Hoof Abscesses: Managing Them and Bandaging the Hoof

You arrive for your evening ride and your horse is holding his hoof up. Is it broken? Is there a nail in the foot? Is it a hoof abscess or just a bad stone bruise? Hoof-related problems can be scary, but with help from your veterinarian and a methodical approach to care, your horse’s foot can quickly mend.

A hoof abscess is a pocket of purulent material (much like a pimple, purulent material is dead white cells that were cleaning up the infection—also known as pus). Since the hoof wall is relatively inflexible, the pocket of pus creates pressure within the hoof causing mild to severe foot pain. If you suspect that there is an abscess, your veterinarian or farrier can determine if an area in the sole needs to be pared away to allow for drainage. Sometimes, the abscess will require some time and a little help through foot soaking and poulticing to pull it close to surface to allow drainage. If there is no change in the horse’s condition after a day or two of poultice application and bandaging, your veterinarian should visit again to make an assessment. Your horse may have a more serious condition, such as a fractured coffin bone, or the abscess may have penetrated a vital structure, such as a joint or bursa.

Soaking the Hoof

Soak the foot on the first day or two to help draw the abscess up to the surface. I don’t recommend soaking the foot for more than a few days, as the water may compromise the structural integrity of the hoof.

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I recommend using Epsom salts (magnesium sulfate) for the soak bath. Fill a soft-sided tub, such as a short feed tub, with warm water. Add Epsom salts until they no longer dissolve and the salt falls to the bottom (supersaturation). Gently place the horse’s foot in the water. Ideally, the water should cover the coronary band.

Keep the horse standing quietly with his leg in the bucket for 10-20 minutes. Make sure to dry the hoof well before bandaging it. Thoroughly dry the sole, hoof and coronary band. I usually towel dry the foot and then stand the horse in a clean area while I get all my supplies together for the bandage.

To Poultice or Not?

Next, you need to decide whether or not you need a poultice. A poultice is used to help draw out the purulent material from the abscess. I prefer to use a poultice impregnated pad such as Animalintex® instead of clay poultices, as it reduces the chance of the poultice getting pushed up and trapped in the hole of the abscess. Also, a poultice pad is easier and cleaner to use, especially when you have to replace the bandage daily.

After the majority of the abscess has been drained, I like to use granulated sugar mixed with a Betadine® solution (not scrub) for a day or two. The sugar is antibacterial and draws fluid out of the foot while Betadine® is an antiseptic and helps to dry out the hoof.

Safety First

Whenever you are working around horses’ feet, you must be very aware of your body. Make sure your feet are not under the horse’s feet and that your head is never in front of his legs (many black eyes have occurred when this advice is ignored). Stay safe, have a handler (helper) present, and ensure that the horse is properly restrained. Collect all your supplies beforehand to have them close at hand and easily accessible when you are holding up your horse’s leg.

Supplies:

Duct tape
Poultice pad (Animalintex®)
Small sized diaper
Flexible stretch gauze wrap (3 inch, Kling®)
Self-adhesive elastic bandages (3-4 inch, Vetrap™)
Elastic adhesive tape (3-4 inch, Lightplast®)
Bandage scissors

Hoof Bandaging Steps:

1. Prepare some duct tape by tearing off strips that are about twice the length of the horse’s hoof (from heel to toe) or about 30 cm long. Make a square by overlapping the strips of tape about half way to give some strength to the square. Apply a second layer of duct tape perpendicular to the first layer. Set the square aside in a safe spot, sticky side up.

2. Make a cut at each corner from the edge towards the centre, leaving an area at the centre approximately the size of the horse’s hoof.

3. Prepare the foot, by picking it out. The hoof, sole and frog should be clean and dry.

4. Prepare the poultice following the instructions on the packaging. If you already know where the abscess will drain (i.e. your veterinarian dug out the sole to drain the abscess or the abscess has burst along the coronary band), you only need to apply the poultice over this small area of the sole or coronary band. This will save product, money and help prevent damage to the surrounding healthy tissue.

5. Using flexible stretch gauze wrap, such as Kling®, bandage around the foot to secure the poultice.

6. Use a small sized diaper and place it over the hoof. This step works well for a couple reasons. First, the diaper is absorbent and will soak up any excess fluid from the poultice. Second, the diaper will provide padding, which can help prevent chipping of the hoof wall and protect the coronary band from pressure from the next layers of bandage material.

7. Using self-adhesive elastic bandages, like Vetrap™, bandage over the diaper, securing it in place. This layer will also prevent the duct tape from adhering to the foot. When wrapping the foot with any bandage or tape, it is important to cover the hoof wall and sole of the foot without putting pressure on the coronary band. After a few wraps around the hoof wall, place a couple wraps diagonally across the sole from toe to heal alternating between sides (similar to a figure eight pattern). Return to wrapping around the hoof wall and then make a couple wraps around the bottom edge of the hoof wall.

8. Take the duct tape square and place the centre of it over the sole of the foot, sticky side down. When placing the square, ensure the cut corners are on the “corners” of the hoof, as this will help with the next step.

9. The corners that you cut in the duct tape square will help to smoothly attach the tape to the bandage. One at a time, fold up a side of the duct tape square and smooth over the hoof.

10. Using the roll of duct tape, wrap the foot, paying extra attention to the toe (especially if the horse has shoes on) as this area will be the first to wear through when your horse walks.
The coronary band should not be covered with any duct tape.

11. Inspect the coronary band. There should not be any pressure on it, including circumferential pressure. The coronary band is made up of fragile tissue from which the hoof wall grows (similar to your cuticle at the base of your finger nails). Pressure on the coronary band can cause damage to the germinal tissue and lead to damaged hoof wall growth. The diaper should provide sufficient padding over the coronary band so that the Vetrap™ does not put any pressure on the coronary tissue. You should be able to insert a finger down inside the top of the bandage easily. If there is any concern for the coronary band, it is best to cut a slit down the front of the bandage starting from the edge above the coronary band. When making the cut it is important to use bandage scissors that have a blunt end to prevent cutting any skin.

12. Place some elastic adhesive tape, such as Lightplast®, around the top of the bandaging to prevent shavings or dirt from getting down into the bandage.

Alternative Method

As an alternative Step 5 and 6, the Kling® and diaper, can be omitted and the Vetrap™ can be placed directly over the poultice to secure it in place. It is important when omitting these steps that the Vetrap™ and duct tape do not cover the coronary band. The Lightplast® can be placed around the top of the bandage and can cover the coronary band as long as it is applied without tension.

Boots & Hospital Plates

There are many different styles of boots available that can be worn over the bottom layers of the bandage instead of using the duct tape. Depending on the hoof size, you may not be able to fit the diaper either. When considering the purchase of a boot, ask yourself:

Will a boot stay on?
Will a boot rub or cause damage to the coronary band?
Is there enough room to use appropriate bandage material under the boot?

A well-fitted boot may be extremely helpful and reduce the time it takes to place the bandage if you have to bandage for a number of days.

An alternative to a boot is a hospital plate. A hospital plate is a thin metal plate that is attached to your horse’s shoe with screws and covers the whole sole of the foot. These shoes are usually custom-made by a farrier for horses that will require long-term treatment of a foot problem, such as a large sub-solar abscess (an abscess that has undermined a large portion of the sole of the foot). A poultice or other medication can be placed on the sole of the hoof and then the hospital plate screwed in place protecting the entire sole and securing the medication.

When you have a foot problem, such as an abscess or sole bruise, a hoof bandage can help protect and treat the foot. Having the correct supplies at hand makes a sometimes difficult bandage an easy task.

Foreign Objects

If you find a foreign object stuck in the hoof, like a nail or piece of wire, it is best not to remove it. Keep your horse quiet and standing still and call your veterinarian. Your veterinarian needs to take a radiograph with the object in place in order to see if the object has penetrated any vital structures that may require more aggressive therapy or surgery.

HOW TO MAKE A “SUGARDINE” POULTICE

* Start with a 1 cup of white sugar. Add Betadine® solution to the sugar until it makes a thick paste.