Treating a foot abscess.

amandap said:
I am very interested in this, please could you point me to the paper or research?


Being a pedant :o, an abscess is a contained capsule(if you like) of infection/necrotic tissues, that is where much of the pain comes from as the pressure builds. It is not an open wound until it is breached/opened. I am very unconvinced most abscesses are caused by puncture or ingress of foreign matter such as gravel.
I am convinced abscesses can be caused by trauma, poor circulation or compromised hoof structure, as well as puncture, leading to damaged and necrotic tissue. After all tooth and other body abscesses in humans aren't usually caused by puncture are they?

ps. Yes, sequestra is the word I couldn't remember.
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A sequestra is a piece of dead bone that becomes necrotic. The most common cause for the necrosis is a bone infection such as osteoporosis. Are you suggesting most abscesses are caused by bone degradation and not a breach of the horn (which can clearly be seen in the case of janei's pictures).
Tooth and body abcesses are caused by the entry of bacteria or organisms that are foreign to the body into the sensitive structures, usually as a result of decay or gum disease, so yet again it is a breach of the natural defence mechanism. As are the majority of foot abscesses. I have already explained how this works in detail.

If you have never seen pictures of equine animals such as wild Zebra, who are probably as close to wild horses as you can get, being hunted by lions or hyena I would suggest David Attenborough could help you out. Suffice to say that any animal without its full running capability would not last too long. Horses have been prey animals for millennia, relying on fleet of foot and fast response to stay alive, any with even a temporary ailment such as an abscess would be picked off as easy meat. Even Britain had its fair share of predatory hunters, wolves and the like, just because they dont exist now doesnt mean they never did, any sick horse would have been an easy kill just as a sick lamb is currently to a fox.
 
I have seen a horse almost die from an untreated abcess, the whole sole became under run and the horse was crippled lame.

to suggest mud is an adequate poultice on an open forum is just dangerous.
If this was the case we could slap it on puncture wounds all day long!
 
I would suggest that very many abscesses are caused by necrotic laminae from sustained low grade laminitis due to excess carbohydrate in the diet.

No entry point there, either.

Graeme you seem utterly determined to believe that all foot abscesses have an identifiable entry point. I can't believe that's really your experience, because its not mine.
 
charlie76 said:
I have seen a horse almost die from an untreated abcess, the whole sole became under run and the horse was crippled lame.

to suggest mud is an adequate poultice on an open forum is just dangerous.
If this was the case we could slap it on puncture wounds all day long!
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No one on this thread suggested leaving an unopen abscess untreated for long enough to cause that sort of issue.

Whether you like the idea or not, leaving a horse standing in wet mud with an unopen abscess is a great poultice to encourage it to break open. Your choice is then to keep it clean. Mine, because the blood barrier has not been compromised by the natural opening of an encapsulated abscess, is to continue to turn the horse out and disinfect regularly as a precaution. I have never had a problem from doing this. The only one I ever had a problem with was opened by a farrier and poulticed as recommended.
 
Graeme Burt farrier said:
A sequestra is a piece of dead bone that becomes necrotic. The most common cause for the necrosis is a bone infection such as osteoporosis. Are you suggesting most abscesses are caused by bone degradation and not a breach of the horn (which can clearly be seen in the case of janei's pictures).
Tooth and body abcesses are caused by the entry of bacteria or organisms that are foreign to the body into the sensitive structures, usually as a result of decay or gum disease, so yet again it is a breach of the natural defence mechanism. As are the majority of foot abscesses. I have already explained how this works in detail.

If you have never seen pictures of equine animals such as wild Zebra, who are probably as close to wild horses as you can get, being hunted by lions or hyena I would suggest David Attenborough could help you out. Suffice to say that any animal without its full running capability would not last too long. Horses have been prey animals for millennia, relying on fleet of foot and fast response to stay alive, any with even a temporary ailment such as an abscess would be picked off as easy meat. Even Britain had its fair share of predatory hunters, wolves and the like, just because they dont exist now doesnt mean they never did, any sick horse would have been an easy kill just as a sick lamb is currently to a fox.
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No I am not suggesting abscesses are caused by sequestra, it was one I meant to add to the list. Bone and other tissue often dies due to loss of blood supply be that due to infection, inflammation, toxicity, mechanical stress etc.
I wasn't aware osteoporosis was a bone infection, my understanding is osteoporosis is weakened bone due to loss of structure.

Microbes can only get into the hoof through puncture or by compromised external hoof structure eg. cracks, compromised white line etc. or via blood stream. A healthy hoof is very resistant to microbial invasion.

I am aware of how the prey predator mechanism works but I was interested in your statement that most wild horses die because of abscesses and wondered how you found this out?
 
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Graeme I think you'll find that the most common cause of sequestra in horses is not osteomyelitis(bone infection) or osteoporosis, but blunt force trauma from a kick or knocking a leg on something. My horse got one rolling in her stable overnight.
 
cptrayes said:
I don't bother. Mud is quite a good poultice :) I just squirt in hydrogen peroxide at 3% as hard as I can twice a day.

I have one out in the mud right now with a puncture wound in the sole.
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this is what you said. The person in which you replied to asked how to keep mud out of the 'holes in the hoof'
this suggests it is open
you then suggest using mud as a poultice on these 'holes'!
 
charlie76 said:
this is what you said. The person in which you replied to asked how to keep mud out if the 'holes in the hoof'
this suggests it is open
you then suggest using mud as a poultice on these 'holes'!
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The horse has a hole in his sole, waiting for the solar corium to produce horn to replace it. Encapsulated abscesses have no blood supply, which is why the horse does not develop septicaemia. I do not advocate turning horses out with bloody foot wounds.

But then I don't advocate giving them bloody wounds in the first place.
 
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How do you know that?you have not seen the horse in question, just photos. you have no idea of the level of lameness . you shouldnt be advising such things without actually seeing the horse in question.
suggesting using mud as a poultice could kill it .
 
I think some sub solar abscesses can come on quickly so it's presence under the whole sole isn't necessarily due to being untreated. Trauma to a thinner sole causing bruising/bleeding is a main cause of these types of abscess I believe. The sole may not have been punctured at all.

Not all abscesses are due to infection. There's a statement to stir things up!
 
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charlie76 said:
How do you know that?you have not seen the horse in question, just photos. you have no idea of the level of lameness . you shouldnt be advising such things without actually seeing the horse in question.
suggesting using mud as a poultice could kill it .
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I can't be bothered to search for it, but I believe the person was saying that their horse had an abscess which was resolved and the horse was ready for turnout, but how could they keep the mud out of the hole the farrier had cut???




ps I haven't seen any photos.
 
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amandap said:
No I am not suggesting abscesses are caused by sequestra, it was one I meant to add to the list. Bone and other tissue often dies due to loss of blood supply be that due to infection, inflammation, toxicity, mechanical stress etc.
I wasn't aware osteoporosis was a bone infection, my understanding is osteoporosis is weakened bone due to loss of structure.

Microbes can only get into the hoof through puncture or by compromised external hoof structure eg. cracks, compromised white line etc. or via blood stream. A healthy hoof is very resistant to microbial invasion.

I am aware of how the prey predator mechanism works but I was interested in your statement that most wild horses die because of abscesses and wondered how you found this out?
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Yes Id agrere a healthy hoof is resilient, but horn is an organic material and like any organic material it can be destroyed by organisms and consumed. Dogs can digest it. There are organisms that specialise in doing so, and when conditions are right (wet and warm) they multipy exponentially and are capable of penetrating even healthy hooves. Do you think dogs will refuse to eat healthy hoof on the grounds that it is so? Cracks are often started by organisms infecting the underlying wall. Overmoisturising softens horn encouraging it to stretch and seperate allowing bacteria into enter the underwall which is softer than the outside wall and as they eat further up the holes they leave behind fill with mud which conducts fresh moisture in enabling the organisms to mulitiply further.
As they get further up the tract they get close to and breach the sensitive, allowing other organisms to enter and other foreign matter. The body reacts by creating an abscess to reject the foreign matter just as it would if it were under the skin.

The vast majority of the abscess I have opened has been caused in this way. All of the vets I have worked with also find this so. All of the othe farriers as well. And no, I dont get loads of blood or create massive holes when I have opened them, the purpose is to relieve the pressure and not to create further problems or allow more mud to enter.

Bone rarely dies, and sequestra are very rare. Treatment for necrotic bone of this type requires surgical removal of the source necrotic bone, not merely poulticing. It would also be another argument for not leaving an abscess to take its course. I have dealt with a few horses that have had fractures of the pedal bone and while it can be pretty painful, an abscess resulted in only one case, and that was a horse that had to have two screws put in his pedal bone to hold it, requiring surgical intervention and removal of some of the sidewall which subsequently became infected. Of the six or seven others that I have dealt with in my over 40 year career none of the others developed abscesses.

Im off to work now.
 
I have to say Graeme's explanation of a healthy hoof being under attack, leads me to the conclusion that shoeing will provide the right environment for abscesses to develop by the rasping of the sole and hoof wall which takes place and of course the nail holes.
 
Graeme Burt farrier said:
Bone rarely dies, and sequestra are very rare. Treatment for necrotic bone of this type requires surgical removal of the source necrotic bone, not merely poulticing. It would
be another argument for not leaving an abscess to take its course.
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I don't understand how you can state this with such authority Graeme. We don't routinely xray healthy horses or abscessed ones. And I understand that if anyone does xray a large number of sound horses, around fifty per cent of them will show bone changes.

The only ones we know about are those that the horse could not resolve for itself.


I realise now that earlier you were only talking about sequestra in the foot. My response was about all sequestra and my mare gave herself one on the cannon bone. Interestingly, that resolved without surgery by reabsorption even though it was the size of my thumbnail.

Last year a vet attempted to make me pay for xrays of a kick wound that was terribly slow to heal, weeping though uninfected. She said there was a sequestrum in it. I refused on the grounds that the horse was sound and that even if one were found I would not put a sound horse under a general anaesthetic to remove it.

After another six weeks of weeping gently, it sealed and over the next six months the lump reduced to nothing. When that vet saw it when she did his jabs, she was astonished.
 
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Graeme I am not arguing with you that the majority of abscesses are caused by compromise of the laminar bond, I just think that with pedal bone infection and abscess combined I haven't seen enough, or any, evidence of which came first, the chicken or the egg.

Are there any studies you can point me to which show that it is the case that the abscess tracks to the pedal bone rather than from it?

All I have seen is xrays with a legend saying 'look how the pedal bone has been eaten by the abscess' which to my inexpert eye look like they could equally well be titled 'look how the death of a small part of the edge of the pedal bone has created an abscess'



I hope you had a good day at work, it's a tough job you do.
 
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Interesting reading.

Until this week I would be in the "let it burst out" camp. However, I took my horse (barefoot) for a lameness investigation and long story short, on xray a line of gravel had tracked up her hoof along the white line .... Looked like a bloody nail in xray! She hadn't abscessed but I guess she may have at some point, though there was so much gravel I can't believe nature would have been able to sort it without a helping hand. Yes she now has a hole in her foot but she will be yarded and walked out in boots until healed.

So I think never say never, eh? Or at least maybe xray before needing to be convinced to dig?
 
Kelpie said:
Interesting reading.

Until this week I would be in the "let it burst out" camp. However, I took my horse (barefoot) for a lameness investigation and long story short, on xray a line of gravel had tracked up her hoof along the white line .... Looked like a bloody nail in xray! She hadn't abscessed but I guess she may have at some point, though there was so much gravel I can't believe nature would have been able to sort it without a helping hand. Yes she now has a hole in her foot but she will be yarded and walked out in boots until healed.

So I think never say never, eh? Or at least maybe xray before needing to be convinced to dig?
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Exactly!

Never say never. My own rule is that provided there is no infection running up the leg, and provided I have localised foot warmth and raised pulse as indicators that it is an abscess, then I am prepared to allow the horse to be significantly lame for one day, to see if it raises a heel or coronet blister for itself.

So far, since taking this approach, I have had no problems.

I have no idea what my horse trod on, but he's got a significant hole in his sole now (and that takes some doing with a barefoot hunter!!!) packed with cotton wool soaked in peroxide. If he goes lame again after being sound as he is now, then he will of course get the attention of a vet.

I hope your horse recovers quickly:)
 
Message To more inexperienced horse owners reading this thread:


If you have a lame horse, call your farrier if you know it's in the foot, otherwise call your vet.

Do not give Bute or antibiotics until you know what it is causing the lameness, no matter what your yard owner finds at the back of the tack room and gives you!
 
thanks CPT (in fact she's a pest to keep re-bandaging but my new hoof boots should arrive tomorrow for her hopefully and that will make life easier!..... it's a big old hole that will take a while to mend but so far so good really.....).
 
Kelpie said:
thanks CPT (in fact she's a pest to keep re-bandaging but my new hoof boots should arrive tomorrow for her hopefully and that will make life easier!..... it's a big old hole that will take a while to mend but so far so good really.....).
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l

The trouble with a hole too big to pack with cotton wool or a filler is that they can so easily bruise the foot where the sole is missing. If it won't hold a filler then a boot is your only option to prevent it, but I do worry about rubs if turned out in them.At least she can start work though, assuming she's now,sound.

I'm sure she'll be right as rain soon :)



Ps watch what the hole does - it's fascinating! It will migrate forwards to the front of her hoof. Bowker's current explanation of that is that the sole is produced at the bars and grows forward from there. For that reason he says trimming bars is a no no.
 
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Well, I would only agree with AmyMay's earlier statement about it depending on the nature of the abscess. Fortunately I had only my first ever experience of one on Monday although I've owned horses for 30 years. The horse in question has mild arthritis and although the heel bulb was tender I called the vet to be sure.

Hoof testers showed no pain at all around white line and sole, only the heel bulb. She hates the vet with a passion so he decided against "digging". I usually carry out whatever needs doing under his direction (within reason!) as she won't let him touch her and there's no way he was letting me loose with a hoof knife. So we poulticed (Animalintex) and put her on box rest, mainly to keep the dressing clean and dry. Next day it burst above the bulb and she's now sound and turned out again. I'm just keeping an eye but letting it resolve itself.

However he would normally have dug around, or got the farrier to do so... good job in this case she is vet-phobic! Had it been a more serious infection, or sub solar though, I don't know what would have happened.
 
dug out i think, mine had several abscesses last year leading to a corn (from all the pressure of standing on one foot!!) so he had half his foot chopped off, leading to the vet and farrier deciding he needed heart bars to build up his heal to try and prevent these abscesses next winter, leading to him getting thrush from box rest (went a bit sore after running him on hard ground), so then the vet and farrier said lets put copper sulphate (medicated, anti-thrush, shock absorbing, miracle wonder gel that costs fortune!) and atm he has no foot problems. So always get them dug out and sorted straight away and if it doesn't clear up call the vet, also mine is farriers formula supplement which is amazing noticed a differnce within days!!
 
cptrayes said:
No one on this thread suggested leaving an unopen abscess untreated for long enough to cause that sort of issue.

Whether you like the idea or not, leaving a horse standing in wet mud with an unopen abscess is a great poultice to encourage it to break open. Your choice is then to keep it clean. Mine, because the blood barrier has not been compromised by the natural opening of an encapsulated abscess, is to continue to turn the horse out and disinfect regularly as a precaution. I have never had a problem from doing this. The only one I ever had a problem with was opened by a farrier and poulticed as recommended.
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but you said you had a horse with a puncture wound (i.e an open wound) out in the mud?
 
Nudibranch said:
Well, I would only agree with AmyMay's earlier statement about it depending on the nature of the abscess. Fortunately I had only my first ever experience of one on Monday although I've owned horses for 30 years. The horse in question has mild arthritis and although the heel bulb was tender I called the vet to be sure.

Hoof testers showed no pain at all around white line and sole, only the heel bulb. She hates the vet with a passion so he decided against "digging". I usually carry out whatever needs doing under his direction (within reason!) as she won't let him touch her and there's no way he was letting me loose with a hoof knife. So we poulticed (Animalintex) and put her on box rest, mainly to keep the dressing clean and dry. Next day it burst above the bulb and she's now sound and turned out again. I'm just keeping an eye but letting it resolve itself.

However he would normally have dug around, or got the farrier to do so... good job in this case she is vet-phobic! Had it been a more serious infection, or sub solar though, I don't know what would have happened.
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In this situation I would syringe 3% hydrogen peroxide into the hole twice a day for at least a week.
 
It depends on the horse and how bad the abcess appears to be (based on lameness).

My old mare had two abcesses in the 12 years I owned her. The first I called the vet out for as she was utterly crippled with pain. She was unshod at the time. The vet started to scrape away sole at the point where she had shown sensitivity to the hoof testers, but called it a day after a few strokes. I still remember his exact words "every stroke of the knife is a week's growth, and she will hurt much more in the long term if I keep going than otherwise". He advised to hot tub it in water and cider vinegar twice daily, poultice the rest of the time until it burst. It took a couple of days. She was box rested during this time as she was too lame to be comfortable doing anything else. When it blew out I continued to poultice until it stopped draining, then dry poulticed for a few days to be sure it was ok. Once she was able to walk she went out during the day wearing a poultice and tractor inner tube as protection from the mud. Even with this cautious approach, it still took weeks for the small hole the vet made to grow out, and the actual pus blew out from somewhere entirely different anyway.

2nd abcess I didn't actually notice until it had blown out! She wasn't in work at the time but didn't show any lame steps. It was winter so often her hooves were muddy and I didn't tend to hose as it made her mud fever worse. On a drier day I chipped all the mud off and whilst handling her hoof found a sharp spot on the wall at the quarter. Turned out to be a tiny hole, presumably where she'd blown an abcess out. She didn't miss a beat with this, no ill effects from it not being treated at all. The tiny defect in the horn grew out without problem.

I had experience of 3 different horses with hoof abcesses in last winter's horrible wet conditions. The first horse had multiple abcesses (he has EMS and a case of laminitis a year ago so his immune system is not wonderful). The initial abcess was dug out by the vet, resulting in long term booting and a huge hole in the sole. Recovery time was weeks and he was box rested for quite a long time as he was so sore. The abcess seemed to have tracked beyond the cut out area and he had pus from another area as well as the drainage hole. The second abcess was hot tubbed and poulticed but not dug out. He wasn't ridden but was able to go out with a poultice and hoof boot on. Recovery time was about a week. The most recent abcess didn't result in him being terribly lame, it was more on and off odd steps than anything else. He was worked when sound, rested when not, poulticed as he showed problems. The abcess burst whilst he was actually being ridden in boots. I was there, he was sound for most of the ride, took about 5 very lame steps then came sound again. When we got back the poultice inside the boot was covered in puss. He's been sound since. No ill effects at all.

Horse 2 didn't see a vet at all. Neither abcess caused lameness so the first the owner knew of them was when they burst, one in her hand as she was picking his foot out (gross!). Both blew at the coronary band on the seam of the hoof wall. No lameness either time. Horse was dry poulticed to keep the foot clean for a few days and to draw out any remaining infection. The first abcess took a fair chunk of wall with it and took some careful managing as it grew out to prevent breakage but the second was tiny and caused no problems at all.

The third horse had two abcesses. The vet was called to the first as the horse was crippled, resulting in a huge amount of foot being dug out. The abcess still blew out of the coronary band. Healing the coronary band wound was a lot less traumatic than growing out the damaged foot caused by the digging. The second was hot tubbed and poulticed, blew out at the quarter and caused no problems.

So, on balance, I'd rather leave a horse to sort itself out for the most part unless it is in utter agony, in which case I would always call the vet as it's unfair on the horse.
 
I feel the need to warn the leavers that if a MOP rang the RSPCA and they attened a lame horse in a field that had recieved no treatment for an abbcess you could get yourself into trouble .
 
The RSPCA can take a running jump, they have no power in that instance. My vets support the leaving it approach as long as the horse isn't presenting broken-legged and I would be happy to give the RSPCA their details. Anyway, they're too busy taking people to court for their own political gain to bother about actual animal welfare these days.

Poulticing/hot tubbing but not effectively performing minor surgery (which is what the vet books state digging an abcess out is, and is why farriers who do so are acting illegally) is not "leaving".

As for sub solar abcesses, you only know if you're dealing with one of those if you have a full workup done and ordinarily that would only happen with repeat occurrences in a short space of time. You can't tell just by looking at the foot, so traditional treatment practices won't make any different at the point of initial lameness.
 
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