I Hope It's an Abscess

I can't tell you how many times I've had a friend call or text to ask what I thought about an overnight lameness. If there is no heat or swelling or obvious wound, I always say that it's probably just an abscess. Are you sure? is usually the response. I never say this, but no, I am not sure, but given the symptoms, it's the most likely answer. So far, I've yet to be wrong. When it's my horse though, that sense of certainly is a lot less certain.

So ... I am pretty sure Izzy has at least one abscess, and likely two.

No wonder!

A little more than a week ago, we got more than half a year's worth of rain in one night. Everything was either flooded or soaked. Izzy had a lake in his paddock. If there wasn't standing water, there was mud. Everywhere. While the standing water disappeared entirely within three days, the wet ground did not. By Tuesday, Izzy was very lame. On Thursday, my farrier came out, but he couldn't find an abscess, and Izzy stood politely for his feet to be reshod in the front, trimmed in the back. On Friday, despite being markedly improved, I poulticed the hoof that was the most sore at the walk.

Given that I get so many questions about abscesses, I thought I'd share my process again.

​Step 1: Have an arsenal of supplies at the ready.
My abscess kit includes hoof testers, a hoof knife, hoof pick with a brush, scissors, vet wrap, brown gauze, Telfa pad, duct tape, and Numotizine.

Step 2: Check for sore spots with the hoof testers and knife.
With a bit of practice, anyone can use a pair of hoof testers. It's a good idea to try them out on a sound horse when it's not an emergency to get an idea of just how hard you need to squeeze. Speedy is super reactive to hoof testers, so I always know right away where his abscess is. Izzy didn't flinch a bit this time which made it impossible for me to diagnose the exact location of the abscess.

Since he was walking with a pointed toe and swinging his foot wide, I could tell that he didn't want to bear weight on the medial heel. This suggested that the abscess is on the bar to the inside of the hoof. Before using a hoof knife, it's a good idea to get at least a little training from your farrier or vet. Having done that many times with my own vet, I feel confident in paring away at the sole as I dig for an abscess. For this particular abscess, I dug at what looked like the tell tale black lines of a track, but it didn't lead me to the abscess. Given how soft Izzy's sole was, I abandoned my search and decided to let the poultice do the work for me.

Step 3: Apply the Numotizine with a Telfa pad.
I like to scoop out the Numotizine with a Telfa pad. First of all, Numotizine stinks, and if you get it on your hands, it seeps into your skin and smells bad for several hours, sort of like when you chop onions. I also like to use the Telfa pad because it keeps the Numotize in place while you attach the the rest of the bandage. I scoop out a small handful using the Telfa pad like a glove. I press it down into the sulcus of the frog, the crevice along the edge of the frog that attracts dirt. If needed, I'll also spread the Numotizine across the entire sole. You need enough to pack into the sulcus, but not so much that it oozes out.

Step 4: Wrap the hoof in several layers of brown gauze.
For a horse that is really sore, you can first add a diaper or other padding under the brown gauze. In all of the many years that I've dealt with an abscess, I've yet to have a horse that sore. Usually, paring away some of the sole will offer a tiny bit of relief. And if I can actually drain the abscess, the relief is instantaneous for the horse, much like getting a splinter out of your finger. You don't need much brown gauze; it's just there to hold the Telfa pad, and any extra padding that you've added, in place.

Step 5: Wrap well with an elastic bandage like Vet Wrap or Co-Flex.
I typically use less than the entire roll. The elastic bandage is not what's really holding the whole thing together. Most of the time, I have a left over roll from a previous injury, so I'll use that first. Then, if needed, I'll open a new roll and wrap it around a few times. I like to start at the heel and do the outside of the foot and then start angling the Vet Wrap so that I cover as much of the center of the foot as possible. I want to hold the Telfa pad and brown gauze securely in place so that the Numotizine doesn't leak out.

Step 6: Secure it all with duct tape.
This is the most important step. If it is cold or wet, your duct tape isn't going to be very sticky, and the whole thing is coming to come off. If you can warm up the duct tape by letting it soak up a bit of sun or put it in your car near the heater for a few minutes, you'll have better luck. Unlike my vet, I don't use the strip method. Duct tape is cheap so I wrap the hoof like I did with the gauze and Vet Wrap. I go around and around the foot, changing my angle so that I cover the hoof entirely. Then, I start cutting strips to layer a row across the foot and a row going with the hoof. When those two layers are complete, I do several more wraps around the permitter of the hoof starting at the heel. Using this system of wrapping, my horses almost never lose the poultice until I am ready to take it off.

And that's it.
​If you've done it well, you should have a secure boot that will allow the poultice to draw out the abscess. I generally leave the possible on for two or three days. On the third day, I cut the boot off, and repeat the lameness exam. With Speedy, I generally poultice two or three times. His abscesses seems to be deeper in the hoof and take about two weeks to resolve. Izzy hasn't had very many, but in the past, his have tended to resolve quickly.

Over the weekend, I free lunged him in the round pen to assess his degree of lameness. On Saturday, I thought he was about 98% sound both directions. On Sunday, it looked as though the other foot was a bit tender. Tonight, I'll pull the abscess and free lunge him in the round pen again to see if a new poultice is  warranted. One thing to consider when doing a poultice like this is that it can heat the hoof up, so it's not something I would leave on forever. Removing it every couple of days to check on the foot is a good practice.

Hopefully it will continue to look better each day, and then before I know it, it will fade away.