Category Archives: laminitis

Hoof abscesses: symptoms and causes

Most Hoof abscesses are pretty simple to treat at home, I recommend this method after consulting with your veterinarian. Other than losing training time and a small fortune in elasticon, your horse will recover, the damaged hoof will grow out, and only the memory will remain.

Unless it doesn’t. This article , although absolutely no substitute for veterinary consultation, will go over the causes of your garden variety, inconvenient “gravel” abscess, as well why some horses seem to always be either having or recovering from abscess related lameness.

horse hoof abscess
Fix my paw!


Symptoms of a hoof abscess

  • the horse may go from normal or slightly off to a grade 3-5 lameness rapidly and unexpectedly in one limb. An affected forelimb will be more obvious.
  • the horse may aggressively manipulate it’s stance and gait to avoid weight-bearing on affected foot.  This horse is so lame, your significant other could diagnose.
  • Swelling or sensitivity of the coronary band, pastern or fetlock.
  • a bounding digital pulse can be felt on one or both branches of the arteries that run down each side of the back of the pastern of the lame leg  (medial versus lateral pulse can help pinpoint location of the infection).
    location for observing digital pulse

    Not always true, but abscesses often occur after paying nonrefundable horse show fees but prior to events such as a motivated buyer coming to see your prospect, trail ride vacation, graded stakes races etc..

Causes of abscesses

“An accumulation of purulent exudate. In the foot, this usually refers to a localised accumulation of exudate between the germinal and keratinised layers of the epithelium, most commonly subsolar or submural.”

Equine Veterinary Education, Vol. 19, June 2007

The above excerpt is a great definition of a hoof abscess, more simply, an abscess is (usually) a pus trapped between the insensitive and sensitive tissues.

The author then goes on to divide the abscess by it’s location: either between the sensitive and insensitive sole (subsolar) on the underside of the foot or trapped behind the hoof wall (submural) .

the “gravel” abscess

This is, by far, is the most common cause of abscessing in my experience, especially if the horse is barefoot.

The “gravel” type of abscess is caused by a small piece of debris getting jammed into a weakened spot in the white line or seat of corn area of the hoof.palmar-foot-drawing-labeled

Click to enlarge or check out structures of the hoof post.

Horses affected with white line disease , a common, fungal invasion of the insensitive horn.  are even more prone to the gravel type of abscess.

If debris manages to penetrate beyond the protective and insensitive hoof wall, bacterial invasion  into the  soft, sensitive tissue (corium) inside the hoof will follow.

Once the body barrier of hoof is penetrated, the abscessing process begins. The horse’s immune systems goes on the offence to prevent further damage from the foreign body: inflammation sets in, a thin, new layer of horn is produced to wall off the debris. White blood cells flock to the site. to fight off the bacteria. Enzymes released by this liquefies the now necrotic tissues involves, which produces the dark grey exudate associated with this condition.This  pocket of serum trapped against a minimally elastic hoof wall and the sensitive tissues within the hoof capsule. This combination is very painful for the horse.

Bad or close nails

Bad/ “Hot” nails

A misplaced nail can be the cause of an abscess. The nail is driven inside the white line and penetrates the soft tissue within the hoof capsule. You will know this because the horse reacts suddenly. He may not set his foot down, instead shaking it inches above the ground. Blood will seep from the clinch or nail head.

Hopefully farriers will circumvent the abscess cycle at this point. They will remove the nail, pour some antiseptic into the offending  and resulting hole, and most will inform the owner so they will be especially observant of that foot.and ensure the horse is up to date on his tetanus vaccination.

By removing the offending object and disinfecting, it is likely that the horse will suffer no more from this incident.

Close nails

A close nail is a nail that is driven into insensitive horn, but displaces hoof material in a way that affects the functioning of the hoof. There is no blood as the sensitive tissue hasn’t been breached. The horse may react to the nail being driven, but not the “kicked in the gut” reaction of the bad nail.

The close nail impedes the function and circulation of the adjacent sensitive foot. This may not become obvious for up to two weeks after the nail was driven. At this point the abscess will run its course as described for the gravel.

It is a good idea to remove the shoe and treat the hoof to speed  recovery and ease pain.

Horses with thin walls, previous hoof damage, clubby or low heels , and wry hoof are more likely to have close nails than a strong footed individual.

hoof abscess
Upright “wry” type of hoof. This hoof is badly twisted due to extreme varus or toed-in conformation in his pastern joint.

Horses that do not stand patiently are also more likely to have a close nail as the farrier cannot distinguish the horse dancing around the aisleway from pain or lack of manners.

Driving nails into a horse’s foot takes years and years to become skilled at. There is a very small area where nails can safely be places and no two feet are quite the same. The last thing a good shoer wants to do is hurt your animal, but it will happen occasionally.

not much room for error. photo:

A good shoer will take responsibility and be glad that this injury is fairly easy to treat.

Abscessing from the inside

Horses with diseases or injuries to the hoof sometimes suffer from abscessing without any external cause.  Horses that do not receive regular hoof care and horses with known hoof problems will  often suffer from chronic abscessing because there is a ongoing internal abnormality.

This is not meant to be a thorough guide to all hoof infections and horses with problems like these should be seen by an equine veterinarian for best results.

Chronic laminitis and pedal osteitis

Horses with a history of laminitis/founder are an excellent example of abscessing due to septic pedal osteitis (coffin bone infection).  The coffin bone of the laminitic horse gets progressively more damaged with each episode. These abscess can be submural or subsolar depending on which portion of the bone is affected.

coffin bone normal and one with changes due to pedal osteitis photo

Seedy Toe

Seedy toe
chronic laminitis and a nasty fungal invasion causes a condition commonly called Seedy Toe. This foot requires a high level of management between farrier, owner and vet.

Horses with chronic laminitis are also likely to have chronic submural abscessing in the toe. This is a result of malformed, scarred and or damaged horn that is a result of  laminitic cycle is prone infection.


The coffin bone may fracture. A fragment of bone that is broken away is called a sequester. The sequester can result septic pedal osteitis, lameness and abscessing. The offending segment may require veterinary intervention to end chronic abscessing.

Horses with coffin bones that have be damaged from trauma can abscess if the injury leads to infection.

Horses with thin soles and/or  worked on hard surfaces can also  develop pedal osteitis. Horses with coffin bones weakened by any disease  are also predisposed to  this internal abscessing.

Acute Laminitis

Horses in the acute stage of laminitis can suffer from abscessing from the extreme internal injuries taking place within the hoof capsule.

Acute laminitis with subsolar abscess caused by pressure from rotated coffin bone
Acute laminitis with subsolar abscess caused by pressure from rotated coffin bone

If a horse presents this type of abscess you are in need of qualified professionals with experience dealing with laminitis.

If a “professional” attempts to pare away at the solar surface of this horse to “dig out” the “infection” please reconsider this person’s expertise in dealing with hooves in general. This practice generally not recommended. The soft tissue will almost always prolapse through the sole causing further insult to an already bad situation.

Again, under no circumstances should an opening be created in the adjacent sole. This seldom leads to the abscess, generally leads to hemorrhage and may create a persistent, non-healing wound with increased potential for bone infection.”

Dr. Stephen O’Grady “Managing Hoof Abscesses”


A keratoma is tumor made of a horn (hoof material) that develops between the coffin bone and the hoof wall. Keratomas are not common, usually benign and a skilled horse person may be able to identify an affected hoof as the growth causes distortions in the hoof wall and white line.

Removal of a keretoma. Note the distorted coronary band that would alert a wise horse person to the abnormality. Photo:

Occasionally, pressure from the growth can cause  necrosis of the adjacent portions of the coffin bone  leading to Osteomyelitis abscessing. These keratomas may need to be removed under veterinary supervision to end the cycle of chronic osteomyelitic abscessing.

For more on keratoma read Dr. O’Grady’s case study.


A horse with an abscess is a common occurrence if one keeps horses for any length of time.  Luckily, most are treated, recovered from and back to work in under two weeks.

Horses that have chronic abscessing may be helped if the causation of the infection is identified. More aggressive treatment may be necessary for horses with certain types of abscesses.

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Middle Tennessee Farrier
Elizabeth the Farrier


How to Treat Hoof Abscesses in Horses

 How to treat  Hoof Abscess in Horses

how to treat hoof absesses

When asked how  to  treat hoof abscess, I recommend using an Animalintex  hoof pack to draw the infection from the hoof capsule. Abscesses will usually resolve themselves given enough time, however, it is far better to be proactive because:

  • The hoof abscess will usually resolve quickly if the abscess is poulticed and drained.
  • The poulticed abscess is more likely to be drawn out through the ground bearing surface. If left to resolve itself, an abscess will generally blow out the coronary band. An abscess venting through the top of the coronary band damages the entire hoof.

    treating hoof abscess
    old abscess tracts allowed to vent at the coronary band leaves the hoof badly damaged. It will take many months for this to grow out and leave a void for hoof eating microorganisms to thrive.

Animalintex packs are the most convenient way to draw the pus to the surface to using an isotonic solution. It is preferable to the traditional “hoof soaks”  which call for repeated, lengthy immersions  of the whole foot because:

  • multiple hoof soakings  water logs the foot. This will  compromise the already weakened foot. Using a warm, damp poultice is a better alternative than repeated, lengthy soaks.
  • The pack can be left on for 24 hours at a time.
  • Getting a horse to stand in a soak is difficult unless you have a special boot.
  • If the abscess does drain, it will be evident if the spent hoof pack is inspected.

    treating hoof abscess
    used Animalintex pack with exudate from hoof abscess

Animalintex is at my local Tractor Supply Company for under $15. You will also need:

  • Vet wrap or elasticon
  • Duct or Gorilla tape
  • wire brush

If  Animalintex is not available, one part epsom salt and two parts wheat bran moistened with warm water and using a diaper as a vessel is a time tested alternative.

I do not think that ichthammol is a good medication for hoof abscesses at all. It contains formaldehyde which hardens the hoof wall, making it more likely the abscess  will vent through the skin at the coronary band. Again, it is much more desirable to get the abscess to vent through the bottom of the hoof. Also,  it’s tarry texture and strong smell will make it impossible to tell if you have drawn the abscess out.

hoof abscss
I do not like  using ichthammol for hoof abscesses.

Elizabeth’s abscess poultice method:

1. Make a hoof-sized hash tag of tape

hoof abscess treatment

This will serve as the protective outer shell. Gently place this near where your lame horse is for use later.

2. Cut a hoof sized piece of the Animalintex Middle Tennessee Farrier

Animalintex comes in squares and hoof shaped pieces. I think the square is the better value.

3. Dampen the Animalintex with warm water.

Middle Tennessee Farrier

Don’t wet it too much or you will wash out the medicine! The moistened Animalintex pad clings to the foot  making the pack  easier to put on.

4. Don’t medicate the dirt! Clean the foot thoroughly with the wire brush.Southern Middle Tennessee Farrier Horseshoer Hot shoeing5. Place the t Animalintex on hoof.

If you have determined that the abscess is in a specific area of the foot such as heel or toe, center the poultice over that area. If unsure, use a big piece.southern middle tennessee farrier service hot shoeing

 6. Use Elastikon or Vet-wrap to secure the wet Animalintex.

Elastikon is more expensive because it is better.

Southern Middle Tennessee Farrier Service
taking the tape from the inside heel to outside toe in figure eight is necessary for the pack to stay on

I alternate catching the heels in a figure eight pattern and circling the perimeter of the hoof. Be careful to keep tight bandages on the hoof only. The bandage needs to be snug or it will fall off. Make sure you get a snug pull when you figure eight the heels to the toe.

7. Place duct tape square over foot and form to fit.treat hoof infection with medicine

ferrier, farrier, horseshoeing
8. Finish by circling foot with more duct tape and put leg down. Middle Tennessee Farrier
9. Clean up edges with knife or scissors and make CERTAIN that this pack does not come above hairline to avoid cutting off the circulation to the foot.Middle tennessee horse ferrier farrier
10. Put a call in to your veterinarian, let them know you have a horse with a possible abscess.

Some vets and farriers like to cut a big hole in the hoof searching out the abscess. I do not care for this practice as

  • More often than not, they do not find the abscess because it is still too deep in the hoof. It is better to continue to poultice until the pus is drawn just below the surface.
  • Now the horse has a foot wound in addition to the abscess. This horse now requires weeks of stall rest and bandaging as his delicate sensitive hoof and possibly bone are now exposed to the environment.
This hole will take a long time to heal.

An experienced hoof person can look and palpate the hoof and have a pretty good idea of where the “track” is. The track is the spot in the hoof where the original breach of the hoof capsule occurred and an excellent place to drain it.  It is best to wait until only the slightest nick allows the pus to be expressed. I prefer allowing more time and poulticing to invading the hoof capsule in search of an abscess. It is usually not necessary to whittle the hoof until it bleeds.

how to treat horse hoof abscess
abscess track draining in the seat of corn region

Once the abscess is vented and drained , the horse will become noticeably less miserable and will continue to become more comfortable. I recommend flushing the tract with hydrogen peroxide and iodine.  There may be some residual foot soreness because the hoof has been traumatized. This should steadily improve until the previous level of soundness is achieved

When the horse is non reactive to reasonable palpation of the affected area, the shoe may be reapplied and the horse may be gradually returned to work.

Hopefully “How to treat  hoof abscesses in horses” helps you in your hoof care endeavors. For more information on the causes of abscessing, including information on horses with chronic hoof abscess check out Hoof Abscesses; symptoms and causes.

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Horse hoof care, fact and fiction

As a kid riding lesson horses first and then grooming and exercising privately owned horses for lesson money.  I got pretty far without knowing much about horse hoof care other than to always pick the  hooves before and after riding.There were a lot of boring hoof products my horsey catalogs that I didn’t understand. I  figured some horses had good feet, some horses had Navicular disease.

I did like those bell boots with the interchangeable colors a lot. Maybe dramatic foreshadowing?? Farriers love bell boots.

Farrier science takes years of study and thousands of feet in your lap to really wrap your head around how they respond to trimming, shoeing, time, the environment, management, use, etc..

The hoof  is so perfect, it seems simple at first glance. It is anything but.

This simple appearance is a source of many misconceptions. What seems like the obvious answer to an otherwise seasoned horse person, or sometimes fellow shoer, is not actually correct once the true complexity of the hoof is considered.

Here are a few examples:

1.  Some horses just have good feet.

hoof care
rock crushing appy feet

There are horses born with good feet, however, usually have some other things in common other than the prized, high quality hoof wall. Often good feet reflect of other nice things about the animal or where he lives.

  • Horses with legs that are mostly straight with hooves pointing in the same general direction will wear their feet evenly and be free of distortions like dished toes and flares
  • Horses with  cupped hooves
  • Horses that are in dry environments
  • Being related to other horses with good feet, intended or otherwise

There are also animals with not so great feet. This is not necessarily because they have actual “bad hooves”, it can be a result of one or a combination of factors.

  • Horses with conformation that causes them to paddle, rope walk, drag a toe, stab, be lame, etc will wear unevenly.  Without the regular intervention of a conscientious farrier one side will get wore to a nub while the other side grows long and flares outward.hip number 666
  • Horseshoeing or trimming by an unqualified or careless farrier can cause problems, especially if the same mistake is repeatedly made.
  • Hoof left not level or not trimmed often enough. The hoof will flare on longer.
  • Shoe doesn’t fit foot or left on too long. This causes corns or bruising of heels.
  • Shoe doesn’t fit, or left on too long. The nails waller out hoof wall of an loose shoe. Excessive nails.
  • Excessively wet environments are very detrimental to hoof quality.
  • Repeated shoe loss
  • Horses with sloping pasterns and low heel angle conformation
  • Nails behind the widest point of the foot restrict hoof function. This can lead to or exacerbate chronic hoof problems.

Horses that I would classify as having truly “bad feet” may have issues such as club foot, chronic laminitis, horses with “no heel”, and or moderate to severe white line disease. Feet like this have weaker or distorted hoof due to pathologies in the hoof capsule. This will require more frequent visits from a farrier with experience in managing imbalances and  management of their environment.

Seedy toe
chronic laminitis and a nasty fungal invasion causes a condition commonly called seedy toe or white line disease. This foot requires a high level of management between farrier, owner and vet.

Fortunately, even horses with compromised and diseased hooves can improve when hoof care is a priority.

My best advice is to be proactive and get your horses feet done before they look overdue and evaluate management practices in regard to the daily care and conditions. A step such as waiting until the dew has dried from a grassy field to turn out a horse would be a good example of this.

If your horse has distressed looking feet that are not improving and you are not getting a satisfactory answer of why, just like in other aspects in life,  it may be time to try a different approach.

2. Feeding supplements will cure my horse’s feet.

I do not recommend hoof supplements until all other balance, management and environmental issues have been resolved. Horses with bad feet have normal levels of biotin in their blood. Despite what you may have heard, there is  little evidence that supports that they have a significant impact on hoof growth or quality. These products cost well over $1 per day and there are valid, industry-wide concerns about the lack of regulation in the supplement industry. There have been recent allegations by scientists claiming these products do  containing any evidence of containing what the label promises.

Biotin can't cure hoof imbalances
Biotin can’t cure hoof imbalances

Biotin is he main ingredient touted by the supplement makers to promote hoof growth and it is required for not only hoof growth. It is required by every cell in the body. What no one ever mentions is that biotin deficiency is extremely rare. It is found in oats, hay and grass which is what most horses eat anyway. If you are feeding quality horse food, you should be fine.

Also, because hoof grows so slowly, it will take more than a year’s worth of supplementation to see the purported “results” that the supplement makers promise. I would like to suggest that it is more likely that improvements in the horses environment, management and farrier work is what leads to better looking hooves.

It is possible that since there are products that are touting other ingredients not as present as biotin in the equine diet. This may be of real benefit to some horses, I am not a nutritionist. People seem to really like to feed the hoof supplements for the right reasons. They want to avoid or remedy a nasty hoof problem, and of course I do too. I don’t think it is possible to “supplement” your way out of the majority of the hoof problems I come across.

The efforts and resources need to go into good shoeing and management first.

3. Judging the quality of a shoeing job by how long the shoes stay on.

No one likes a lost shoe, but losing shoes is a part of shoeing horses well. The best way to never have to go back and replace lost shoes is to use a shoe that is too small for the foot.

I was reading an olden time farrier book that has all horses on a 3-4 week cycle and going any longer was asking for trouble. Those people needed those animals so they did what it took, that may be the case with some today.

A properly fit horseshoe is going to be slightly larger than the horse’s hoof, especially in the heel area. The hoof repeatedly expands as it strikes the ground, supporting the horse and rider then contracts as the hoof is picked up. The shoe must be fit to accommodate both phases.

proper heel fit
the heels should be fitted slightly wider than the hoof from the mid line back towards the heels. This is to accommodate and protect  for expansion of the back half of the foot under full load


Although this extra lip of shoe is needed to avoid heel pain, it is more likely to get pulled than one that is too small. Fortunately, an expertly applied shoe should come off without damaging the wall.

 Using a hoof gauge to determine toe and heel length

A hoof gauge is a protractor for the hoof that measures the toe angle in relation to. Mathematically, the correct answer would be “not enough information”. No two horses are alike it is not possible to determine optimal balance without first addressing the animal.

I have worked for many nationally respected farriers and have attended many continuing education clinics and none  give any credence to this measurement that seems so important to some people.

Toe angle is important in the way the hoof relates to the limb and the horse’s conformation, not the ground, which is what the gauge is measuring.

The hoof angle should match the angle of the pastern. The length of the pastern will dictate the hoof angle and no farrier can change the conformation of your horse, nor is it a  good idea to try.

pastern anlge

5. Don’t touch the heel!

The heel should be brought back  to the widest point of the frog. Attempting to make the toe steeper by leaving the heel sounds like a good idea, but since the hoof grows forward and down, this practice is detrimental to the health and proper functioning of the foot.

heels don't grow down, instead they migrate forward causing stresses in the back half of the foot. hoof care
heels don’t grow down, instead they migrate forward. This loads the foot  inappropriately, causing heel trauma.


hoof care long heels move the base of support towards the toe. Normally the weight is born on the cushy back half of the foot. With the heels left long the bony structures are taking the majority of the load. This can lead to navicular syndrome.

6. Using topical products to “fix” imbalance issues.

There are many premade hoof dressings on the the market and many more old-timey recipes that people claim will heal hoof cracks, grow hoof fast and cure what ails your horses troubled soles.

Hoof dressings can enhance the water repellency of hooves in some environments. It may help with some fungal/bacterial invasions as the ingredients usually contain some kind disinfectant like pine tar.*

Topical dressings do not grow new hoof or do anything to heal the sensitive structures within the hoof capsule no matter what they claim.**The hoof is dead, it is not possible for it to heal, it only possible to create conditions where it will be eventually replaced with undamaged horn.

*Horses with cracks in their hooves are very common in the Southeast that is related to year round wet/dry conditions that is hard on all of us. It is usually a white line disease related problem and needs a farrier with experience to debride affected horn. I do recommend antifungal topicals to fight fungal and bacterial invasions of the hoof wall.

**I do think hoof poultices are helpful to help with inflammation and isotonic soaks/packs to draw infections from the hoof,  See this for more.

Thanks for reading my blog, please spread the word. If you have any questions about consultations on your horse or general hoof care questions you would like to see my take on, feel free to contact me here.

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