It turned out that the recurring coronary abscess that we've been fighting all this time was actually an infection of P3 (the coffin bone) that ran from the tip of the bone all the way up into the coronet band. Because of the extent of the infection, it was inoperable. There was really only one decision to make.
You're probably wondering how, after all this time, we could have missed something so extensive. My vet has literally taken nearly a hundred xrays of his foot (and the other one for comparison). We have done ultrasounds, a veinogram, and used basically every diagnostic tool we had at our disposal short of a recumbent MRI, because he couldn't have handled the sedation and his ginormous foot wouldn't have fit into a standing MRI. There are four other excellent vets in-house at our clinic, plus my vet consulted with three external vets on his case (including the one who is considered the expert equine podiatrist in the US). There have been a LOT of exceptionally good people involved with this case, and yet somehow Brego managed to stump them all.
You see, there was never any indication on his xrays that there was infection. The bone was solid on every film. He was never lame, except when he was blowing out an abscess.
After his first hoof wall resection back in July, we had high hopes even though we weren't able to find the root cause of the problem. But then the hoof wasn't growing in normally - it grew up instead of down. We did a second, very minor resection in late August to try to correct that problem, and at the same time we dissected the area around the coronet band and halfway up the pastern to try to find the root of the problem. My vet found no tracks, no foreign bodies, nothing. Brego recovered from that surgery just fine, and the new hoof he was laying down grew in straighter, but it had an odd, cracked quality to it.
Then mid September, Brego went very lame immediately after he'd had his shoes reset. Our farrier (who is an amazingly talented man with a piece of metal), made an emergency visit and found an abscess right in the middle of the area where there was no hoof wall, about halfway down his foot. It was quite a puzzle... why was there an abscess there? We took more xrays to try to find where it was coming from, but nothing showed up on the films. We speculated and scratched our heads while Brego begged cookies from the entire clinic staff, but eventually decided to wait and see since we didn't have anything to go on.
Then on Monday, the abscess blew out again, in the same spot. This time, we did a dye study to follow the track of the abscess. The dye showed a shadowed spot at the tip of P3, as well as a number of little "filament" tracks going partway up the front of P3. At this point we knew the news wasn't good, but we decided to go in anyway and at least try to give Brego the best possible chance.
You can see the probe coming in on the left, and ending nearly at the tip of P3 (obscured because of the nails). The little filaments going up the front of P3 are dye tracks, but even these don't show the extent of the infection that they found.
What's really amazing is that the first abscess he had was nearly four years ago, when he was with his previous mum. She's got xrays from that too, and there's nothing to be seen. So he's been foxhunting, eventing, jousting, and living with an infected bone for literally four years, and we never knew. As my vet put it, Brego never read any of the books on how things are supposed to happen.
Brego leaves an incredible legacy. I know many folks (myself included) who started blogging because of Brego's blog, The Eventing Percheron. He touched the lives of those he met in person as well - from his massive feet to his larger-than-life personality. There was never any question that he owned the universe and everything in it.
And today it's a sadder, smaller place because he's missing from it.
We love you, big guy, and we'll miss you so much.