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Hoof Abscesses

Hoof Abscesses
11 June 2020
 “My horse was fine yesterday but is now pointing his hoof like a ballerina!”
(Hoof abscesses and sole bruising)
What is a hoof abscess?
It is an internal infection of the hoof, where there is a build up of pus which causes pressure behind the hoof wall or under the sole. This is extremely painful as the horse has to constantly try to weight on the affected area. This infection can be caused by a penetrating wound, hoof cracks or shoeing nails.
They are most commonly seen during the wetter months of the year, when the hoof is softer. They can however also occur in the drier months when the hoof is more prone to cracks.
Clinical signs and Diagnosis
The horse is often acutely and severely lame. This lameness can be very sudden in onset, often overnight. They are very reluctant to bear weight on the affected leg. There is heat in the hoof and a strong digital pulse. If the lameness is only mild, they often point the toe of the affected hoof when walking. Sometimes it is only obvious when the horse walks on a hard surface. With long standing abscesses, the pastern and fetlock may become swollen. There may also be swelling and pain on the coronary band above the affected area.
The best way to diagnose a hoof abscess is with hoof testers. When pressure is applied over the affected area the horse shows significant pain. If there is an obvious puncture wound in the sole then x-rays are often indicated to check for any foreign bodies in the hoof. Foreign bodies can have more severe implications on the treatment and prognosis of hoof infection. Deeper wounds can cause damage to the coffin joint, deep flexor tendon and the navicular bone. X-rays are also indicated when there is a poor response to treatment.
The best and most effective way to treat the abscess is to drain the pus. If this is not done, the abscess will try to follow the path of least resistance. This means rupturing on there own and draining through the coronary band or heel bulb. Mostly a small hole will be created through the white line, in the sole or hoof wall to allow drainage. This is best done by your vet or farrier. Once drainage is established, a poultice is applied to the hoof to draw out the pus and debri. Animalintex is a good choice of bandaging material to use, this is kept in place with elastoplast and duct tape. Epsom salts can also be used as a drawing agent. This can be made into a paste and applied over the drainage site before applying the bandage. Newborn baby nappies work just as well, and can be secured with duct tape.
You should see a dramatic improvement within 24 hours of starting treatment. It is recommended that the bandage be changed daily until it is clean over the affected area.
Diluted Hydrogen Pyroxide, weak Iodine Solutions, and Cow Mastitis remedies can all be used in flushing a hoof abscess once it has been successfully opened.
Antiflammatories can also be given initially to relieve the pain. Antibiotics are only really indicated in abscesses non-responsive to poulticing alone, or if there is evidence of drainage at coronary band or heel bulb.
Also ensure that the horse’s tetanus vaccination is up to date.

Regional Perfusion:

This is a particularlurly sucdcesful form of treatment which allows the appropriate antibiotic to perfuse directly to the lower limb. Due to poor circulation accompanied by a hoof abscess, systemic antibiotics will battle to reach its target area. By applying a tourniquet above the knee and then slowly injecting the antibiotic of choice intravenous below the constriction, the medication has a far greater chance of reaching the hoof region. See photos below.

The best prevention is to create a strong sole-wall junction. Regular farrier work and hoof care is important in ensuring this but is not a full guarantee in preventing abscesses. While difficult to control, avoiding extremely wet or dry conditions will help with prevention. Ensure that stables and stalls are cleaned out regularly.
A hoof abscess can sneak up suddenly, but with proper care and treatment, you can minimize the damage and your horses downtime.