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Dan C., DVM
Dan C., DVM, Horse Veterinarian
Category: Horse Veterinary
Satisfied Customers: 992
Experience:  Solo Equine Practitioner/Mobile Practice Owner for 14 years.
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My Thoroughbred mare suddenly has a shoe boil the size of a ...

Customer Question

My Thoroughbred mare suddenly has a shoe boil the size of a softball hanging from her elbow. In the week that she has had it, it has gone down to baseball size and is softer and not as hot. I have put a shoe boil boot on her to prevent her from re-injuring the elbow. Will this go down enough that I will be able to show her? I''ve been hand walking her. Is it safe to ride her with this growth on her?
Submitted: 6 years ago.
Category: Horse Veterinary
Expert:  Dan C., DVM replied 6 years ago.

Hello, Riptide's Mom!

Sorry to hear about Riptide's condition. Shoe boils (elbow hygromas) can be a frustrating condition, but are normally not a problem that is going to affect gait or performance. I fyou find that Riptide has any lameness associated with the boil, I would recommend Veterinary intervention soon, as it could be suggestive of a fracture of muscle damage.

If this condition has not been long-standing, there is sometimes good success in getting them to reduce with the use of cold water compresses, followed in a few days by having your vet drain the boil followed with the injection of an anti-inflammatory. If the condition has been present for some time, however, surgery is often required as the contents of the boil may have become fibrous and resembling scar tissue.

Occasionally, some will reduce completely on their own if no further iriitation is present. It is difficult to tell you how long it may be before Riptide's boil reduces in size however, as they all behave differently and have different contributing factors. As mentioned previously, as long as there is no associated lameness with the elbow, there is no reason that Riptide can not be ridden. Be careful, and try to avoid any possibility of her scraping or damaging the boil, as doing so could open up the chance of a bacterial infection.

I hope this has helped, and please let me know if you have any further questions.

Thanks, XXXXX XXXXX of luck!

-Dan

Dan C., DVM, Horse Veterinarian
Category: Horse Veterinary
Satisfied Customers: 992
Experience: Solo Equine Practitioner/Mobile Practice Owner for 14 years.
Dan C., DVM and other Horse Veterinary Specialists are ready to help you
Expert:  Dan C., DVM replied 6 years ago.

Hi Riptide's Mom:

Thanks for the accept, but I'm sorry if you felt my answer was too vague. I strive to be as thorough and complete as possible, and leave my posts open with asking you to let me know if you have any further questions. I would rather you don't accept if my answer has not been helpful to you.

I'm unsure as to which point is unclear, or vague for you, and I would like everything to be as clear as possible. If you need a definite time frame as to when the boil will reduce in size, I attempted to explain that that is not possible, as there are many factors involved that can affect healing; such as length of time the boil has been present, if she has had boils before, if there is any possibility of her re-injuring or irritating the area while lying down, and her own body's metabolism is involved as well, as no two horses are the same in that aspect. And yes, it is safe to ride her, as long as she is not lame on that limb. Again, I can't tell you if it will be reduced in size enough to show her for the reasons mentioned above. If the show is next week, chances are it will not have reduced significantly, however if the show is next month and she doesn't re-injure it it may be small enough. That can depend on the type of show and activity, however, and I do not have that information.

If you have further questions please let me know, and as you have already paid for an answer I don't feel you should be asked to pay again. I would like you to feel that you have gotten your money's worth.

Thank you, XXXXX XXXXX look forward to hearing from you.

Customer: replied 6 years ago.
Thank you for your response. To get into greater depth, I purchased her almost two years ago. She had an ever so slight swelling at her elbow so I was aware that she had had a shoe boil before, but it was difficult to see. I should have put a shoe boil boot on her before this, but had no problems with it. It really surprised me that all-of-a-sudden it showed up (actually 3 weeks ago now, along with a splint the same day). I had been having trouble getting my farrier to come out...he was three weeks late and she was in dire need of a trim, so I stopped riding her, but still let her play in the paddock. She plays hard. I've been walking her 2 times a day for 20 minutes, mainly because of the splint. I had a vet out to look at her and he said to hand walk for 4 weeks. As far as the boil, he said that there was nothing to be done about it. I asked about draining it and he said that there is nothing to drain in a boil. I asked about surgery and he said that it would never heal in that area and I was asking for trouble. I was uncomfortable with his diagnosis so I went looking elsewhere. That's when I found you. I am training her for dressage and will not begin showing her until the 2009 show season. By then I will have saved enough for a trailer...hopefully.
After 3 weeks of hand walking she is jumping out of her skin (even with a major decrease in her grain)so I started putting sports boots on her and letting her out in the indoor arena where the footing is soft. This has now been for three days. She is lame on neither the splint nor the boil. She still plays VERY HARD.
Can you tell me if the boil is harder to get to go down once she has had one? Is it more likely that it will go down again if it went down once before? Is there a % of success that is relevant to this case? When the boil first appeared it was very hard and high on her elbow. It is slightly smaller now (3 weeks later...from softball to baseball sized)is soft and is starting to hang. Does this progression tell you anything that may be helpful in determining if it will eventually disappear or not? Is the running, rearing, bucking, quick stops and starts and spinning hurting her chances of recovery? My only recourse would be to have her stall-bound since she has so much energy. She plays like this no matter how much you ride her...it's just her personality. She is wonderful to ride...as long has she gets her chance to blow it all out in the paddock.

I purchased this mare from the track before she actually raced. She is strikingly gorgeous. If there is nothing that can be done with this boil then I now have a very expensive trail horse.
Expert:  Dan C., DVM replied 6 years ago.

Thanks for getting back to me!

The fact that the boil appears to be softening is a favorable sign, as it indicates that fluid may be forming that can be drained. Although her play habits are not conducive to creating a rapid healing environment, I see no reason as to why this should make the boil worsen. If anything, it may help to encourage softening of the swelling within the boil. Also, as she has not had a large boil while in your possession, this also increases the chance that it can be resolved.

So to answer your question, yes, there are treatments that can be tried. The cold water poultice is usually attempted first, along with DMSO, which is a potent topical anti-inflammatory. With the size of her boil, however, chances of it reducing with just poulticing are low. I would recommend perhaps having another vet take a look if there is one in your area. By inserting a needle into the boil, it will be able to be determined if there is a major fluid pocket underneath the skin that can be drained. If so, the boil can be drained using either a large gauge needle or a small stab incision. Following drainage, a pressure bandage needs to be applied to help prevent the fluid from re-forming. There is the challenge, especially as Riptide is so active in her paddock. I would recommend using a tape called Elastikon, which is a stretchable adhesive tape with excellent adhesive characteristics. I have seen people get very creative in their bandaging! When treating knee boils (carpal), I will often inject a steroid directly into the area which was just drained. This can help to knock out any residual inflammation, which is the major source of the fluid collection. Some practitioners also recommend the insertion of rubber tubing through the boil while it is bandaged, which can help to keep the drain hole open, preventing fluid build-up while the incision heals. As a last resort, surgical resection of the boil is attempted, which entails opening the boil and removing any residual scar tissue and excess skin, then bandaging for a period of 10-14 days while the site heals.

So yes, you do have options. I hope you can find a vet that will work with you, and I'll be sending you good thoughts that all will be resolved. I've included two links for you that discuss this condition in further detail. If you are unable to read the first link, I recommend registering for the site, as it is free, and contains much useful information concerning horse health.

http://www.thehorse.com/ViewArticle.aspx?ID=4754

http://petcaretips.net/lumps_bumps_knots_horse.html

Please let me know if you have any more questions.

-Dan

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