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Horse hoof abscesses

Quick facts

  • Injury, poor hoof quality and poor hoof care can cause an abscess.
  • Abscesses cause sudden, severe pain and lameness.
  • Draining, bandaging and keeping the hoof clean are key to treating an abscess.
  • It may take a week to several weeks for the abscess to heal depending on the infection.
  • Routine hoof care and keeping your horse’s area clean can prevent abscesses.

Causes of a hoof abscess

Bottom of unshod horse hoof with abscess.
An abscess on a horse hoof.

An abscess occurs when bacteria get trapped inside the hoof.

  • Nails, screws and glass may damage the hoof and leave behind bacteria.
  • Horseshoe nails inside the white line (where the hoof wall meets the sole) may allow bacteria to enter.
  • Poor hoof quality may allow bacteria to enter the deeper parts of the hoof. Genetics or the environment may cause poor hoof quality.
    • Wet weather or wet dirty stalls can soften the hoof and allow bacteria to enter through gaps in the white line.
    • Changes in weather from dry to wet and wet to dry can lead to brittle hooves, which are more likely to crack.
  • Poor hoof care that results in long flared toes or crushed heels, can weaken the white line and increase the risk of hoof abscesses.

Signs of a hoof abscess

Similar to your fingernail there’s little room for swelling in the hoof. When the pressure builds it causes sudden pain and severe lameness. Owners often worry about a broken bone because of these severe signs. Usually, seeable wounds or swelling aren’t present.

Severe abscesses can lead to swelling and infection that goes up the leg. The pastern or heel bulbs and coronary band may be swollen. Often, the hoof wall is warmer, and you can feel pulses near the pastern.

If you see a nail or other object in the hoof, don’t remove it. Call your veterinarian right away. Tell the veterinarian where the object enters the foot and at about what angle.

Treating an abscess

The goal of treatment is to drain the abscess and prevent further infection. Due to the level of pain, it’s inhumane to wait for the abscess to rupture on its own.

Finding the pain source

Your veterinarian will look at your horse’s history and do a lameness exam. A lameness exam will make sure there are no broken bones or other injuries. They will use hoof testers to pinch parts of the foot and find the source of pain. They may find a crack or drain track after cleaning the hoof and removing the old sole.

If your veterinarian can’t find a drain track, they may take radiographs to look for gas (produced by bacteria) within the hoof. This will also help rule out other causes of lameness.

Draining the abscess

Once they find the abscess area, they can use a paring knife to cut a hole just large enough to drain the pus. Some horses will need analgesics (pain relievers) or local nerve blocks. Normally, the horse has sudden pain relief once the infection drains.

Bandaging the abscess

Your veterinarian will apply an antiseptic bandage to keep the abscess draining for 48 hours. Common antiseptic bandages include a povidone-iodine or a medicated bandage pad. You or your veterinarian can then put on a waterproof covering such as a diaper or hoof boot. This covering must stay clean to prevent lengthening the infection or dirtying the drain hole.

  • Keep your horse in a clean, dry area, such as a well-bedded stall or small paddock.
  • Remove and change the bandage daily.
  • Keep the hoof bandage on until the draining stops, the hole is dry and the lameness is gone.

Multiple, daily warm water and Epsom salt soaks may do more harm than good. Over soaking can weaken and harm the hoof. Tap water soaks can help moisturize the sole. Your veterinarian may suggest soaking the hoof once in a while to encourage draining. They may prescribe bute (phenylbutazone), firocoxib, or banamine to control pain or swelling.

Recovery time for an abscess

Horses with a mild infection can return to work in less than a week. Deep infections can take several weeks to heal and may lead to laminitis if not taken care of.

Call a veterinarian if

  • The infection continues to drain or drains more after 48 hours.
  • The horse remains in pain or needs analgesics (pain reliever) for more than one to two days.
  • The horse doesn’t want to eat.
  • The horse shifts its weight often, rests its good leg, or lies down more than normal.
  • Tissue (proud flesh) grows out of the drain hole.

Preventing an abscess

  • Keep your horse’s environment clean and dry. Routinely clean stalls and remove manure from paddocks.
  • Apply hoof hardeners before extreme weather changes. Hoof hardeners protect the hoof wall from too much moisture. You can use pine tar or other covering to hold in moisture during drought.
  • Routinely trim your horse’s hooves.
  • Remove any nails, tools, metal pieces, and glass from your horse’s area to lower the risk of injury.

Author: Felice Cuomo, DVM

Reviewed in 2021

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