Webinar – Hoof Abscesses: Causes, Care and Recovery by Dr Kieran O’Brien

When your horse suddenly goes lame, could it be something as “simple” as a hoof abscess or could it be more serious?

In this essential webinar, our experienced equine vet Dr Kieran O’Brien takes us inside the hoof to explain what really happens during a foot abscess, why they can be deceptively painful, and how to approach treatment and aftercare with confidence. From subtle signs to major complications, Kieran shares practical advice, vet-tested methods, and hard-earned insights from years in the field.

This webinar is packed with must-know information to help you spot, manage and not panic about hoof abscesses.

• What not to do if you find a nail in your horse’s foot
• Why some abscesses resolve quickly, and others can become major issues
• What tools and techniques make the biggest difference
• How to spot the signs before things get serious!

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Please note: This presentation contains some graphic veterinary images.

Transcription
Here is a transcription of the webinar. (Please note this is an automated transcription, so we apologise for any errors.)

Hello and welcome to my AnimalWeb webinar on hoof abscesses. It’s quite an important subject. It’s a very common cause of lameness. My name is Kieran O’Brien. I’m an equine vet working in the west, southwest of the UK. And this is a subject of great interest to me and a subject that I have spent a lot of my working life dealing with. I think it’s fair to say it is probably the most common cause of lameness.

Certainly in non-exercised horses, for example, brood mares, young stock, retired horses, but it’s also very common in horses that are in work. In fact, there’s a sort of little kind of humorous saying that we say to veterinary students, which is that even if you think it’s lame and it’s left here, take the shoe off, because they are so common. And sometimes they’re a bit elusive and they can sort of grumble for a while and they can be hard to find, but almost always.

I have a kind of rule of thumb that if you don’t find an abscess it will find you because eventually it will expand and possibly break out somewhere. But certainly if we ever deal as vets with lame horses we must always exclude abscesses as a first line of investigation. Usually the lameness is initially mild, small amount at pass, not causing much pressure in the hoof, but if it’s not relieved the abscess enlarges and the horse becomes more lame.

Most of them you just simply make an opening in the hoof and drain the pus and they respond very quickly. If we detect them early and they come back into work quite quickly, the shoe can be put back on. However, there are complicated ones and these are usually caused by some deep foot penetration and these can be potentially life threatening in the sense that they can cause permanent lameness if they’re not dealt with properly and quickly.

and I will talk a little bit about those at the end. So if we imagine the hoof essentially as a thimble on the end of your finger. So the thimble is a sort of semi-rigid structure, semi-flexible, the hoof is, and it’s intimately attached to your finger. So the tip of your finger is essentially the solar corium in the hoof, and then around the edge of your finger, the sides of your finger are the laminae.

And essentially an abscess forms when the thimble is penetrated and the pus sits between your finger and the thimble. And to drain it, we make an opening in the thimble and we release the pus. So here is a hoof viewed from the inside. You can see the laminae on the inside of the wall, the hoof laminae, and they interdigitate with the laminae sitting on top of the pedal bone. And right down at the bottom at the front,

is the junction of the wall and the sole and that is what we call the white line and that is a very common entry point for bacteria. You could say there’s a sort of design fault in the horse’s hoof in that this is an area where the sole joins the wall and that junction, although in theory it’s a very tight junction and it completely seals off the junction, unfortunately it can be weak and dirt can get in there and get into the…

get through the thimble and into the hoof. So here is a hoof that’s just been trimmed in preparation for a shoe, trimmed and rasped and the farrier will be putting the shoe on shortly and you can see, and the yellow arrow shows the white line, and you’ll notice that along it there are little bits of dirt and maybe little bits of grit and you can see potentially

some of that stuff could get through the white line and into the hoof. And you’ll see here, you can see with the arrow, there’s a much bigger area of separation here as the hoof expands in the heel region. So potentially any little bit of grit or dirt could get in there. I mean, there is an expression, certainly in the West Country, where a foot abscess is called a gravel. And I presume the reason for that is the assumption is that a little bit of grit has got into that region. But actually, in my experience,

that is relatively uncommon, mostly it’s just a little bit of dirt. Now, so the upper picture shows the cross section of a hoof and the yellow line is where the coronary band would be. And if we go down to the toe, the lower illustration, you can see there is the white line. And that is this area of weakness where the sole joins the wall. And if infection tracks up through the white line, it will form an abscess.

And the abscess is essentially where those red blobs are. And that is where the pus is accumulating. Now, normally it would track up the white line and form an abscess just under the sole here. So it’s between the hard hoof and the sole aquarium, which is the sole producing tissue. And the pus sits in there. It can also, of course, go up the wall. And of course, infection can gain entry not just through the white line, a simple penetration.

here can form an abscess there and this shows the tip of the frog. So this is the entire sole here and this is where the abscess will be and of course treatment then is to make an opening in this hard sole and release the pus.

Now, so here’s a lame horse that I examined. It’s got a warm foot. I put my hoof testers on and I found a sore spot just where that yellow mark is. And I’ve taken the shoe off. so that is it. I strongly suspect there’s an abscess in that region on the white line. And sure enough, with my knife, I make a little opening and there the pus appears. Not much pus. It’s a small abscess. So there’s a small cavity.

So the cavity probably would be about that size. sorry. And that horse, that’ll drain and that horse will get better quite quickly and we’ll get the shoe on back on probably in a few days. Now here’s another one where my hoof testers has found a sensitive area not under the shoe eye, not on the white line, but further onto the sole. Explore that with my knife. And here’s this little crack, a little split.

Perhaps the horse has trodden on a sharp stone or something like that. And that’s where he’s very sensitive and I suspect there’s an abscess under there. And sure enough, I open that area and a little bit of pus comes out.

Now here’s a much bigger one, a sole penetration. So when I say bigger in the sense that there’s so much pus, there’s obviously quite a large cavity there which we will have to drain. And because the cavity is large, it’s likely the horse was very lame. Now this is a video of one where I drained a large amount of pus and you can just see squeezing there is just dripping out from under the sole. I’ve taken quite a bit of sole off.

And this is a more dramatic one, which Stephen Hilda Farrier very kindly gave to me. There’s even some sound here, the illness, amazement when it happens. And so he has found a very sore spot, and even with his fingers, the horse is reacting. And so he just makes an opening and there it flows. A large amount of pus.

So there’s very likely now a very large abscess there and he will make as he has done quite a large opening to ensure that drains adequately. So that’s going to under run the soil completely. Now, can also go and the pus can also, of course, as well as tracking under the soil, it can track up the wall. And why some go up the wall and others don’t? I don’t think we really know.

They can be quite difficult to drain. And the other thing about abscess under the hoof wall is that they seem to cause a disproportionate amount of pain in relation to the amount of pus that’s in there in comparison with the sole. They can be very, very lame. We make a small opening in the wall, release the pus and there’s always a surprisingly small amount of pus for the degree of lameness. And of course, as well as tracking up the wall, it can actually

break out of the coronary band if it’s not released. So here we’ve made a big opening in the sole but in actual fact the puss has already worked its way up and burst out of the coronary band. So that horse would have been lame probably for maybe a week or more. Almost certainly at that point the lower leg was beginning to swell. Probably wouldn’t have been wanting to bear weight at all on the leg. So that would have been a very lame horse.

But when it does track up the wall, it tends to follow the horn tubules, which are in this direction. So it always breaks out not directly above, but slightly back. So in fact, what we have here, if I was to take that hoof wall off, we would have an inverted triangle, essentially. So it’s tracking up here and the undermined or under run hoof wall is getting wider and wider as it gets to the top. And here you can see

it’s broken out. Very often it tracks backwards depending on where it is, particularly if it’s more towards the heel. So here you can see an area of separation in the heel where it has burst out. Now very often actually breaking out like that will actually significantly improve the horse. In fact, I suspect that, you know, feral ponies, ponies on Dartmoor and that sort of thing, if they get hoof abscess, I suspect a lot of them probably self cure by the pus.

breaking out like that. Of course, we can’t rely on that. But it certainly does happen. Now here’s this is actually one of my own Connemara ponies. It was quite lame, picked its foot up and there the pus had broken out of the heel. So under here is a cavity of some sort and it has trapped back and come out.

Now that area of separation that will never rejoin but it will grow out. So these are two cases where they have previously had an abscess under the wall which has broken out on the left side here broken out here and that has gradually grown out so it’s now completely healthy and sealed under here and here is this area where it broke out and similarly in this one. So this horse here on the right probably had it

was probably very lame, probably two or three months ago. And here is that line growing out. Of course, abscess can also come from any kind of hoof splitting. Like here, it’s an overgrown foot in a broodmare. You get this grass crack that, of course, upsets the integrity of the hoof as an antibacterial barrier, infection gains entry, and cracks can occur, of course, anywhere in the hoof. You get a horizontal.

cracks in the heel region, quarter cracks, any kind of hoof splits, that sort of thing that damage the integrity of the hoof will let infection in.

Now, the other thing we see is a condition called corns, where generally in an overgrown hoof, the inside bar of the shoe comes and rests in the area where it shouldn’t be, which is the seat of corn causing bruising. So here is a, you can see here, this bruising in this horse that had a corn. Now that of itself will cause fairly, will certainly cause lameness.

not usually very severe and removing the shoe and refitting it will often resolve it and we may also use a special shoe to relieve the pressure on that area. But that area where the hemorrhage occurs can also get infected. So here is now an infected corn. This horse would have been quite lame. I’ve made a small opening, released the pus. Now if I hadn’t released that almost certainly it would have tracked backwards and burst out in the heel region.

And here just a couple of other ones, another abscess inside the white line. Here’s just another one, another white line abscess with quite a lot of pus in this case. Now, of course, the other way infection can gain entry into the hoof is a chewing. And if we look at the photograph on the right, you can see that when a farrier nails the shoe on, he goes in through the white line.

The nail has got a bevel on it which causes it to bend outwards as it goes through the wall and then the farrier bends it over and the shoe is held on simply by this hook arrangement. And of course when the shoe removes he cuts the hook off. But of course you can understand how, you know, I don’t envy farriers nailing shoes, you know, a thin walled horse or an uncooperative horse, it would be so easy for the nail just to go a little bit further in.

and go into the sensitive area. And it’s remarkable how farriests, you know, can go for weeks and weeks and weeks without ever having, you know, it’s a huge testimony to their skill. Normally we would like the clenches to be parallel to the coronary band, sloping slightly backwards, because the hoof wall is thinner the further back you go. So we want this, the most

should we say the most cordial or the rear, the most rear clench to be fairly low, but never beyond the widest part of the hoof because there you’re getting into a very thin wall. So this is sort of thing we’re aiming for. And of course, it’s not surprising that farriers will occasionally the nail will go into the sensitive area. And that’s what we call a prick. And if he does prick a horse, usually

the horse will react and flinch and the farrier will take that nail out and redirect it. Now, very often nothing happens, but occasionally they can just simply introducing the nail through the hoof, you take bacteria in and that can set up an abscess where the nail accidentally went. And that can grumble for quite a while. It can be up to two weeks.

before it really kicks off and the horse goes lame as a consequence of a nail prick.

Of course, the other very common cause of foot abscess in the horse are penetration by foreign bodies. So here you can see a little tack. It’s extraordinary how they stand on these things and they will penetrate. And of course, if they go through the sole, bacteria get in and you can form an abscess. On the left, we see this is a shoeing nail. Very often,

When a horse stands on nails, they’re deflected into the frog grooves on either side. Now, luckily, this is quite a shallow penetration. Hopefully, it not have caused an abscess or will cause a small abscess in that region. But it’s an important point. And although this is a nail that has come out of a shoe that’s been removed and the pointed clench has been cut off, they can still penetrate.

It underlies that the reason why when a farrier shoes your horse, must, he or she must be able to work on a bare floor because if they drop the nails, they need to be able to find them and pick them up. There’s nothing worse than a farrier having to shoe on a, you know, in a stable with thick bedding and a nail drops in through no fault of his own on the ground and they can’t find it. So sweep the bedding back or shoe the horse out in the yard. On the right here we have

another nail, another bent nail that somehow the horse has picked up. Now here is another shoeing nail and this one’s gone a lot deeper. And interestingly, when I removed the nails, you can see on the bottom right there, it actually had not been used for shoeing because you can see the point is still on it. So for some reason, the farrier must have dropped that in the stable and penetrated into the hoof.

Be just makes the point again. Always shoe trim the feet on a bare floor. Black thorns are very nasty things and they cause all kinds of injuries in horses. And we tend to see back thorn penetrations in the autumn and winter when the hedges are cut and the clippings are left around the edge of the hedge and the horse stands on them and you can have a black thorn. You wouldn’t have thought a black thorn would be

strong enough to penetrate the horse’s hoof, but it certainly is. And we do see these bizarre ones. This is one I saw a few weeks ago where a piece of wood has penetrated into the heel region and that caused quite a deep penetration. Fortunately, it did respond to fairly straightforward treatment. So what kind of complications? So I’ve described to you abscesses where we just make an opening and drain the pus. But of course, there are a lot of important structures in there and

For example, the pedal bone can become infected if the penitent, if the infection extends through the core of the soul into the bone or the penetration goes right through into the bone, we can get an infected pedal bone. And of course, in the hoof, and I’ll show this in more detail later, there are some very vital structures that potentially a penetration by a nail could go through and create major issues. Now, so here’s an X-ray of a horse with a foot abscess.

And the pedal bone has become infected as well because the abscess has spread, it’s been there for quite a while without being treated and we’ve now got some infected bone. So as well as draining the pus, we will have to remove that infected bone and scrape it out. And generally they do well, but the recovery will be much longer. Now here is a…

a case, this is the right hind leg where you can see this very long nail which somehow got dropped in the field. There were some, I can tell you the background of this, there was some building work being done in the stable yard.

and some of the sort of wooden debris that they’ve removed with nails in it was dumped in the field where the horse lived and somehow a nail got loose from the wood and has penetrated deep into this horse’s foot. So this was a very lame horse and that nail has gone through some vital structures. Now there is an area in the horse where if we get a penetration

It can be very serious because underneath this area we have got some important structures, deep digital flexor tendon, navicular bursa, coffin joint, these sort of things. Whereas penetrations outside that area tend to be much more benign and tend to cause a localised abscess. So these are the danger zones and deep penetrations, as I said, usually go through the frog grooves in either in the centre or more commonly at the side, the side grooves of the frog, the sulky.

And so if we look in cross section at what is under this area shown in the square. And that is the the three important structures. We’ve got the deep flexor tendon, which is coming down here. Attaching underneath the pedal bone, so a nail going through here can go straight through this deep flexor tendon and here with the red arrow is what’s called an avicular bursa. This is a little

fluid-filled structure which protects the navicular bone, this is the navicular bone, as the tendon glides over it. So that’s another very serious, if infection gets in there it’s very serious. And of course here we have the coffin joint and a deep penetration potentially could go into there as well. So that, this is the danger zone, what we call the middle third of the foot. Penetrations through here can be very, very serious. Now, so the question then is,

If your horse goes suddenly lame, you pick up the foot and you find there’s a nail stuck in the foot. What should you do about it? Well, generally speaking, you should resist the temptation to pull it out because we want to know where it is and how deep did it go. So the concern, course, if you leave it in is it’ll be pushed even further in. So what you can do is put just straps and little bits of wood.

wooden blocks either side of the nail, bind them on with some duct tape so the nail can’t be pushed in further. And of course, then we come and see the horse and then we can take an x-ray with the nail in place and see exactly where it went. Otherwise, we have to sort of guess and we might make the wrong decision. So while instinctively you want to pull it out, there are huge advantages in leaving it in until we can see it. But if you do take it out,

We want to know the exact entry point. Now, you may think, well, it’ll be obvious. Well, actually it isn’t because particularly the frog is very elastic and the penetration site closes immediately and you can’t see it. So we want you to make a note or even with a felt tip, make a mark. The exact place it went in, what the angle was, how deep did it go? And obviously keep the forearm body for us to have a look at.

but we very often would like you not to remove it and to x-ray it with the foreign body in position. So moving on then, if a horse gets a foot abscess, what are the sort of signs you’re going to see? Well, the foot certainly will be warm, almost always obviously warmer than the other foot and remember that it’s an instant impression so you put a hand on one foot, feel the temperature and immediately go to the next one, the one

opposite it so it’s an instant impression and here this is a thermographic illustration here and you can see here’s a warm place in this foot where there’s an abscess. Now if you’re lucky of course the foot will have dried out so here we have this horse is brought in from the field lame on the left fore which is on the right side as you look at it and you can see the mud has dried out much more quickly

then on its right four and that straightaway tells you that’s a warm foot. And here are some others. Here you can see on the left here you can see that this just this side has dried out. Suggesting there’s an abscess here on the outer outer side of this foot. This one you can see it’s still muddy here but this is dry. And once again this is a warm foot and here is another one where it’s dried out.

And this one is still damp. So that’s an indication. The other thing to feel is the digital pulse. Now, a lot of people struggle to find this, primarily because they’re feeling in the wrong place and they don’t realize that it’s much slower. You have to be patient. So there’s an artery that runs down the side of the the horse’s fetlock.

the digital artery and here it is and it’s just sort of around the sesamoid bone here and it’s quite easy to feel but of course in a normal horse it’s quite faint but it is there and you can feel the pulse on every horse. So what we’re interested in is increased strength of pulse in comparison to the other leg or sometimes even in comparison to the other side on the same leg. So you just rest your fingers on there and this is how I do it.

You don’t need to worry about having your own pulse in your thumb. It just doesn’t matter. So a finger either side and wait. See, and I say wait because the horse’s heart rate is much slower. The human pulse rate is 60 to 100. Horses, it’s only 28 to 40. So be patient. You will feel it and you can feel it in every horse. And what we’re interested in is it’s stronger in the lame leg in comparison with the other leg. Because we also get an increased digital pulse.

anything that causes inflammation in the limb, in the foot for example, laminitis or a bad bruise or something like that, fractured pedal bone. But it tells you this horse has got an increased blood supply to its foot and we want to know the reason for that and the majority of cases it’s because of an abscess. Now the leg can swell, not normal, if an abscess has been present for more than a few days, five, six days, even a week, the lower leg will begin to swell.

Now it can start off being quite subtle so you can’t quite see it but if I just show you here you can see that the horse’s right fore on the left of the screen has got a slightly wider pasten region in comparison to its left fore. So it’s quite subtle but once it begins to swell generally the horse is quite lame and it’s pretty obvious which leg is involved.

Now here’s one where it’s a lot more swelling. This horse is probably very, very lame. the swelling tends to track up the leg. So you’ve got swelling here. And I’ve been called to these, you know, I think my horse is injured, it’s tendon, because it’s swollen here. But actually it was an abscess in the foot and the swelling has tracked up. Now, infection isn’t tracking up there. It’s not swelling.

because infection has come out of the hoof into the horse’s leg. It’s simply because it’s inflamed and got an increased blood supply. But the infection is still contained in the hoof.

And here’s a, you can see another one, long standing case, swollen leg and it’s swelling, the fecklock’s swollen and starting to swell the lower limb. Now, another very important thing for you to do when you think your horse has got an abscess is to feel the coronary band. So, just to refresh, you felt the temperature of the hoof, you felt the digital pulse, and then pick up the foot and go around with your fingertips the whole way around the coronary band.

And not uncommonly, you get to a specific place and the horse flinches. And that’s because the pass has tracked up and is about to break out. It hasn’t broken out yet, but it’s always sore where it’s going to break out generally for a day or two before it does actually break out. So that’s an important thing. And the only way you can do it is if you pick the foot up and just go the whole way around with your fingertips, just pressing with your fingertips the whole way around. Obviously, we

We use hoof testers quite a lot and that allows us to localise the pain and we can put the hoof testers on the frog, we can put them on the sole, across the heels, so very, very useful. Now, if you have a horse that you discover is actually non-weight bearing,

And by that we mean a horse that’s resting the limb most of the time and is reluctant to move. The question is, what do do with that? Is it an abscess? Is it some catastrophic injury somewhere in the limb? So obviously we would look from a distance, we would look at, you know, what is his posture? How is he holding the limb? What is the shape of the limb? And is it swollen anywhere? And then a quick and of course the causes.

of non-weight bearing lameness in the horse are abscesses, very much so. And I’ve said it twice because they are so common. But of course you could have any infection of the limb anywhere from a wound, a puncture wound, or some trauma to the limb, or some tendon, suspensory check ligament injury, or even a fracture. So you’ve got a horse that’s very lame.

and you’re not sure what the cause is. So one guide is to determine whether it’s what’s called a supporting leg lameness or a swinging leg lameness. So you just walk the horse a few paces and now if he will advance, let’s say it’s a forelimb, if he will bring the limb pretty much forward the same amount as the non lame leg, that tells you the problem is almost certainly in the lower limb.

below the knee. But if he’s reluctant to advance the limb at all, the problem is either in the knee or above. so that’s kind of a quick guide as to where is it low down or is it high up in the leg. And obviously you’re going to check the foot for a foreign body and all those other things we’ve mentioned. So let’s get on to treatment of foot abscesses. What are we going to do?

Well, we need to make an opening in that thimble, let the pus out. And then having let the pus out, of course, we’ve made a hole in an area that’s normally completely sealed. So we’ve got to protect the opening from contamination by bedding, mud, that sort of thing in some way. We always have to consider tetanus. I’ve seen a few cases of tetanus in my life and two of them were certainly related to foot penetrations. And

I’ve seen cases where we never found the point of entry. We know how the tetanus get into that horse and almost certainly it was a penetration. So every horse should be vaccinated against tetanus. If it’s not, we will give it an anti-tetanus, which will give it instant protection, but it only lasts for three weeks. We may use a topical antiseptic. We may often will give pain relief.

Antibiotics generally we don’t use for foot abscesses unless we feel there is a deeper penetration because the secret is drainage. And if you think about it, farriers have been treating foot abscesses in horses for several hundred years without, before antibiotics were even invented, simply by creating drainage. But if we think the deeper structures have been penetrated, well then antibiotics are essential. So drainage, we use hoof knives. This is my little set here on the…

on the left and obviously something to sharpen them. They must be razor sharp. We then also use hoof cutters and this hoof cutter here has got curved blades, which I use if I want to take track and infection up the wall. So these are sort of basic equipment. Now, poultices are very commonly used and they’re sort of deeply rooted in the equine folklore.

And if we go and if you look at the Victorian veterinary texts, they all begin to polter says for just about everything, including pneumonia. They used to put them on the chest, put them on the belly of a horse, a colic and obviously put them on the foot. And William Ewart in his classic book, The Horse, published in 1865, says in all inflammation of the foot, polter says are very beneficial by softening the horn, hardened by heat of the foot and contracted.

and pressing on the internal structures. we have to ask the question, why have poultices been virtually abandoned in human medicine? And the answer is they don’t really work. They’re not very effective. Now, what is in a poultice? Well, this is a commercial poultice and there are lots like it and they are all more or less the same. They contain something called Tragecant. Tragecant is a

It’s the sap of a plant that grows in the Middle East, which is harvested and dried. And it’s a polysaccharide, so it’s a sugar molecule, and in which case it’s highly osmotic, mixed with water. And they also put some boric acid in, which is, I think, an antiseptic. But if you think about it, if you look on the lower right, how does osmosis work? Osmosis works when we have a semi-permeable membrane.

with a concentrated solution on one side and a weak solution on the other side. And what moves? What moves is the fluid, not the contents. So if this is an abscess in a horse’s foot and we apply this very concentrated solution, first of all, we don’t have a semi-perical membrane. We might have a hole or very often there’s nothing at all. It’s just solid hoof.

and the white blood cells aren’t going to move through, the pus is not going to move through. So essentially, use of poultices in horses’ feet is largely a myth. And people argue, well, they soften the horn, make it easier to open. Well, yes, I suppose that’s true. But if you’ve got a very sharp knife, that isn’t necessary. But certainly they will never draw anything. There’s this sort of myth that poultices draw the pus through the soul. Well,

They won’t unless there’s a hole made. So in my view, poultices are very overrated. I hardly use them. The only place I might use one is on the coronary band because of course the coronary band is skin and tissue fluid can be drawn through the skin, through the coronary band and help the pus to break out there. But to use a poultice on a hoof made of horn is in my view and in the view of many people who work in this area.

a complete myth and of no value. So what do I do? Well, if I make an opening and release the and that’s the only way the pus is going to come out, a poultice isn’t going to draw it out, make an opening, what do I then do with the cavity that I have exposed? So I’m looking through this hole in the soul. I can see underneath the corium, which has moved away slightly from the soul because of the pus that was there.

Well, I put some antiseptic in there usually and what I use is I want an antiseptic that will kill bacteria but will not prevent the pus from draining. The pus is draining largely by gravity, so the horse weight bears and also when the horse weight bears the pedal bone drops so that’s squeezing the pus out through the hole I’ve made and I don’t want to block that but it be quite nice to have an antiseptic. So I use povidone iodine mixed with sugar which in the fairy world is called sugar dyne.

And I make a thick paste, you can see on that bottom right photograph, pack that into the hole. Now, the beauty of that is the will dissolve its way through that. It’ll have an antiseptic action in the abscess cavity. And when I put that in and bandage it and come back the next day, it’s almost certainly all gone because it’s been dissolved by the pus. And the next day it’s all gone. But maybe the day after that, it’s still there. And that tells me the pus is no longer draining.

because it’s not dissolving the sugar and iodine. in which case I know that it’s now fully drained and we can seal it off and put the shoe back on if that’s what we want to do. But on the subject of iodine, you’ve to be very careful because iodine sold in tax shops and agricultural merchants is the stuff on the left. Strong iodine solution. So this is traditional iodine. This is the stuff that stains your hands brown. It’s far too strong.

far too caustic, should never be put in contact with living tissue, i.e. should never be put inside the abscess cavity. It can certainly be used on the soul to treat thrush because thrush is very superficial, it hasn’t penetrated into the soft tissues. But in terms of mixing it with sugar and making sugar dine, you should not do that. You should use what’s called povidone iodine, which is tamed iodine. It’s called tamed iodine.

and that does not stay in your hands and is not toxic to tissues but strong iodine should not be used on living tissue. The only place we use it is for dipping foals’ navels and even then we dilute it to two and a half percent and the effect of that is it’s a strong antiseptic and it’ll dry the nasal stump but certainly not in the hoof unless you’re treating treating thrush. So then we’ve made a whole

We’ve put the sugar dine in. We’ve got to cover it. Certainly you can put a pad on there and then I use a vet wrap, probably a whole roll of vet wrap around the hoof, maybe halfway up the pastin to cover it. Some people use a baby’s nappy, newborn nappy. It’s the right size for a hoof.

Obviously that’s put on dry. And the other thing about vet wrap is vet wrap is very, very useful, but it’s a bit unforgiving because once it’s stuck to itself, it doesn’t stretch. So if you’re bandaging for more than a few days, there’s a worry that you’ll get a pressure sore on the coronary band and just above it. So in that case, I would use some cotton wool around the coronary band around the lower part of the past and.

But generally speaking, abscess heals so quickly you don’t need to do that. But if anything more than a few days, you need to do some padding on the coronary band.

Now, we then put some duct tape on to protect it and keep it waterproof. And I show this photograph because it illustrates an important point. Now, both of these horses had duct tape put on the day before. So the abscess has been drained. Vet wrap was put on duct tape on top. And if you look, you’ll see where the tape has worn round the edge. And in fact, here it’s probably now incomplete.

and dirt can get in there, in fact here as well. And similarly on this one. So in 24 hours, it’s already worn through. So that tells me two important things. One is that you should try and avoid having a bare floor. You know, if he’s on rubber mats, not so bad. But if it’s a concrete floor and the horse is standing on this, wearing this duct tape, you should have bedding right up to the door.

And secondly, it’s very important that you have enough duct tape material round the edge, not in the centre, but round the edge. That’s the important area to protect. So this is how I do it. I started at the back and I worked round and round and round down to the toe and then I go round and round again back to the heel and I tear it off. And then I go round the rim, probably six or seven times, just round and round and round.

So I want to protect this edge. That’s the most important area, not in the center, but on the edge.

And then if you want to the horse out, people do this kind of thing. You can put the foot in a bag like that and just wrap it with some tape, any kind of a plastic bag sort of thing. People use shopping bags, all kinds of things, you know, and if you decide you want to put the horse out, that is the way to protect it. Although you’ll find when they come in that it could be quite worn here, but at least you have given some protection. Now, there is a traditional practice called tubbing.

which many of you will have heard of and probably used, which is where you add magnesium sulfate, adds some salt to water and you immerse the foot. The logic of this, I’m afraid, escapes me. I think it’s a technique that probably needs to die out. I don’t know, is the rationale that somehow the magnesium sulfate solution is going to draw something out? Well, you’ve already made an opening. and its gravity is going to cause it to drain.

If you think that magnesium sulphate going into the abscess is beneficial, well then why don’t we just flush the cavity with magnesium sulphate? And equally, of course, if you immerse the foot, which now contains, which has got a cavity in water, almost certainly there’s going to be an air pocket in there. So is the magnesium sulphate actually going to go into the abscess at all? So my personal view is tubbing is completely overrated, of no value, whatever. And I have never done it and never will.

Now, what kind of complications can we get? Well, obviously, recurring infections, if we get inadequate drainage, we may too small an opening, or if the bone is infected, you get infected pedal bone that will continue to discharge. Keratoma, which is a tumor of the hoof producing tissue, they often present as recurring abscesses.

And we think, why is this hapsace still happening in this place? Because we’ve drained it adequately each time. And then we suspect a keratoma, we x-ray the horse and we can see the evidence that there’s a keratoma present. Fractured pedal bone obviously could potentially occur if deep penetration could cause the bone to fracture. And of course, this, which we’ve mentioned already, infection of deeper structures.

usually caused by a deep penetration. Now, if we have an infection, so let’s say this horse has had a deep penetration where this red arrow, so it’s gone in through the deep, so this is the, this is a nail, it’s gone through the deep flexor tendon into the navicular bursa. Now, there is no way of draining that externally, that horse has to go on an operating table and this area flushed. And how it’s generally done on the operating table is

The surgeon puts an arthroscope into the tendon sheath, which is either side of the deep flexor tendon, comes down here, makes an opening at the end of the sheath, into the vicular bursa and flushes it. And very often it’ll flush it down through here and then it’ll come out through the penetration site. And of course, obviously that requires a general anaesthetic.

Deep penetrations are an emergency unless we get in there very, quickly after it happens. The outlook is very poor to control that infection. So these sources have got to be referred very quickly to a hospital where this can be done. so this is how it’s done. The foot is here. They’ve gone in through the deep digital flexor tendon sheath and

have put the flush through and there’s a video here which shows it being flushed and you can see it coming through the original opening which has been enlarged where the penetration went through so it’s been flushed in a sort of retrograde direction and we just do this and we pray that we’ve got on it quickly enough and of course the horse would have intensive antibiotic treatment, pain relief

So deep penetrations are very scary and unfortunately they often have a very unsatisfactory outcome.

Now having made the hole in the sole and drained the abscess, how are going to protect it? Well on the right we have what’s called a hospital plate and we do these where we do major excavations in the feed, maybe make a large opening for example if we’re caretting or removing infected pedal bone and this allows us to protect it but then access it because these screws can be opened, take the plate off and go in there and treated, use some topical treatment and so on.

But if it’s a straightforward, simple abscess with a hole that we’ve made in the white line around the sole, I like to use this stuff called hoof putty. I mean, traditionally people have used a Stockholm tar and cotton wool and that sort of thing. I like this stuff. Basically, it’s a form of wax. And when you open the tin, it’s actually quite solid. And I scoop it out with my finger and I get a little blob.

And then I work it between my fingers and it softens and gets quite sticky. And then it’s, it’s, it’s, think it’s medicated with some iodine, I think, or some, something similar. And then I, I just push that into the hole and it hardens and seals the hole and is really useful stuff. So I’m a great believer in this. And very often if I, know, I will go to a, to a client’s horse, I’ll drain the abscess and I will give them some of this wax to use.

when the abscess has stopped draining. I just give them a piece and then they’ve got it ready. So just to finish off, a few take home messages. First of all, work on the digital pulse. See if you can convince yourself you can feel it and you should be able to feel it on every horse. Remember that the strength of the pulse does slightly depend on the position of the limb and whether it’s weight bearing.

So if the horse rests the leg completely with the heel off the ground, the digital pulse can be very hard to find. So if I’m going to check the digital pulse, I will try and get the horse to stand normally with the foot in the normal position directly under the horse. in other words, the leg is loaded and then I can feel it and it’ll be much more obvious. So get used to that. It’s a good thing to practice. If you think your horse is an abscess,

Don’t delay in treatment. The quicker we can get in there, the smaller the opening we need to make, the quicker we get back into work. Obviously, we’ve got to establish adequate drainage and use correct aftercare to make sure it doesn’t get blocked afterwards. And if it’s a recurring case, well, then we need to do some more investigating as to why is this not resolving. I hope you found this webinar useful. If you’ve got any queries, questions for me, email them in.

the Animal Web, email them into Animal Web through the website and using the contact section and I will try and answer them for you but I hope you’ve found it useful.