Abscess

Your horse is happy, healthy, and sound at dinnertime.  The next morning she comes limping into the barn three legged.  Severe pain, swelling past the fetlock, heat to the touch you panic.  The horse must have broke it's leg!  Well, especially if you live in northwest Washington state, it is probably an abscess.  An abscess is described by Dr Stephen O'grady, "as a localized accumulation of purulent exudates (pus) located between the germinal and keratinized layers of the epithelium, most commonly subsolar or submural."

What do you do?

There is much debate whether it is up to a vet or farrier to treat an abscess.  I suggest discussing this in advance with your hoof care professionals (vet and farrier), as it takes a skilled hand when locating an abscess as well as thorough knowledge of anatomy to guess the structures which may be involved.  Your vet and farrier should be a team with the owner in making decisions on care for the equine.  In the event of a puncture, make sure the vet is involved.  Do not pull out the foreign material (nail, stick, etc.) as it may be deeper and involving sensitive structures and may need to be surgically removed.  It is important to be up to date on the horse's tetanus.

A typical abscess with no apparent direct puncture may go as follows.  The horse came up with acute mild lameness.  The hoof was cleaned and examined by the owner and trainer, no puncture or foreign material was noted.  Heat was present as well as mild swelling just above the hoof capsule.   The owner brought the horse to the Westman Farrier Service shop.  The first thing I did is feel for an elevated digital pulse.  There was a pulse, but not bounding on the left rear.  There was slight swelling and heat around the heel bulb region with elevated positive response to palpation on the lateral bulb.  I used hoof testers, always following the same protocol, around the hoof searching for a sore spot.  I then used a digital laser thermometer to search for a spot of elevated temperature.

 The hoof testers came up with a very slight response near the frog, at the bar.  I cleaned the area with my hoof knife.

 Usually, an abscess track is not very apparent if it is an indirect puncture.  Do you see the problem spot?  It is very small.

A very slight cut with a hoof knife opened the track to allow the exudate to escape.

A bone curet is used to enlarge the opening only enough to allow drainage and not clog, but be least invasive as possible.

The abscess is draining nicely and has about a 1/4" opening to the pocket of the abscess.

A poultice is added around, but not in, the site of the abscess as well as both lateral sulci of the frog.

I like to use a diaper to keep the hoof clean, provide a bit of padding, and hold poultice.  This is a #5 diaper, I prefer the colorful jungle animal pattern ;)  The toe of the hoof goes nicely into the fold of the diaper.

Complete coverage of the hoof to the pastern is desirable to hold everything together and keep foreign matter such as moisture and debris out.  The velcro tabs on the diaper attach around the pastern.

I am using elastic tape bandage here to hold everything together and provide some sturdiness to the boot.  Co-Flex or Vetwrap type of wrap also works here.

Completely wrap the hoof

I use Duck tape or Gorilla tape to make a boot to waterproof and add strength to the temporary boot.  I use strips of tape to make a pad for the ground surface.

I use two layers for strength and durability.

After making a pad, I use scissors to cut from the corners to make 4 triangles.  I only cut the part which will be folded up the sides of the hoof.  This makes the pad easier to apply and provide more consistent coverage

Applying the pad.  Fold the front and rear 'triangles,' then the sides.

Use the roll of tape or strips to complete the coverage for the boot staying off the hair or skin of the horse.

A complete temporary boot.  Make sure the wrap is not too tight around the hairline of the hoof to allow blood flow.  I use my finger to make sure adequate space is provided. 

This wrap should last 2-3 days depending on footing.  The hoof should be inspected, cleaned, and rewrapped every couple of days to make sure the abscess is draining and the opening not clogged.  The farrier should follow up in 7-10 days and may want to apply a shoe with a pad to protect the area while it heals.  After allowing the abscess to drain, depending on damage, the horse should return to soundness fairly quickly and be serviceable within a week or two.