EquiSearch's Ask the Vet: Help for a Hoof Abscess
Question: We recently purchased a sound, well-gaited Standardbred pacing gelding. He came up very lame quite suddenly while being jogged on the track. We had the vet in for full X-rays, which were clear for broken bones. The diagnosis was an abscess, and we began the poultice program, plus we had him on stall rest for about six days, and he got sound. On the 14th day my husband harnessed him up to jog. He only went about 20 feet when the colt became severely lame, to the point he thought the horse was going to lay down, jog cart and all. We went back to poultice two times a day. The colt was dead lame at this point, 3-legging it. After about another week, we were able to get him into the paddock and once he moved around a bit, he was able to trot, canter, gallop, buck and kick, and enjoy some green grass. Walking back to the barn he was definitely looser and more comfortable then he had been on the walk to the paddock, but still lame. By the next morning, he was dead lame again...We now have the colt on prescribed stall rest, poultice and soaking. We have never had to deal with an abscess before. Most of the articles I've read indicate resolution within a few days, or perhaps two weeks. We are at day 32 since the initial lameness. We are dreadfully concerned he may have a broken bone that did not show in the initial X-ray.
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Answer: There are several things that could be causing this ongoing lameness that is severe at times. You are correct that it could be a cracked coffin bone that did not show up on the original X-ray. It is not too uncommon for a crack, especially a small one, to be missed when an X-ray is done soon after the injury. The reason for this is that the crack can be very thin, so it is hard to see. After about 10 days to 2 weeks, the changes in the bone as it heals actually make it easier to see a small crack.
Abscesses can last a really long time. The most common abscess forms, causes lameness, gets opened up and drains in a couple of weeks or even less. However, I have documentation of abscesses lasting for one year or more and one that was likely in a foot for 10 years, which is very unusual. The way an abscess forms is like any pimple or site of a splinter on a human. First there is inflammation which can be quite painful. If you try to find it and drain it at this point, you will be very unsuccessful. The soaking you have been doing is very helpful to try to bring it to a head. When the abscess organizes into a pus-filled pocket, it can be drained and the horse will experience a great deal of relief, usually immediately.
Sometimes the inflammation does not proceed to the pus pocket stage smoothly and quickly. When this occurs, it is hard to localize the abscess and impossible to get it to open. Soaking and treatment with agents that help draw infection and inflammation to the surface are useful. A commonly available product is Iccthamol, a black salve used for this purpose for many years. Other products include poultices, some of which you may have used. One poultice you may not have tried is called Draw.
To help bring an abscess to a head faster, I frequently use homeopathic medicines. My favorite for bringing out a stubborn abscess is called Silicea 30. I give about 6-8 tabs or 1/2 tsp. once a day for up to 7 days. You can get this at some health food stores and from my website. This can bring the abscess to a head, then you proceed normally with opening it and treating the foot. Tea Tree oil can be used once the abscess has opened to clean and protect the open area.
Another reason for this type of lameness can be a deep bruise. A bruise that is deep often does not show up on the bottom of the foot for 1-2 shoeings, then you see a red mark growing out. Even if you think your horse is not around stones or hard ground, all it takes is one poorly placed piece of gravel or hard material. A deep bruise can last several months while it grows out. In some cases the pain is from the bone inside the foot getting bruised, and a bone bruise is quite painful. Soaking these types of injuries can be helpful as you have been doing. You can use the foot soaks above or something like Sore No More, available from many tack stores. This product has herbs that help relive bruising and pain but are not as drawing for an infection. In many cases more rapid healing can occur with Chinese herbal topical ointments. Also homeopathic remedies are helpful such as Arnica or Bellis Per, given at the doses listed above but usually only needed for 3-5 days.
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