Brego had his hoof wall resection yesterday. According to my vet, it was NBD for Brego (of course, he had good drugs on board and lots of people taking care of him). For me, it was super nerve-wracking - I was so worried they would get in there and find something really bad. Plus, I wasn't there for it, so I had to wait for updates as my vet could send them.
The procedure went off with no problem. He got a special set of custom shoes for support, and then they started removing the hoof wall. As they started digging, they discovered that the entire hoof wall, all the way down, was dead - there was no connection to the laminae underneath. When they got to the top of the hoof, they didn't find a keratoma, but instead a pocket of damaged and infected cells. That area got cleaned and debrided until nothing but healthy cells were left.
The theory that the vets (there were four in attendance) and the farrier have is that years ago, Brego either had some tiny bit of infection or foreign body travel up from the toe all the way to the coronary band, or he had some slight damage to the coronary band. He blew out an abscess in exactly the same spot almost two years before we got him, so this whole thing probably started back then. He then went two years with no abscess, blew one out last spring, then went ANOTHER year with no abscess, then six months, and then it really became a problem this year. But, guy has been walking around with a compromised hoof for quite some time, and he's so stoic that nobody even suspected.
As for recovery, the plan is a little up in the air. He's staying at the hospital for the next week, and right now his hoof is just wrapped with daily bandage changes. We may continue with daily changes once he comes home, or we may put a hoof cast on him. He'll definitely be on stall rest or in a very small paddock for a while, but whether that is weeks or months we won't know until we see how he progresses. Once we are sure the hoof is growing back in normally, the vet wants him to get as much (careful) movement as possible since movement helps the hoof grow. Total time to grow an entirely new hoof is 9-12 months, but he should be able to return to at least light work long before that.
So, please keep your fingers crossed for an uncomplicated recovery and a beautiful, perfect new hoof!
And now the moment you've all been waiting for... the gory pics. Seriously, if you don't do blood, please don't look.
Cutting guides for the resection. You can see just how many abscesses he's blown out in the last few months.
Starting to nip out chunks.
So much hoof to get through!
Here's what it looked like after they nipped out some of it. That black section in the middle is dead hoof that doesn't connect to the laminae underneath.
After using the nippers, they got to work with the dremel (I would have had to leave for this, gah). You can see how many holes there are down the hoof wall, and how much dead area there is under it all. Poor guy.
Did I mention there was an audience?
Hoof wall resection complete. The white part is laminae. Note how his coronary band is pushed up and bulging? That's where the root of the problem was.
Post-debridement under the coronary band. You can see that it's no longer bulging and the coronary band looks more even all the way around.
Today I get to FaceTime with my vet during the bandage change so I can see everything up close and personal. Ah, the magic of technology!