This is a fistulous wound on any part of the coronet just above the hoof, having one or more openings communicating with each other under the skin by pipes or channels (sinuses), and usually involving the deeper structures at this part.
The cause of quittor is an injury to the coronet, such as a tread, or bruise from other causes; or it may result from a stab from a sharp instrument; or from injury to the sensitive parts of the foot at the sole, as from pricks in shoeing, festering corns, or bruises on the sole, or any other accident, followed by the formation of matter (suppuration) under the horny hoof. It is sometimes induced by frost-bites in the winter, the matter following the inflammation so produced burrowing into the deeper tissues of the coronet.
The parts affected in quittor are the skin and underlying tissue (cutaneous quittor), or it may extend to the ligaments so called (tendinous quittor), or deeper still, to the gristle (cartilaginous quit-tor), or it may penetrate under the horny foot (sub-horny quittor), and even to the bone itself and the joints. It most frequently attacks the heels and extends forwards to the quarters, and even to the front of the coronet, or it may commence at the latter and extend in a backward direction. Heavy horses are more often affected than the lighter breeds, but this is only because they are more exposed to injuries of the coronet. Moreover, it is generally the inner side of the foot that is affected, probably because corns, which are common causes of the malady, are most frequently found there, and the animal is more likely to tread on the inner side of the foot than on the outer.
The principal symptom is a hot and painful swelling on the coronet, usually on the bulb of the heel, where matter forms (abscess), and finally bursts through the skin just above the hoof. If the wound is probed we shall probably find channels (sinuses), running in more than one direction, usually, however, downward behind the coronary band at the top of the hoof; others may pass horizontally round the coronet either in a forward or backward direction. These latter frequently form fresh centres of suppurative inflammation, the skin either just in front of or a little behind the original wound swells, forms matter, and breaks, forming a second wound; and this may go on until there are several wounds on the skin, leading by narrow canals (sinuses) to one another, and so forming a net-work of channels in the tissues of the foot. As may be imagined, this gathering and channelling process is a very painful one, and makes the animal very lame, so much so in some cases that the limb is constantly being lifted from the ground in an uneasy manner. From the wounds a more or less copious purulent discharge flows, which is most offensive when the gristle or the ligamentous or bony tissues are involved. Under all circumstances the disease is a tedious and slow one when these lowly organized tissues become affected, and the prospects of immediate success cannot be said to be very encouraging.
Fig. 397. - Quittor.
The treatment consists in giving free liberty for the escape of all matter (pus). This is usually effected by opening the sinuses with a knife (bistoury) specially constructed for the purpose. When the sinuses run in a downward direction the horn covering the channels must be rasped away as thin as possible, and then the pipe laid open; but this is far easier to put in black and white than it is actually to put it into practice; nor is it unattended with danger, for one may possibly injure the underlying structures and even open the joint, especially if the sinus is situated towards the front of the foot, and the horse is at all restive, as it frequently is. In these circumstances it is far safer to cast the animal than run any risk of injuring the joint, or of the animal injuring the operator. Another method, and not one to be despised, is to cauterize with a hot iron. Here again we must be careful of the joint. We remember once operating on a horse's hind-foot by this method in the standing position, and although all ordinary precautions were taken, such as placing a twitch on the nose and holding the fore-limb of the same side up, we had no sooner touched the wound with the heated iron than he kicked violently out and unfortunately struck the iron, which penetrated the foot-joint, with the result that he died within two or three days. We relate this unfortunate accident to show how dangerous an ordinary simple operation may be, especially with a restive animal.
Another and safer method is to plug the sinus with caustic, such as corrosive sublimate or arsenic, and after the "core slough" has come out (which takes from four to six days), the wound should be injected with an antiseptic lotion. Or caustic and antiseptic liquids may be injected repeatedly into the wounds. These are often followed by stimulating injections, such as the tincture of iodine. A blister rubbed on the coronet sometimes starts healing action in the wound. The cartilage frequently becomes diseased, rendering the malady a formidable one to treat. In fact, cauterize by what method we. may, or inject whatever lotion we may, nothing seems to be of any use. In such a case recourse is had on the Continent to extirpation or cutting away of the cartilage, which is, it is needless to say, a somewhat formidable operation, and altogether beyond the resources of the amateur; even in the hands of the most skilful veterinary surgeon it frequently fails to bring about the desired result.
We may say that all wounds inflicted on the feet of horses are attended with danger and are liable to lead to abiding disease, because it is so very difficult to keep them clean - a most essential point with all wounds. This, together with the class of tissues involved in quittor, and the constant movement going on at this part, renders such cases very unthankful ones to treat even under the most favourable circumstances; and when any inattention or neglect in dressing and cleanliness takes place on the part of the attendant, it makes it almost impossible to effect a cure. Again, animals so affected are usually restive, and the attendant having insufficient or no help, soon gets disheartened at the slow progress his patient makes; for which perhaps there is some excuse. Whatever method of treatment is adopted in these fistulous wounds, we are confident it is quite as important to get an attendant (nurse) who will religiously carry out the instructions given to him by the medical adviser, as it is to select a proper remedy, because there is not a method or a line of treatment that is not at times successful and at other times the opposite.
To prevent quittor all injuries to the coronet, however slight, should be placed under treatment at once, and all injuries to the sole of the foot, followed by the formation of pus, should be thoroughly opened to allow the free exit of the matter below, and thus prevent as much as possible the probability of the matter ascending up the wall of the hoof.