Destructive mass in forefoot; chronic ulcers; chronic skin issues; poor hoof quality
When there is something wrong with your horse, ideally your vet has seen the problem many times and knows exactly how to fix it. Or, if the problem is less common, then there is a known strategy for resolution. The least desirable scenario is when your vet says she has never seen this problem before. And then a second, third, and fourth vet confirm that your horse has a rare and unique problem for which there is no clear treatment.
This is the situation in which Bailey’s owner found herself when she took over ownership of the 16-year-old OTTB mare. Bailey struggled with issues that are common in OTTBs: persistent foregut and hindgut ulcers that required constant cycling through ulcer medications to keep her comfortable but that rapidly returned with medication cessation; skin that was prone to rainrot and scratches, signs consistent with a compromised immune system; and poor hoof quality with inability to grow heels.
At a show in June 2024 — earning two division championships — one with a first and two second places and the other with a clean sweep
Chronic ulcers, skin issues, and hoof quality are readily addressable (and resolvable) from the holistic tool kit but Bailey’s biggest issue was her constantly abscessing right front foot. The abscessing frequency was so extreme that it suggested that there was a problem inside her foot. Radiographs and then MRIs read by multiple specialists revealed that she had a mass inside her heel bulb. The reports noted: “well-marginated, encapsulated region of multiloculated fluid and moderate enlargement; synovitis, distal interphalangeal joint; palmar fluid, navicular bone; deep digital flexor tendinopathy; arthrosis, proximal interphalangeal joint; synovitis and arthrosis with third metacarpal bone sclerosis, metacarpophalangeal joint; remodeling, third metacarpal bone lateral collateral fossa; mal-positioned, metacarpophalangeal joint lateral collateral ligament; enlargement, lateral suspensory branch.”
Translation: the mass was wrecking her foot. It was speculated that it might be a keratoma or a seroma or a cystic mass or a hemangioma – but regardless of its identity, no one knew with certainty how to treat it without creating more unsoundness for Bailey. Retirement was suggested. It looked very much like her owner’s dream of showing hunter/jumper with her new partner would never become a reality.
Bailey was diagnosed in Summer 2023 and seen here at an October 28, 2023 clinic. She was lame on her right front. The foot had recently abscessed and was still uncomfortable. Her coat was dull, her skin was struggling with rainrot, and her hoof walls were weak. She was requiring injections every six months to keep her hind end sound and she was due. She clearly did not feel well and frustration radiated from her – she wanted to work but her body would not allow it.
What to do?
Her diet was changed to emphasize gut-friendly, easily absorbed foods. Supplements were added to cover her key vitamins and minerals, to enhance the resistance of her skin to pathogens and improve its integrity, to target hoof growth, to reduce full-body and joint-specific inflammation, and to initiate deep gut healing in order to avoid the use of ulcer medications.
What about her foot? That was the tricky part. First, do no harm.
I could only think of two ways to approach the foot. One strategy was to use a nutrient that can reduce the size of cystic structures – if there was a cystic component to the mass, then this tactic might help. If not, then the nutrient would not hurt her. The second strategy was to re-conceptualize the mass as an over-response to a prior trauma to her foot that had occurred on the racetrack. There was some evidence for this idea because a needle biopsy had revealed that the mass was filled with blood. This way of thinking about the mass led to approaching it as an entrenched bruised area that her body had walled off. Pulsed use of a homeopathic remedy that stimulates resolution of bruising was initiated.
When all the needed components are assembled nutritionally and therapeutically, a synergy occurs such that even animals with layers of problems begin to move rapidly in the direction of vibrant health.
Two weeks after the clinic, Bailey no longer reacted to pressure on the mass and it had started to shift upward, taking the pressure off the internal structures of her foot. She was off ulcer medications, eating comfortably, and no longer sensitive to grooming or ulcer acupressure points. At 30 days, her owner reported that her skin “looks amazing,” her coat was shiny, and she was showing no signs of ulcer-related discomfort.
Over the next year she abscessed only once, the abscess resolved quickly in three days, and she returned to soundness. The mass remains higher up in her heel bulb and partly near her pastern and has reduced in size; her long-term soundness suggests that it is no longer destroying her foot. She has not needed hock injections for 19 months and has been able to work in bare hind feet with well-grown heels.
She is showing and winning and happy and well.
How is this outcome possible? When the body receives what it needs to heal, including reminders of what might need fixing such as a long ago trauma to a foot, then anything is possible.
- MRI images of Bailey’s right front foot in June 2023. Note that mass in her heel pressing on all internal foot structures.
- Bailey’s foot in December 2023 — note that the heel is now no longer bulging outward; the mass has shifted upward and is no longer traumatizing her foot.
Bailey’s heel bulb in October 2023 when seen at the clinic.- Bailey’s heel bulb in July 2023 — the heel is bulging and inflamed from internal pressure.
- Bailey in April 2024, looking gorgeous and fit with a glowing coat and standing square on her front feet.
- Showing in October 2024… in fabulous condition and completely sound.