Reasons for coffin bone infection

Maria Duran

Hi all,

There is a horse with P3 infection, bone loss and rotation (right front hoof). I can imagine only a few reasons why a horse would get an infection within the hoof. He didn´t step on a nail, hygiene is good, no former abscesses, no PPID or IR...

Do you know which pathologies or conditions could lead to coffin bone infection? he had affected both front hooves initially by laminitis, but only the right one is still giving problems with infection and rotation and vets don´t know the origin of this. Only knowing the cause the horse can be cured.

My other question is if in coffin bone infections systemic antibiotics are or any help or perfusion is the best approach.

Thank you very much.

Maria Duran
Madrid, Spain.

Lavinia Fiscaletti

Oral antibiotics aren't very useful for infections in the hoof as the concentration of medication just doesn't get high enough. Regional Limb Perfusion is usually the better route, although it can have its own complications. Surgically debriding the area may be necessary. If there are draining tracts to the outside, sterile maggots can be used.

If there was ongoing abscessing from the initial laminitis (or more damage from ongoing, sub-clinical laminitic episodes) then there could be necrotic bone that developed, which could lead to osteomyelitis. Abscesses don't always show up clearly on radiographs and don't always leave a clear sign when they drain.

Is the rotation bony column, capsular or both? Whichever the case, that needs to be corrected so that mechanical forces aren't contributing to the problems.

Jan 2005, RI

Moderator/ECIR Support

Maria Duran

Hi Lavinia,

What a pity that pics can´t be posted here straight away. There were both capsular and P3 rotation but now only P3, heels keep being too high IMO but toe has been removed.

Is there any recommended antibiotic specifically adequate for osteomyelitis in P3 infections? How many cycles of regional perfusion are recommended or expected to be enough?

Do you know of any pathology that can be causing this like Lyme or something alike? I am not familiar with Lyme as it is not common here. What other kind of systemic infection could be going on with no obvious ill symptoms but the hoof infection?
Thank you very much for your help.

Eleanor Kellon, VMD

You need to back up here and put up a DETAILED history, including all laboratory work, horse details, diet details and send radiographs to Lavinia to post. There is no where near enough information to answer you.
Dr. K

Maria Duran

Thank you Dr. Kellon,

I am aware, I will do it as soon as I have all the details. It is from a case about to enter and still don´t have all the info, so just wanted to know if there are known diseases that are already known to lead to this to work in advance. For expample, just as we know IR can lead to laminitis or piroplasmosis leads to muscle wasting and lethargy, I was hoping an answer kind of, the following diseases or plants can cause laminitis and/or end up in hoof infections if not treated.

I know...haha don´t say it. I will post when I have the details.

Thank you.