Treating a foot abscess.

I'm interested in people's responses too... My mare had an abscess a few months ago and went 'broken leg' lame, the farrier only had to scrape her sole and found the exit point. Anything that required 'digging' I'd let it work its way out.
 
paulineh said:
I have always had mine dug out . Tubbed and dressed
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I've always taken the farrier's advice with these things........ the problem is that if they're "left to rot" then they'll look for an escape route, and can explode out through the coronary band. This happened with my old boy, he was laminitic/cushinoid and was always having absesses. In the worst case scenario you can get total hoof separation and infection setting in. I'd far rather the damn things were dug out and allowed to drain, then tubbed and dressed. Much much better.
 
I always leave them to find their way out, because my experience is that once they have come out of the heel bulb or coronet band (as is usual, more often through the heel) the horse is sound and back in work much quicker than if they are dug out.
 
Not digging for the abscess is the barefoot preferred method of dealing with them according to some practitioners. However, some farriers claim that not digging for them and allowing them to break out is neglect, and could render owners or trimmers to allegations of causing unnecessary suffering.
Personally, I'd go for not digging as I think it is detrimental and prolongs recovery significantly.
 
Where do we get 'digging out' from? Do you really think its right to allow a horse to hobble around in excruciating agony (anyone who has had a tooth or jaw abscess will testify to this) while the pressure from an abscess constantly increases? Or does barefoot ideology transgress your horses comfort?
The vast majority of abscesses show evidence of their point of entry. Anyone with a trained or experienced eye can usually isolate the area of pain, search for the point of entry, locate it and relieve the pain in a few minutes. In most cases they give away their presence by horn infection, usually a black mark (where mud has entered following the bacteria or some other foreign body) and following that leads to the seat of the abscess.

By way of warning, leaving an abscess break out can lead to damage of the horn producing surfaces which is permanent, I have in the past removed nearly 100ml of pus from an abscess that was left to break out which ulcerated the sole causing permanent damage and rendering the horse continuously lame due to constant further breaches of the damaged sole. If the horn producing surfaces are damaged, the horn that is produced by the damaged area can leave open holes or weaknesses that allow penetration through to the underlying tissues, especially when liquid mud is around. There may well be a foreign body present causing the abscess like a hawthorn or the broken tip of a rusty nail. Leaving this kind of thing present can and has in the past led to bone infection and subsequent destruction.

As someone has already pointed out legally it is classed as neglect, and farriers are only strictly allowed to carry out first aid treatment and refer it to the vet for further action, although most vets generally hand over foot issues to those farriers that they trust to do the right thing. A courtesy call to the vet is always required though.
 
Graeme I understand your point about the pain which is obviously severe if the horse is bearing weight on the foot, but the total time from start to finish needs to be counted into the equation, and my experience, which is zero to do with any barefoot mantra, is that horses that break them out for themselves after a day of 'crippling' lameness recover much more quickly with no hole in the sole.

You are a farrier and your clients also expect you to 'do something' which puts quite a lot of pressure on you.

You are obviously very highly skilled. My own experience of several farriers in different areas is that they are not as good as you at getting the infection out first time. And don't start me on vets, who are sometimes happy to dig a trench :)!

None of us would, I hope, advocate leaving a horse in severe pain, which I would count as clearly walking lame, for days on end. But one day, rather than cut a hole in the sole and days of box rest and poultice? Yes, I'd take that option every time.
 
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Having watched the pain and misery a horse was put through last winter because the YO decided he didn't need treating I would personally now opt for treatment. Same YO's horse had an abscess and it was treated (dug out by farrier) and the horse displayed nothing like the level of discomfort the untreated horse had shown.
 
Good to hear from a farrier on here about this subject! Hoped one would respond.

Personally....... if there's a problem with the foot, I'd ask the farrier to take a look at my two instead of calling the vet, in the first instance. Then if farrier feels its a vet-job, all well and good, but IMO the farrier is the one who's dealt with their feet and knows their condition, and I'd far rather the farrier do his "render first aid" stuff sooner rather than later rather than let something develop inside the foot and before you know if you've got a mega-big problem which you've left too late to sort.

You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!
 
MiJodsR2BlinkinTite said:
Good to hear from a farrier on here about this subject.

You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!
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Absolutely. And a pain I can identify with having had an abscess which took days to pop but when it did ; whew the relief.
 
MiJodsR2BlinkinTite said:
Good to hear from a farrier on here about this subject! Hoped one would respond.
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There are farriers who do not agree with Graeme's opinion.

You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!
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Would it also choose the box rest and poulticing?

The horses I've had treated by cutting a hole in the sole were lame for a minimum of four days to a maximum of six weeks afterwards. Those I have allowed to blow on their own have been ridden, sound in trot on roads, within a maximum of 48 hours and sometimes on the same day.

It is the totality which counts, plus the likelihood of complications, not one moment of release from serious pain to lesser pain.

I wish the Farriers Registration Council would get off their backsides and do some proper research into what the best way to treat a foot abscess for a trouble free resolution is.
 
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amymay said:
It totally depends on the nature of the abscess.
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^^^ This^^^

Every case should be treated on an individual basis.

Sometimes nature isn't best and the horses need a helping hand and other times it's best to let it burst on it's own.

The onus is on the owner to either have enough knowledge and/or experience to make that call or have someone on her "team" who does be that a vet, farrier or trimmer.

I'm guessing this question is being asked after the thread on a NHCP Facebook page? I have to say I think the blanket advice & recommendations that they are handing out as gospel are dangerous. They may know when to leave it and when to get a vet out but going by some of the replies their followers clearly all don't. One woman was posting about how lame her horses was, so bad that her FRIEND wanted to call the RSPCA on her. But don't worry; said woman was giving the horse bute - a contradiciton to abscesses (and horse still THAT lame on bute?!).

A little knowledge is dangerous and people marketing themselves as professionals should know better.
 
cptrayes said:
There are farriers who do not agree with Graeme's opinion.

The horses I've had treated by cutting a hole in the sole were lame for a minimum of four days to a maximum of six weeks afterwards. Those I have allowed to blow on their own have been ridden, sound in trot on roads, within a maximum of 48 hours and sometimes on the same day.

It is the totality which counts, plus the likelihood of complications, not one moment of release from serious pain to lesser pain.
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I think every situation is different and there is no black and white answer. The first time I had an abscess being very innocent and finding my horse in pain on 3 legs I called the vet. The vet didn't share my panic, advised me to soak it, poultice it and let it take it's course. I prevaricated about antibiotics, pain killers and cutting it out but the vet thought poulticing and soaking for a few days was best. I did that and it soon resolved. Luckily I have a vet who is not into cutting feet appart for the sake of it.

One of my others has just had an abscess for no apparent reason. It looked very much like an abscess so I immediately went into the soaking, poulticing and walking routine. Did several walks in hand with a poultice in a boot. The next day I picked the foot up to poultice and it had exited already. More poulticing and lots more walking with his poultice on this time ridden as he was perfectly sound to carry me. We lost 1 days riding and even on that day he was exercised in hand.
All I have to do now is make sure the exit area doesn't rub against the boot when ridden, the sole is perfect. Just as well as he tramps around a gravel yard all day otherwise I would have weeks of booting to protect it.
 
I generally work on the theory if it's going to come out on it's own it'll come out pretty quickly.

So when I first suspect an abcess I'll generally call the farrier immediately, forewarm them and ask where they will be over the next 24-48h, i.e. are they in my area?

Then tub and poultice. Sometimes they burst naturally and quickly, and that would be my preference. Sometimes they don't, and in that instance my preference would be to let the farrier to try and locate & release it rather than risk ongoing pain and further more serious complications for the horse.

What I am against is people writing on forums in absolute terms. The problem is that some novice or numpties do read things on the internet and take them as gospel.
 
amandap said:
Perhaps the dentist should have opened it to drain? Sorry, couldn't resist. ;) :D
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My dentist did just that and the relief was immense. I wish I hadn't put up with the agony for 4 days beforehand.

However regarding hoof abscesses, I agree with TPO.

My old school vet sorted an abscess out last year with a deft cut and gave her considerable relief. For her it was efficient and humane, but it depends on the situation.
I think to say all abscesses should be left is risky. Its better to seek advice from a vet or farrier for diagnosis rather than giving the impression to owners that letting nature take its course is always the right option.
 
I rarely ever get an foot abscess on this yard have had a few always after they cut the blackthorn hedges but once worked on a few yard with sawdust bedding and they got them a lot always we always got them dug out .
My vet and I shared a mare and it belonged to let it out itself person before we got her the sole was so underun and damaged by little pockets of pus tracking about my friend removed the whole sole and kept in and dressed until she was well on the way of growing a new one.
We changed her diet and management a fair bit verses how she was kept before and never had an issue again.
 
cptrayes said:
Graeme I understand your point about the pain which is obviously severe if the horse is bearing weight on the foot, but the total time from start to finish needs to be counted into the equation, and my experience, which is zero to do with any barefoot mantra, is that horses that break them out for themselves after a day of 'crippling' lameness recover much more quickly with no hole in the sole.

You are a farrier and your clients also expect you to 'do something' which puts quite a lot of pressure on you.

You are obviously very highly skilled. My own experience of several farriers in different areas is that they are not as good as you at getting the infection out first time. And don't start me on vets, who are sometimes happy to dig a trench :)!

None of us would, I hope, advocate leaving a horse in severe pain, which I would count as clearly walking lame, for days on end. But one day, rather than cut a hole in the sole and days of box rest and poultice? Yes, I'd take that option every time.
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OK cp, perhaps I was a little harsh. I apologise.

I agree that there are farriers that leave a little to be desired. Unfortunately that is true of every walk of life, and I do know that the powers that be are making great efforts to put this right.
With regards to abscess treatment, I would say this. Its not necessarily that horses will need to spend a long time on box rest following abscess investigation/treatment. The important thing is to remember that this is an open wound, and treat it as such. Once the pus is released, I tend to explain to clients that healing is a two stage process. Firstly, encourage the pus to competely evacuate, which means keeping the area wet and clinically clean usually by poultice, which discourages the wound to close. Usually this takes a few days, four is what I encourage, to make sure that all is gone. Then you need to encourage healing, which will begin the growth of a skin over the area to discourage any further infection or entry of foreign matter. That requires the opposite, drying action, for which I usually suggest dry dressing the wound. Generally within a week to ten days the horse can be back to normal.

Personally I hate box rest. Usually I recommend a concrete area where air can circulate, keeping things dry, I am lucky enough to have such facilities at my disposal, but I know many of you do not. An Equiboot or poultice boot is invaluable in these circumstances, provided you can keep the mud out and keep it on, your horse can usually be treated quite normally while the healing process goes on.

I know you are not keen on treatment by farriers. Thats OK, use a vet - its not always that they dig massive holes, and they are approachable, let the vet know your concerns, and one thing they have learned from farriers is that we like massive holes in feet even less than you do! So many vets are now learning not to expose massive areas of sensitive tissue, apart from anything else its simply not necessary to get the job done, and if a large area is exposed it takes longer to cover making re-infection a real likelihood, especially in these present very muddy conditions.
 
I called the vet when my horse came in on 3 legs at the end of August, I had really (very luckily!) never experienced this before and thought it was a serious hind limb issue and not foot related (naïve)! Vet came and advised it was foot related and cut a rather large hole in his hoof, after a couple of week he was sound, it was dry and I began exercising gently and building up. I thought we had cracked it, unfortunately he has come in again on 3 legs so I think the wet/muddy weather has infected his foot again, I was using Hoot Stuff but I think the wetness has breached this. So I have flushed it out and am poulticing again, he will have to stay in to ensure it keeps clean and if he still uncomfortable I will phone the vets - am I missing anything is there anything else I need to be doing? Thanks
 
Liquid mud is a pain janei, it sounds like it has crept in to the area you have been trying to heal. You are doing the right thing, contact your vet if your current action does not result in an improvement of your horses condition. While wet and warm conditions prevail, abscesses are likely, although I would say this is a fairly long time (August to October) for healing, most horses in my experience have grown quite a bit of horn since August.
 
Thanks very much for your reply Graeme, I do agree it is a long time but sorry forgot to include that the issue started with a grass crack in hind which has obviously let the liquid mud back in to re-infect and is still very much there - its been a learning curve and one that has sadly been uncomfortable for my horse! If he is not comfortable in a day or two I will re-contact vet. Thanks again for advice and sorry op for hijacking thread :-)
 
I wonder if the situation in shod horses is different to those who go without due to the movement (or restricted thereof) of the hoof/difference in blood flow affecting the speed of progression of the inflammatory response and how long an abscess will take to blow on its own... I would guess that the same likely applies to speed of healing and reluctance to dig at particularly thick soles so perhaps shod and not aren't that comparable.
 
Shod hooves are weaker, thinner doled and less sensitive, than proper barefoot hooves. I think when shod horses go lame, the situation is bad. Barefoot horses will feel less of an abscess sooner.
This must affect treatment I'd have thought.
 
I wondered about this too. I've had a couple blow from the heel without the horse ever being lame, and my impression, if anything is that barefooters are bothered by them later, perhaps due to the thickness of sole preventing pressure on them until later in the process. Which would also fit with my impression that they blow quickly too, hence the lack of need to dig holes in the sole.

This really should be being researched, I wonder why no one has done any.
 
I'm wondering as well about barefoot v shod. However the mantra for most BF horse owners is movement in everything. I suspect most wouldn't confine them to a stable for an abscess so perhaps constantly moving to push the gunk out could help.
 
I'm convinced movement speeds up the process no end. I'm of the opinion, that movement, poulticing and pain relief is the answer to getting a swift solution without having to cut into the sole.
 
Pale Rider said:
I'm convinced movement speeds up the process no end. I'm of the opinion, that movement, poulticing and pain relief is the answer to getting a swift solution without having to cut into the sole.
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What pain relief do you use PR? I don't think anti inflammatories like Bute are a good idea,as they can suppress the inflammation you need for it to eat its way out. I assume you are using something else?
 
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