FAQ – Hoof Abscesses

By Dr. Alicia Nolfi

There are a several common reasons why horses get abscesses. Mechanical reasons would be: excessive quarter loading causing terminal papillae to be stretched and essentially white line disease in the quarters (although we don’t usually call it that, but that’s what happens); White Line Disease at the toe which can be caused by club foot syndrome; thin soles due to club foot syndrome or crushed heels or chronic laminitis. Non mechanical reasons are: excessively moist conditions causing WLD, or a simple puncture wound.

Here is what I do for an abscess – have seen too many go south without aggressive treatment. (They have 3 days with me!) One of the most important parts is addressing the mechanics of the foot. If we don’t address and attempt to correct that, we still have the excessive load on that area of unhealth, and decreased perfusion.

1. Identify the region and attempt to establish drainage asap. This is either through the coronary band via hot animalintex poultice pads around entire CB secured in place with bandage material every 12 hrs; or investigate the terminal laminae for stretch or fissures and probe those areas to see if infectious material comes out – if it does then probe a little deeper to est a drainage tract. (This way I am staying away from opening a hole in the sole that will need to be treated). I don’t routinely soak the foot bc it ends up being a bacterial soak – if for some reason I need to soften the sole I use my hot animalintex poultice pads there.
2) If this has not made the horse almost completely sound in 3 days, I get much more aggressive and XRay The infection can spread to deeper tissues. It is preferable to not have this happen. Using radiographic guidance (and if that doesn’t help me then I use a venogram to specifically localize the optimal place) to create surgical drainage and possible infected tissue debridement I proceed with opening an area for that. If it has to be through the sole, then I create a hospital plate for daily antiseptic wound care with FIRM betadine soaked gauze packing into the hole. Prolapsed sole corium is extremely painful so you have to pack that hole very firmly. Takes about 30 days for sole corium to grow good cornified sole so that the hole is no longer open to the sole corium. Additionally, prolapsing sole corium is an impediment to healing – strangulated sole corium can’t make cornified sole.
3) FIGURE OUT WHY THE HORSE HAD AN ABSCESS – could be as simple as a puncture wound, or commonly can be due to things like club foot syndrome and white line disease, excessive quarter loading from crushed heel syndrome, lamellar scar tissue, other areas of chronic underperfusion (of blood) or damage.
4) Once I have identified the likely reason for the abscess I address the underlying cause, and apply the appropriate mechanics and podiatry to the foot, to unload the unhealthy area to create an optimal environment for nutrient delivery to infected tissues, via blood flow (perfusion). Another good thing about doing the venogram is that you can visualize this.

Please follow the hashtag #HVChoofabscess to post any questions related to the topic on that FAQ Post.

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