Q -- Other than signs of lameness, what are some of the symptoms of a sole abscess in a horse. What are some of the causes and treatments?
Subsolar abscesses are perhaps one of the more common causes of sudden lameness in horses. Be aware, however, that horses with such problems are not always lame. First of all, a subsolar abscess is a localized pocket of infection which has accumulated, in this case, between the horny sole and deeper tissues of the foot.
The causes can vary with the most common being entry of infection via a penetrating wound such as stepping on a sharp object or a poorly placed shoe nail. This means that the local infection could be anywhere on the sole. It is also possible for localized injections to begin at the junction of the hoof wall and sole at the so-called white line.
The symptoms usually include lameness and at times are sufficiently painful to the degree that the involved horse may keep the foot elevated or be "3-legged." As the abscess continues to expand one may find evidence of focal swelling or drainage (usually a blackish and odoriferous material) oozing at the junction of the heel bulbs of the foot or elsewhere at the coronary band region. Often the involved foot will be warmer than the feet of the uninvolved limbs. In more advanced cases, the lower limb of the involved foot may be uniformly swollen and warm. Generally one can localize the area of involvement with careful use of hoof testers or with tapping on the sole region with a small hammer. In some instances one can localize the infection with digital pressure on thin soled horses. In most instances the ability to find and define the exact entry point of the wound may be difficult because of the elastic nature of the horny sole.
The problem can occur at any age and under all conditions, however, the incidence of problems is higher in horses that tend to have weak feet (thin soles, flat feet and under-run heels) and have access to less than ideal footing (rocks, gravel, mesquite, in combination with wet conditions). Horses with well conformed heels/feet and thick wall and sole material are less likely, but still are susceptible.
The basic principle of treatment is to promote drainage and protect the underlying tissue to allow it to heal. This requires locating the area of involvement before making an effort to open the area with a hoof knife or similar piece of equipment. If the exact area of involvement is not readily apparent applying a foot poultice or soaking the foot in Epsom salts (magnesium sulfate) will often help to soften the hoof material and localize the area. Those cases that remain difficult to localize may be apparent with radiography.
Once the area is localized, careful efforts are made with a hoof knife or similar instrument to open and drain the wound. As little horn material as possible should be removed since it is necessary to adequately drain the area. The more that is removed the longer will be the recovery as well as the possibility of further damage. The wound should be explored carefully to determine, if possible, the depth of activity. Known or suspected deep wounds should be examined with radiography or other forms of imaging to determine if deeper tissues (such as the coffin bone) are involved. The area is thoroughly cleaned and treated with a local antiseptic. The opened area should be protected with a foot bandage or foot boot, to allow healing as well as maintaining a clean area. The horse's status with regard to tetanus protection should be considered. Systemic use of antibiotics are of very limited use as they do not concentrate in hoof tissues to any meaningful degree; they may, however, be utilized in the event that deeper tissues are involved.
Foot abscesses are common and generally are not long term problems if properly handled. The most common error that I have encountered has been at the hands of inexperienced people using a hoof knife by using it as either an 'exploratory instrument' or removing and damaging surrounding healthy tissue. Thus foot abscesses should be examined by a qualified equine practitioner to avoid the occasional long term or even permanent dilemma.
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