# Treating a foot abscess.



## Pale Rider (20 October 2013)

I'd be interested to know what people think about treating an abscess in the hoof. 

Dig holes and drain it, or let it work it's way out.


----------



## ellie11987 (20 October 2013)

I'm interested in people's responses too... My mare had an abscess a few months ago and went 'broken leg' lame, the farrier only had to scrape her sole and found the exit point. Anything that required 'digging' I'd let it work its way out.


----------



## paulineh (20 October 2013)

I have always had mine dug out . Tubbed and dressed


----------



## MiJodsR2BlinkinTite (20 October 2013)

paulineh said:



			I have always had mine dug out . Tubbed and dressed
		
Click to expand...

I've always taken the farrier's advice with these things........ the problem is that if they're "left to rot" then they'll look for an escape route, and can explode out through the coronary band. This happened with my old boy, he was laminitic/cushinoid and was always having absesses. In the worst case scenario you can get total hoof separation and infection setting in. I'd far rather the damn things were dug out and allowed to drain, then tubbed and dressed. Much much better.


----------



## AdorableAlice (20 October 2013)

Depends what level of pain you expect your horse to tolerate and for how long.


----------



## cptrayes (20 October 2013)

I always leave them to find their way out, because my experience is that once they have come out of the heel bulb or coronet band (as is usual, more often through the heel)  the horse is sound and back in work much quicker than if they are dug out.


----------



## Pale Rider (20 October 2013)

Not digging for the abscess is the barefoot preferred method of dealing with them according to some practitioners. However, some farriers claim that not digging for them and allowing them to break out is neglect, and could render owners or trimmers to allegations of causing unnecessary suffering.
Personally, I'd go for not digging as I think it is detrimental and prolongs recovery significantly.


----------



## Graeme Burt farrier (21 October 2013)

Where do we get 'digging out' from? Do you really think its right to allow a horse to hobble around in excruciating agony (anyone who has had a tooth or jaw abscess will testify to this) while the pressure from an abscess constantly increases? Or does barefoot ideology transgress your horses comfort?
The vast majority of abscesses show evidence of their point of entry. Anyone with a trained or experienced eye can usually isolate the area of pain, search for the point of entry, locate it and relieve the pain in a few minutes. In most cases they give away their presence by horn infection, usually a black mark (where mud has entered following the bacteria or some other foreign body) and following that leads to the seat of the abscess.

By way of warning, leaving an abscess break out can lead to damage of the horn producing surfaces which is permanent, I have in the past removed nearly 100ml of pus from an abscess that was left to break out which ulcerated the sole causing permanent damage and rendering the horse continuously lame due to constant further breaches of the damaged sole. If the horn producing surfaces are damaged, the horn that is produced by the damaged area can leave open holes or weaknesses that allow penetration through to the underlying tissues, especially when liquid mud is around. There may well be a foreign body present causing the abscess like a hawthorn or the broken tip of a rusty nail. Leaving this kind of thing present can and has in the past led to bone infection and subsequent destruction.

As someone has already pointed out legally it is classed as neglect, and farriers are only strictly allowed to carry out first aid treatment and refer it to the vet for further action, although most vets generally hand over foot issues to those farriers that they trust to do the right thing. A courtesy call to the vet is always required though.


----------



## cptrayes (21 October 2013)

Graeme I understand your point about the pain which is obviously severe if the horse is bearing weight on the foot, but the total time from start to finish needs to be counted into the equation, and my experience, which is zero to do with any barefoot mantra, is that horses that break them out for themselves after a day of 'crippling' lameness recover much more quickly with no hole in the sole.

You are a farrier and your clients also expect you to 'do something' which puts quite a lot of pressure on you.

You are obviously very highly skilled. My own experience of several farriers in different areas is that they are not as good as you at getting the infection out first time. And don't start me on vets, who are sometimes happy to dig a trench !

None of us would, I hope, advocate leaving a horse in severe pain, which I would count as clearly walking lame, for days on end. But one day, rather than cut a hole in the sole and days of box rest and poultice? Yes, I'd take that option every time.


----------



## TrasaM (21 October 2013)

Having watched the pain and misery a horse was put through last winter because the YO decided he didn't need treating I would personally now opt for treatment. Same YO's horse had an abscess and it was treated (dug out by farrier) and the horse displayed nothing like the level of discomfort the untreated horse had shown.


----------



## MiJodsR2BlinkinTite (21 October 2013)

Good to hear from a farrier on here about this subject! Hoped one would respond.

Personally....... if there's a problem with the foot, I'd ask the farrier to take a look at my two instead of calling the vet, in the first instance. Then if farrier feels its a vet-job, all well and good, but IMO the farrier is the one who's dealt with their feet and knows their condition, and I'd far rather the farrier do his "render first aid" stuff sooner rather than later rather than let something develop inside the foot and before you know if you've got a mega-big problem which you've left too late to sort.

You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!


----------



## Amymay (21 October 2013)

It totally depends on the nature of the abscess.


----------



## TrasaM (21 October 2013)

MiJodsR2BlinkinTite said:



			Good to hear from a farrier on here about this subject.

You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!
		
Click to expand...

Absolutely. And a pain  I can identify with having had an abscess which took days to pop but when it did ; whew the relief.


----------



## cptrayes (21 October 2013)

MiJodsR2BlinkinTite said:



			Good to hear from a farrier on here about this subject! Hoped one would respond.
		
Click to expand...

There are farriers who do not agree with Graeme's opinion.




			You've only got to see the instant relief that's obtained from flushing out a foot abcess, whereas before the horse was hopping lame, to see which option the horse would prefer!
		
Click to expand...


Would it also choose the box rest and poulticing?

The horses I've had treated by cutting a hole in the sole were lame for a minimum of four days to a maximum of six weeks afterwards. Those I have allowed to blow on their own have been ridden, sound in trot on roads, within a maximum of 48 hours and sometimes on the same day.

It is the totality which counts, plus the likelihood of complications, not one moment of release from serious pain to lesser pain.

I wish the Farriers Registration Council would get off their backsides and do some proper research into what the best way to treat a foot abscess for a trouble free resolution is.


----------



## TPO (21 October 2013)

amymay said:



			It totally depends on the nature of the abscess.
		
Click to expand...

^^^ This^^^

Every case should be treated on an individual basis.

Sometimes nature isn't best and the horses need a helping hand and other times it's best to let it burst on it's own.

The onus is on the owner to either have enough knowledge and/or experience to make that call or have someone on her "team" who does be that a vet, farrier or trimmer.

I'm guessing this question is being asked after the thread on a NHCP Facebook page? I have to say I think the blanket advice & recommendations that they are handing out as gospel are dangerous. They may know when to leave it and when to get a vet out but going by some of the replies their followers clearly all don't. One woman was posting about how lame her horses was, so bad that her FRIEND wanted to call the RSPCA on her. But don't worry; said woman was giving the horse bute - a contradiciton to abscesses (and horse still THAT lame on bute?!).

A little knowledge is dangerous and people marketing themselves as professionals should know better.


----------



## paddy555 (21 October 2013)

cptrayes said:



			There are farriers who do not agree with Graeme's opinion.

The horses I've had treated by cutting a hole in the sole were lame for a minimum of four days to a maximum of six weeks afterwards. Those I have allowed to blow on their own have been ridden, sound in trot on roads, within a maximum of 48 hours and sometimes on the same day.

It is the totality which counts, plus the likelihood of complications, not one moment of release from serious pain to lesser pain.
		
Click to expand...

I think every situation is different and there is no black and white answer. The first time I had an abscess being very innocent and finding my horse in pain on 3  legs I called the vet. The vet didn't share my panic, advised me to soak it, poultice it and let it take it's course. I prevaricated about antibiotics, pain killers and cutting it out but the vet thought poulticing and soaking for a few days was best. I did that and it soon resolved. Luckily I have a vet who is not into cutting feet appart for the sake of it. 

One of my others has just had an abscess for no apparent reason. It looked very much like an abscess so I immediately went into the soaking, poulticing and walking routine. Did several walks  in hand with a poultice in a boot. The next day I picked the foot up to poultice and it had exited already. More poulticing and lots more walking with his poultice on this time ridden as he was perfectly sound to carry me. We lost 1 days riding and even on that day  he was exercised in hand. 
All I have to do now is make sure the exit area doesn't rub against the boot when ridden, the sole is perfect. Just as well as he tramps around a gravel yard all day otherwise I would have weeks of booting to protect it.


----------



## ihatework (21 October 2013)

I generally work on the theory if it's going to come out on it's own it'll come out pretty quickly.

So when I first suspect an abcess I'll generally call the farrier immediately, forewarm them and ask where they will be over the next 24-48h, i.e. are they in my area?

Then tub and poultice. Sometimes they burst naturally and quickly, and that would be my preference. Sometimes they don't, and in that instance my preference would be to let the farrier to try and locate & release it rather than risk ongoing pain and further more serious complications for the horse.

What I am against is people writing on forums in absolute terms. The problem is that some novice or numpties do read things on the internet and take them as gospel.


----------



## amandap (21 October 2013)

TrasaM said:



			Absolutely. And a pain  I can identify with having had an abscess which took days to pop but when it did ; whew the relief.
		
Click to expand...

Perhaps the dentist should have opened it to drain? Sorry, couldn't resist.


----------



## dogatemysalad (21 October 2013)

amandap said:



			Perhaps the dentist should have opened it to drain? Sorry, couldn't resist.  

Click to expand...

My dentist did just that and the relief was immense. I wish I hadn't put up with the agony for 4 days beforehand. 

However regarding hoof abscesses, I agree with TPO. 

My old school vet sorted an abscess out last year with a deft cut and gave her considerable relief. For her it was efficient and humane, but it depends on the situation. 
 I think to say all abscesses should be left is risky. Its better to seek advice from a vet or farrier for diagnosis rather than giving the impression to owners that letting nature take its course is always the right option.


----------



## Goldenstar (21 October 2013)

I rarely ever get an foot abscess on this yard have had a few always after they cut the blackthorn hedges but once worked on a few yard with sawdust bedding and they got them a lot always we always got them dug out .
My vet and I shared a mare and it belonged to let it out itself person before we got her the sole was so underun and damaged by little pockets of pus tracking about my friend removed the whole sole and kept in and dressed until she was well on the way of growing a new one.
We changed her diet and management a fair bit verses how she was kept before and never had an issue again.


----------



## Graeme Burt farrier (21 October 2013)

cptrayes said:



			Graeme I understand your point about the pain which is obviously severe if the horse is bearing weight on the foot, but the total time from start to finish needs to be counted into the equation, and my experience, which is zero to do with any barefoot mantra, is that horses that break them out for themselves after a day of 'crippling' lameness recover much more quickly with no hole in the sole.

You are a farrier and your clients also expect you to 'do something' which puts quite a lot of pressure on you.

You are obviously very highly skilled. My own experience of several farriers in different areas is that they are not as good as you at getting the infection out first time. And don't start me on vets, who are sometimes happy to dig a trench !

None of us would, I hope, advocate leaving a horse in severe pain, which I would count as clearly walking lame, for days on end. But one day, rather than cut a hole in the sole and days of box rest and poultice? Yes, I'd take that option every time.
		
Click to expand...

OK cp, perhaps I was a little harsh. I apologise.

I agree that there are farriers that leave a little to be desired. Unfortunately that is true of every walk of life, and I do know that the powers that be are making great efforts to put this right. 
With regards to abscess treatment, I would say this. Its not necessarily that horses will need to spend a long time on box rest following abscess investigation/treatment. The important thing is to remember that this is an open wound, and treat it as such. Once the pus is released, I tend to explain to clients that healing is a two stage process. Firstly, encourage the pus to competely evacuate, which means keeping the area wet and clinically clean usually by poultice, which discourages the wound to close. Usually this takes a few days, four is what I encourage, to make sure that all is gone. Then you need to encourage healing, which will begin the growth of a skin over the area to discourage any further infection or entry of foreign matter. That requires the opposite, drying action, for which I usually suggest dry dressing the wound. Generally within a week to ten days the horse can be back to normal.

Personally I hate box rest. Usually I recommend a concrete area where air can circulate, keeping things dry, I am lucky enough to have such facilities at my disposal, but I know many of you do not. An Equiboot or poultice boot is invaluable in these circumstances, provided you can keep the mud out and keep it on, your horse can usually be treated quite normally while the healing process goes on.

I know you are not keen on treatment by farriers. Thats OK, use a vet - its not always that they dig massive holes, and they are approachable, let the vet know your concerns, and one thing they have learned from farriers is that we like massive holes in feet even less than you do! So many vets are now learning not to expose massive areas of sensitive tissue, apart from anything else its simply not necessary to get the job done, and if a large area is exposed it takes longer to cover making re-infection a real likelihood, especially in these present very muddy conditions.


----------



## janei (21 October 2013)

I called the vet when my horse came in on 3 legs at the end of August, I had really (very luckily!) never experienced this before and thought it was a serious hind limb issue and not foot related (naïve)!  Vet came and advised it was foot related and cut a rather large hole in his hoof, after a couple of week he was sound, it was dry and I began exercising gently and building up.  I thought we had cracked it, unfortunately he has come in again on 3 legs so I think the wet/muddy weather has infected his foot again, I was using Hoot Stuff but I think the wetness has breached this.  So I have flushed it out and am poulticing again, he will have to stay in to ensure it keeps clean and if he still uncomfortable I will phone the vets - am I missing anything is there anything else I need to be doing?  Thanks


----------



## Graeme Burt farrier (21 October 2013)

Liquid mud is a pain janei, it sounds like it has crept in to the area you have been trying to heal. You are doing the right thing, contact your vet if your current action does not result in an improvement of your horses condition. While wet and warm conditions prevail, abscesses are likely, although I would say this is a fairly long time (August to October) for healing, most horses in my experience have grown quite a bit of horn since August.


----------



## janei (21 October 2013)

Thanks very much for your reply Graeme, I do agree it is a long time but sorry forgot to include that the issue started with a grass crack in hind which has obviously let the liquid mud back in to re-infect and is still very much there - its been a learning curve and one that has sadly been uncomfortable for my horse!  If he is not comfortable in a day or two I will re-contact vet.  Thanks again for advice and sorry op for hijacking thread


----------



## ester (21 October 2013)

I wonder if the situation in shod horses is different to those who go without due to the movement (or restricted thereof) of the hoof/difference in blood flow affecting the speed of progression of the inflammatory response and how long an abscess will take to blow on its own... I would guess that the same likely applies to speed of healing and reluctance to dig at particularly thick soles so perhaps shod and not aren't that comparable.


----------



## Pale Rider (22 October 2013)

Shod hooves are weaker, thinner doled and less sensitive, than proper barefoot hooves. I think when shod horses go lame, the situation is bad. Barefoot horses will feel less of an abscess sooner.
This must affect treatment I'd have thought.


----------



## cptrayes (22 October 2013)

I wondered about this too.  I've had a couple blow from the heel without the horse ever being lame, and my impression, if anything is that barefooters are bothered by them later, perhaps due to the thickness of sole preventing pressure on them until later in the process. Which would also fit with my impression that they blow quickly too, hence the lack of need to dig holes in the sole.

This really should be being researched, I wonder why no one has done any.


----------



## paddy555 (22 October 2013)

I'm wondering as well about barefoot v shod. However the mantra for most BF horse owners is movement in everything. I suspect most wouldn't confine them to a stable for an abscess so perhaps constantly moving to push the gunk out could help.


----------



## Pale Rider (22 October 2013)

I'm convinced movement speeds up the process no end. I'm of the opinion, that movement, poulticing and pain relief is the answer to getting a swift solution without having to cut into the sole.


----------



## cptrayes (22 October 2013)

Pale Rider said:



			I'm convinced movement speeds up the process no end. I'm of the opinion, that movement, poulticing and pain relief is the answer to getting a swift solution without having to cut into the sole.
		
Click to expand...

What pain relief do you use PR?   I don't think anti inflammatories like Bute are a good idea,as they can suppress the inflammation you need for it to eat its way out. I assume you are using something else?


----------



## janei (22 October 2013)

Quick Q - has anyone got any tried and tested methods of keeping liquid mud/dirt out of hoof holes please?  Really don't want to leave him in as he needs to move around but there'd mud everywhere?  or do you just choose your days for turnout when its as dry as poss??  thanks for any more advice


----------



## cptrayes (22 October 2013)

janei said:



			Quick Q - has anyone got any tried and tested methods of keeping liquid mud/dirt out of hoof holes please?  Really don't want to leave him in as he needs to move around but there'd mud everywhere?  or do you just choose your days for turnout when its as dry as poss??  thanks for any more advice 

Click to expand...

I don't bother. Mud is quite a good poultice   I just squirt in hydrogen peroxide at 3% as hard as I can twice a day.

I have one out in the mud right now with a puncture wound in the sole.


----------



## maccachic (22 October 2013)

I let mine work there way out movement of the horse helps.  Once out I wash daily with salty water and leave to heal.  I feed devils claw to help with pain / inflamation.

If there is a hole I find cotton wool soaked in tea tree oil packed in the hole works well.  A nail is best for packing it in.


----------



## Graeme Burt farrier (23 October 2013)

cptrayes said:



			I don't bother. Mud is quite a good poultice   I just squirt in hydrogen peroxide at 3% as hard as I can twice a day.

I have one out in the mud right now with a puncture wound in the sole.
		
Click to expand...

cp, please remember you are on a public forum and children will be reading this abject incorrect nonsense and believing it.

Based on this, the best place for locating a hospital operating table is in the middle of a muddy field. Lets not bother with cleanliness, just squirt in a little peroxide when the operation is over, thatll be OK.

An abcess wound is an OPEN WOUND. Filling it with mud, which is packed full of all sorts of bacteria, moisture and is abrasive which will abrade away any attempt for the wound to begin to grow a skin over and heal, is simply madness, and begging for re-infection constantly. To confess you have one with an open puncture in the mud is an indication of indifference to the dangers. If you had a cut on your hand, would you go out and daily immerse it in liquid mud? No of course you wouldnt. So dont advocate horses should be treated as such, for a cut on a horses foot is the same.
There is a good reason why the Victorians believed 'cleanliness is next to godliness'. They knew that keeping wounds clean gave the very best chance of healing, although they didnt know why, they didnt know very much about bacteria and viruses or how they worked. All they knew was that those that kept clean healed more readily than those that didnt, so they believed god approved of cleanliness.
It is my opinion that mud is the worst enemy of the foot, it encourages a lot of destruction both moisture wise and bacterially. Remember, the horn is an organic substance, it is by its very nature digestable, look at the enthusiasm of the dogs to gobble it up when your farrier comes! Not only can dogs digest it, but chickens, rats, snakes, cats and a great many other animals can do so as well.
There are bacteria and organisms that specialise in the destruction of horn. They are plentiful, and are part of the natural cycle of destruction. If they didnt exist, after millions of years of horse evolution, we'd all be swimming in the stuff!

Not only does mud contain horn eating organisms, it also contains others that will take advantage of any breach of the horn layer that protects your horses foot by infecting the sensitive structures that lie beneath them. These can get in to your horses bloodstream and give them very nasty infections. They can also damage the horn producing surfaces, leading to future problems.
An abscess is one way the body has of trying to eject these organisms. It does so by creating pus and pressure, which under the skin can easily burst through it. Within the foot however, there are unique conditions, and if an abscess occurs deep beneath the horn, there can be complications that cause toxic pus to enter essential structures, or even enter the boodstream causing toxic shock.

janei asks a very legitimate question. Liquid mud is a very real problem because it is pervasive, and can get into the tiniest hole causing constant re-infection. Boots are a good idea, the higher the better to prevent liquid mud from getting over the top - but they dont come without problems of their own. Chafing, splitting, or just coming off are some. Then theres the problem that horses sweat in them, raising temperatures and making the area damp, causing wet and warm conditions which of course are the perfect breeding ground for more bugs. Wrapping in cotton wool inside a boot, and changing it every day, works for some, and of course things like peroxide or iodine can then have a more lasting effect while healing progresses. For some horses this is the solution, for others it throws up more problems than it solves.
Ultimately I prefer to try to keep mud away from the area while healing progresses, by keeping the horse on a concrete area where air can circulate and encourage healing. Again, this works for some and not others. Some horses stress in such conditions and will not settle making an awful mess which they then mash into their foot and the open wound! Own worst enemies, I say.

At the end of the day, you pays your money and takes your choice. But remember two things. Remember this is an open wound, so needs to keep clean for proper healing. And remember one day the mud will all be gone, and if you have healed it properly, you will be able to forget all about this and go out and enjoy a day out riding and being with your horse. Maybe he might just thank you then, for protecting him now.


----------



## Amymay (23 October 2013)

Really interesting.  Thanks Graeme.


----------



## Christmas Crumpet (23 October 2013)

What I don't get is the whole bute thing. Surely if a horse is in that much pain then it is more than cruel not to help them with that pain. If a person was in that much pain they would be given strong painkillers because it is inhumane not to treat them.

So are we just expected to stand by and watch them on three legs and wait for the abscess to burst? Not me, I'm afraid. I think that it is downright cruel not to give them something for the pain OR to have the abscess dug out. I can't imagine any other situation where a horse is allowed to be in that much pain with no assistance.


----------



## Amymay (23 October 2013)

carolineb said:



			What I don't get is the whole bute thing. Surely if a horse is in that much pain then it is more than cruel not to help them with that pain. If a person was in that much pain they would be given strong painkillers because it is inhumane not to treat them.

So are we just expected to stand by and watch them on three legs and wait for the abscess to burst? Not me, I'm afraid. I think that it is downright cruel not to give them something for the pain OR to have the abscess dug out. I can't imagine any other situation where a horse is allowed to be in that much pain with no assistance.
		
Click to expand...

No, there is absolutely a point where pain killers have to be administered if the situation is bad enough and continues for long enough.


----------



## janei (23 October 2013)

Thanks for the responses, interesting discussion and shows we approach things in differing ways sometimes 

Fwiw - he has had 3 days in, poulticed - but he's a buggar for getting them off!  I didn't give him any bute as he was on 3 legs on the first day only, after cleaning and poulticing he was then weight bearing the next day, he broke out of his stable yesterday and went galloping around the fields until I caught up with him.  So it doesn't appear there is any abscesses.  Have been flushing out with iodine, have soaked some cotton wool in tea tree and put in hole (easier to get out) and put 'hoof stuff' in the external crack in hoof and turned him out.  I am using the cotton wool for the time being as intend to clean/flush before and after turn out to keep it clean, I have found Hoof Stuff is good but hard to get out to clean, so once I know we are healing will go back to using it in the hole.  I will look at boots but he is very opinionated and tried to kill me when I tried some on his fronts!  If it gets really wet again will keep him in.  It does somewhat feel like a catch 22 situation though and a really rubbish time of year to have hoof cracks/holes!


----------



## janei (23 October 2013)

eta:
pics of said hole if anyone interested (sorry am a hoof pic bore lol)


----------



## cptrayes (23 October 2013)

Dear me, Graeme, reading your post you would never believe that the vast majority of abscesses that horses in this country get resolve all by themselves, many without the owner even noticing.

You only have to see the number of 'what is this horizontal hole in my horse's foot' threads that come up from time to time, which are clearly abscess exit holes from abscesses of which the owner was completely unaware.

Do you think the wild native herds are kept out of the mud every time they get an abscess,?  Abscesses encapsulate to cut off from the blood supply and prevent septicaemia of the whole horse. Provided no one cuts a bloody hole in the sole here is no reason why it should go septic if kept open to heal from inside.


----------



## LCH611 (23 October 2013)

amymay said:



			Really interesting.  Thanks Graeme.
		
Click to expand...

Agreed! Thank you Graeme for posting such insightful responses!


----------



## amandap (23 October 2013)

Graeme Burt farrier said:



			An abcess wound is an OPEN WOUND.
		
Click to expand...

May I just point out that an abscess is not an open wound until it is opened.


----------



## LCH611 (23 October 2013)

amandap said:



			May I just point out that an abscess is not an open wound until it is opened.
		
Click to expand...

Wasn't Graeme replying to cptrayes's post when she (he?) said that they had a horse with an open wound out and was using mud as a poultice? In other words he was advocating that it be treated hygienically, not just sloshing about in mud?


----------



## cptrayes (23 October 2013)

LCH611 said:



			Wasn't Graeme replying to cptrayes's post when she (he?) said that they had a horse with an open wound out and was using mud as a poultice? In other words he was advocating that it be treated hygienically, not just sloshing about in mud?
		
Click to expand...

The horse has a punctured sole. I did not say it had an open wound, it does not.

And Graeme specifically stated that an abscess is an open wound, to which Amanda made a perfectly sensible reply.


----------



## amandap (23 October 2013)

Yes, but that particular statement is incorrect in my view. 

Once you have opened an abscess you have to take care until it seals. Introducing infection is a risk if you are opening them.

ps. CPT got in, I was replying to the previous poster LCH611.


----------



## hayinamanger (23 October 2013)

This is a very interesting subject.  I have usually had the farrier evacuate the abcess, a couple have been too deep for this and burst out at the heel.  I have a question.....is there a risk of osteomyelitis developing from a foot abcess, untreated or treated?


----------



## cptrayes (23 October 2013)

hayinamanger said:



			This is a very interesting subject.  I have usually had the farrier evacuate the abcess, a couple have been too deep for this and burst out at the heel.  I have a question.....is there a risk of osteomyelitis developing from a foot abcess, untreated or treated?
		
Click to expand...

This is what we need researched. I don't believe anyone has a scientifically based answer, just gut feelings. 

My gut feeling is no, otherwise there would be high rates of it in feral and other largely untended herds like big breeding farms, and there isn't any evidence for that, I don't think.

I get very frustrated by the automatic assumption that abscesses erode the pedal bone. It seems equally likely to me that an edge of the pedal bone dies and causes the abscess in the first place.

Interesting to muse on, an abscess which is not opened by man will usually burst either on the heel/leg join or on the coronet band. Both of these are places where dirt will not be ground in by the horse walking. Nature knows best, maybe?


----------



## amandap (23 October 2013)

cptrayes said:



			I get very frustrated by the automatic assumption that abscesses erode the pedal bone. It seems equally likely to me that an edge of the pedal bone dies and causes the abscess in the first place.

Interesting to muse on, an abscess which is not opened by man will usually burst either on the heel/leg join or on the coronet band. Both of these are places where dirt will not be ground in by the horse walking. Nature knows best, maybe?
		
Click to expand...

Yes, excess pressure from thin soles etc. is rarely cited as a possible cause of P3 erosion.

I do have my personal concerns about routinely opening the sole and think your musings are interesting CPT.

I am keeping quiet generally though before I make a "ridiculous" comment.


----------



## Pale Rider (23 October 2013)

I tend to treat each abscess as it unfolds. As CP says, very often they burst out and no-one knows they've had one.

I give danilon if the pain is bad. I know there are drawbacks but most treatments are a compromise with contra indications.

Access to willow, which ours have, I've noticed some will self medicate, negating the need for additional drugs.

I like to keep them out of the mud and clean on a hard track.

I poultice, wet till drained, and protect the foot with vet wrap and protection.

I agree that it's an open wound if you open it up. We don't often open them up, movement seems to make them breakout.

We never boxrest.


----------



## Graeme Burt farrier (23 October 2013)

cptrayes said:



			Dear me, Graeme, reading your post you would never believe that the vast majority of abscesses that horses in this country get resolve all by themselves, many without the owner even noticing.

You only have to see the number of 'what is this horizontal hole in my horse's foot' threads that come up from time to time, which are clearly abscess exit holes from abscesses of which the owner was completely unaware.

Do you think the wild native herds are kept out of the mud every time they get an abscess,?  Abscesses encapsulate to cut off from the blood supply and prevent septicaemia of the whole horse. Provided no one cuts a bloody hole in the sole here is no reason why it should go septic if kept open to heal from inside.
		
Click to expand...


Properly wild horses (of which there are very few nowadays) frequently die when they get an abscess. If a horse cannot run fast he cannot run from a predator. If you mean native ponies like Dartmoors or New Forests as someone who has been called to deal with some of the foot conditions subsequent to their being sold on after being out on the forest I can assure you there are a fair number that show permanent effects from previous infections of both the horn and the sensitive structures. Unfortunately those that are not sound are either destroyed prior to market or very often sold as meat, so they do not enter the riding world.

Abscesses are open wounds because the horn covering the area has already been breached. If it had not been, _there would be no abscess._ To exit the foot, whether it is cut out or not, the pus will create yet another open wound, whether or not it exits in the same place it entered is irrelavent to further infection, as any path of entry can conduct liquid mud into the sensitive structures once the pressure has been relieved.  I would have thought amanda that you would have seen this is common sense.

Yes many do occur close to the site of entry meaning they can discharge quickly but some do not. Either way, if a foreign body like a thorn or a flint is present it will require veterinary treatment to remove whether or not the abcess is close to the surface, so simply leaving it to take its course is not advisable and to advocate on a public forum that all abcesses will naturally resolve themselves is simply wrong.


----------



## ester (23 October 2013)

but plenty of abscesses are not caused by entry of a foreign body so there has been no path of entry, no breach of the horn etc?


----------



## Graeme Burt farrier (23 October 2013)

ester said:



			but plenty of abscesses are not caused by entry of a foreign body so there has been no path of entry, no breach of the horn etc?
		
Click to expand...

At the risk of repeating myself. An abscess is the body's response to a foreign object entering a sensitive structure. If there were no entry, there would be no abscess. Just like if you have toothache, its because an organism has breached the covering of the tooth.

If this were not the case, pus could break out at any time, at any depth, in any part of the body. The reason it doesnt is because there are structures protecting the body from organisms entering. The horn covering the foot has the function of protecting the structures within, as well as bearing the weight.


----------



## ester (23 October 2013)

necrotic tissue will also cause an abscess... but will have no entry point.

I'm good on both bugs and the immune response as a microbiologist .


----------



## cptrayes (23 October 2013)

Graeme Burt farrier said:



			to advocate on a public forum that all abcesses will naturally resolve themselves is simply wrong.
		
Click to expand...


Which is why nobody has done so.


----------



## Brightbay (23 October 2013)

ester said:



			necrotic tissue will also cause an abscess... but will have no entry point.

I'm good on both bugs and the immune response as a microbiologist .
		
Click to expand...

Yes, agreed - sequestra would fall into this category


----------



## amandap (23 October 2013)

Graeme Burt farrier said:



			Properly wild horses (of which there are very few nowadays) frequently die when they get an abscess.
		
Click to expand...

I am very interested in this, please could you point me to the paper or research?



Graeme Burt farrier said:



			Abscesses are open wounds because the horn covering the area has already been breached. If it had not been, _there would be no abscess._ To exit the foot, whether it is cut out or not, the pus will create yet another open wound, whether or not it exits in the same place it entered is irrelavent to further infection, as any path of entry can conduct liquid mud into the sensitive structures once the pressure has been relieved.  I would have thought amanda that you would have seen this is common sense.
		
Click to expand...

Being a pedant , an abscess is a contained capsule(if you like) of infection/necrotic tissues, that is where much of the pain comes from as the pressure builds. It is not an open wound until it is breached/opened. I am very unconvinced most abscesses are caused by puncture or ingress of foreign matter such as gravel.
I am convinced abscesses can be caused by trauma, poor circulation or compromised hoof structure, as well as puncture,  leading to damaged and necrotic tissue. After all tooth and other body abscesses in humans aren't usually caused by puncture are they?

ps. Yes, sequestra is the word I couldn't remember.


----------



## Graeme Burt farrier (23 October 2013)

ester said:



			necrotic tissue will also cause an abscess... but will have no entry point.

I'm good on both bugs and the immune response as a microbiologist .
		
Click to expand...

Of course but necrosis is usually a result of extreme trauma, frostbite or infection coming from elsewhere, is likely to be catastrophic and pretty unlikely to be capable of being out in a field. The resulting pus will still create an exit wound which connects the outside with the sensitive and will probably accelerate the necrosis as a result. Anyway you are splitting hairs, the most common reason I have come across for necrotic tissue within the foot is a previously untreated infection. As a microbiologist would you advocate placing such a wound in mud?


----------



## cptrayes (23 October 2013)

Necrosis is actually pretty easy to create with normal bandaging Graeme, I think you are overestimating the level of trauma required to create necrosis.

If horses can fracture their pedal bone as a relatively common thing, then they can create necrosis inside the foot pretty easily too.


----------



## maccachic (23 October 2013)

Graeme like other posters have repeated over and over again a lot of abceses resolve themselves with out ever presented symptoms - in muddy paddocks with no problems.  i would never stick my horse in a a stable (restrict his movement) and have never had any infection issues from abcesses.  

I had quite a few as we were resolving my horses pre existing feet issues and would happily wager they were not a result of an entry point. 

A farrier once explained to me why he wouldn't cut to find an abcess as being like a deep pimple that hasn't erupted yet, you can go digging but most the time you just make a big hole and don't sort it anyway.

All of mine are 95% sound once it has popped and heals pretty quickly with minimal treatment, and are normally able to be worked with a couple of days.  

I find Devils claw helps with any discomfort.


----------



## amandap (23 October 2013)

cptrayes said:



			Necrosis is actually pretty easy to create with normal bandaging Graeme, I think you are overestimating the level of trauma required to create necrosis.

If horses can fracture their pedal bone as a relatively common thing, then they can create necrosis inside the foot pretty easily too.
		
Click to expand...

... and if there is any inflammation present(aka laminitis/lgl) internal trauma and circulatory problems are going to lead to a higher risk of abscessing due to internal damage of tissue.

I am not clear of the mechanism where recurrent abscessing is helped or resolved by appropriate mineral supplementation. Perhaps tissues are unhealthy (weakened) due to lack, excess or imbalance of particular minerals?

ps. I wonder how often P3 fracture is accompanied by thin soles?


----------



## Graeme Burt farrier (23 October 2013)

amandap said:



			I am very interested in this, please could you point me to the paper or research?


Being a pedant , an abscess is a contained capsule(if you like) of infection/necrotic tissues, that is where much of the pain comes from as the pressure builds. It is not an open wound until it is breached/opened. I am very unconvinced most abscesses are caused by puncture or ingress of foreign matter such as gravel.
I am convinced abscesses can be caused by trauma, poor circulation or compromised hoof structure, as well as puncture,  leading to damaged and necrotic tissue. After all tooth and other body abscesses in humans aren't usually caused by puncture are they?

ps. Yes, sequestra is the word I couldn't remember.
		
Click to expand...

A sequestra is a piece of dead bone that becomes necrotic. The most common cause for the necrosis is a bone infection such as osteoporosis. Are you suggesting most abscesses are caused by bone degradation and not a breach of the horn (which can clearly be seen in the case of janei's pictures).
Tooth and body abcesses are caused by the entry of bacteria or organisms that are foreign to the body into the sensitive structures, usually as a result of decay or gum disease, so yet again it is a breach of the natural defence mechanism. As are the majority of foot abscesses. I have already explained how this works in detail.

If you have never seen pictures of equine animals such as wild Zebra, who are probably as close to wild horses as you can get, being hunted by lions or hyena I would suggest David Attenborough could help you out. Suffice to say that any animal without its full running capability would not last too long. Horses have been prey animals for millennia, relying on fleet of foot and fast response to stay alive, any with even a temporary ailment such as an abscess would be picked off as easy meat. Even Britain had its fair share of predatory hunters, wolves and the like, just because they dont exist now doesnt mean they never did, any sick horse would have been an easy kill just as a sick lamb is currently to a fox.


----------



## charlie76 (23 October 2013)

I have seen a horse almost die from an untreated abcess, the whole sole became under run and the horse was crippled lame. 

to suggest mud is an adequate poultice on an open forum is just dangerous. 
If this was the case we could slap it on puncture wounds all day long!


----------



## cptrayes (23 October 2013)

I would suggest that very many abscesses are caused by necrotic laminae from sustained low grade laminitis due to excess carbohydrate in the diet.

No entry point there, either.

Graeme you seem utterly determined to believe that all foot abscesses have an identifiable entry point. I can't believe that's really your experience, because its not mine.


----------



## cptrayes (23 October 2013)

charlie76 said:



			I have seen a horse almost die from an untreated abcess, the whole sole became under run and the horse was crippled lame. 

to suggest mud is an adequate poultice on an open forum is just dangerous. 
If this was the case we could slap it on puncture wounds all day long!
		
Click to expand...

No one on this thread suggested leaving an unopen abscess untreated for long enough to cause that sort of issue.

Whether you like the idea or not, leaving a horse standing in wet mud with an unopen abscess is a great poultice to encourage it to break open. Your choice is then to keep it clean. Mine, because the blood barrier has not been compromised by the natural opening of an encapsulated abscess, is to continue to turn the horse out and disinfect regularly as a precaution. I have never had a problem from doing this. The only one I ever had a problem with was opened by a farrier and poulticed as recommended.


----------



## amandap (23 October 2013)

Graeme Burt farrier said:



			A sequestra is a piece of dead bone that becomes necrotic. The most common cause for the necrosis is a bone infection such as osteoporosis. Are you suggesting most abscesses are caused by bone degradation and not a breach of the horn (which can clearly be seen in the case of janei's pictures).
Tooth and body abcesses are caused by the entry of bacteria or organisms that are foreign to the body into the sensitive structures, usually as a result of decay or gum disease, so yet again it is a breach of the natural defence mechanism. As are the majority of foot abscesses. I have already explained how this works in detail.

If you have never seen pictures of equine animals such as wild Zebra, who are probably as close to wild horses as you can get, being hunted by lions or hyena I would suggest David Attenborough could help you out. Suffice to say that any animal without its full running capability would not last too long. Horses have been prey animals for millennia, relying on fleet of foot and fast response to stay alive, any with even a temporary ailment such as an abscess would be picked off as easy meat. Even Britain had its fair share of predatory hunters, wolves and the like, just because they dont exist now doesnt mean they never did, any sick horse would have been an easy kill just as a sick lamb is currently to a fox.
		
Click to expand...

No I am not suggesting abscesses are caused by sequestra, it was one I meant to add to the list. Bone and other tissue often dies due to loss of blood supply be that due to infection, inflammation, toxicity, mechanical stress etc.
I wasn't aware osteoporosis was a bone infection, my understanding is osteoporosis is weakened bone due to loss of structure. 

Microbes can only get into the hoof through puncture or by compromised external hoof structure eg. cracks, compromised white line etc. or via blood stream. A healthy hoof is very resistant to microbial invasion.

I am aware of how the prey predator mechanism works but I was interested in your statement that most wild horses die because of abscesses and wondered how you found this out?


----------



## cptrayes (23 October 2013)

Graeme I think you'll find that the most common cause of sequestra in horses is not osteomyelitis(bone infection) or osteoporosis, but blunt force trauma from a kick or knocking a leg on something. My horse got one rolling in her stable overnight.


----------



## charlie76 (23 October 2013)

cptrayes said:



			I don't bother. Mud is quite a good poultice   I just squirt in hydrogen peroxide at 3% as hard as I can twice a day.

I have one out in the mud right now with a puncture wound in the sole.
		
Click to expand...

this is what you said. The person in which you replied to asked how to keep mud out of the 'holes in the hoof' 
this suggests it is open 
you then suggest using mud as a poultice on these 'holes'!


----------



## cptrayes (23 October 2013)

charlie76 said:



			this is what you said. The person in which you replied to asked how to keep mud out if the 'holes in the hoof' 
this suggests it is open 
you then suggest using mud as a poultice on these 'holes'!
		
Click to expand...

The horse has a hole in his sole, waiting for the solar corium to produce horn to replace it. Encapsulated abscesses have no blood supply, which is why the horse does not develop septicaemia.  I do not advocate turning horses out with bloody foot wounds.

 But then I don't advocate giving them bloody wounds in the first place.


----------



## charlie76 (23 October 2013)

How do you know that?you have not seen the horse in question, just photos. you have no idea of the level of lameness . you shouldnt be advising such things without actually seeing the horse in question. 
suggesting using mud as a poultice could kill it .


----------



## amandap (23 October 2013)

I think some sub solar abscesses can come on quickly so it's presence under the whole sole isn't necessarily due to being untreated. Trauma to a thinner sole causing bruising/bleeding is a main cause of these types of abscess I believe. The sole may not have been punctured at all.

Not all abscesses are due to infection. There's a statement to stir things up!


----------



## cptrayes (23 October 2013)

charlie76 said:



			How do you know that?you have not seen the horse in question, just photos. you have no idea of the level of lameness . you shouldnt be advising such things without actually seeing the horse in question. 
suggesting using mud as a poultice could kill it .
		
Click to expand...


I can't be bothered to search for it, but I believe the person was saying that their horse had an abscess which was resolved and the horse was ready for turnout, but how could they keep the mud out of the hole the farrier had cut???




ps I haven't seen any photos.


----------



## Graeme Burt farrier (24 October 2013)

amandap said:



			No I am not suggesting abscesses are caused by sequestra, it was one I meant to add to the list. Bone and other tissue often dies due to loss of blood supply be that due to infection, inflammation, toxicity, mechanical stress etc.
I wasn't aware osteoporosis was a bone infection, my understanding is osteoporosis is weakened bone due to loss of structure. 

Microbes can only get into the hoof through puncture or by compromised external hoof structure eg. cracks, compromised white line etc. or via blood stream. A healthy hoof is very resistant to microbial invasion.

I am aware of how the prey predator mechanism works but I was interested in your statement that most wild horses die because of abscesses and wondered how you found this out?
		
Click to expand...

Yes Id agrere a healthy hoof is resilient, but horn is an organic material and like any organic material it can be destroyed by organisms and consumed. Dogs can digest it. There are organisms that specialise in doing so, and when conditions are right (wet and warm) they multipy exponentially and are capable of penetrating even healthy hooves. Do you think dogs will refuse to eat healthy hoof on the grounds that it is so? Cracks are often started by organisms infecting the underlying wall. Overmoisturising softens horn encouraging it to stretch and seperate allowing bacteria into enter the underwall which is softer than the outside wall and as they eat further up the holes they leave behind fill with mud which conducts fresh moisture in enabling the organisms to mulitiply further.
As they get further up the tract they get close to and breach the sensitive, allowing other organisms to enter and other foreign matter. The body reacts by creating an abscess to reject the foreign matter just as it would if it were under the skin.

The vast majority of the abscess I have opened has been caused in this way. All of the vets I have worked with also find this so. All of the othe farriers as well. And no, I dont get loads of blood or create massive holes when I have opened them, the purpose is to relieve the pressure and not to create further problems or allow more mud to enter.

Bone rarely dies, and sequestra are very rare. Treatment for necrotic bone of this type requires surgical removal of the source necrotic bone, not merely poulticing. It would also be another argument for not leaving an abscess to take its course. I have dealt with a few horses that have had fractures of the pedal bone and while it can be pretty painful, an abscess resulted in only one case, and that was a horse that had to have two screws put in his pedal bone to hold it, requiring surgical intervention and removal of some of the sidewall which subsequently became infected. Of the six or seven others that I have dealt with in my over 40 year career none of the others developed abscesses.

Im off to work now.


----------



## Pale Rider (24 October 2013)

I have to say Graeme's explanation of a healthy hoof being under attack, leads me to the conclusion that shoeing will provide the right environment for abscesses to develop by the rasping of the sole and hoof wall which takes place and of course the nail holes.


----------



## cptrayes (24 October 2013)

Graeme Burt farrier said:



			Bone rarely dies, and sequestra are very rare. Treatment for necrotic bone of this type requires surgical removal of the source necrotic bone, not merely poulticing. It would 
 be another argument for not leaving an abscess to take its course.
		
Click to expand...


I don't understand how you can state this with such authority Graeme. We don't routinely xray healthy horses or abscessed ones.  And I understand that if anyone does xray a large number of sound horses, around fifty per cent of them will show bone changes.

The only ones we know about are those that the horse could not resolve for itself.


 I realise now that earlier you were only talking about sequestra in the foot. My response was about all sequestra and my mare gave herself one on the cannon bone. Interestingly, that resolved without surgery by reabsorption even though it was the size of my thumbnail.

Last year a vet attempted to make me pay for xrays of a kick wound that was terribly slow to heal, weeping though uninfected. She said there was a sequestrum in it. I refused on the grounds that the horse was sound and that even if one were found I would not put a sound horse under a general anaesthetic to remove it.

After another six weeks of weeping gently, it sealed and over the next six months the lump reduced to nothing. When that vet saw it when she did his jabs, she was astonished.


----------



## cptrayes (24 October 2013)

Graeme I am not arguing with you that the majority of abscesses are caused by compromise of the laminar bond,   I just think that with pedal bone infection and abscess combined I haven't seen enough, or any, evidence of which came first, the chicken or the egg.

Are there any studies you can point me to which show that it is the case that the abscess tracks to the pedal  bone rather than from it?

All I have seen is xrays with a legend saying 'look how the pedal bone has been eaten by the abscess'  which to my inexpert eye look like they could equally well be titled 'look how the death of a small part of the edge of the pedal bone has created an abscess'



I hope you had a good day at work, it's a tough job you do.


----------



## Kelpie (24 October 2013)

Interesting reading. 

Until this week I would be in the "let it burst out" camp. However, I took my horse (barefoot) for a lameness investigation and long story short, on xray a line of gravel had tracked up her hoof along the white line .... Looked like a bloody nail in xray! She hadn't abscessed but I guess she may have at some point, though there was so much gravel I can't believe nature would have been able to sort it without a helping hand. Yes she now has a hole in her foot but she will be yarded and walked out in boots until healed. 

So I think never say never, eh? Or at least maybe xray before needing to be convinced to dig?


----------



## cptrayes (24 October 2013)

Kelpie said:



			Interesting reading. 

Until this week I would be in the "let it burst out" camp. However, I took my horse (barefoot) for a lameness investigation and long story short, on xray a line of gravel had tracked up her hoof along the white line .... Looked like a bloody nail in xray! She hadn't abscessed but I guess she may have at some point, though there was so much gravel I can't believe nature would have been able to sort it without a helping hand. Yes she now has a hole in her foot but she will be yarded and walked out in boots until healed. 

So I think never say never, eh? Or at least maybe xray before needing to be convinced to dig?
		
Click to expand...


Exactly!  

Never say never. My own rule is that provided there is no infection running up the leg, and provided I have localised foot warmth and raised pulse as indicators that it is an abscess, then I am prepared to allow the horse to be significantly lame for one day, to see if it raises a heel or coronet blister for itself.

So far, since taking this approach, I have had no problems. 

I have no idea what my horse trod on, but he's got a significant hole in his sole now (and that takes some doing with a barefoot hunter!!!)   packed with cotton wool soaked in peroxide.  If he goes lame again after being sound as he is now, then he will of course get the attention of a vet.

I hope your horse recovers quickly


----------



## cptrayes (24 October 2013)

Message To more inexperienced horse owners reading this thread:


If you have a lame horse, call your farrier if you know it's in the foot, otherwise call your vet.

Do not give Bute or antibiotics until you know what it is causing the lameness, no matter what your yard owner finds at the back of the tack room and gives you!


----------



## ester (24 October 2013)

I think everyone else has already said what I would have!


----------



## amandap (24 October 2013)

Graeme Burt farrier said:



			and to advocate on a public forum that all abcesses will naturally resolve themselves is simply wrong.
		
Click to expand...

I don't think anyone is saying that. As has been said "never say never".

Obviously I don't have your years of experience nor am I a vet, I just see things differently.


----------



## Kelpie (24 October 2013)

thanks CPT (in fact she's a pest to keep re-bandaging but my new hoof boots should arrive tomorrow for her hopefully and that will make life easier!..... it's a big old hole that will take a while to mend but so far so good really.....).


----------



## cptrayes (25 October 2013)

Kelpie said:



			thanks CPT (in fact she's a pest to keep re-bandaging but my new hoof boots should arrive tomorrow for her hopefully and that will make life easier!..... it's a big old hole that will take a while to mend but so far so good really.....).
		
Click to expand...

l

The trouble with a hole too big to pack with cotton wool or a filler is that they can so easily bruise the foot where the sole is missing.  If it won't hold a filler then a boot is your only option to prevent it, but I do worry about rubs if turned out in them.At least she can start work though, assuming she's now,sound.

I'm sure she'll be right as rain soon 



Ps watch what the hole does - it's fascinating!  It will migrate forwards to the front of her hoof.  Bowker's current explanation of that is that the sole is produced at the bars and grows forward from there. For that reason he says trimming bars is a no no.


----------



## Nudibranch (25 October 2013)

Well, I would only agree with AmyMay's earlier statement about it depending on the nature of the abscess. Fortunately I had only my first ever experience of one on Monday although I've owned horses for 30 years. The horse in question has mild arthritis and although the heel bulb was tender I called the vet to be sure.

Hoof testers showed no pain at all around white line and sole, only the heel bulb. She hates the vet with a passion so he decided against "digging". I usually carry out whatever needs doing under his direction (within reason!) as she won't let him touch her and there's no way he was letting me loose with a hoof knife. So we poulticed (Animalintex) and put her on box rest, mainly to keep the dressing clean and dry. Next day it burst above the bulb and she's now sound and turned out again. I'm just keeping an eye but letting it resolve itself.

However he would normally have dug around, or got the farrier to do so... good job in this case she is vet-phobic! Had it been a more serious infection, or sub solar though, I don't know what would have happened.


----------



## PartlyPickled (25 October 2013)

dug out i think, mine had several abscesses last year leading to a corn (from all the pressure of standing on one foot!!) so he had half his foot chopped off, leading to the vet and farrier deciding he needed heart bars to build up his heal to try and prevent these abscesses next winter, leading to him getting thrush from box rest (went a bit sore after running him on hard ground), so then the vet and farrier said lets put copper sulphate (medicated, anti-thrush, shock absorbing, miracle wonder gel that costs fortune!) and atm he has no foot problems. So always get them dug out and sorted straight away and if it doesn't clear up call the vet, also mine is farriers formula supplement which is amazing noticed a differnce within days!!


----------



## LCH611 (25 October 2013)

cptrayes said:



			No one on this thread suggested leaving an unopen abscess untreated for long enough to cause that sort of issue.

Whether you like the idea or not, leaving a horse standing in wet mud with an unopen abscess is a great poultice to encourage it to break open. Your choice is then to keep it clean. Mine, because the blood barrier has not been compromised by the natural opening of an encapsulated abscess, is to continue to turn the horse out and disinfect regularly as a precaution. I have never had a problem from doing this. The only one I ever had a problem with was opened by a farrier and poulticed as recommended.
		
Click to expand...

but you said you had a horse with a puncture wound (i.e an open wound) out in the mud?


----------



## cptrayes (25 October 2013)

I've,already explained this but you missed it. Check back a page.


----------



## cptrayes (25 October 2013)

Nudibranch said:



			Well, I would only agree with AmyMay's earlier statement about it depending on the nature of the abscess. Fortunately I had only my first ever experience of one on Monday although I've owned horses for 30 years. The horse in question has mild arthritis and although the heel bulb was tender I called the vet to be sure.

Hoof testers showed no pain at all around white line and sole, only the heel bulb. She hates the vet with a passion so he decided against "digging". I usually carry out whatever needs doing under his direction (within reason!) as she won't let him touch her and there's no way he was letting me loose with a hoof knife. So we poulticed (Animalintex) and put her on box rest, mainly to keep the dressing clean and dry. Next day it burst above the bulb and she's now sound and turned out again. I'm just keeping an eye but letting it resolve itself.

However he would normally have dug around, or got the farrier to do so... good job in this case she is vet-phobic! Had it been a more serious infection, or sub solar though, I don't know what would have happened.
		
Click to expand...

In this situation I would syringe 3% hydrogen peroxide into the hole twice a day for at least a week.


----------



## BayLady (25 October 2013)

It depends on the horse and how bad the abcess appears to be (based on lameness).

My old mare had two abcesses in the 12 years I owned her.  The first I called the vet out for as she was utterly crippled with pain.  She was unshod at the time.  The vet started to scrape away sole at the point where she had shown sensitivity to the hoof testers, but called it a day after a few strokes.  I still remember his exact words "every stroke of the knife is a week's growth, and she will hurt much more in the long term if I keep going than otherwise".  He advised to hot tub it in water and cider vinegar twice daily, poultice the rest of the time until it burst. It took a couple of days.  She was box rested during this time as she was too lame to be comfortable doing anything else.  When it blew out I continued to poultice until it stopped draining, then dry poulticed for a few days to be sure it was ok.  Once she was able to walk she went out during the day wearing a poultice and tractor inner tube as protection from the mud.  Even with this cautious approach, it still took weeks for the small hole the vet made to grow out, and the actual pus blew out from somewhere entirely different anyway.

2nd abcess I didn't actually notice until it had blown out!  She wasn't in work at the time but didn't show any lame steps.  It was winter so often her hooves were muddy and I didn't tend to hose as it made her mud fever worse.  On a drier day I chipped all the mud off and whilst handling her hoof found a sharp spot on the wall at the quarter.  Turned out to be a tiny hole, presumably where she'd blown an abcess out.  She didn't miss a beat with this, no ill effects from it not being treated at all.  The tiny defect in the horn grew out without problem.

I had experience of 3 different horses with hoof abcesses in last winter's horrible wet conditions.  The first horse had multiple abcesses (he has EMS and a case of laminitis a year ago so his immune system is not wonderful).  The initial abcess was dug out by the vet, resulting in long term booting and a huge hole in the sole.  Recovery time was weeks and he was box rested for quite a long time as he was so sore. The abcess seemed to have tracked beyond the cut out area and he had pus from another area as well as the drainage hole.  The second abcess was hot tubbed and poulticed but not dug out.  He wasn't ridden but was able to go out with a poultice and hoof boot on.  Recovery time was about a week.  The most recent abcess didn't result in him being terribly lame, it was more on and off odd steps than anything else.  He was worked when sound, rested when not, poulticed as he showed problems.  The abcess burst whilst he was actually being ridden in boots. I was there, he was sound for most of the ride, took about 5 very lame steps then came sound again. When we got back the poultice inside the boot was covered in puss.  He's been sound since. No ill effects at all.

Horse 2 didn't see a vet at all. Neither abcess caused lameness so the first the owner knew of them was when they burst, one in her hand as she was picking his foot out (gross!). Both blew at the coronary band on the seam of the hoof wall. No lameness either time. Horse was dry poulticed to keep the foot clean for a few days and to draw out any remaining infection.  The first abcess took a fair chunk of wall with it and took some careful managing as it grew out to prevent breakage but the second was tiny and caused no problems at all.

The third horse had two abcesses. The vet was called to the first as the horse was crippled, resulting in a huge amount of foot being dug out. The abcess still blew out of the coronary band.  Healing the coronary band wound was a lot less traumatic than growing out the damaged foot caused by the digging.  The second was hot tubbed and poulticed, blew out at the quarter and caused no problems.

So, on balance, I'd rather leave a horse to sort itself out for the most part unless it is in utter agony, in which case I would always call the vet as it's unfair on the horse.


----------



## Goldenstar (25 October 2013)

I feel the need to warn the leavers that if a MOP rang the RSPCA and they attened a lame horse in a field that had recieved no treatment for an abbcess you could get yourself into trouble .


----------



## BayLady (25 October 2013)

The RSPCA can take a running jump, they have no power in that instance.  My vets support the leaving it approach as long as the horse isn't presenting broken-legged and I would be happy to give the RSPCA their details.  Anyway, they're too busy taking people to court for their own political gain to bother about actual animal welfare these days.

Poulticing/hot tubbing but not effectively performing minor surgery (which is what the vet books state digging an abcess out is, and is why farriers who do so are acting illegally) is not "leaving".

As for sub solar abcesses, you only know if you're dealing with one of those if you have a full workup done and ordinarily that would only happen with repeat occurrences in a short space of time.  You can't tell just by looking at the foot, so traditional treatment practices won't make any different at the point of initial lameness.


----------



## amandap (25 October 2013)

Goldenstar said:



			I feel the need to warn the leavers that if a MOP rang the RSPCA and they attened a lame horse in a field that had recieved no treatment for an abbcess you could get yourself into trouble .
		
Click to expand...

Oh yes, lets all ring the RSPCA who didn't take this case up! http://www.thisisgloucestershire.co...tory-16161621-detail/story.html#axzz2ijMTjuGD
Wonder why?

ps. The horse is what is important not fear of some organization!


----------



## Graeme Burt farrier (25 October 2013)

Pale Rider said:



			I have to say Graeme's explanation of a healthy hoof being under attack, leads me to the conclusion that shoeing will provide the right environment for abscesses to develop by the rasping of the sole and hoof wall which takes place and of course the nail holes.
		
Click to expand...

OK, now I will make your day.

You are absolutely right.

Shoes also trap moisture under capillary action, but probably worse they create mud traps which cannot be cleaned. Then in subsequent warm weather wet and warm conditions are created that see bacteria numbers in this area explode. I have been working for over 20 years now on methods of negating this problem. As a result I have reduced abscess numbers amongst my shod horses by 80% since 2002. Not only that, I have also virtually eliminated foot shatter, where the walls of the feet become 'shelly' and break away, the vast majority of WLD cases have been resolved, around 70% of all shod laminitics have had their feet rebuilt (depending on the severity and rate of recurrence of laminitis). Around 90% of flat feet have become normal because their strength and resilience is improved, the wall becomes more capable of supporting its share of the load and joints between pedal bone and wall are far more parallell as a result.
I hear a lot of people saying 'pull the other one' and others just thinking I'm advertising but truly, Im not. Its not rocket science. If you reduce the rate of destruction of the horn to a low enough level that there is more healthy horn created than is being destroyed, the foot becomes capable of doing its job as it should and horses stay sound and in work. That applies equally to shod and barefoot.

I note you live in Spain. With the higher ambient temperatures the ground there is likely to be much dryer and miosture to evaporate a greate deal quicker than it does in the UK. When it is truly dry and the ground is parched its likely that it will behave in exactly the opposite way to the prevailing conditions here at present, where mud is currently a considerable problem. Mud sticks to the surfaces of the feet constantly leeching moisture into them, softening the horn and saturating it. That encourages it to stretch and to seperate, allowing in the destructive forces.
On parched ground, the dust actually draws moisture out, which denies bacteria the moisture they need for multiplication and reduces their number. That hardens the horn quickly and makes for better conditions and creates more healthy horn than is being destroyed.

One of the benefits of barefoot is that during dry times the feet can readily aerate and reduce moisture levels quickly, whereas shod feet cannot do this. It is only once the shoes are removed they can aerate, so its an important consideration when shoeing. It doesnt mean that barefooters are completely immune from the ravages of the environment, as janei can tell you - but it does give them an advantage.

As a result, I am pro barefoot and try to keep as many horses barefoot as possible. I also try to rest feet from shoes where I can. But where I have to shoe, I try to minimise the advantage it gives to the destructive forces. Since working in this way, I find the differences between soundness levels of my shod horses and those that have no shoes on has been all but wiped out.


----------



## cptrayes (25 October 2013)

Goldenstar said:



			I feel the need to warn the leavers that if a MOP rang the RSPCA and they attened a lame horse in a field that had recieved no treatment for an abbcess you could get yourself into trouble .
		
Click to expand...



It would make an interesting court case. The defence would be able to produce both vets and farriers as witnesses who will say that the best way to treat abscesses is to let them break out of their own accord if they will in a few days. By the time it got to court the horse would also be well recovered and the defendant would have photographic and video evidence of how short a time it took and how little damage ensued.

Burden  of proof would be beyond reasonable doubt that the the horse had not been given treatment when it should have been, and since both Bute and antibiotics are contraindicated for abscesses, it seems to me that it would be pretty tough to get a conviction.


----------



## cptrayes (25 October 2013)

Graeme I just wish your Registration Council could do more to ensure everyone's farrier was able to do what you can do. Standards are desperately variable and its a real problem for owners, who don't know who they can trust   Your clients are some of the lucky ones, by the sound of what you write about horn quality and shoeing.



ps I don't know if PR  has moved or is joking, but until recently he lived in wet west Yorkshire


----------



## Goldenstar (25 October 2013)

It is unlawful not to get apporiate help for a lame horse that's what I am pointing out.
If you had advice been told its an abscess and been told to leave the horse that's fine your covered but people do call welfare orgs to lame horses in fields and what those orgs  chose to do is very variable .
The very least you would get is a ticking off for not calling the vet.


----------



## Moomin1 (25 October 2013)

Goldenstar said:



			It is unlawful not to get apporiate help for a lame horse that's what I am pointing out.
If you had advice been told its an abscess and been told to leave the horse that's fine your covered but people do call welfare orgs to lame horses in fields and what those orgs  chose to do is very variable .
The very least you would get is a ticking off for not calling the vet.
		
Click to expand...

Agree. If a vet confirms to a welfare organisation that the horse is being treated appropriately, and getting pain relief, fine, however people just leaving abscesses with no pain relief is prosecutable.

And yes, the RSPCA do prosecute for this.


----------



## FfionWinnie (25 October 2013)

I just had this happen after a stone bruise. Poulticed it for 3 days and it came out the same place as the stone was. 

So when would you start riding again because she is completely sound, there is no hole, but the poultice still has stuff on it.


----------



## Kelpie (26 October 2013)

cptrayes said:



			l


Ps watch what the hole does - it's fascinating!  It will migrate forwards to the front of her hoof.  Bowker's current explanation of that is that the sole is produced at the bars and grows forward from there. For that reason he says trimming bars is a no no.
		
Click to expand...

ooh, will look out for that, thanks  

as for the RSPCA potentially getting involved in cases where an abcess is left to find its own way out, well fair play for them to ask what's going on if an obviously lame horse is in a field for a few days but I can't see as though they'd be in a position to try and get some sort of ruling that all hoof abcesses must be dug for?!


----------



## Moomin1 (26 October 2013)

Kelpie said:



			ooh, will look out for that, thanks  

as for the RSPCA potentially getting involved in cases where an abcess is left to find its own way out, well fair play for them to ask what's going on if an obviously lame horse is in a field for a few days but I can't see as though they'd be in a position to try and get some sort of ruling that all hoof abcesses must be dug for?!
		
Click to expand...

No, but a horse SHOULD by law be made comfortable and free from pain as much as is possible.


----------



## cptrayes (26 October 2013)

Not so, Moomin.

Only if it is in the best long term interest of the horse.

And there is dispute about that amongst vets and farriers, as some of the above posts have shown.


----------



## cptrayes (26 October 2013)

FfionWinnie said:



			I just had this happen after a stone bruise. Poulticed it for 3 days and it came out the same place as the stone was. 

So when would you start riding again because she is completely sound, there is no hole, but the poultice still has stuff on it.
		
Click to expand...

I would ride any sound unmedicated horse. It's good for their minds and their bodies and feet.


----------



## cptrayes (26 October 2013)

Goldenstar said:



			It is unlawful not to get apporiate help for a lame horse that's what I am pointing out.
If you had advice been told its an abscess and been told to leave the horse that's fine your covered but people do call welfare orgs to lame horses in fields and what those orgs  chose to do is very variable .
The very least you would get is a ticking off for not calling the vet.
		
Click to expand...

The point is G that no one is advocating leaving the horse badly lame for days on this thread, so by the time the RSPCA arrived the horse would either have popped it and be fine, or be under the care of the appropriate professional already.

It's simply not an issue.


----------



## amandap (26 October 2013)

Moomin1 said:



			No, but a horse SHOULD by law be made comfortable and free from pain as much as is possible.
		
Click to expand...

Ah yes but fear of prosecution to drive horse care is not a way to go! It could lead to all sorts of inappropriate and unnecessary interventions just to be seen to be doing something. Severe broken leg lameness due to abscesses should not be allowed to go on for days anyway!
Horse care should be driven by horse centred careful and open consideration of the causes, situation and the impact of approaches on that individual horse.

I'm sorry if I was abrupt Goldenstar but to me that thinking is the wrong way round and not a valid basis for horse care or treatment.

ps. Some times pain and discomfort is unavoidable, just doing something and filling a horse full of pain killers is not sorting possible causation... this is a big problem I believe, we are so quick to jump in and try to fix things now without looking at the reasons why the horse is having problems.


----------



## SO1 (27 October 2013)

So how long would you wait before getting vet or farrier to dig it out? I think i read in your previous posts that the abcesses blew within days of the horse becoming lame which is lucky but I suppose lots of people would not want to see their horse being very lame especially if they don't know how long it will take for the abcess to blow.




cptrayes said:



			The point is G that no one is advocating leaving the horse badly lame for days on this thread, so by the time the RSPCA arrived the horse would either have popped it and be fine, or be under the care of the appropriate professional already.

It's simply not an issue.
		
Click to expand...


----------



## cptrayes (27 October 2013)

SO1 said:



			So how long would you wait before getting vet or farrier to dig it out? I think i read in your previous posts that the abcesses blew within days of the horse becoming lame which is lucky but I suppose lots of people would not want to see their horse being very lame especially if they don't know how long it will take for the abcess to blow.
		
Click to expand...

I have already answered this.

But to save you the trouble of reading the thread back  I'll answer again.

Provided there is no infection spreading up the leg, and providing there is localised heat in one part of the foot, and there is a pounding pulse to confirm in-foot damage, then I will let the horse be  severely lame for one day to see if it raises a blister on the coronet or at the heel. 

If a blister is rising then I will give it another day to pop, if I cannot pop it myself.

So far, I have not needed any outside help with abscess resolution.

You need a lot of experience to know when to call for help. If in any doubt call a vet or a farrier.


It is easy to see a lame horse as severely in pain all the time. With a foot abscess, I believe that the pain is only really severe when the foot is bearing weight. Therefore a severely lame horse can look as if it is in terrible pain when in fact it is actually avoiding severe pain, not necessarily experiencing it.


----------



## Orangehorse (27 October 2013)

I was interested to see that someone said that Devils Claw is a good pain relief, because that is a common problem.

In my case horse came in on three legs, sweating and feeling VERY sorry for himself.  Vet confirmed probably abscess and then because he was so miserable, gave him bute, although I had misgivings.  But what can you do?  Horse is looking in desperate pain, bute is the painkiller. I also know that it is anti-inflammatory and can prevent the abscess bursting.  So it did.  Several visits to dig holes by the vet, X rays in case it was a broken bone, and dozens of animallintex, duck tape and bandages later I had a horse with a huge hole that was on and off lame for 6 weeks.  He got better in the end, but I have since then wondered if there was an alternative to bute that would have killed the pain, but let the abscess build up and resolve quickly.


----------



## sheepdog (27 October 2013)

cptrayes said:



			l

The trouble with a hole too big to pack with cotton wool or a filler is that they can so easily bruise the foot where the sole is missing.  If it won't hold a filler then a boot is your only option to prevent it, but I do worry about rubs if turned out in them.At least she can start work though, assuming she's now,sound.

I'm sure she'll be right as rain soon 



Ps watch what the hole does - it's fascinating!  It will migrate forwards to the front of her hoof.  Bowker's current explanation of that is that the sole is produced at the bars and grows forward from there. For that reason he says trimming bars is a no no.
		
Click to expand...

As an aside, my barefoot for life mare grows bars too strong to ware down with road/track work alone.  My trimmer has asked me to rasp down between her visits as they are causing bruising.  How does this fit in with Bowker's explanation?


----------



## cptrayes (27 October 2013)

I really struggle to believe that the bars are too strong to wear on the road. Are you really suggesting that the hoof wall wears but the bars don't?

Does this bruising that your trimmer identifies result in lameness?

Rasping bars is difficult as they are inside the hoof wall and beside the frog. Are you sure we are talking about the same thing?


----------



## cptrayes (27 October 2013)

Orangehorse said:



			I was interested to see that someone said that Devils Claw is a good pain relief, because that is a common problem.

In my case horse came in on three legs, sweating and feeling VERY sorry for himself.  Vet confirmed probably abscess and then because he was so miserable, gave him bute, although I had misgivings.  But what can you do?  Horse is looking in desperate pain, bute is the painkiller. I also know that it is anti-inflammatory and can prevent the abscess bursting.  So it did.  Several visits to dig holes by the vet, X rays in case it was a broken bone, and dozens of animallintex, duck tape and bandages later I had a horse with a huge hole that was on and off lame for 6 weeks.  He got better in the end, but I have since then wondered if there was an alternative to bute that would have killed the pain, but let the abscess build up and resolve quickly.
		
Click to expand...

I believe that Devils Claw is also an anti inflammatory. 

I know it's difficult to see them in pain, but your boy's is a case in point. If he'd been in serious pain for another 24 hours, would he have been spared 6 weeks of subsequent milder problems??? We'll never know. Possibly yes, possibly no.

I would like to see some research done on this so we all know what is for the best. It would be so easy to do, as well.


----------



## OwnedbyJoe (28 October 2013)

sheepdog said:



			As an aside, my barefoot for life mare grows bars too strong to ware down with road/track work alone.  My trimmer has asked me to rasp down between her visits as they are causing bruising.  How does this fit in with Bowker's explanation?
		
Click to expand...

You could try this:http://www.horsefarrier.com.au/products.htm#scs - the sole chisel, advertised halfway down the page. David is a highly respected Australian farrier.
That tool is used a lot here for overgrown bars when the long dry summer means hooves are as hard as iron...
I don't see bar overgrowth in four of my (barefoot) herd of 5, but  do have one pony who develops excessive amounts of bar despite running on 100 acres of gravelly soil and being ridden up to 30kms a week (!!), so I take some if that off, although personally I would only trim bars when they are actually at risk of folding over (as seen in the pic advertising the sole chisel, although clearly that is quite extreme).


----------



## amandap (28 October 2013)

sheepdog said:



			As an aside, my barefoot for life mare grows bars too strong to ware down with road/track work alone.  My trimmer has asked me to rasp down between her visits as they are causing bruising.  How does this fit in with Bowker's explanation?
		
Click to expand...

Not Bowker but http://www.hoofrehab.com/TheBars.htm

My understanding is as long as the walls are kept in check by enough work and or regular sensitive trimming the bars will take  care of themselves. Obviously overgrown bars that fold over need to be trimmed but generally once the fold is removed and the wall kept in check the bars will find their own level that the horse requires.

ps. Only my lamiitic pony has needed her bars trimmed in the last 3 years, none of my other horses have and they aren't great big folded over monsters.


----------



## amandap (28 October 2013)

OwnedbyJoe said:



			You could try this:http://www.horsefarrier.com.au/products.htm#scs - the sole chisel, advertised halfway down the page. David is a highly respected Australian farrier.
		
Click to expand...

Tbh I cannot see any need for an owner to have or use this tool in UK.


----------



## sheepdog (28 October 2013)

Thanks for the link Ownedbyjoe.  I think the bars are too hard to fold over, it would be more comfortable for my cob if they did, I think; it would stop the slight bruising I suspect.


----------



## amandap (28 October 2013)

sheepdog said:



			Thanks for the link Ownedbyjoe.  I think the bars are too hard to fold over, it would be more comfortable for my cob if they did, I think; it would stop the slight bruising I suspect.
		
Click to expand...

Purely out of interest where is this bruising and how does it manifest itself? Is your horse sore or lame when the bars are not kept short/er?


----------



## sheepdog (28 October 2013)

When sherrie's trimmer comes (every 9 weeks) and takes the bars down, sometimes there are tiny areas of bruising evident in the horn.  Sherrie is never lame or sore.  She's never had lami or absesses.  My trimmer said it's simply that she grows super strong horn and if I worked on sand/gravel they would wear down naturally, but we don't have these surfaces.


----------



## amandap (28 October 2013)

Thanks for that info sheepdog.


----------



## cptrayes (28 October 2013)

I do not believe that any horse which is sound needs the bars trimmed.

Why not just listen to the horse?  So what if you can find a little pink spot if you cut them back? If the horse was sound the pink spot was irrelevant, in my opinion.


----------



## amandap (28 October 2013)

cptrayes said:



			I do not believe that any horse which is sound needs the bars trimmed.

Why not just listen to the horse?  So what if you can find a little pink spot if you cut them back? If the horse was sound the pink spot was irrelevant, in my opinion.
		
Click to expand...

I do believe pink areas may not be bruising due to pressure but possibly dietary for eg, like pink areas that can show in the hoof wall. I wouldn't be concerned about trimming the bars if the horse was sound either.


----------



## OwnedbyJoe (29 October 2013)

amandap said:



			Tbh I cannot see any need for an owner to have or use this tool in UK.
		
Click to expand...

Ah well, whatever. I'm just putting it out there.
I don't see many Australian horses that need it either, but David Farmilo and I have had to agree to disagree on a few things, mainly on the fact that he thinks a horse cannot be a "high performance" horse without shoes!!  However his knowledge of hoof balance and how to trim a foot are second to none.


----------



## spotty_pony (29 October 2013)

Dug out by Farrier, tubbed in salt water, and then hot poulticed until gone, when gone dry poulticed for a few days. I have seen a particularly nasty abscess appear at the coronet band before and it wasn't nice. IMO not treating it it a form of ignorance and therefore neglect.


----------



## cptrayes (29 October 2013)

Did it cause any problem SP, or is it just that you could see the hole, whereas you can't see the hole in the sole?  

Abscess exit holes normally just grow down with the hoof and cause no trouble at all. And the hole is much easier to keep clean than a hole in the sole too.


----------

