Brego Wrestling

Today is 17 days post-surgery, and Brego's doing great. Earlier this week, we took him off bute and let him have a bigger turnout area (haha, it's like 12x12 plus his stall). Unfortunately, the additional movement caused some soreness, so he's back in his stall with bute on board. It's frustrating because the best way to get a hoof to grow quickly is movement, but keeping him comfortable and ensuring the hoof grows correctly (if really really slowly) is the most important thing.

Right now the biggest challenge I have (other than keeping Mr. SassyMcGiantPants from running me over - stud chains make for such POLITE Bregos!) is wrapping his foot every few days. He's a good boy for it, but goodness that is one big foot and there are a lot of steps! Plus, if he wants to put his foot down at a really inopportune time, I have to really hang on and do my best not to let him. Thusfar I've won all the wrestling matches, but we both know he's only humoring me.

So, what does it take to wrap a Brego? (warning, one somewhat squicky pic at step 4, but really, it looks so much better!)

Step 1: Acquire one Brego. Try to resist when he begs for treats. Give him a handful anyway because he's so cute and you feel sorry for him.

Step 2. Collect all your supplies (vetwrap, abdominal pad, gauze, ela$ticon) and make a duct-tape boot. This requires about half a roll of Gorilla Tape, because obviously Bregos can't use normal duct tape.

Step 3. Clean the floor as best as you can, then remove all the old wrappings. I bought bandage scissors to do this and seriously, you need some if you don't have any. Here I've removed everything except the gauze.

Step 4: Gently clean the area with saline-soaked gauze. Take pics and send to your vet. According to the vet, this looks "awesome"! And it no longer totally grosses me out either.

Step 5. Pack about 40 gauze pads in the resection site, slap a 5x9 abdominal pad over that, then use an entire roll of vetwrap to hold it all on. His foot is so big, I take the first two wraps of vetwrap while it's on the ground, and then pick it up and wrap it the rest of the way. You have to do this all at once so sorry, no pics of the gauze and stuff. 

Step 6: Pick up his foot and apply the duct-tape boot to the bottom, then fold the sides up and stick them down. Neatness doesn't count much here.

Step 7: Wrap that entire sucker with ela$ticon, being sure to get it well up on his pastern so that no shavings can get in. This is usually the part where he's done with me messing with his foot and we have our little wrestling match. I won this time. 

Step 8: Give the Brego all the cookies!

Brego hoof update: "It looks GREAT!"

Warning: more graphic pics. Heck, let's just go with the disclaimer that for the next 9 months, if it's a Brego hoof update, there will probably be graphic pics included. You're welcome.

Let me start this post by saying that my version of "It looks great!" and my vet's version of "It looks great!" are two very, VERY different things.

My version: A completely grown-out hoof with no defects, ever again.

My vet's version: The following:

Surgery +1 day

Surgery + 3 days

Surgery +5 days. You can see the new tissue is starting to grow in from the top.

1 Brego foot requires: 1 5x9 surgical pad, ~40 gauze squares, 1 roll of vetwrap, 1 triple layer duct-tape boot, and 1 roll of ela$ticon. 

Home and hoovering as usual!

Tomorrow I get to do my first solo bandage change. Luckily Brego's super good about this, but still, it's a 5-step process and that is one BIG foot. He's 100% sound and about ripped my arm off coming out of the stall this morning, complete with head tossing and squealing. Clearly he feels quite good, despite missing the better part of a hoof!

Brego's hoof wall resection

WARNING: Graphic pictures. Do not continue if you don't want to see.

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!