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Foot Abscesses Foot abscesses are the most common cause of acute lameness in the horse. A foot abscess forms when bacteria gain access to the sensitive structures of the foot through cracks in the sole or hoof wall or from penetrating foreign bodies such as nails. Frequently the route the bacteria take closes, leaving the perfect environment for certain bacteria, such as Clostridium spp., to multiply. Presenting Signs Most horses with foot abscesses present with acute, severe lameness; some to the point that the horse is unwilling to bear weight on the affected foot. During the early stages of infection, there is increased heat in the affected hoof and coronary band. In addition, there will be an increase in the strength of the digital pulse. Within 24-48 hours, the pastern and fetlock may swell. If left untreated, the abscess will follow the path of least resistance and rupture at the coronary band. Diagnosis Hoof testers are used to apply direct, focal pressure on areas of the sole and frog. Acute cases commonly display pain over the entire surface of the frog, with some localization over the area of the abscess; chronic cases may tend to show more localized rather than diffuse pain over the sole. Those areas to which the horse responds to the hoof testers (i.e., is painful) are investigated with a hoof knife. The area is pared down, and potential abscess tract sites are followed. These tracts may appear to be small black cracks, or there may be a soft spot felt in the sole. In some cases, the horse may need a local nerve block to relieve the pain while the abscess is being investigated. Treatment Establishing drainage is the key to effective treatment of hoof abscesses. Once a potential abscess tract is found, the sole is pared away and the tract is followed to the abscess, establishing a drainage tract. Sometimes the tract cannot be followed all the way to the abscess because the abscess is too deep. Regardless, treatment is the same. A poultice slurry of betadine and Epsom salts is applied to the sole and changed every 24 hours for 3-5 days. The poultice acts like a magnet and pulls the infection down and out of the hoof. Many cases of foot abscesses do not require antibiotic therapy because the area is so localized. However, in instances where there is significant swelling in the pastern and fetlock, oral antibiotic treatment may be indicated. Horses that have had penetrating wounds, such as a nail, should have a tetanus toxoid booster and a tetanus antitoxin.
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