Getting to the “Sole” of Stone Bruises
Every horse will likely have to deal with stone bruises at some point during their lives but the situation is usually resolved fairly easily.
By: Nicole Kitchener |
Have you ever spent any length of time shoeless? Perhaps kicking off your footwear at the cottage for a week or two? At first, your soles complain when they land on every little bump and stone. They probably feel pretty bruised and beaten. But, by the end of your shoe-free period, your feet have roughened up and become more desensitized to the ground’s ups and downs.
Similarly, horses in the wild grow harder, stronger hooves. They, too, are better able to withstand harsh, uneven footing and are, therefore, far less prone to bruising – unlike the hooves of many domesticated horses.
“Any accidental injury to the sole of the foot, such as treading on a stone or another hard object can cause a bruise. Other causes of sole trauma are poorly fitted shoes and excessive work on hard ground,” said Dr. Judith Koenig, who evaluates horses for lameness and performance issues at the Equine Sports Medicine and Reproduction Centre at the Ontario Veterinary College.
Stone bruises are one of the most common causes of lameness. Horse management has a lot to do with that. So many horses are kept in well-bedded stalls, grazed on cushy pasture and ridden on consistent, manicured surfaces. Additionally, according to Hans Wiza, who has more than 40 years’ experience shoeing and trimming all types and breeds of horses, certain kinds of bedding or footing like wood chips, gravel and even sand, can lead to bruising in thin-soled individuals. He further cautioned that “using rubber stall mats with just a handful of shavings or shredded paper can lead to excessive moisture in the stall, which can soften the soles over time.”
Genetics also play a role. Modern breeding practices have resulted in many breeds that are created for specific sporting endeavours, but not necessarily for optimum hoof conformation. This has led to a number of breeds that have inherently weak hooves. Take, for example, the Thoroughbred. Produced over the generations for speed, they race on soft surfaces, where overall their hooves fare quite well. Move that Thoroughbred off the track onto less forgiving footing, and his thin or soft soles and/or flat feet, will probably end up mighty sore.
Although every horse will likely suffer a stone bruise at some point during their lives, the situation is usually fairly easily resolved. But horses who are predisposed to bad feet from the get-go can experience chronic bruising that causes permanent lameness due to inflammation of the coffin bone – which is situated only 3/8 of an inch away from the sole in a normal hoof.
How a Bruise Happens
When the sensitive, blood-filled tissue between the sole of the hoof and the coffin bone suffers trauma, blood vessels in that area rupture, causing bruising and bleeding (hemorrhage). In many cases, there is a quick resolution, explained Dr. Koenig, but sometimes the damage results in the formation of a hematoma (blood-filled blister) between the sensitive tissues and the sole.
“The pressure caused by this “blister” on the sensitive tissues causes pain and lameness. The human analogy is a painful bruise or hemorrhage under a fingernail,” she said.
Stone bruises usually only affect one leg. Horses can become suddenly and/or intermittently lame on the affected foot. Lameness can be mild or often will be much more dramatic. “They look like they broke their leg,” said Rick Corkum, a farrier from Nova Scotia, who has been working on horse’s feet for 32 years and has witnessed his share of bruises.
If your horse has stepped on something that could potentially cause a bruise, Dr. Koenig recommends checking the hoof immediately for signs of trauma, but she warns, “Once the stepping on something is done, the damage is done. Some people advocate putting the foot in ice to prevent a hematoma.” But usually the original injury will have taken place many weeks or months before the horse begins to experience discomfort.
Once the pain rears its head and you suspect a bruise, Corkum suggests putting the horse in a stall with six to eight inches of bedding to keep him comfortable.
Although a bruise isn’t an emergency situation, if extremely lame, the horse should be examined by a farrier or veterinarian who can rule out other, more serious lameness conditions such as laminitis, help alleviate the horse’s pain and prevent one of the major complicating factors of bruises – abscesses.
If the horse is wearing a shoe on the foot, it will be removed. Then, said Corkum, “if you can’t see the bruise, you can use your hoof testers – they look like large clamps – to palpate the sole of the foot.” The horse typically responds by flinching when pressure is applied to the location of the bruising.
The superficial layers of the sole are then pared away gently using a hoof knife. (Note that you don’t want to be overzealous with the hoof knife, as removing too much sole horn, will only further compromise the sole.) A bruise will appear as a red or purple spot. Sometimes paring will reveal spots of blood. The bruise is then drained.
According to Wiza, another clue that bruising has occurred is the appearance of swelling on the back of the leg, which he referred to as a ‘circulatory response’ to the injury. “Many times, you will find a large, palm-sized swelling on the back of the limb, right above the fetlock joint. The area will be mushy, fluid filled,” he said. “Also, the digital pulse will be raised, and the artery engorged with blood. These are good indications that bruising has occurred.” It may also hint at the formation of an abscess.
Like many experts, Dr. Koenig suggests poulticing the foot after the bruise has been drained, then applying a protective bandage to the hoof. This will help reduce inflammation, draw out any pus that maybe present (indicating the presence of an abscess) and clean the wound. There is a wide range of commercial preparations and pre-treated poultice pads available – ask your vet to recommend one. “The poultice is removed after 24 hours and the bandage is removed and reapplied for another 48 hours,” said Dr. Koenig, advising that a veterinarian should be called again if there is no improvement within 24 to 48 hours.
Corkum, on the other hand, prefers to use a topical iodine or copper naphthenate-based commercial preparation on the affected area for a week to harden it and prevent infection. Additionally, he likes the horse to remain in a clean stall for three or four days, then slowly put back to work and onto regular turnout.
Some practitioners recommend soaking the foot in an Epsom salt bath with warm water to aid in drawing out the inflammation caused by the bruise. However, it should be noted that excess moisture will actually begin to soften the sole, potentially weakening it and prolonging the healing process. As such, it is recommended that you only soak the hoof once or twice a day, for no more than a day or two.
Wiza advocates “doing whatever it takes to alleviate the inflammation in the hoof. Poulticing or soaking is okay, as is cold hosing. I am old school, and usually go to Epsom salts or a bran mash poultice.”
When the horse is no longer sore, it’s time for a trim and/or shoeing. At this point, it is essential to resolve predisposing factors and, in many cases, shoes, either standard or corrective, are recommended to help prevent further bruising. Wide-web shoes that cover a wider area of the hoof are often applied, as are those with metal plates, particularly behind the toe, which is a common area of bruising.
Many horses are outfitted with hoof pads as protection. These are layers of rubber or, less commonly, leather that fit between the hoof and the shoe. Full pads cover the entire sole, while rim pads are cut to follow the contour of the shoe.
Corkum suggests pads might not be an ideal treatment because they create a moist environment that softens and weakens the sole. “You don’t really want to pad a horse that has [bruising]. Once you pad it, the area can’t self clean, so you’re actually creating more of a problem by putting a pad on,” he said.
“You just want to leave it open and keep the horse in a clean, dry environment.”
Yet, he admitted that pads can help thwart bruises in the first place. “This is the funny part. After a bruise, you wouldn’t put on a pad, but if you put a pad on beforehand, that will ideally prevent a bruise,” said Corkum. “I have some clients that just do that for preventative maintenance. They have a show horse and they can’t risk having them bruised. And a bruise can happen at any time.”
Pads are not intended to be a permanent solution. Some experts even suggest they can exacerbate the effect of uneven ground because they effectively bring the sole closer to the ground. Full pads also prevent adequate hoof picking as well as full and regular examination of the sole and frog. And, added Dr. Koenig, “Stones can also sneak in between the heel and the pad.”
Preventing Stone Bruises
Let’s return to the tender cottage tootsies that we discussed earlier. Remember that the more calloused and hardened they were, the less pain they endured when treading on unforgiving ground? Well, the same goes for our equine pals’ hooves. “Try and keep that foot as dry and hard as you possibly can because a hard foot won’t bruise,” said Corkum. “I was out west and because of the environment there, the horses’ feet were extremely hard. And that, bar none, is the best thing you can do. People think that if the hooves get hard, they get brittle, and that’s not the case at all. They chip when they’re soft. Keep that foot as hard as you possibly can keep it.”
Corkum said using iodine-based products will help keep the hoof dry and hard. But management is also important. “This will only harden the very surface. So, a clean, dry environment is key.”
Other regular and simple prevention measures a horse owner can implement include picking out a horse’s feet daily (especially before and after riding) to remove stones or other objects that might produce a bruise. Check for loose shoes that can shift out of place, putting pressure on the incorrect areas of the foot.
Consider setting your horse up with boots like endurance riders’ mounts wear. They can be helpful for horses that are prone to bruising or that are going to be working on ground that is rougher than what they are used to. Boots can be pulled on over shoes or bare hooves.
Always encourage healthy hoof growth by providing proper nutrition and, if necessary, supplementing with products that are proven to contribute to strong hooves such as biotic, methionine or zinc.
A bruise might feel like the end of the world, especially if you were planning a fun trail ride or competing in a show. But the good news is that they are usually fairly innocuous and easily and quickly treatable.
A corn is a bruise that occurs at the angle of the sole between the hoof wall and the bars, an area that is also called the seat of the corn.
Corns appear as yellow or red spots usually on the front feet. They can be dry with mild bruising, or moist with a discharge of pus where infection and abscessing are likely.
The majority of corns are caused by ill-fitting shoes. In particular, shoes that are too small or narrow can cause trauma to the heel area.
Corns may also result when shoes are left on too long. If the hoof wall grows around the outside of the shoe, the shoe moves forward creating pressure at the bars, resulting in trauma. In other cases, stones can become trapped between the shoe and the seat of the corn, resulting in bruising. Horses with long toes and low heels are also susceptible due to excessive weight-bearing on that area.
Horses suffering from corns will usually stride with toe hitting the ground first, to avoid heel contact with the ground.
Like other forms of sole bruises, corns should be pared and drained by a farrier or veterinarian.
Heart-bar shoes, which have a metal tongue that offers support over the frog and takes the pressure off the hoof wall, are a helpful temporary measure that allows the corn heal.
An abscess is a collection of pus that is the body’s response to an infection or invasion by a foreign body. An abscess can be secondary to a bruise when bacteria become trapped in the injured area.
“Often we are dealing with a bruise first, they are lame from that, and then the bruise will abscess and they are lame from that as well,” said Dr. Colleen Dickie, of the Charlottetown Veterinary Clinic in P.E.I. “Either way, they’re very frustrating to deal with.”
Permanent damage can result if an abscess is ignored. Dr. Judith Koenig said it can be a “challenge to differentiate” between a bruise and an abscess, but the latter may exhibit a warmer foot and higher digital pulse. “Often, paring a sore spot will show if it’s just a bruise or, if pus comes out, an abscess”
A farrier or veterinarian should open and drain the abscess either through the sole or the hoof wall. The area may then flushed with an iodine preparation to sterilize the area and harden the hoof tissue. Poulticing is also commonly recommended to draw out the infection. Further, non-steroidal anti-inflammatories and a tetanus booster are sometimes prescribed.
Once this is done, the horse usually experiences immediate relief and a full recovery can be expected within a week or so.