nail. He was shocked and quite apologetic. He recommended bute, but when the horse continued lame, I took him to Dr. Tolley. My farrier freaked out when he heard that the vet dug out the abscess. While I respected my farrier, there is no I am ever going to choose a farrier's recommendation over a board certified vet's. I eventually left that farrier when he refused to pursue a change in trimming recommended by my vet.

As far your young horse, I did a fair amount of research on Cushing's Disease and wrote about it here: https://www.bakersfielddressage.com/home/a-cushings-tutorial. I am not sure there is anything to do to prevent it, but my vet did say getting blood work earlier than you think you need can establish a baseline. Thank you for sharing your thoughts. :0)

AMacG
2/24/2020 05:01:44 pm

I never said anything about the quality of your vet or your farrier. You did quite a set of mental gynnastics to get upset about that. I'm sure your farrier knows about your horse's bar issues and I'm sure he's working to correct them. You posted a picture of a malformed foot with malformed bars, it's right there to see. I know all to well what it's like to be a poor farrier trying my best to work with a trainwreck and an owner who goes behind my back and sabotages my work, I totally feel for him and I'm sure he's well respected.

What I am bothered by - and what everybody else has been commenting on - is that you don't seem to have any grasp that what you did was wrong and dangerous. You wrote an entire post about an abscess. Yoi talked about how you actually found it and released pus. That should have been the end of it. But you said you wanted to take one more swipe with the knife and so you did, and the horse bled. Did you then say you were horrified? No, you went on to actually post a photo of the blood and tell every one how satisfying poop, pee puss and blood are to you. That is horrifying behavior. You harmed your animal and not only did you do it, you actually took the time to post an entire blog post about it and actually admit what you did. If I were you I would have been so mortified that I would have never told the entire internet about it. Then you posted an entire response about how you're perfectly qualified to do this to your horse when you very clearly don't. If you were my client I would have fired you on the spot for this behavior... Your farrier must be a wonderful and patient man.


Comments are closed.

    About the Writer and Rider

    ​I am a lifelong rider. 
    I began endurance riding in 1996 where I ultimately completed five, one-day 100 mile races, the 200-mile Death Valley Encounter, and numerous other 50, 65, and 75 mile races. I began showing dressage in 2010.
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    About Speedy G

    ​Speedy went from endurance horse to dressage horse. After helping me earn a USDF Bronze medal in the summer of 2020, he is now semi-retired. Speedy is a 2004, 15'1 hand, purebred Arabian gelding. His Arabian Horse Registry name is G Ima Starr FA.
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    Izzy was started as a four-year old and then spent the next 18 months in pasture growing up. I bought him as a six-year old, and together, we are showing at the lower levels. He is a 2008, 16'3 hand warmblood gelding. His Rheinland Pfalz-saar International (RPSI) name is Imperioso.
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