Horse Hoof Abscess Treatment

Learn How to Identify and Treat Horse Hoof Problems

Promoted by Vetericyn
Horse Hoof Abscess Treatment

By Heather Smith Thomas – Your horse is suddenly lame, with heat and swelling above the hoof. These signs might mean an abscess — a pocket of infection putting pressure on surrounding tissues — and require horse hoof abscess treatment. When it comes to this type of horse hoof problem, there are two types of abscesses: superficial abscesses that involve tissues just under the horn — beneath the hoof wall, the frog or sole — and deep abscesses that involve deeper structures of the foot such as bones, joints, bursa around the joints, and sometimes tendons and ligaments. These are often more complicated to treat.

CAUSES: Hoof abscesses have multiple causes including punctures from sticks, glass, nails — such as fence-board nails or misdriven farrier nails — or some other foreign body. Sole bruising, such as serious stone bruises, can also result in abscesses. Hoof horn defects or distortions can cause separation between the wall and sole, and if debris gets into that separation it may cause an infection that travels up the white line between the wall and inner tissues, to eventually break out at the coronary band.  Underrun squashed heels can become abscessed. Poor hoof conformation, with extra strain and stress on part of the foot, can weaken the structure and lead to an abscess.

Foundered horses may abscess; chronic founder leads to a flat sole that is more susceptible to bruising. Any flat-footed horse is prone to bruising when ridden on gravel or rocky terrain. If the bruise is severe, there is damage to tissues inside the sole and serum accumulates in that area.  Serum and damaged tissue make a perfect environment for bacteria to multiply and create an abscess if they gain access to that area.

An abscessed bruise breaking out at the top of the foot.

TREATMENT: Regardless of the cause, basic treatment for any hoof abscess is the same — after you determine the cause and try to correct it. If a foreign body (such as a nail, stick or sharp rock) is still in the foot, you need to pull it out, for instance. You won’t clear up an abscess until you get rid of the initial cause.

This horse with a foot in the blue bucket and ice water has a stone bruise that has not yet abscessed and the ice-water is being used to reduce the pain, heat, and inflammation and possibly prevent an abscess.

You also have to establish drainage. Locate the abscess, open it up, get rid of the pus, and get medications into that area. Many hoof abscesses are under pressure, because of a buildup of pus, and pressure causes a lot of pain. It’s like a swelling or infection under your thumbnail or toenail; it hurts excruciatingly because it can’t expand. The swelling is encased under a solid structure.

It’s important to establish adequate drainage, but this should be carefully done so you don’t interfere very much with the integrity of the hoof. If you make a huge hole it takes longer for it to heal and close up.

It’s often a fine line between what’s adequate (to allow proper drainage without the hole closing up before all the infection is gone) and too much. If you are unsure, have your veterinarian do it. He/she will be thorough — so that everything drains away and the infection clears up — but a small enough hole that it can heal quickly.

Once the infection is opened and drained, it should be soaked daily for 20 to 30 minutes for a few days, to draw out any remaining pus, so the area can begin to heal. Use of a soaking boot or standing the horse with his foot in warm water and Epsom salts work well, but some of the newer antiseptic soaking compounds (like chlorine dioxide) work even better than Epsom salts.  With a deep abscess, your veterinarian may recommend systemic antibiotics to battle the infection from both outside and inside.  A wound spray can be squirted into the abscess hole after draining and soaking, applying it each time you finish soaking the foot.

Soaking a foot (after the sole abscess was opened and drained).


Soaking with chlorine dioxide solution in a thick plastic bag.


Bandaging the foot after soaking.

With proper horse hoof abscess treatment, most hoof abscesses, if adequate drainage is established and you can get proper medications to the site of infection, clean up and do well in a few days. The horse is usually much less lame by the second day, with the pressure relieved, and it’s just a matter of making sure there’s no infection left in the hole. If the horse is not healing up and doing well within a week or two, there’s an underlying problem (more than just an abscess) and it’s not going to heal on its own.  You need your veterinarian to find out what’s at the root of the problem.

DEEP PUNCTURE WOUNDS: If your horse steps on a nail (if a board comes off a fence or some other structure) or some other sharp foreign object, contact your vet. You may need an x-ray of the foot while the foreign body is still lodged there — to know exactly how deep it went and which structures it may have injured.  If it’s not still lodged there, the veterinarian may squirt opaque material into the puncture, which will show up on x-rays, giving a picture showing the path of the nail.

It’s best to do this immediately. If you simply try to soak the foot for several days and the foot keeps getting worse, it becomes a surgical issue, where the veterinarian has to lay the horse down under anesthetic and remove the dead tissue.  At that point, it becomes a life-threatening condition.

If a horse comes into their clinic with a deep nail puncture most veterinarians horse hoof abscess treatment as a medical emergency. They anesthetize the horse and do a roto-rooter type of surgery, figuring it’s safer to cut a nice clean hole in the foot rather than waiting to see if the horse develops an infection. By the time an abscess forms, it may be a lot more serious. If the horse’s tetanus protection is not current, he should immediately have a booster shot.

Less common are abscesses caused by misdriven horseshoe nails. In this instance, the shoe is usually removed, and a hoof tester used to determine which nail created the problem.  Once the site is located, it can be opened more fully to drain and treat.

A hoof tester being used to pinpoint a sore area under the sole (possible abscess).

PROTECTING THE AREA: After you’ve opened and drained the abscess you need to bandage the foot to protect the hole between soakings. Once it’s no longer sore you may want your farrier to put on a shoe (if the horse is barefoot) and a pad to help protect the foot, or use a hoof boot.

A shod foot with neoprene pad to protect a hole in the sole (from a healed abscess) until the sole grows in.

If the horse’s sole or frog is tender because you had to open up an abscess and there’s a hole there, he won’t want to stand on it.  But if you protect the tender area, the horse will bear weight on it more readily. Weight-bearing and walking around really increases blood circulation in the foot and facilitates quicker healing.

If a stone bruise abscesses and you had to make a hole in the sole for drainage, it takes a while for the sole to regrow and the hole to fill in. The infection may be gone within a few days, but without protecting the area you may not be able to ride the horse for weeks or months while waiting for the sole to regrow. The foot is perfectly sound, but the horse can’t be ridden in rocky terrain because of the sole’s vulnerability. If a shoe (or shoe with pad) can cover the hole, the horse can continue work while the sole regrows.

If you aren’t riding the horse, some of the new hoof boots are helpful to protect the horse’s foot. Some people still use padding like baby diapers (on the bottom of the foot), taped on with duct tape. This will protect the hole in the sole from mud and dirt but is not enough protection to allow the horse to be ridden.

If the abscess is extensive and the vet had to dig deep into the foot, ending up with a large hole, he/she may apply a shoe with a treatment plate — a piece of thin metal or aluminum attached to the ground surface of the shoe with screws — to allow access to the bottom of the foot for any additional horse hoof abscess treatment or to allow for checking on the hole in the sole while still protecting it from external contamination and trauma.

Shoe with metal to weld onto it.

Have you had to administer horse hoof abscess treatment in your herd? Let us know about your experiences in the comments below. Countryside Network is a great resource for horse tips!

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