Treating the Dreaded Abscess

The first time my horse had an abscess I thought he’d broken a leg. He was standing in his field holding up his leg, refusing to put any weight on it.  I panicked. I called my (then) vet who came out and ran a battery of tests, including x-rays. Then my farrier showed up, snorted, and told me to fire my vet because it was crystal clear that it was an abscess. Ultimately, that abscess burst out the coronet band and left my horse uncomfortable for probably another week. With vet bills, it cost me $400!

Given that experience, you’d think that I would recognize the signs. But no. Yesterday morning when I went to feed my horses, I could tell that one of them was not quite right. It was just the way he was standing. He was resting his right hind and he looked, well, uncomfortable. This horse is very stoic and I just know when he looks pained, he usually is. Of course, a host of scenarios ran through my mind — pulled suspensory, kick, pulled muscle. But there was no swelling, no cuts and he looked sound at the walk. I took him out for a hack to see if he worked out of it, but a few steps at the trot convinced me he was not even close to sound. 

I called my current vet who suggested an abscess based on my description. Sure enough, that’s what it was. He got worse throughout the day, holding his hoof up and refusing to put weight on it. A friend’s farrier was in the area and by paring the hoof he was able to find some red tinted horn, indicating bruising, so an abscess was definitely brewing. 

Hoof abscesses are infections between the corium and the horn. The pus that occurs causes pronounced pain and lameness as the infection grows. Abscesses are caused when bacteria and moisture penetrates the white line, when a puncture occurs (for example, when a horse pulls a shoe and steps on a clip, or as a result of deep bruising.

The infection results in acute and sudden lameness, an increased digital pulse, heat in the foot, and sometimes swelling in the pastern or fetlock area. An abscess surfaces and drains either through the sole of the foot (if drained) or will bust out at the heel or the coronary band.

The standard treatment for hoof abscesses is to:

Locate the abscess using hoof testers to locate the sensitive area.

Drain the abscess. If possible, creating a way for the abscess to drain will result in a smaller hole that will heal more quickly. Typically, the farrier or vet pars the sole of the hoof the pressure from the abscess causes it to burst and the pus drains. At times, there might also be some blood. However, you do not want to dig a large hole in the sole, either. Often if the sole is thinned and you pick up the other foot, the added pressure can cause the abscess to break through, otherwise, you can soak the foot in hot water and epsom salts to soften the sole. Once the abscess drains, your horse should experience immediate relief.

Next, you should clean the hole with a betadine solution and pack the hole (defect) with betadine soaked cotton and then wrap the hoof (or put on a hoof boot) to keep dirt out of the hole.

Soak the hoof for 20 minutes once or twice daily in hot water and Epsom salts for several days, or until the horse is sound. The water can be quite hot. I like to heat it in an electric teapot. You add Epsom salts until no more will dissolve. I like to use a Davis soaking boot as I’ve had no luck at all trying to keep a horse standing with its hoof in a bucket! With a soaking boot, you can put your horse on the cross ties, or even in its stall during the soaking period.

Protect the hoof — and keep it clean — after soaking by bandaging it or wrapping it and covering it with a hoof boot. Here’s a link to a great photo essay on the best way to bandage a hoof. Keep it covered for about a week while the defect heals to keep dirt and bacteria from entering the hoof.

There is some debate as to whether chronic soaking (for several days) is an effective treatment. According to an article by Dr. Stephen E. O’Grady, an equine practitioner and farrier practicing in the Northern Virginia area, there is little documented research on the therapeutic value of soaking a horse’s hoof beyond the first 12-24 hours to localize an abscess:

There is no question that excessive moisture will damage the hoof wall. The more the foot is soaked, the more the hoof softens. The hoof wall quickly deteriorates, the wall begins to flake and separate and the loss of integrity allows it to expand or bend outward. At the same time, the white line width increases and the sole begins to drop and become closer to the ground. As the softening process continues, the horse begins to walk on the sole, creating another source of discomfort. Many times, this will mimic an abscess that has not completely resolved. It is believed that soaking damages the protective barrier on the foot (periople) and the widened sole wall junction thereby allowing additional microorganisms to penetrate and further damage the wall. Over-softening of the foot can potentially weaken it. The softened hoof wall does not hold nails well so it is difficult to replace or maintain a shoe on a chronically soaked foot. 

Chronic foot soaking for an abscess can actually prolong the healing process. In many cases, the pocket resulting from the accumulation of exudate from the abscess will be prevented from draining and drying up as the softened structures of the chronically soaked foot compress the affected area. 

Instead, he recommends applying a poultice.

The poultice provides a warm moist hydroscopic environment which stays in contact with the foot twenty-four hours a day but does not have the detrimental effects of continuous soaking. There are many good commercial poultices on the market. A medicated poultice [Animalintex®] is an excellent first choice when a poultice is indicated. The Animalintex® poultice, made of multiple layers of medication-impregnated cotton sheets, is immersed in hot water, the excess water is squeezed out and the poultice is applied to the foot, covering the ground surface and extending over the coronary band. The poultice has its own plastic outer covering to maintain heat. It is left in place for at least 48 hours. Moist heat applied to the coronary band may also help an abscess to break out spontaneously. 
Another useful form of poultice is a combination of wheat bran and Epsom Salts (2 parts bran and 1 part salts). This poultice is cumbersome but has certainly withstood the test of time. Packing the foot with Ichthammol or a combination of Ichthammol and glycerin is also used frequently with good results reported. 

Whichever poultice is used, it must be held in place with a bandage. An ideal foot bandage is a medium-sized disposable diaper covering the enclosed medication. For more padding, use multiple diapers. For a sweating effect, use plastic-covered diapers and duct tape. For more breathing, use non-plastic covered diapers and gauze bandage. The bandaged foot is protected as well as medicated. A rubber Easy Boot® can also be used for protection, but is difficult to place over a hoof that is bandaged with poultice.

What’s worked for me is to apply a poultice of Epsom salt paste and then putting an air-activated heat pad (like Thermacare) over it. The pad provides low-level heat for 8-12 hours. I then put vet wrap on to hold the poultice in place and cover it with a hoof boot. I have an oversized hoof boot that I use for this application; a hoof boot that fits normally won’t fit over a wrapped hoof. In my experience, this helps the abscess come to the surface. It also eliminates the need for repeated soaking. 

This last time it worked like a charm. Today when I came to the barn, my horse was walking more comfortably. 

9 thoughts on “Treating the Dreaded Abscess

  1. Hi there, I love natural healings. I just recently had a situation with my miniature donkeys. Elvis came up lame one day, limping but got worse. I first thought that it was an abscess and then 2 days later my other donkey came up very lame in the right front as well. Elvis by this time could hardly get up and in extreme pain
    I tried to doctor them myself for 1 week but Elvis got so bad he could hardly stand and Brutus would not put any weight on his right front. They were both lame within 2 days of each other which is very strange. I was scared that they had gotten into something so I called the vet. $300.00 later She said that at least one of them had foundered. Brutus who was so lame on the right foot looked like an abscess. Elvis (foundered) came around within 5 days but Brutus (abscess was very lame and very sore) I had been soaking in epsom salts for 2 weeks at this point and almost crying every time I went out. I was then speaking to a friend who told me that when he had cows with an abscess he would put on a white bread poultice. I thought that he was nuts but I had nothing to lose and it was cheap. I soaked it, then put 3 buns (good buns) on the sole of his foot and wrapped it up. By morning he was putting weight on his foot. I put another one on for the day and by the following morning, I came home from walking the dogs and both Brutus and Elvis were wrestling and playing like usual. I almost started crying and thanked my lucky stars for old remedies. Who would have thought? white bread….I love this kind of thing. Old remedies are fantastic. Please share this for me. It was just such a relief to see him playing and happy again. Elvis has fully recovered from his founder as well. I love them both. Thanks for letting me share this.

  2. Great write up on equine abscesses. As a farrier I consider it to be an area of great concern. It takes great care and skill to correctly deal with an abscess. Recognising the problem and calling the farrier and or vet promptly is the most important part. I find that abscesses occur more during wet weather, when the horn is softer. Almost always the cause is a stone bruise during these wet conditions when the horse mis-steps and steps akwardly on a rock. Penetration of the sole is not as usual as you might think. Only occasionaly I find the site on the sole with a little pairing. Mor often it is found with the hoof testers. I use a dremel tool to drill a small hole in the area I have determined. The horse gives a pretty definitive answer with only a slight squeeze of the testers. The hole is drilled and out comes the blood and puss. But if not, do not worry, Another hole may be drilled as they are small. But even if there is no sign that you have found the exact spot, you have given the abscess a channel to find, and the it always finds the path of least resistance. A poultice may now be applied for the next few days until it comes out. If you have drilled and found the spot. The site must still be covered and poulticed. The horse should recover within the week, as is usually the case. Keeping the horse owner involved and educated is very important, and a follow up call from the farrier after a couple days is important.

    1. i have opened the abscess up which has drained out and dryed up rapidly. his frog and horn was getting soft so after 3 days i left the bandage off however it looks better but he is still tender on the horn?? any help would be greeat (: thanks.

      1. From my experience, it’s pretty normal for your horse to be sore for several days after the abscess drains. I usually keep a hoof boot on (or wrap it) to make sure that no debris gets into the drainage hole.

  3. This is a great article. I wish I had found it and refreshed myself about a month ago, before I had the same situation happen. Like you, I also panicked and called the vet ASAP. It had been so long since I dealt with an abcess that I forgot how quickly and acutely they show up.

  4. I also object with placing the horse’s hoof in water for a long period of time as we had constant downpours of rain and the ground was sloshy, manure and urine in the horse’s shed mixed with rain and slosh was so unhealthy. I opened my concreted garage to the horses and let them use that for a stable. Both horses developed abscesses and the vet informed me it could well have been due to the continual wet ground. The horses feet had nothing dry to stand on. one of them was waving his back leg around and could not walk on it without great pain. I then discovered an abscess and when it burst he slowly began to recover. I have used the poultice of Epsom salts. The other horses has abscesses coming out of his lower leg and keep repeating. The vet has been out so much and he was given antibiotics. He is still going through another break out of abscess, on which I banadaged Epsom salts, betadine and petroleum jelly to keep on the mix and took it off the next day and found it draining. I read about using iodine with Epsom salts and will do so in future. I am still treating the wound, cleaning it with Apple Cider Vinegar and water, sometimes using betadine to wipe over it and it is taking so long. I figured we need to be constant with this as the horse relies on us to keep it clean. Love is about caring.

  5. we have a lot of mud this year and i’ve had two 2 YO come up lame.. The first was treated by a vet using a diapers soaked in antiseptic and a boot… He recovered w/o an abscess breaking hrough and then he became lame again and then recovered again. Now then 2 YO to go into training yesterday is lame and we have decided to treat him using ECHTHAMMAL plus the diaper and boot. I’m told by knowledable people that the ECHTHAMMAL willdraw the abscess to the surface so our farrier can open it up to drain..

    Also, does anyone think front shoes might help prevent this problem; at least until it drys out a little?/


  6. Hi – my poney was standind holding his hind leg up , got the vet out & he thought some thing had entered his frog, gave a jab of antibiotics , no better 2 days later , vet gave another jab & gave me antibiotic granules, next day i noticed blood had dripped down his hoof & relised it had burst through the cornet band , i put animallintex on & left over night , took of this morning , not much flued had come out . still holding his leg up but is putting weight on it now & again . has any one any idea how much longer it will take befor i see an improvement . it has been going on for ten days , it burst through the cornet band yesterday . any answeres much appreceated .

  7. HI my pony is very lame can not walk very well infection has burst out the coronet band after nine days , i thought now it had burst i would see an improvment , but he seems to be getting worse , shuffeling , other hind hoof is hot , is this because he is bearing more weight on it to rest the infected hoof . really worried , keep calling vet for advise , he said to call next week if no improvement , got farrier coming in three days . cant wait . ponyis 23 years old & is a lamanitic . now im worried he is going or allready has laminitis through the stress of this infection . has any one been in the same situation as me . if so please advise . thanks .

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