What are the usual treatments used?
It is preferable that the abscess would break out at the sole rather than travel up and burst at the coronary band. The reason for this being that any damage to the coronary band may cause a future distorted foot as the hoof grows from this area.Whether a drainage hole has been made or not, it is important to keep the hoof as clean as possible and to apply a poultice. If no drain hole is made, the poultice can help to soften the sole and hasten the bursting and drainage of the abscess. Where there is a drainage hole, it is imperative to keep the hole protected and clean while the abscess drains and the hoof heals.A poultice applied to the bottom of the hoof in the first 24 to 48 hours can help draw any remaining infection out of the hoof and help to prevent the abscess from progressing up to the coronary band. The whole foot, including the coronet, should be enveloped in the poultice.Hot tubbing etc, also help to soften the affected area and draw the infection out of the abscess. This means placing the foot in hot water (taking care not to have the water too hot) a few times each day for approximately 15 minutes.Standard treatments include the application of an Epsom Salt poultice to the sole of the hoof. A bandage poultice may also be used. Poulticing “draws” the abscess by pulling the bacterial infection out of the hoof.The hoof is then wrapped well and may be placed in a treatment boot to help cushion and protect the hoof to ensure that dirt and manure cannot come in contact with the hole and sensitive tissues. If a poultice boot is not available, an alternative type of cover is used to seal and protect.If the poultice is applied immediately after drainage has been established, the horse should show signs of recovery in two-four days.
Following the poultice or foot soak bandage, the hoof is kept bandaged with an appropriate antiseptic solution/ointment until all drainage has ceased and the wound is dry. At this point, the treating veterinary surgeon may decide to fill the opening with a hoof filler or putty to keep the affected area clean and prevent the accumulation of debris within the wound on the sole.The shoe is only replaced when the horse is sound.If the horse is not already vaccinated against tetanus, an anti-tetanus should be given.If the veterinary surgeon decides to open an abscess, how is this procedure carried out?
The offending tract is followed within the white line, using a thin small hoof knife. The white line may be very lightly pared to identify any tracts that could indicate the location of the abscess.At this point, the tract is open into the cavity of the abscess.Once the veterinary surgeon locates the abscess, he/she will then open it to allow the pus to escape, which will relieve the pressure and the pain.The tract is slowly followed until a grey/black exudate (pus) is released.A small opening is all that is necessary to obtain proper drainage. This can be determined by placing thumb pressure on the solar side of the tract and observing more drainage being expressed or a bubble at the opening when pressure is applied. Once the hole has been created, treatment of foot abscess mainly revolves around a) draining the pus from the foot and b) keeping the hole in the foot clean.
As mentioned previously the draining tract can be kept soft and drainage promoted in many ways using the methods mentioned - hot tubbing and poulticing. In some cases, to establish drainage, the treating veterinary surgeon may decide that a larger opening is required and sedation may be necessary. Sensitive tissue will need to be invaded and possibly trimmed and as there may be haemorrhage, medications such as antibiotics and anti-inflammatory drugs will need to be prescribed.In some cases the veterinary surgeon may have to freeze the nerves of the foot to numb it where the animal’s foot is too painful to open it without doing this.What is a soak bandage?
This is a type of poultice and another method used to encourage drainage. Here, layers of practical cotton are criss-crossed to form a heavy bandage that envelops the foot. Epsom salts is placed in the inner foot surface of the bandage and the bandage is attached to the foot.The bandage is now saturated with hot water and saturated periodically over the next 24 to 48 hours. This is kept in place with another bandage and sealed using appropriate covering.What is the outcome where the infection travels upwards?
In many cases the painful tract can be located but drainage cannot be established at the sole-wall junction.In this case, the infection is deep and may have migrated under the sole or wall away from the white line. Treatment of these cases is usually poulticing and hot tubbing to soften the tissue and encourage bursting of the abscess.Preferably this is done at the onset of lameness, before the infection migrates upwards towards the coronary band.