# Abscess burst at coronet band - advice please



## kafue (6 December 2010)

Hello!!
I have a two year old who has a burst abscess in his coronet band. Never ever had to tend to an abscess burst from coronet band, so please can i have some of your wonderful advice. He normally lives out but he is enjoying the luxuries of stable life at the moment. 
Thank you all in advance!


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## ImogenBurrows (6 December 2010)

Do not poultice the coronet wound!!! You'll just get a horrid soggy coronary band.  I find it best to get a farrier  or vet to try and find the corresponding hole at the bottom too to establish drainage down the way if poss....often not.

In the meantime, salt water tub the foot twice daily in warm water for at aleast 10mins per time using a good handful of epsom salts and the dry dress the foot to keep clean.....not dry poultice either.....

Oh and don't use antibiotics unless your vets advise them, often owners request these but more often than not they will surpress infection not get rid of it!!! Not v helpful. 

HTH
Imogen


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## Bertthefrog (6 December 2010)

Once the abscess has gone - what is the likelihood of hoof growth being affected in the affected area of the coronet band?

Is it worth using cornucrescine on the area?


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## ImogenBurrows (6 December 2010)

I'm not a fan of cornucresin for these things....may once sealed to help then but not while wound open. 

I find most have no effect long term on hoof regrowth.


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## cptrayes (6 December 2010)

Don't worry! The hole will grow down and drop off the bottom. It's very common, I've had a dozen do it over the years and never once had any long term repercussions. I personally squirt hydrogen peroxide 3% into the hole every day until it's completely gone, just to make sure no nasty anaerobic bugs get a grip in the damp and dark in there ....  For the same reason, make no attempt to plug the hole with anything that does not breathe. If you show, and must plug it to hide it, make sure you use something like keratex hoof putty and dig it out again when you get home.  

If you want to see a gross picture of a horse with a pair of scissors stuck inches into a hole, which evented as the hole grew out with no problems at all, let me know 

SO SO SOOOOOO pleased to see Imogen advise against antibiotics!!!  The only abscesses that friends horses have had that have ever had long term problems were ones treated with antibiotics.


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## amandap (6 December 2010)

I've always left these alone and had no problems. As the wall grows down a horizontal (usually) split will become evident. It will grow out as the hoof grows down. I've not seen any problems with hoof growth. My lot haven't had abscesses for a few years now but I personally prefer them to burst at the coronary band much less problems than digging a hole in the sole ime.


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## ImogenBurrows (6 December 2010)

cptrayes said:



			SO SO SOOOOOO pleased to see Imogen advise against antibiotics!!!  The only abscesses that friends horses have had that have ever had long term problems were ones treated with antibiotics.
		
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I get so grumpy with ongoing requests - there's pus so I must use ab's.....grrrr.


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## kafue (6 December 2010)

Thank you all!! I feel much more prepared now. (and relived!) I must post a pic of him on here soon, when he is better. 
Thanks!!


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## Daisychain (6 December 2010)

I have had a few of mine burst at coronary band, and tbh i have just squirted with purple spray and left well alone, and they just grow out!

In away its better than digging about at the hoof at the bottom, it seems to heal much quicker.


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## LucyPriory (7 December 2010)

see http://barefoothorseblog.blogspot.com/2010/09/story-of-abscess.html for photos of an abscess hole progression


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## Bertthefrog (7 December 2010)

Cheers all - I've had it drummed into me that you don't you antibiotics for foot abscesses too.

I use HP for foot abscesses too - very useful stuff. Must admit though, I prefer to get the abscess to come out through the sole if possible. Quite happy to whip a shoe off and have a dig myself - though the tubbing and poulticing is a pain in the butt! 

My old boss was paranoid about abscesses heading upwards - I've only ever had this happen once before and we didn't experience any long term issues - but just wondered why he was so worried about it!

Thank you!


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## amandap (7 December 2010)

Abscesses will burst (naturally) at the point of least resistance so coronary band, heel bulb etc. are more usual places if digging isn't done. The sole should be thick and hard so not a normal place for an exit hole. Tbh opening a hole in the sole is strictly speaking a vet proceedure although I know many farriers are accomplished diggers and prefered by many owners to vets for this proceedure.


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## applecart14 (7 December 2010)

kafue said:



			Hello!!
I have a two year old who has a burst abscess in his coronet band. Never ever had to tend to an abscess burst from coronet band, so please can i have some of your wonderful advice. He normally lives out but he is enjoying the luxuries of stable life at the moment. 
Thank you all in advance!
		
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Picture of abscess in coronet band - old term for it is quittor - http://medical-dictionary.thefreedictionary.com/quittor

_This is a quote from the Merck Veterinary Dictionary _- Quittor is a chronic, purulent inflammation of the cartilage of the third phalanx characterized by necrosis of the cartilage and one or more sinus tracts extending from the diseased cartilage through the skin in the coronary region. It is seldom encountered today but used to be common in working draft horses. Quittor follows injury to the coronet or pastern over the region of the cartilage, by means of which infection is introduced into the deep tissues to form a subcoronary abscess, or it may follow a penetrating wound through the sole. The first sign is an inflammatory swelling over the region of the alar cartilage, which is followed by abscessation and sinus formation. During the acute stage, lameness occurs. 
Surgery to remove the diseased tissue and cartilage is usually successful. Local or parenteral therapy (or both) without surgery is likely to fail. In the absence of any therapy, poor drainage, cartilage necrosis, and recurrent abscessation lead to chronic lameness and extension to deep structures. If damage is extensive and the distal interphalangeal joint has been invaded, the prognosis is unfavorable.


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## amandap (7 December 2010)

I don't think quittor and hoof capsule abscess are the same thing though.


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## Bertthefrog (7 December 2010)

amandap said:



			Abscesses will burst (naturally) at the point of least resistance so coronary band, heel bulb etc. are more usual places if digging isn't done. The sole should be thick and hard so not a normal place for an exit hole. Tbh opening a hole in the sole is strictly speaking a vet proceedure although I know many farriers are accomplished diggers and prefered by many owners to vets for this proceedure. 

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Don't worry - I would only dig if there was a likely looking crack where they had shown sensitivity with hoof testers. Never go deep - that's the farriers job!


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## mrdarcy (7 December 2010)

Bertthefestivefrog said:



			Don't worry - I would only dig if there was a likely looking crack where they had shown sensitivity with hoof testers. Never go deep - that's the farriers job!

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It's no one's job! Never dig for abscesses - let them burst naturally. Out through the coronary band is a great result... the best place for them to come out. No idea why people are so terrified of this happening - it's the way nature designed the hoof structure to work. Now abscess has burst just leave it alone to heal up - the peripole will  have sealed over the hole almost immediately - which is why it's known as nature's elastoplast.


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## ImogenBurrows (7 December 2010)

applecart14 said:



			Picture of abscess in coronet band - old term for it is quittor - http://medical-dictionary.thefreedictionary.com/quittor

_This is a quote from the Merck Veterinary Dictionary _- Quittor is a chronic, purulent inflammation of the cartilage of the third phalanx characterized by necrosis of the cartilage and one or more sinus tracts extending from the diseased cartilage through the skin in the coronary region. It is seldom encountered today but used to be common in working draft horses. Quittor follows injury to the coronet or pastern over the region of the cartilage, by means of which infection is introduced into the deep tissues to form a subcoronary abscess, or it may follow a penetrating wound through the sole. The first sign is an inflammatory swelling over the region of the alar cartilage, which is followed by abscessation and sinus formation. During the acute stage, lameness occurs. 
Surgery to remove the diseased tissue and cartilage is usually successful. Local or parenteral therapy (or both) without surgery is likely to fail. In the absence of any therapy, poor drainage, cartilage necrosis, and recurrent abscessation lead to chronic lameness and extension to deep structures. If damage is extensive and the distal interphalangeal joint has been invaded, the prognosis is unfavorable.
		
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Amandap is quite right quittor and a coroary band abscess are NOT the same thing. 

A quittor is as you've stated in your quote a infection of the pedal bone cartilages - not a white line abscess which has tracked up.  Quittor in the true diagnosis is a far more worrying and serious condition.  The last case of this I had ended up in surgery


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## ImogenBurrows (7 December 2010)

mrdarcy said:



			It's no one's job! Never dig for abscesses - let them burst naturally. Out through the coronary band is a great result... the best place for them to come out. No idea why people are so terrified of this happening - it's the way nature designed the hoof structure to work. Now abscess has burst just leave it alone to heal up - the peripole will  have sealed over the hole almost immediately - which is why it's known as nature's elastoplast.
		
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I disagree that they should never be dug out for on the basis that I not unfrequently see PIF that is left for several days or more and just underruns the sole like buggery rather than working up to coronet.  If it can be released earlier then the horse is in far less pain sooner. IME more underrun and go on and on than pop out at the top....

I do agree that it is not a disaster if pus pops out the top, most heal without complication here.


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## Angelbones (7 December 2010)

ImogenBurrows said:



			like buggery
		
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A breath of fresh air Imogen, one of my favourite phrases!


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## mrdarcy (8 December 2010)

ImogenBurrows said:



			I disagree that they should never be dug out for on the basis that I not unfrequently see PIF that is left for several days or more and just underruns the sole like buggery rather than working up to coronet.  If it can be released earlier then the horse is in far less pain sooner. IME more underrun and go on and on than pop out at the top....

I do agree that it is not a disaster if pus pops out the top, most heal without complication here.
		
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But if you dig you're digging blind, creating a big hole for more infection and foreign objects to enter. Plus it most often means the horse has to be kept inside to keep the hole clean when the priority for an abscess which is brewing or draining is movement, lots and lots of movement. Horses kept on box rest will brew abscesses for days and days (or longer) as they are prevented from moving! And once the abscess has burst to help it drain effectively you need movement. None of which you can get if the horse is on boxrest with a dressing on their foot.

Also releasing the pressure earlier is false economy. The abscess has formed round either a foreign object or some dead internal tissue - this is what needs to be pushed out of the foot, along with the pus surrounding it. It's the pressure formed by the abscess that pushes this foreign object or dead tissue out - if you release early you often will release only the pus and not the object. The pain will disappear for a while but as the object remains in the foot the abscess will reoccur sooner or later.


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## Daisychain (8 December 2010)

Yeah i would actually agree with Mr Darcy here, i used to be paranoid about them bursting through the top until i saw it happen!!! Heals easily and quickly and just grows out.

I think unless it just sitting under the white line, leave well alone.


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## amandap (8 December 2010)

Me too.  The sole is a thick (or should be) hard defense to protect internal structures. Opening it is always imo a risk and it takes ages to grow out properly. I would only consider letting a vet dig now if the horse was in extreme prolonged pain. The effect of bute is unclear on this sort of pain but I have used it in a single or two doses to give the horse enough relief to move if the 'broken leg lame' stage starts to last more than a few hours. This extreme lameness usually seems to me to be the abscess being on the point of bursting.  Movement encourages bursting and as Mr Darcey says, draining so is tobe encouraged but of course on the horses own volition!


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## Bertthefrog (8 December 2010)

There are obviously two very different thoughts on how to deal with an abscess.

I would never dig blind - I only follow any suspiciously black cracks or holes in the area where the horse has shown sensitivity. And as said before - would never go deep as I believe that is a job for an expert.

Any pus found can then be tubbed and poulticed - the hole is not left open, but when the signs of infection are gone then a dry dressing can be applied and covered with tape to protect the foot. I don't keep a horse with an abscess on box rest. Just tape up the sole and they can go out as normal (with poultice or dry dressing) so they get the benefits of motion.

I have never experienced a secondary infection from this method, and the relief to the horse is instantaneous. I could not leave an abscess to work its way up if the horse was in pain, and why would I want to feed bute if I can relieve the pressure without?

Perhaps I am a bit of a fossil eek but I have only known abscesses to be treated in this manner and it was instilled into my brain that is was bad practice to allow them to burst out through the coronet.

Has this alternative method come about from research or barefoot? I am intrigued, but will be sticking with my tried and tested method as I know it works for me!


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## mrdarcy (9 December 2010)

Bertthefestivefrog said:



			Perhaps I am a bit of a fossil eek but I have only known abscesses to be treated in this manner and it was instilled into my brain that is was bad practice to allow them to burst out through the coronet.

Has this alternative method come about from research or barefoot? I am intrigued, but will be sticking with my tried and tested method as I know it works for me!
		
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It's come from the observation of wild horses - they will most commonly burst abscesses out through the coronary band. That's one of the reasons the peripole exists. I'm not sure why it became known as bad practise - my only guess is that because it causes a small hole in the hoof wall people panicked, thinking the whole hoof would collapse! However the small hole grows down the hoof wall and causes zero problems. There are some wildly inaccurate myths floating round the horse world about hooves - one I hear a lot is that white hooves are not as strong as black hooves. Amazing how many people still believe that's true.


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## Bertthefrog (9 December 2010)

mrdarcy said:



			It's come from the observation of wild horses - they will most commonly burst abscesses out through the coronary band. That's one of the reasons the peripole exists. I'm not sure why it became known as bad practise - my only guess is that because it causes a small hole in the hoof wall people panicked, thinking the whole hoof would collapse! However the small hole grows down the hoof wall and causes zero problems. There are some wildly inaccurate myths floating round the horse world about hooves - one I hear a lot is that white hooves are not as strong as black hooves. Amazing how many people still believe that's true.
		
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Thankyou MrD. I suspect it is more to do with concern that hoof growth in the area may be affected, but from what you and Imogen have said, this is obviously not the case.

I think there is a lot of common sense in the barefoot reasoning, the more I read about it the more I am impressed. I certainly have no intention of having my chap shod when he begins his working life - and it will be very interesting having first hand experience of the practice.


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