The Truth About Hoof Abscesses

The Truth About Equine Hoof Abscesses.

Hoof abscesses can be much more serious than most of us realize.  Abscesses usually are misunderstood, misdiagnosed, mistreated and cause our horses unnecessary suffering, loss of use and too often loss of life.

The following is a brief explanation of White Line Abscesses of the hoof wall and White Line abscesses of the hoof bar (sub-solar).

White line Abscesses of the Hoof Wall:  It’s commonly believed that a horizontal crack appearing in the hoof wall is caused by injury at the hairline (coronary ridge) that treks down the hoof with the wall growth.   

However, a crack or rather split in the wall that develops as a result of trauma at the hairline will typically be “vertical” and will nearly always become a permanent fixture of the wall to some degree.

Conversely, horizontal cracks in the hoof wall are most often caused by abscesses (affecting the white line - WL) that rupture at the hairline and migrate with wall growth to the ground where it should be trimmed off.  

Abscess rupture sites may be any width; from a hole the size of a match head, to several inches wide, as often seen in draft hooves. Multiple abscesses can affect the same hoof at the same time or in very close succession.  More than one hoof can be affected at the same time due to a duplication of the conditions that lead to abscessing.

Cause:   WL abscesses generally affect hooves that have been neglected, or that are trimmed regularly, but incorrectly, shod or unshod.

 

The hoof wall, if allowed to flare creates leverage on the connective tissue (lamina/white line) between the wall and the sole which can cause stretching of the white line.  Laminitic connection stretches to a point, and then separation ensues. 

WL separation (the primary and secondary layers of connective tissue detach interrupting life support of one to the other) causes death of the lamina.  Once necrotized, that tissue mixes with bacteria and debris and entire pocket of inflammation causing pus begins its ascension up the wall into the narrowing space between the wall and bone below the hairline.  Pain will increase due to the increased pressure as the pocket continues to become more inflamed and makes its way to sensitive nerves near the coronary ridge.  The abscess is most painful just prior to rupture.  At some point in the process lameness is usually presented in varying degrees.  

It’s important to understand that as the pus pocket treks up the inside of the wall to the soft hairline where it finally and painfully ruptures, a channel of dead lamina is left in its wake.

The abscess channel will eventually dry up leaving an area of disconnection (a tunnel) behind the wall from the ground to the hairline.                                                                                                                                                                                                                            

Lameness soon subsides after rupture. As the wall grows, new/well-connected lamina develops (grows down) above the descending “crack” and takes the place of the damaged tissue. Lameness soon subsides. As the crack (rupture site) treks closer to the ground, the detached wall below the crack may snap off.

White line Abscesses of the Bars:  Bar abscessing is more serious and painful than wall abscesses.  That is because affected areas of the WL may also migrate to the sub-solar connection (papillae) causing eventual detachment of sole (and frog) and in severe cases can cause permanent damage to the solar papillae. 

Mistaken assumptions are made that abscesses of the sole (bars) are caused by trauma to the sole. Sharp objects may impact the sole of a soft-soled hoof, but the result generally will be a localized wound.  Abscesses and injuries to the bottom of the hoof are different conditions and we need to distinguish between sole trauma and white line abscess to avoid confusion.

The bars of the hoof are an extension of the hoof wall.  Which means abscesses can develop in the white line of the bars, tracking up connective tissue to rupture at the hairline of the heel bulb. 

The lameness that the horse incurs is often described as “mystery lameness.”   The resulting rupture sites appear as horizontal splits in the back of the hoof and are typically misinterpreted as injuries caused by forging and other misstep type injuries.

Cause:  When hooves are neglected or the bars left unattended during trimming, the same stretching of the white line of the bar will result - just as we see in the white of the hoof wall.

In a hoof affected by bar abscess, a section(s) of white line of the bar will become blackened where stretching and invasion takes place.  The main difference we see in bar abscess is that its affect is not limited to the lamina.  But also invasion of solar connective tissue (papillae) often occurs. 

Left in the aftermath of a processed sub-solar abscess is profuse dried, blackened, necrotized residue in place of the once healthy connective tissue.  This disconnection will eventually lead to complete detachment of sole material from the hoof as well as the frog in severe cases.

Symptoms:  Usually we notice varying degrees of lameness.  Horses suffering abscess have been observed lying on the ground, unwilling to stand except to eliminate -- or no observable lameness at all.  When an abscess takes place in the hind we often don’t observe lameness.  Or a horse can process numerous abscesses that no one notices essentially because no one was observing the equine.

Treatment for both types of WL abscess: There is no actual treatment for an abscess once the white line has been invaded. The condition has to run its course. Epsom salt or vinegar soaks may help soften the coronet band, while pain meds and padded boots can offer relief post rupture.

Don’t Do This:  Digging openings into the sole or white line is a common approach to relieve pressure.  However, by the time the horse displays pain, the abscess is close to rupturing at the hairline. Therefore, that procedure most often only causes further trauma to a hoof, rather than relieving pain.  Poultices sometimes may help drain a bar abscess if caught soon enough, but the pain and rupture will still take place.

However, when veterinarians or farriers increase the opening of an abscess entrance site in the hoof as a treatment, they do offer the owner a means to feel like they are contributing to the horse’s rehabilitation.  Typically prescribed aftercare includes hoof packing (needed to treat the enlarged hole) along with hoof soaks, and ridiculously extended periods of stall rest.  Most horses would tell you they don’t appreciate any of the above recommendations.  

Skilled veterinarians have been known to drill tiny holes in the outer wall in the path of the abscess causing discharge and instantaneous relief from pressure and pain.   Done correctly, this is one of the only methods that can provide instant and actual relief to a horse suffering from a wall abscess.  However, this method isn’t practical for an abscess of the bar.  Also, many veterinarians aren’t aware that the abscess doesn’t trek straight up the wall, but treks at the same angle of the angle of the growth of the horn tubules.   Numerous holes drilled into the hoof wall in an attempt to find the abscess track could cause secondary problems.

Anytime I have introduced this technique at conferences, the first question is always, “How do you know when to stop drilling?”  The answer: When you hit pus!  The important bit is to follow the angle of the horn tubules from the entrance site and you’ll find the abscess channel.

What to Expect: For horses that have been processing white line abscess chronically for some time, expect it to take several hoof growth cycles before the horse stops processing abscesses or at least less often.  

Rehabbing an abscessing hoof requires trimming at 4 week intervals. It can take many months, or

years to grow out new hoof material to replace the involved connective tissue.

 For the sake of your horse, please be patient with the rehab process.  It will take as much or more time for your horse to make his way out of this condition as it took to get into it.

Prevention: Preventing abscesses of the white line is as simple as making sure that your horse’s

hooves receive correct trimming at regular and frequent intervals, removing and controlling flare.  

For optimum hooves, trim scheduling should be at 4 to 6 intervals.  Trimming strategies should produce healthy hoof horn (no flare) and well maintained bars with tight, connecting tissue (lamina/white line).  This strategy will reduce and eliminate abscesses. 

Common Misunderstandings of Hoof Abscesses:  Lameness caused by WL abscesses is frequently misdiagnosed because it’s difficult to identify an abscess until rupture at the hairline takes place followed by “gradual” relief.  Even then, the condition remains a mystery when we hear the owner state that “The lameness simply went away.”

Radiology and even MRI usually will not pick up the abscess channel.  This lack of obvious cause of the observable lameness often leads to a search for alternative causes.  The use of this technology can show us different hoof anomalies that otherwise would never be discovered, that have always been a part of the hoof internal structures, and have no relevance to the horses current discomfort, but will receive the blame.   Such as "navicular syndrome" which in most cases isn't a syndrome at all.

The above isn’t always the case, but it is not an uncommon scenario that leads to mistreatment, usually an unorthodox shoeing strategy, which may not produce an obvious, permanent and/or “immediate” cure.  So the only consideration for the horse at some point is to euthanize. 

Thermal Imaging does at times illuminate abscess inflammation.

Founder can result in more than one hoof caused by the severe inflammation in the abscessing hoof or hooves.  It’s not unusual for a horse to be diagnosed with founder, but the initial cause (abscess) miht never be detected.  That’s when horses who have never had an issue with “grass” are often pulled of pasture indefinitely, but needlessly.

Once a horse has been pronounced with the “f” word – founder.  It’s thought that the cure is troublesome and expensive, or worse, there is no hope at all.  That simple isn’t true in most cases.

Important Notes

Abscess pain often mimics colic pain before obvious lameness is displayed. I wonder how often horses are treated for colic, that would love to be able to say, “The pain is in my foot!” 

Founder can result in more than one hoof caused by the severe inflammation in the abscessing hoof or hooves.  The cause of the founder is mechanical in this case and not organic.

In severe cases a hoof can be fully engulfed in several abscesses at one time causing severe pain and lameness and founder. If left untreated (untrimmed) the hoof may eventually lose most of its attachment material.

Shoes can stall out the process of abscess and should be pulled during rehab.  Lameness in a shod hoof is frequently caused by abscesses located at the junction of the bar/heel (seat of the corn) which can be difficult to locate until the hoof has been indefinitely unshod and trimmed correctly and regularly. 

Abscess discomfort may not cause a horse to display obvious lameness all the time or at all.  Lameness may be off and on.  Not appearing at the walk, but obvious at the trot or canter.  A horse may seem fine until the weight of the saddle/rider is added. 

Even if we can drain an abscess, it will still rupture at the hairline in most cases.  

One hoof growth cycle (HGC) takes about one year so patience is required.  The horse will improve with frequent corrective trimming.

Creating craters in an abscessing hoof will only add further healing time and will allow pebbles and debris to invade the hoof that wouldn’t otherwise be an issue.  This procedure creates a secondary problem in the hoof.

Because no obvious signs of pain can be detected initially when a hoof is processing an abscess, very often riders will comment that their horse is lazy because their horse is fine in the pasture, but has learned that if he starts to limp when being ridden he will get out of work.  First, that is ridiculous.  Second, that is exactly how abscess pain is often presented.  Off and on!  Those horses are often referred to as “heartbreak horses.”  As if the horse is at fault!

The more we know - the better we understand the cause, prevention and cure of hoof abscesses, the more years of soundness our equines will experience.  Thank you for taking the time to read and understand this important information about a very common, yet commonly misinterpreted hoof ailment.

Patricia Morgan Wagner

Hoof Rehabilitation Specialist

Rainier, Washington

Revised: 1-2015

How My Horse Changed My Life Contest

Hi all!

I haven't uploaded a post in awhile as we have been super busy!  We've taken in several horses, Rudy, Roxy, Captain, and Star.  Captain and Star both suffered from severe hoof neglect, but they are doing much better.  Captain is on the REHRC website, but I have a few pages I need to upload for the other horses.

But this post is a request for your votes!  Recently, I entered the story about how my horse, Missy, changed my life in a contest that Horse and Rider magazine is hosting on their website.  I really want to become one of the finalists.  Not so much to win prizes, but to get the word out about our hoof recovery center.  If we should win prizes, we could raffle them to purchase hay and feed. 

So I'm really hoping you could go to the H&R website (that link will take you right to Missy's story) rate the story and vote for us!

Please vote once per day until the deadline.  This would be a great way to help out our horses without leaving your chair or spending a dollar!

The true story that I submitted for the contest is below if you'd like to read it here and then decide if you'd like to vote.  Thank you so much for taking the time to help us out!

In 1996, a scruffy little 8 year old quarter horse came into my life. Within months, I dropped a twenty year smoking habit and fifty extra pounds, while Missy developed into a beautiful bay mare. We earned awards and were pictured in an AQHA publication for riding hundreds of miles together. But while I worked in a basement office, I yearned for an occupation involving horses.
Then at 15, Missy came up lame and I was hurdled toward the emerging changes to traditional hoof care often referred to as bare hoof trimming. Missy’s unnaturally shod hooves led me to my new profession as an Equine Hoof Rehabilitation Specialist and the owner of my own business, Heel First Landings, Inc.
Before this sweet mare came into my life, I had rarely traveled, but my quest to learn more about equine lameness and corrective hoof trimming took me all over the US to mentor with other trimming instructors.
Overwhelmed with customers, I began offering workshops teaching the craft to others, and published a professionally filmed DVD, Discovering Your Horse’s Natural Hooves – How to Trim the Barefoot Horse.
Missy, at 23 has seen many horses move into her pasture, most with hoof ailments that destined them to be euthanized - each rehabilitated back to soundness without shoes.
Helping horses has become a passion that evolved into an official non-profit equine rescue called Rainier Equine Hoof Recovery Center. My horse saved my life so I could save the lives of many equines!

September 2011 Hoof Trimming Clinic

The Classroom!

Watching Captain's trim closely.

  What a great three days we had together! Everyone was a joy to meet and spend time together. It wasn't all one way, we shared so much important information.  We're going to do offer the next clinic at the end of October.  Go to our website or send an email for more information!

Rehabilitation of OTTB

We like to share our story of Captain (Really Unique) a 10 year old Off Track Thoroughbred gelding who has been having a very hard life for the past few years.  He is listed with a few of our other rehab cases at  www.rainierhoofrehab.com. 

My Advice for the New Trimmers:

Recently I was contacted by someone interested in becoming a professional barefoot trimmer.  I responded with this email only slightly modified for blogging.

I applaud you for removing yourself from that shoeing course.  People are so interesting when it comes to shoes.  Yesterday, I attended a local barrel racing competition.  I was there to trim a customer’s horse who lives a ways from me so we met there for this appointment.

She had sold one of her horses to another competitor some months ago and that horse happened to be there as well.  I was introduced to her former horse’s new owner and the horse had shoes on.  That owner smiled in my face and bragged about how he fixed his horse so its feet never hurt and he could ride him anytime he wanted.    

My customer and I walked away and under my breath I muttered, continuing his line of thought, “Screw the horse, it’s about me getting to ride, right!” 

We had just been discussing how ALL farrier reference books recommend frequently allowing the horse some time out of shoes. Why would that recommendation be in those books?  Because it's well documented that shoes damage the hooves over the long term. 

I get so tired of hearing, “My horse can’t go without shoes.”  Well, could that be because the shoes have wrecked your horse’s hooves and now they are too weak to support themselves?

I often hear that the walls of hooves left unshod will wear faster than the hoof can grow it.  That's true when the hoof is trimmed incorrectly which most are, but not true if the hoof is correctly trimmed and growing at a healthy angle with healthy connective tissue (laminae).

I saw an ad recently showing 3 different hooves, all very poorly trimmed and 2 shod.  The ad was for this band that is tacked around the outside of the hoofwall to relieve pain.  But the hooves wouldn't be in pain if they weren't so poorly trimmed and shod.  And the band does nothing except mask the pain caused by the condition the hooves are in.  Why not just fix the hoof with the trim?  I never can get that logic.  Wreck the hooves and use "this product" to mask the pain so you can ride the horse which will continue causing damage to the hooves until the horse can't even support its own weight, then put it down.  Common Scenario. 

The same can be said for some shoeing systems-such as NBS.  I've heard that even the developer of that system wished he'd had never shared it because it's so unnatural for the horse.  The few farrier's who are competent at applying those shoes do okay, but there are so many out there applying that systems who really botch the hooves up horribly and leave horses in serious trouble.  I've pulled so many of those NBS shoes off dead lame horses, I get angry just catching a glimpse of one of those shoes on or off a horse!

So where you live tells me you are up against more peer pressure to go with shoes than I am in my area.  We do have quite few open-minded horse owners in this region. Unfortunately not enough compitent trimmers to care for all the owners who want to go barefoot, but that's a good problem to have in some respects.

At that barrel racing event, I ran into 4 of my customers whose horse are barefoot and all raved about how well their horses are doing without the shoes.  That’s always nice to hear.  And other’s here it as well and begin questioning their line of thought regarding hoof care.

There is a lot to learn when considering to trim professionally.  Not just because you’ll need to know and understand everything that can go wrong with transitioning hooves from shod to bare, but because you’ll have lots of questions to answer. 

My DVD shows the natural maintenance trim from start to finish on several horses and a donkey.  So it is also a good place to start.  It’s professionally filmed in High Definition and I’ve been told that it is one of the best (hoof trimming) teaching DVD’s available.  DVD's by other professional trimmers are packed with great info, but it’s difficult to see exactly what being done with the tools on more "homemade" DVD’s.

Much of what I feel I know to be right about natural hoofcare, I learned from Pete Ramey, and from my own research.  I was able to get into a trimming clinic with Pete when he visited our area back in 2004, I believe it was, and then I went to Georgia the following year to learn from him directly.  With only 2 students (one from the U.K.) we were fortunate to get one-on-one instruction.  That will not be a part of any other professional trimmer's training as he only offered a couple of those clinics that I know of.  I realize how priviledged I was to be part of one of them.

To really become the best professional trimmer you can be, I recommend avoiding any  organization that dictates your trim and threatens to toss you out if your trimming methods don't adhere exactly to what they teach.  Different hooves call for different trimming strategies.  Learning to read hooves and knowing how to approach each one with your tools is the better than a one-size fits all trim when you're rehabilitating hooves.

Apply for a membership with the AHA American Hoof Association so you can be in contact with many other experienced trimmers.  As you go, you can work on getting certified by that organization.  It’s not a school, it's a screening organization to filter the hacks and only certify the true professionals and list them on their website.

Take everything you learn from each person and toss out what doesn’t seem right and stick with what does.  Just like horse training - which you'll want to also become adept at.  In most cases, you can't trim a horse who refused to allow you access to the bottoms of their hooves.  (Although there are times when you do have to trim a horse without gaining access to the bottom of his hooves.)  Let me just say, you will have to weed through a TON of misinformation. 

You don't have to agree with every trimmer out there.  You have to do much of your research on your own.  I don't agree with some of the trimmers for whom I have the highest respect.

Take abscesses for instance.  I honestly believe I’m one of the few professional trimmers out there who really understands abscesses.  I don't believe they are caused by trauma/bruising.  And there is no such thing as white line "disease" or "infection."  Those terms imply that there may be a cure.  Laminae is either live and healthy or dead and gone and there is no cure for what is no longer viable.  So soaking in chemicals in our attempts to cure WLD is probably only going to damage the healthy laminae attachement that is trying to grow to the ground with new hoofwall.  
WL separation is that is caused by flare.  Flare walls cause stretching of the white line which can lead to separation of the white line (dead laminae) and then leaves the hoof vunerable to abscessing either in the wall or the bar.  When I trim an abscessed hoof, I see what we have come to term as WLD.  But as I said, it's not diseased, it's dead. 
When a hoof is affected by an abscess in an overgrown bar (bar is an extension of hoof wall) the abscess often invades the much of, or the entire hoof.  Abscesses can cause problems in a hoof for years if the horse is shod and even after it goes barefoot can take years to completely fester out.  Not usually, but I have seen that situation and the cause if typically flare.

Review: Flare, (not "flair" as some trimmers spell the word:0) stretches the white line to the point of separation of the white line, then abscesses get their start either in the white line of the hoofwall, and/or the white line of the bar which is an extension of the wall.

An abscess in the bar can affect the entire solar papillae, which causes the sole to separate from the hoof, but new sole develops underneath the sloughing sole - like a blister.  Simple! 

Bar abscesses are so often misdiagnosed as navicular, founder, white line disease and a myriad of other hoof disorders which then puts a horse into corrective shoeing or an early grave.  So sad.  But we are here to fix that! 

All my best in your journey into a profession that is basically not accepted by the majority of horse owners, farriers, or vets, because we humans get so stuck in what they do because it's been what they've always done.

My best advice is to try to get to the horses while they are still young.  Before the damage has been done...

...and have fun!:0)
pat

Hoof Care Professionals and You

 As barefoot horses become more popular, which is awesome for the horses! More and more barefoot trimmers are getting into the business. Most have had lots of training and experience and are very good at what the do. Some are not as well trained or experienced and not so good at what they do. It's a horse owner's responsibility to pick up their horse's hooves and examine them frequently and ask questions if what they see doesn't appear to be right. Just as there are good and poor farriers/horseshoers, we are all hoof care professionals and some don't have the knack for it that others do.

Some don't recognize hoof issues like founder and abscesses and hoof ailments are often misdiagnosed so it's the owners responsibility to determine when a veterinarian should be called in to check their horses.

Hoof care professionals, in some cases may know more than your vet about hoof related illnesses, but we are NOT veterinarians and it's not even legal in the state of Washington for hoofcare professional to diagnose problems like laminitis/founder. If we suspect serious hoof issues, we need to recommend a vet be called in.

I have to write this because I'm seeing so much of the opposite going on and walking into cases with horses who have been under a farrier or trimmers care for months even years and finding issues that are usually associated with serious neglect.

Ultimately the horse's hoof care is the owner's responsibility. If you don't like what you're seeing call for a second opinion. If that bothers your hoof care professional, replace him/her. Second opinions are typical in other fields and we shouldn't feel guilty about making sure our horses are getting the best care possible and that our money isn't being wasted on anything less. If your trimmer/shoer objects, get's angry and quits, or assures you that they already know it all, then they don't know what they don't know and they are the most dangerous ones to have working on your horses!

Hoof Trimming DVD Now Selling

Easycare Inc. is now distributing copies of our barefoot trimming DVD, Discovering Your Horse's Natural Hooves. 

And it is also available on our non-profit website Rainier Equine Hoof Recovery Center

along with a few trimming tools that we are offering as a fundraiser for the horses here at the center.

Great gifts for the horse owners in your family!

Hope you all are having a happy Holiday Season

Pat Wagner

DVD Reviews!

We're happy to be receiving some greaet feed back from people who have purchased and watched the DVD.

Here are a few viewer testimonials for Discovering Your Horse's Natural Hooves - How to Trim the Barefoot Horse:


The DVD arrived yesterday and I watched it immediately. Twice! The DVD is terrific! Very informative, great quality, and just the
motivation needed! It is exactly what I needed. I've visited all the websites, I've read many of the books (including Pete Ramey's), but what I needed was a visual presentation that would give me the confidence needed to try that first trim. You're DVD was perfect! Eric, CA

We are extremely impressed and excited about practicing and learning to trim our horses. It isn't nearly as intimidating as we learn more about the goals. Keep up the great work and please realize that you are a prayer answered for so many horse owners. Dan, WA

What a very good DVD you made! It was easy to understand and done in laymans language. I've watched the trimming twice. It was nice to be able to see exactly what you were doing. Other DVD's are not as professional as this one and it's difficult to see what exactly what he's doing! Debbie, WA

Great DVD! Very professional. My wife is a teacher and she was very impressed with your teaching style. Cliff, WA

Pat, your DVD is awesome! It is wonderful. I love how it repeats so I don't have to replay what I want to hear again. It is totally, totally,totally too cool. Linda, WA

Okay, so going out to my barn now to make a few changes to my trims recommended on your DVD. I finally feel like I've found the answers I've been looking for! Thank you SO MUCH! Sara, OR.

DVD's are in!

Order yours today at Rainierhoofrehab.com.  I'll have them with me if you want to buy directly from me also.

Having a Great Time on Their Barefoot Ponies!

 

Tawna and I and our girls are going great! I attached a photo from this weekend after a 1 hour ride on the road in our easy boots! Both horses did great and had no problems! We had a REALLY good time and thought of you when we were headed home!

Thanks again for all your help!

Rachel & Tawna
Cashmere, WA

Update on DVD:  Expected shipping date: 5-25-10.  I apologize for the delay.  Thanks for your patience!