Hoof abscesses in horses 

A hoof abscess is a painful, pus-filled infection that forms between soft, sensitive tissue and the hard outer layer of the hoof. Abscesses are a common cause of severe, sudden-onset lameness. Fortunately, most abscesses resolve quickly with proper treatment.  

Cause 

Abscesses are caused by bacteria entering the hoof and becoming trapped. There may be no obvious reason that a horse has developed a hoof abscess. However, they are more likely to occur if the hoof is weakened due to:  

• A stretched white line or seedy toe  
• A puncture wound (potentially from improperly placed shoe nails)  
• Tiny cracks in an overly dry or very soft hoof wall 
• Bruises that can be caused by stepping on stones

Moisture, dirt, and bacteria then enter the hoof, triggering an immune response that includes inflammation and build-up of pus. This creates pressure within the hoof cavity and can be extremely painful for the horse. 

Signs of an abscess 

Abscesses can affect any hoof but are more common in the front feet than hinds. Depending on the severity of the abscess, signs can include: 

• Heat in the hoof
• A bounding digital pulse in the pastern or towards the back of the fetlock, on either side of the leg
• A swollen/filled lower leg
• Sudden-onset lameness, including being non-weight bearing on the affected leg
• Signs of severe pain/distress such as elevated temperature and loss of appetite
• The horse may also change the way they put the foot down, to avoid putting pressure on the painful area
• If the abscess has already burst (most likely around the coronary band or heels), there may be an open, pus-filled wound

If an abscess is suspected, first inspect the hoof thoroughly to ensure there are no objects, such as nails, lodged in the sole. If there is a foreign object penetrating the hoof, if possible, try and leave it where it is until the vet arrives to remove it safely.  

Abscesses should be treated by a vet and/or farrier, as it is important to accurately diagnose any lameness or suspected pain. While hoof abscesses are common, similar signs can be caused by more serious problems such as tendon injuries, laminitis or fractures, all of which require veterinary intervention. Vets can prescribe medication to relieve pain. If the horse is shod, a vet or farrier may need to remove the shoe to properly inspect the hoof. A vet should be contacted if a horse suffers from recurrent abscesses as they can look for, diagnose, and treat any underlying causes.  

Treatment

The key to treating abscesses is to establish drainage. Vets or farriers can use hoof testers to help locate the abscess. Paring away some hoof in this area may allow the abscess to drain. However, if the abscess is not located, large amounts of sole should not be removed as this can prolong recovery. Instead, soaking the hoof in warm Epsom salt baths once or twice a day and/or poulticing the foot can encourage the abscess to burst. Poultices can make the hoof more comfortable by providing padding. It is important that the bandage is not too tight over the coronary band – make sure that you can comfortably insert a finger all the way around the hoof between the coronary band and the bandage.  

Movement is beneficial as pressure changes within the hoof can help the abscess to drain. However, it is important to keep the hoof clean by using a waterproof poultice wrap/boot, and by turning out into a clean, dry area. 

Once the abscess bursts, the horse is likely to experience immediate relief and improvement in lameness. It is important to keep the area clean until it has fully healed. Your vet or farrier can advise on the best way to do this in your specific circumstances (abscess location, environmental conditions, etc.).  

Antibiotics are generally not recommended in the treatment of foot abscesses as they do not improve healing in uncomplicated cases. However, protection from tetanus is very important. If the horse has not received a tetanus booster vaccination recently, or is unprotected, your vet will be able to advise you on the best way to provide immediate protection. 

Risk factors and prevention  

Any horse can get a hoof abscess, though some are more vulnerable than others. Risk factors include: 

• Thin soles
• Cushing’s disease (PPID); horses with Cushing’s disease may experience recurrent abscesses, as well as other infections
• Laminitis
• Living in very wet, muddy conditions or very dry conditions, and alternating between the two environments (e.g., wet fields and dry stables); it may be helpful to brush off mud instead of rinsing it off and muddy fields could have hardstanding areas and shelters to provide a dry place to stand
• Poor hoof care: long hooves that flare can stretch the white line making it vulnerable to entry of dirt and bacteria – it is therefore important to provide regular hoof care
• Poor nutrition could be a factor in repeat abscesses; work with a nutritionist and/or vet to ensure that a proper diet is being provided