Hoof abscesses are caused by bacteria entering the hoof through a sole bruise/puncture or a diseased white line. White blood cells build up to combat the bacteria, creating painful pressure around a pocket of fluid.

Treatment involves encouraging the abscess to pop, then keeping the area clean while the abscess’s track through the hoof heals.

If you’ve ever dealt with an abscess, you may still have nightmares about toting hot water to the barn in winter and asking your fidgety horse to please stand in a bucket for just a few minutes longer. But you can banish abscess apprehension using tools you may already own.

To Soak Or Not To Soak

Soaking a horse’s foot is one of the oldest remedies to draw out an abscess; many people swear that soaking the hoof in water will soften the hoof, offering a path of least resistance to the pocket of pus looking for a way out of the hoof capsule. However, getting a horse to stand—quietly—in a 5-gallon bucket of warm water for up to 30 minutes can be nearly an act of Congress.

If the abscess is trending toward the sole of the hoof, standing the horse in a shallow rubber feed pan may work—and make him less fidgety, since he has more room to place his foot on the bottom of the pan. If the abscess needs to work its way out through the coronary band, however, a shallow pan won’t be an option, as it will be impossible to get the water up high enough to cover the area.

Supplement the Soak

While water alone will soften the hoof to encourage an abscess to burst, there are additives that can be used to offer even more drawing power. These can include:

◆ Epsom salts: Easily purchased at the local grocery store, Epsom salts (magnesium sulfate) offer both inflammation relief and antimicrobial benefits. Adding a cup to the soaking water will help draw out the infection in the horse’s hoof.

◆ Bleach: You’d be hard pressed to find a household without at least one gallon of bleach, and there are plenty of equine- and farm-related applications for it. Best for abscesses is the 5.25 percent household bleach, which destroys bacteria, viruses and mold.

◆ Apple cider vinegar: Adding a ¼ cup of vinegar to 1 gallon of warm water will allow the acidity in the apple cider vinegar to draw out infection.

◆ Baking soda: Adding 1 to 2 tablespoons of baking soda (sodium bicarbonate) per quart/liter of warm water has also been known to draw out an abscess. With disinfectant, antibacterial and antifungal properties, baking soda can be used in conjunction with Epsom salts in soaking water.

◆ Povidone-iodine (Betadine): Adding 2 ounces of povidone-iodine, possibly in conjunction with 1 cup of Epsom salts, to water that reaches just over the horse’s coronary band can help draw out an abscess.

Non-Bucket Options

If you can’t seem to get your horse to stand in a 5-gallon bucket, but would still like to soak his hoof, there are other options.

◆ Muck tubs: Some horses are more likely to stand with both their feet in a larger bucket, like a muck tub.

◆ Hoof soaking boots: Made of nylon, hoof soaking boots go on over your horse’s hoof like a sock and contain an interior bag you can change out to keep everything hygenic. A foam pad at the bottom offers support and protects the bag from being worn through by the horse’s hoof. Fill the bag with water and any additive you choose, place the horse’s leg in the boot, and close it with the straps provided.

◆ Ice boots: Often used after strenuous exercise, these tall, up-to-the-knee boots can also be used to soak abscesses.

◆ Plastic bags: If you’d rather repurpose something you already have on hand, try using a heavy plastic bag (like the kind some supplements come in) or some IV bags (ask your vet to save a few for you if you have none on hand). Applying a soaking bag to the horse’s foot allows him to move around instead of having to stand still while soaking. Duct tape on top of the bag around the ankle will keep it secure, and you can cut the whole thing off with bandage scissors when done.

A word of caution: If you’re strapping anything around your horse’s leg, it’s worthwhile to get him used to having something on his foot before adding water.

Poultice Power

Whether you choose to soak or not, all horses with abscesses benefit from a pack or poultice applied to the affected hoof to act as a longer-term drawing agent.

Commercial pads that already contain drawing agents can be a timesaver. One of the most popular is Animalintex, a cotton wool pad that contains tragacanth gum and boric acid; it’s available in both sheets and hoof-shaped pads. You can wet it with hot or cold water, apply to the hoof, and wrap the whole thing with Vetrap followed by duct tape.

Poultice Alternatives

You can also use cotton 4×4 pads, cotton wool, gauze or diapers to pack the hoof if no poultice pads are handy. The following are often added to the packing material and placed against the sole of the hoof to act as drawing agents before securing on the hoof.

◆ Baking soda: Add water to baking soda to make a paste and slather the sole of the hoof with the mixture; some people choose to add Epsom salts to the mixture as well.

◆ Linseed: Damp, warm cooked linseeds that are boiled and made into a mash can be packed into the hoof and wrapped.

◆ Epsom salts and Vaseline: Combine both ingredients to make a gel that sticks to the bottom of the hoof.

◆ Manuka honey: the antibacterial properties of honey are well documented; it draws out toxins, as well as cleans and prevents infection and encourages healing once the abscess track is open.

◆ Sugardine: Combine ¼ cup sugar with 3 tablespoons of povidone-iodine solution until it makes a thick, granular paste to slather on the bottom of the hoof. Sugar absorbs the moisture in which bacteria thrives; the povidone-iodine helps kill any bacteria that is present.

◆ Ichthammol: Stinky and incredibly sticky, this old-school remedy for drawing an abscess is still one of the best.

◆ Cabbage leaves: Cabbage leaves boiled in Epsom salt water to make them pliable is a lesser-used home remedy that draws out infection and eases pain. The leaves can also be chopped, boiled and packed into the hoof sole.

◆ Sauerkraut: No time to boil your own cabbage leaves? Packing the hoof with sauerkraut has also been said to work; the sauerkraut’s acidity makes it hard for bacteria to survive.

Wrapping

Once you’ve picked your drawing agent and slathered it on, you can create your own wrapping using heavy-duty plastic bags (like the ones some supplements come in), Vetrap, and duct tape, or you can purchase a pre-made boot to hold the dressing in place.

These boots offer a variety of fasteners depending on the brand; they may have zippers or Velcro straps. The best boot for your horse will be one that is easy to get on and stays on—some horses are Houdinis about removing things.

Key Takeaway

Abscesses can be painful for the horse and frustrating for his owner, but with perseverance and a bit of ingenuity, they will (hopefully) resolve rapidly. If at any time you’re concerned that the abscess is not resolving or that your horse’s pain is unmanageable, reach out to your vet for guidance.

This article about hoof abscess treatment options appeared in the September 2024 issue of Horse Illustrated magazine. Click here to subscribe!

The post Hoof Abscess Treatment Options appeared first on Horse Illustrated Magazine.

How a Hoof Abscess Starts

A hoof abscess begins when environmental bacteria access the horse’s hoof capsule.

The most common way that bacteria does this relates to fluctuating moisture in the environment. When the ground is dry, hooves become hard and somewhat brittle. This causes small fissures (cracks) to develop in the sole. When the ground becomes wet, the hoof acts like a sponge and softens, further opening these small cracks. Bacteria in the environment can take advantage of these small breaches in the otherwise impenetrable hoof wall and invade the tissue inside.

As they invade the warm, healthy inner hoof tissue, the bacteria multiply rapidly. The horse’s immune system comes to the rescue, but during the battle between good and evil (the horse’s white blood cells versus bacteria), casualties occur as white blood cells die and cause pus to accumulate.

This pus exerts pressure in the confined and inflexible hoof wall. If you’ve ever had swelling under a nail, you know the pain this causes. Now imagine the pain a horse might deal with as they stand on an abscessed hoof.

Hoof abscesses can, however, occur at any time of year, so the weather is not the only cause. Sole bruises caused by hard ground and penetrating hoof wounds also invite bacteria to invade the hoof. One type of penetrating wound is a close nail, or one that is driven too close to the sensitive laminae (internal supporting structures between the outer hoof wall and the coffin bone). This creates a convenient path for bacteria to enter on the nail, which can lead to infection.

Poor hoof conformation can also be a contributing factor to the development of a hoof abscess. Some thin-soled horses are naturally predisposed to frequent abscesses. This is likely due to their increased risk of sole bruising and the shorter distance bacteria have to travel between the outside and inside of the hoof.

What You Might See

While you might expect to see a severely lame horse, keep in mind that not all abscesses are created equal. Observable signs depend on how large the abscess is, where in the hoof it is, and how long it’s been developing. If caught early, some horses are only slightly lame. Others may have some leg swelling up to the fetlock, while others may have a bounding digital pulse and a hoof that’s hot to the touch.

Horse owners that have seen abscesses before may feel comfortable identifying one and starting treatment on their own. If this is your first time with a hoof abscess, or you feel there may be other complicating issues, it’s a good idea to call your veterinarian for help.

If lameness is accompanied by a visible injury, such as a penetrating wound, or is part of a chronic hoof disease, radiographs may be necessary to assess any internal hoof damage.

Treating Hoof Abscesses

For uncomplicated hoof abscesses, treatment starts with releasing the pressure and granting the horse instant pain relief. This is done by draining the abscess. If your horse is an extremely painful condition, sometimes a local nerve block and/or sedation may be required for safe treatment of the wound. For this, you’ll need a veterinarian.

Using a hoof knife, your veterinarian will clean and trim back the horse’s sole, which gives the ability to see any dark spots or tracts. These are usually indicative of where the abscess is. Hoof testers can also help narrow the location of the abscess.

The hoof knife is then used to carefully pare deeper until the pocket of infection is hit. Once opened, the abscess drains, although it’s usually anticlimactic. A draining abscess may only be a tiny wet spot or area of dark fluid that trickles down. However, the horse may visibly show his relief.

If left alone, an abscess will eventually rupture on its own. However, there are a few downsides to this wait-and-see approach. First, it prolongs pain for the horse. Secondly, if an abscess is not treated, it tends to move up to the coronary band or out the heel bulbs.

Manually draining the abscess with the hoof knife through the sole allows gravity to help with the process; a coronary band abscess (also called a “gravel”) may prematurely close, leaving some infection behind to cause a problem later.

Once drained, your horse now has an open wound in his sole. While it’s important to protect this wound from further infection, it’s also a handy window to allow for continual drainage. Therefore, packing the sole with a poultice and wrapping the hoof with a bandage for protection can ensure the abscess completely drains.

Depending on depth and location, sometimes an abscess can’t be located or easily drained. In such cases, repeated soaking of the hoof in an Epsom salt bath will help soften the hoof and draw the infection closer to the sole for easier drainage. A shallow feed tub makes for an ideal foot soak. Alternatively, there are special soaking boots made specifically for horses, or some owners make “soak bags” out of sturdy plastic IV bags.

Stalling a horse for 24 hours with a soak bag is usually enough time to soften the hoof so that on recheck with a hoof knife, the abscess is more easily drained. Occasionally, you might get lucky and the abscess drains itself overnight. This is often noticeable the next day since the horse is much more comfortable.

How to Prevent Abscesses

The natural expansion and contraction of a horse’s feet in response to external moisture are impossible to control, so to an extent, hoof abscesses could be considered impossible to prevent. However, a few rules of thumb can help decrease their likelihood.

Regular year-round hoof maintenance is the best place to start. Balanced hooves keep weight distributed evenly, and trimmed feet are less likely to crack and allow bacteria inside.

Providing your horse with the best of nutrition also helps keep hooves healthy, as does daily hoof cleaning and maintaining excellent stall and paddock hygiene. Removing soiled bedding and fixing chronically wet or boggy areas help hooves stay clean and dry so you’ll spend less time obsessing over abscesses and more time enjoying your horse.

Using a Poultice Supplies Needed: Iodine, soft and disposable packing material (gauze pads, diaper, etc.), ichthammol or other poultice material, Vetrap, duct tape, scissors Steps: 1. First, thoroughly clean the sole with iodine. 2. Any soft, disposable and clean material will work as packing. One common method is to use a stack of 4×4 medical gauze pads. Other options include a disposable diaper or sanitary pad. 3. Slather a glob of ichthammol or other common poultice on the packing material and place it directly over the draining abscess. 4. Use a stretchy bandage like Vetrap around the entire hoof to keep the gauze or diaper in place. Be careful not to tighten it above the hoof hairline where it could restrict circulation. 5. Next, slightly overlap strips of duct tape to make a square just larger than the bottom of the hoof. reinforce with strips laid at 90 degrees to these. Stick the square to the bottom of the hoof and wrap the edges around to adhere to the Vetrap on the hoof wall. Wind tape once or twice around the top of the square where it meets the hoof wall to hold in place. 6. Keep your horse stalled or in a small, dry paddock for a few days. 7. Change the wrap once a day, replacing the poultice and using new tape. Scissors makes cutting into the bandage for removal much easier than peeling it apart with your fingers. As a general rule, horse’s hoof abscesses tend to fully drain within three days or so, and often sooner. However, anticipate the entire healing time to take seven to 10 days, but this will depend on the depth of the abscess and the size of the drainage hole.

Key Takeaway

In this article, you’ll find common causes of hoof abscesses, methods for treating them, and tips on how to prevent abscesses, all of which are essential for hoof care and maintaining a clean environment.

This article on treating a horse’s hoof abscess appeared in the January 2020 issue of Horse Illustrated magazine. Click here to subscribe!

The post How to Manage and Treat a Hoof Abscess appeared first on Horse Illustrated Magazine.

Soaking the hoof several times a day will eventually cause an abscess to erupt and drain. However, some vets now advise against frequent soaking as it may weaken the hoof wall. Some horse owners instead choose to apply drawing agents, such as ichthamol or Epsom salts, directly to the hoof under a bandage.

The goal in the treatment of a horse’s hoof abscess is to draw out the infection and keep the area clean to prevent reinfection while the hoof heals. Once you have confirmed the diagnosis with your vet, follow the steps below to put your horse on the road to recovery.

For treatment of a horse’s hoof abscess, you will need a flexible bucket or tub, Epsom salts and poultice pads or iodine. Bandaging materials include sheet cotton or a diaper, elastic bandage and duct tape.

Step 1:  Mix Epsom salts in a bucket of warm water.  Use enough salts to reach the point of saturation, where no more will dissolve.

Step 2:  Submerge the entire hoof up to the coronary band and soak for 10 minutes.  This will help draw out the infection and will encourage the abscess to erupt if it has not already been opened and drained.

Step 3:  Soak a poultice pad in hot water.

Place the pad over the sole of the hoof.

If you do not have any poultice pads, you can make a poultice with Epsom salts and iodine.

Pack the paste into the hoof so it covers the entire sole.

Step 4:  Wrap the hoof in a diaper or sheet cotton.  Secure the diaper by tightly wrapping it with elastic bandage. Cover the entire bandage with duct tape for durability. If your horse will be turned out or is prone to destroying bandages, you may want to use a hoof boot.   Click here for step-by-step instructions on bandaging a hoof.

Your horse may be sound in as little as a couple of days.  Once the abscess has drained, keeping the hoof protected from dirt and debris is the best way to avoid complications or reinfection.  And of course, always consult your vet to help you decide the best course of action. 

Further Reading on Treatment of Hoof Abscesses in Horses

◆ Hoof Abscesses and Puncture Wounds
◆ How to Manage and Treat a Hoof Abscess
◆ Causes of Equine Lameness: Foot Abscess

This article about treatment of hoof abscesses first appeared in Horse Illustrated magazine. Click here to subscribe!

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Abscess (hoof abscess, sole abscess)

What it is: A pocket of infection in the foot.

Symptoms: Lameness, which can be severe; heat in the foot (hoof feels warm); swelling and redness in the bulbs of the heel; a dark area on the sole; pain when the affected area on the sole is pressed with a hoof pick or hoof testers.

What to do: Hoof abscesses aren’t emergencies. Many owners become adept at diagnosing and treating them, especially after they’ve done it a few times. If you’re not quite to that point, call your vet during regular hours. Severe abscesses that require paring of the sole should be treated by a vet.

To treat a hoof abscess, clean out the foot and then soak it in warm water with Epsom salts (about one cup per gallon of water) for 10 to 20 minutes. Moisten a 3-inch square piece of poultice pad (Animalintex) or disposable diaper, and smear povidone iodine (Betadine) or chlorhexidine ointment (Novalsan) on it. Place the pad on the bottom of the foot (over the abscess site if possible) and secure it with Vetrap, then with duct tape or elastic tape (Elastikon). Confine the horse in a clean, well-bedded stall or grassy paddock. Repeat the treatment every other day, or more frequently if the poultice bandage doesn’t stay on.

Outlook: Many hoof abscesses clear up with appropriate treatment, but some recur with distressing frequency. This usually means that the drainage was inadequate and/or the abscess site healed over prematurely, entrapping bacteria, which eventually forms another abscess. Horses that develop recurrent abscesses may need long-term antibiotic therapy to resolve the problem.

Back to Horse Health Glossary

This article originally appeared in the 2012 issue of Horses USA. Click here to purchase the most recent issue.

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