"Doc – What is a Quittor?"
© A.J. Neumann, D.V.M.
published in The Draft Horse Journal, Autumn 2005

An untreated quittor of long standing duration.

What a difference one letter in a word will make as to the word's meaning. The word "quitter" with the "or" present at its end is a term applied to a disease of the feet of horses, asses and mules. In contrast, the term "quitter" with an "er" at its end is a name applied to a human who quits a job or shirks his duty when he or she is expected to carry their load and perform a job. This term is also applied to the horse or mule that quits easily and will no longer work with its teammates.

To me the human quitter is a very sad specimen of the human race. I personally despise these individuals and can find very little reason to put up with them. I will give you an example of precisely what I am referring to.

Sometime this past spring, late at night, my phone rang and upon answering it I found myself talking to a very distraught gentleman from Wisconsin. I did not know this individual from Adam's-Off-Ox but he had a big problem.

I soon found out the individual was concerned about a draft mare which was foaling. She had been at it for about two hours or so. An equine veterinarian was called because it soon became apparent the mare was in trouble and could not deliver the foal. The veterinarian determined that it was an anterior presentation; however its head and neck were turned off to the side, apparently in such a position that it could not be straightened, in which case the foal could not be delivered. When this happens in the draft mare no one can reposition the foal's head to facilitate a normal delivery.

Do you know what this miserable excuse of a veterinarian did? He packed up and left the premises with no effort being made to refer the client and his mare to an equine clinic or another veterinarian. The owner of the mare was frantic! What was he to do?

I calmed him down and told him there was lots of hope left for the mare. I asked him if he was in dairy country. He replied "yes, in fact a few years ago almost every farm around here had dairy cows." I then inquired of him if he knew of a veterinarian in the area who practiced mainly on dairy cows, and preferably had a little age on him. "Sure," he said, "I used to get this vet all of the time when I had cows, but when I got rid of them and bought some draft mares I changed over to this young equine vet."

I told the man to call the "dairy cow vet" and explain to him the fact that he would have to perform an embryotomy on the unborn foal. In essence, using a wire saw to sever its neck so it could be delivered. I reminded the gentleman on the phone that this vet had probably done many of these on unborn calves with the same problem as this unborn foal.

The veterinarian was called and he easily performed the embryotomy and delivered the foal. The following day, the mare's owner again was on the phone to inquire about her care. She had cleaned as soon as the foal was removed so I discussed the appropriate aftercare with him. I also told him to stick with the old "cow vet" because, in the long run, this veterinarian would do him more good than the first, who was a first class "quitter" and, in my opinion, a disgrace to the profession!

In the equine family the term quittor refers to a disease of the foot. Today, equine quittors are divided into two groups. The "cutaneous quittor" involves the soft tissues just above the foot or coronary band. The layman's term for this condition is "gravel." The owner of a horse with this problem will often say "my horse is graveled." Another term for this condition that's not so common is "suppurative laminitis."

These are the shoes which were put on the chore teams. They are from left to right: spade calk shoe, homemade sharp shoe, the round calked shoe. These shoes were very dangerous in that the shod horses would calk themselves often causing a quittor.

If the disease involves the lateral cartilage of the foot, it is then classified as a "cartilaginous quittor." This condition is, by far, the more serious of the two.

Cutaneous Quittor

I have seen an enormous number of cutaneous quittors in horses but never referred to them by that term. I always called the condition "gravel," which is the common name applied to the disease. Every draft horse owner has knowledge about a "graveled horse," especially if he has worked his stock.

Gravel will occur in all of the equine population, however it is not common in mules or ponies. Light horses will experience cases of gravel but it is by far the most common in the various breeds of draft horses. It is not often seen in those animals used primarily for show as most cases of gravel seem to occur in the unshod working draft horse.

Many people believe that very small stones enter through the sole of the foot and make their way up the inside of the hoof wall and break out at the top above the coronary band. Hence the term "gravel" or the animal "has been graveled." This is entirely wrong. Small bits of gravel do not cause this condition in the hoof of the horse. Bacteria, instead of minute stones, are the cause of the disease. Bacteria can enter through the sole of the foot via the minute cracks which can be seen in the structure. Stone bruises to the sole as well as punctures of the tissue are other means of bacterial entrance. Bacteria may also enter the white line if the tissue has received some damage.

Once the bacteria has passed through the sole, it often forms an abscess known as a "sub-solar abscess." This abscess will create substantial pressure in the area and will take the path of least resistance, which is upward through the laminae and soft tissue of the foot, eventually forming an abscess and breaking out in the vicinity of the coronary band at the hoofhead. Once in a great while, the abscess will break through the sole of the foot and drain to the outside, thus relieving the pressure.

As the abscess forms above the sole, the first symptom is lameness of the infected foot. The gravel may occur in the front or hind legs. The lameness will generally last four or five days becoming increasingly severe until the animal will scarcely bear any weight on the foot but rather it will stand on three legs and keep the affected hoof clear off the ground.

When the lameness is severe, an examination of the coronary band region of the infected foot will reveal a small, hot and painful swelling in the skin of the area. Touching this area will produce great pain for the animal. Sometimes, within a few hours after the formation of the abscess, the pastern or even the whole leg up to the knee or hock becomes swollen. In many of these cases, the lameness is very severe and the animal will have an elevated temperature, be dull, lose its appetite and show an increased thirst.

If no treatment is instituted at this time, the abscess will soften and rupture, discharging an amount of greenish yellow exudate or "pus." If there is no swelling of the affected leg, the rupturing of the abscess will provide the horse with immediate relief and, often in a few hours, the animal will be "hobbling" around.

In the untreated horse, an abscess may form two or three times and, occasionally, the gravel may never heal. The infection may stay deep in the tissues of the foot and infect the bones there as well as the joints. Occasionally, some of these horses will never recover.

It is very important to diagnose and treat a gravel case as soon as the animal shows the first symptom of lameness. The sole should be cleaned and pressure applied to it by the judicious use of a hoof tester or by tapping the sole with the small end of a light ball peen hammer. When pressure is applied over the abscess the horse will experience pain and try and remove its foot from you. One can then mark the area and by using the small curved end of a hoof knife, drill a hole through the sole and drain the abscess. Often, the abscess is under so much pressure that when you contact it, the pus will spray out all over the knife and handle. This exudate is almost always black in color.

• Open the area until it bleeds. Put some 7% strong tincture of iodine in a plastic syringe, about 5 to 7 cc., and with the needle off, just using the plastic tip of the syringe, insert it into the abscess and flush it out.
• Next, take a small piece of cotton and soak it in the iodine. Push it down into the hole in the sole, tamping it in tightly.
• Place the horse on penicillin twice daily for five to seven days.
• The next day, remove the cotton and soak the foot in a warm Epsom salt solution using 2 ounces of Epsom salt to 1 gallon of water. Soak the foot twice daily for five to seven days.
• After soaking the foot, put 5 to 7 cc of penicillin in a plastic syringe and inject this into the abscess, thus flushing it out with the antibiotic. Do not use any more iodine to flush the abscess area.
• When you are done injecting the penicillin, take your small piece of cotton soaked in iodine and tap it tightly into the hole in the sole.

This treatment works very well and often on the second day, the horse can be worked in the field. One will be surprised how nicely the iodine impregnated cotton will stay in place in the hole in the sole.

If the gravel has abscessed at the hoofhead or coronary band region, the sole should still be opened and the subsoler abscess drained. Treat the abscess area of the sole the same as above. Place the horse on penicillin for two weeks and soak the foot twice a day for seven to ten days.

It is much more difficult to remove the infection that has gone up the foot and even more difficult if the infection has invaded the tissues of the pastern and lower leg. In these cases, the patient must be placed on antibiotic treatment until complete recovery is accomplished.

Now there is a catch to all of these procedures–You must have trained your horse to pick up and give you his foot or have good stocks. Do not expect the veterinarian to train your horse to pick up its foot!!! That job is for the trainer or owner or both!

Cartilaginous Quittor

A cartilaginous quittor is necrosis of the lateral cartilage of the hoof. This disease of the foot is characterized by one or more fistulous openings discharging a green-yellow pus through or generally above the coronary band.

The cause of this disease is direct injury to the lateral cartilage, largely due to deep puncture wounds, severe wire cuts involving the cartilage or injury from calkins. Years ago, the latter was a very common cause of the problem. Almost every farmer had a chore team which he had "sharp shod" with either "spade calks" or the "round calks." This was done in late autumn or early winter. These horses often "calked" themselves. I remember these farmers saying "one of my horses 'corked' himself." It was never "calked" but "corked." Animals used for heavy draft with low heels and flat feet were those that often calked themselves.

It was a well known fact in years gone by, that a horse which stood with one rear foot ahead of the other should not be sharp shod as this individual would often calk itself.

The disease is not quite as common today because of the advent of powerful antibiotics. However, I had three cases so far this year, all of which were referred to me for treatment.

The first symptom, of course, is lameness. Close examination of the foot will reveal a very sensitive swelling over the affected cartilage. The swelling may be relatively small or extend over the entire cartilage. The swelling may have one or more openings usually above the coronary band, from which a greenish-yellow material is being exuded. If the lesions are located toward the front of the foot, the lameness is usually severe. If the lesions are to the rear of the hoofhead the animal may have only a slight lameness.

These infections may also involve other parts of the foot, especially if the condition has been present for a long time and has been poorly managed. It may then involve the coffin bone and joint, the deep digital flexor tendon, and the sensitive laminae.

I have treated the uncomplicated cases very successfully using a combination of old fashioned methods and the new antibiotics.

I generally anesthetize the foot and open the tracts down to the cartilage. Infected cartilage is blue-green in color and all infected tissue must be removed. I then pack the area with an old-time salve called BIPP. I have tried many other modern drugs and salves but, in my estimation, nothing works as well as BIPP for this condition.

The bandage and pack is changed every two days until the area is granulated in, and then the area is treated like an open wound, keeping down any formation of proud flesh until the skin has closed over the site.

Of course, the horse must be on antibiotics systemically until most of the healing has taken place.

An x-ray of the foot will reveal the presence or extent of any complications. If present, these will have to be treated either by surgery or by the local use of modern antibiotics.

I believe the successful treatment of the two forms of quittors seen in horses and mules depends largely on their early diagnosis and the correct treatment being used for each.

As far as the human quitter is concerned, only preventive measures will prevail. Leave them alone. They are no good for you and no good to themselves.