As the Clinic Mouse, I’m pretty good at seeing things around the clinic (but not being seen–being a mouse has its advantages!). But I am best at seeing things closer to my eyeline… and I’m all about horse feet. The doctors here at Springhill Equine pay special attention to their patients’ hooves because they are so important and can cause oh so many things to go wrong if not cared for properly.

The most expert of all the experts on horse feet is Dr. Staples. She’s an equine podiatrist, which means she’s a veterinarian, and certified journeyman farrier. We’re very fortunate to have her in our corner of the world!

Whinny Wisdom: Podiatry is a branch of medicine dedicated to diagnosing and managing conditions affecting the foot.

Dr. Staples says that horses with abscesses are acutely lame on just a single foot. While there can be multiple causes for a single-leg lameness, abscess is always high on the list! Tony (the best kitty mentor a mouse could ask for) says that “abscesses usually make their presence very well known.” In fact, I hear it’s not unusual for a human to call in saying they think their horse has broken their leg, but when our team gets out there it’s just a foot abscess! I’ve used that word a lot, so I should define it, huh?

An abscess is basically just a pocket of pus. Pus is a collection of immune cells, dead tissue, and bacteria. Abscesses can form anywhere in the body, but they love to form when a bit of bacteria sneak their way in between the hard hoof wall and the soft inner tissues of the foot. They can also form if your horse steps on something and sustains a small puncture wound which allows bacteria in. It always amazes me how much you humans miss being up there–the ground around horses is often hiding little nails, metal pieces, or other things that can injure your horse (or mouse!).

When abscesses occur under the skin due to injury, there is usually room for the skin and surrounding tissues to expand and swell. The veterinarians and technicians here at Springhill all get very excited when they get to “pop” one of these big swellings! But in the hoof, there’s a hard outer covering preventing major swelling. Still, the way to make the pain go away is to establish drainage. When the horses are lucky, that drainage happens out the bottom of the foot, but sometimes it comes out the top, near the coronet band.

The best thing you as the human can do to help your horse once it’s been diagnosed with an abscess is help to promote drainage. The doctors like to use epsom salts as a drawing agent. They even have a video to show you how use a baby diaper and secure it to your horse’s foot. Alternatively, you can soak your horse’s foot in warm water with epsom salts a few times per day. Usually I see ground feeders or other small buckets used for this–just once I wish they’d fill one up for me to have a little mousey soak without a giant horse hoof in the way.

So, let’s say you call the clinic to send a doctor out for your horse’s acute, non-weight bearing lameness. Let me talk about what you’ll see happen. First, they’ll ask you all about when you first noticed it, if you’ve given your horse any medications (don’t do this without asking first!), and if he’s ever had any hoof issues before. They might ask about when the last time the farrier was there too. Then, they’ll likely take a look and a feel of the leg and the hoof.

You may see them examine more legs than the one you think is the problem, and there’s a few reasons for that. It’s always easiest to tell what abnormal is when it is compared to normal, so the doctors may do a lot of compare and contrast of the different legs to help determine the cause. You’ll likely see them bring a hoofpick and a big, barbaric looking tool called a hoof tester. Hoof testers are used to apply pressure to specific spots around the hoof to look for reaction or pain.

Depending on how obvious the lameness is, the doctor may need to see the horse walk or trot, or they may perform diagnostic local anesthesia to isolate the problem to the hoof. If your horse has a very obvious soft or painful spot, the doctor may take a hoof knife and gently and carefully remove some sole. It’s very easy to do more harm than good with this, so it’s a strictly DVM endeavor.

Often, our veterinarians will need to take radiographs–otherwise known as x-rays–of your horse’s foot to look for the abscess location.

Whinny Wisdom: X-rays involve taking a 2-D image of a 3-D structure, so at least two views are always needed. Often 3 or more views are needed to see the problem in all planes and get an exact location.

Sometimes the doctor needs to sedate or even block the foot just to take those x-rays because the horse is so painful. But once they can find the location, they can give you a better idea of how long you’ll need to treat. And as Tony says, the good news with abscesses is that, almost always, once they are opened and drained, your horse will return to being happy and comfortable. He may be a cat, but even I have to admit he’s right most of the time. In addition to the diaper and/or soaking treatments, our team will likely put your horse on pain medication. The pain medication not only helps them feel better, but also encourages them to put full weight on the problem hoof, thereby squishing out the abscess.

So how do you prevent hoof abscesses? Well, you can’t prevent all of them, but regular trimming by an experienced farrier is a good start. In between trims, you should clean your horse’s feet every day with a hoof pick. And keep a close eye at mouse-level around your barn for nails, screws, or any other possible puncture risks. Any time your horse is lame, give the clinic a call and let us get you an appointment to figure out why.

That’s it for this week!

~Whinny

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If you have horses, chances are you will deal with a hoof abscess at some point. Have you noticed that horses can be pretty dramatic creatures, and don’t often keep their feelings to themselves? Horses generally have the opposite of a poker face, unlike cats. If that little pocket of infection is causing pressure in his hoof, he will definitely let you know about it! A horse with a hoof abscess can look almost as lame as if he had broken a leg.

It’s usually pretty good news if my doc comes out to see your 3-legged lame horse and tells you she found a sub-solar abscess. Of course you don’t actually want your horse to have an abscess, but compared to some of the alternatives, it’s generally a pretty easy thing for my docs to take care of. They would much rather be able to tell you it’s just a hoof abscess rather than an injured tendon or even a fracture. My doc will try to locate the abscess and open it up to drain it and relieve the pressure. Occasionally, she’ll need to soak or poultice the hoof for a few days to draw the abscess out. Usually, as soon as the abscess is drained, your horse will start feeling better and will be on the road to recovery.

But what if it’s not so simple? Most hoof abscesses are infrequent, uncomplicated, and resolve quickly. But there are situations where abscesses don’t behave how you want them to (very cat-like behavior, I admit). Some abscesses linger and don’t heal, and some keep coming back. Some aren’t just a hoof abscess at all, but a much more serious problem. You’ll want to know when your horse needs more than just the basic treatment, so you can avoid a potentially life-threatening situation. Here’s what you need to keep in mind.

The Repeat Offender

Once drainage is established, a “normal” hoof abscess should begin to dry out and fill in with healthy tissue, and your horse’s lameness should resolve within a few days. Some horses seem prone to abscesses though – you finish treating one and a couple months later, he gets another. If your horse seems to have abscesses pop up frequently, in the same foot or in different feet, there is usually a reason. Here are a few common culprits.

The first thing to do if your horse seems prone to abscesses is to check the hygiene of his environment and the condition of his feet. It’s important to provide a clean environment for your horse. Standing in manure, urine, or mud will degrade hoof tissue, and allow bacteria to enter the hoof and form an abscess. Horses with feet that aren’t in good shape can develop hoof cracks or white line disease, both of which allow an entry point for infection. Regular trimming (every 4-6 weeks) will help to maintain a good barrier. Make sure your farrier has the hooves well balanced and the toes don’t get too long. Those are common problems my docs see in horses with repeat abscesses.

Horses with chronic laminitis often have compromised blood flow to the feet, which makes it harder for them to fight off infections. Their white line is often abnormally stretched out, making it easier for bacteria to enter the foot. A horse with untreated Cushing’s disease may have a reduced immune system, making him susceptible to infections. He’s also prone to laminitis, making it a double whammy. My docs can check your horse out for laminitis or Cushing’s and recommend a treatment plan.

Another possible cause of recurrent abscesses in the same foot is a keratoma. A keratomas is a slow-growing benign tumor inside the hoof wall that can cause pressure necrosis of the bone, leading to chronic abscesses. You won’t see much from the outside, so my docs will recommend x-rays if they want to check for one. A keratoma can be removed surgically, and the hoof wall will grow back normally over time.

The Abscess That Won’t Resolve

This is a different situation from the repeat offender, and potentially a dangerous one. You think you find and drain the abscess, and your horse should be feeling better, but a couple days go by and he’s still quite lame. You may still see swelling and drainage as well. This abscess just won’t quit! You’ll want to take this situation seriously.

A ”normal” abscess is when the pocket of infection occurs in the area underneath the sole. Drain it through the bottom of the hoof, and it usually resolves without needing antibiotics. That’s how we want it to go. A deep abscess can travel up and burst out of the coronary band instead of through the bottom of the foot, which can take longer to resolve, and may recur if it doesn’t fully drain. Even an abscess that drained through the sole may recur if the hole seals over too soon or gets plugged up with dirt. The least severe possibility is that the abscess needs to be opened again.

Much more worrisome is an infection that has involved one of the important structures of the hoof, like the coffin bone, or a joint or tendon sheath. This can look like a regular hoof abscess in the beginning, but it doesn’t resolve when it’s drained. An infection of these structures is life-threatening, so you’ll want to have my docs out promptly if signs linger. A regular hoof abscess can develop into an infection of the coffin bone, called septic pedal osteitis, if it’s deep in the foot and isn’t able to find a way out. Septic pedal osteitis can also occur due to a puncture wound, for example if your horse steps on a nail. Don’t discount this possibility if you don’t see an obvious nail hole – they’re often very small and hard to find.

Another source of infection may be a coffin bone sequestrum, which occurs when a small piece of the bone dies and festers until it is removed. It’s also possible to have a foreign body like a small piece of wood or metal stuck in the foot. None of these scenarios will heal until the infected material is located and removed.

Anytime you suspect your horse has a hoof abscess, it’s best to call my doc out. Hopefully it’s just a simple treatment, but like with most horse problems, prevention and early intervention can help to keep things from getting worse and usually ends up less expensive than waiting to fix big problems.

Until next week,

~ Tony

P.S. If you want to learn more about your horse’s feet, check out some of the videos over on my YouTube Channel. My docs have a whole library for you over there. Don’t forget to Like and Subscribe, and tell them Tony sent you!