This still squicks me out
Brego seemed to be doing well, galloping around like an eediot, showing no signs that his Holey Hoof was bothering him at all.
And then he went lame again, and another abscess blew. In the same spot.
I had the vet and farrier out AGAIN. They discussed options, took more rads, and called some of their peers to consult. The consensus is that there must be *something* causing these abscesses, and it's most likely that Brego has a keratoma. Keratomas are benign tumors that form under the hoof wall, for reasons yet unknown. The only way to address the issue (repeat abscessing) is to remove the tumor... which, given its probable location (up near the coronet band), means a hoof wall resection.
You can see the new hoof is coming in completely mangled.
Since there's nothing's showing up on radiographs, my vet wanted to have an MRI done so they could see the extent of the issue before they started surgery. After calls to several clinics with standing MRIs (Brego almost died on the table during flap surgery before we got him, so he is not a candidate for full anesthesia, ever again), we discovered that standing MRIs can only handle hoofs up to 7 inches in diameter - and M'sieur Brego is 8.5 inches in diameter right after a trim. And apparently all standing MRIs are made by the same company, in one size... so an MRI is out.
Sooo... the plan is that Brego will have a standing hoof wall resection done as soon in a week or two, when my farrier and vet can get their schedules to align. They will do an ultrasound and some sort of vein trace just before, so they can attempt to pinpoint the keratoma's exact location so they know how far to go. The good news is that it hasn't affected any bones, so the prognosis is excellent if they can get it all.
Brego will be in a hoof cast for about a month, so the new hoof can start to regrow. He's already on massive doses of hoof supplement to help with hoof growth. Once the cast can come off, he'll be in a special shoe, probably with metal bands epoxied across the surgery site for additional support. Horses seem to handle hoof wall resections surprisingly well, despite some of us humans (namely me) being completely grossed out just looking at pictures of other resections. I don't know what it is about blood and horse feets, but it's just SO WRONG. But I'm sure I'll have plenty of gross pictures to share, because there's nothing more fun, right?
And don't worry... Brego is milking this for ALL he is worth. Which is currently several carrots per day while he gets his foot cleaned and treated!