Horse Hoof Abscess

What Is a Horse Hoof Abscess?

A hoof abscess is an infection that gets trapped in the foot and forms a pocket of exudate, or pus. This builds up pressure and causes discomfort for a horse because the hoof is a fixed structure that can’t expand very much.  

The hoof is made up of an outer hoof wall (the part visible to the human eye) and the laminae (the tissue layer that connects the hoof wall to the coffin bone). A horse hoof abscess forms when bacteria become trapped inside the hoof.

Hoof abscesses are one of the most common reasons for acute (sudden) lameness in horses. Horses can be completely normal in appearance and become unable to bear weight due to an abscess within 24 hours. 

Hoof Abscess Symptoms

If a horse is experiencing a hoof abscess, they may show one or more of the following signs: 

• Mild to severe lameness 

• Swelling of limb 

• Warmth to the touch on the hoof wall or limb 

• A bounding or increased digital pulse felt near the fetlock, which means there is increased blood flow to the foot which occurs when inflammation is present.

• Discharge coming from the bottom of the hoof sole, or near the coronary band where the foot grows from, if the abscess occurs higher in the foot. 

• Foul smell coming from hoof 

• Object punctured in the hoof 

If you see anything abnormal stuck in the hoof, do not remove it. Call your veterinarian right away.

What Causes a Horse Hoof Abscess?

An equine foot abscess can form for a variety of reasons, but the condition is most seen during the spring and fall. The changes in weather from wet to dry, or dry to wet, may cause a horse’s hoof to become brittle and more prone to cracks and gaps, which allow bacteria to enter.  

Poor hoof care leading to crushed heels or long, flared toes can also increase the risk of hoof abscesses. Trauma, such as a puncture wound from a nail or another foreign object, can also lead to a horse hoof abscess or severe infection. 

If a foreign object is ever found in a horse's foot, do not remove the object. This is an emergency that needs to be seen by a veterinarian immediately.  Your veterinarian may need to perform radiographs before removing any foreign objects, such as a nail, to ensure that no vital structures are involved in the wound.

How Veterinarians Diagnose Horse Hoof Abscesses

To determine a diagnosis, your veterinarian will likely start by asking about the horse’s lifestyle history prior to the new lameness or visible symptoms.  

Your veterinarian will also want to determine the following: 

• Date of the horse’s last farrier appointment 

• Timeline of symptoms 

• Whether the horse is stalled or in a pasture 

• If the horse is ridden regularly 

• If there has been discharge, foul smells, or wounds around the hoof 

Your vet will perform an exam, likely starting with touching the affected leg from shoulder to hoof while looking for swelling, heat, pain, and wounds.

The vet will likely feel for an increase in the digital pulse, which can be a sign of an issue in the foot. Additionally, they will clean the hoof out with a hoof pick and look for any abnormalities.  

Hoof testers will be used around the hoof wall and sole to investigate the potential location of the pain by applying gentle pressure to different parts of the foot. If they can find an area that seems to get a reaction (your horse may try to pull their foot away), the vet may use a hoof knife, a common veterinary and farrier tool, to dig into the sole to explore for the source of infection.  

If the abscess is near the surface of the bottom of the hoof, the vet may be able to open and drain it, which generally gives the horse immediate pain relief when the pressure is gone.

In some instances, the abscess may open on its own at the coronet band. These abscesses tend to be more painful for the horse and may take longer to heal.

Horse Hoof Abscess Treatment

Horse hoof abscess care involves draining the pus and preventing infections.

Draining a Hoof Abscess

Once your vet finds the abscess in the foot and opens it to drain, it’s critical to keep the hoof clean and continue draining until the infection has been cleared completely. They may drain the abscess manually with the hoof knife, or they may encourage drainage with a drawing salve or poultice to encourage the infection to work its way out of the foot.

There are two ways to help the abscess to continue to drain: 

1. Soak the hoof one to two times daily in warm water with Epsom salt. Your horse must stand in a bucket of warm Epsom salt water above his coronet band for 15–20 minutes at a time. Epsom salt poultice is also available. Follow the instructions indicated on the packaging.

2. Use a poultice pad and wrap the foot. To use this pad, wet it completely and then put the non-plastic side against the hoof. Wrap the hoof so the poultice pad stays against the bottom of the hoof.  

Make sure that the bandage is not too tight around the coronet band, which can cause blood circulation issues. You will need to change the bandage once a day or every other day depending on how well it stays on your horse.

Prescription Medications for a Horse Hoof Abscess

Your vet may include a non-steroidal anti-inflammatory prescription medication, such as phenylbutazone, flunixin meglumine (Banamine®) or Equioxx® to help with pain and inflammation.

Besides providing relief from inflammation, these medications also reduce pain so your horse can be comfortable enough to put weight on the affected hoof. Large or chronic abscesses may also require oral antibiotics to help treat the infection.  

Recovery and Management of Horse Hoof Abscess

If left untreated, a horse hoof abscesses can lead to severe infections of the bone or even laminitis.

If a horse frequently gets hoof abscesses, your vet may want to investigate an underlying cause. For example, Cushing’s disease in horses can lead to a weaker immune system, making your horse more vulnerable to infections.

How Long Do Abscesses Take to Heal?

Horses tend to recover from a hoof abscess, but the timeline depends on the severity and location of the abscess.

A mild hoof abscess located and drained quickly may heal in as little as a few days to a week. More severe abscesses can take weeks—or even months—to completely resolve, particularly if they involve the entire sole or are high in the foot.

It’s more common for a hoof abscess to form in a front hoof versus a back hoof. When they form in a back hoof, they tend to take longer to heal.  A horse bears more weight on the front feet (~60%), so they apply more pressure on an abscess when they walk which can help the infection get to the sole faster and burst open to begin the healing process.

Preventing Horse Hoof Abscesses

There are ways to prevent your horse from developing a hoof abscess, including: 

• Ensure your horse’s environment is clean and dry by picking up manure and urine daily. 

• Keep your horse on a routine farrier schedule. Every hoof grows at a different rate, but generally every four to six weeks is a good timeline for a farrier visit. 

• Ask your farrier about your horse's hoof health and whether it’s abnormally dry or needs any additional care. 

• Clean hooves out daily and check for any foreign objects. Always pick up any nails, metal, glass, or other sharp objects.