Coffin Bone Tumors in Horses by a Vet – 2025 Guide to Keratoma Diagnosis & Surgical Recovery 🦴🐎
In this article
Coffin Bone Tumors in Horses by a Vet – 2025 Guide to Keratoma Diagnosis & Surgical Recovery 🦴🐎
By Dr Duncan Houston, BVSc
Introduction
Lameness in horses can stem from many causes, but one of the rarest and most overlooked is a keratoma—a benign tumor affecting the hoof. This mass originates between the hoof wall and the coffin bone, in a space so tight that even a small lesion can cause significant pain. In 2025, awareness of this condition is key for equine caretakers and veterinarians to diagnose early and treat effectively.
What Is a Keratoma? 🧠
A keratoma is a non-cancerous growth that develops from the hoof’s keratin-producing tissue. Although benign, it’s problematic because it:
- Grows between the inner hoof wall and coffin bone
- Exerts pressure on sensitive structures
- Causes chronic pain, distortion of hoof shape, and recurring abscesses
Where Can It Occur? 📍
- Most often in the toe region
- Also seen in the quarters, heel, and sole
- Rarely above the coronary band
Signs & Symptoms 🚩
- Slow, progressive lameness – not improving with routine treatment
- Bulging of hoof wall – if tumor is large enough
- Recurrent hoof abscesses – especially if localized to same area
- White line separation – allowing bacterial entry and infection
- Positive hoof tester response – similar to a sole bruise or abscess
Why It’s Misdiagnosed ❌
- Keratomas mimic hoof abscesses in symptoms
- Respond to initial drainage but abscess returns repeatedly
- Not always visible on x-rays unless bone remodeling has occurred
How to Diagnose a Keratoma 🧪
1. Radiographs (X-rays)
- May show semicircular defect in the coffin bone
- Only visible if keratoma has compressed or damaged the bone
2. MRI (Magnetic Resonance Imaging)
- Highly accurate for identifying soft tissue masses
- Recommended when x-rays are inconclusive
3. Surgical Exploration
- Sometimes the only way to confirm diagnosis
- Helps with both diagnosis and treatment
Treatment Options 🛠️
1. Surgical Removal
- Gold standard for treating keratomas
- Procedure depends on tumor location:
- Toe/quarter: Hoof wall is resected to access and excise tumor
- Sole: Hole made through sole if keratoma is accessible below
2. Post-Surgical Care
- Special bandaging to keep site clean and supported
- Therapeutic shoeing for stability during regrowth
- Antibiotics and anti-inflammatories as needed
3. Recovery Timeline 🕒
- Initial healing takes 6–8 weeks
- Full hoof regrowth takes 6–12 months
Prognosis 👍
- Excellent if keratoma is fully removed
- Rare recurrence when procedure is properly done
- Most horses return to full athletic function
Case Example: Recurring Abscess Reveals Keratoma
- 12-year-old gelding with 3-month history of abscesses in right front toe
- X-rays showed subtle bone change; MRI confirmed keratoma
- Surgical hoof wall resection performed
- Hoof wall regrew over 10 months; horse returned to light training by 6 months
FAQs About Keratomas in Horses 🧠
Q: Is a keratoma cancerous?
A: No. It is benign and doesn’t spread, but it can be locally destructive.
Q: Can a horse live with a keratoma?
A: Not comfortably. They typically cause pain, lameness, and abscessing until removed.
Q: Can shoes cause a keratoma?
A: Not directly. Repeated trauma or pressure may contribute, but most causes are unknown.
Conclusion
Keratomas are a rare but important differential diagnosis for chronic lameness or recurring hoof abscesses. While benign, they can cause significant hoof distortion and require surgical treatment. With proper veterinary care and aftercare, most horses recover fully and return to regular work. Early diagnosis and imaging are crucial—don’t overlook a “simple” abscess that keeps coming back.
Think your horse’s abscess might be more than just an abscess? Visit AskAVet.com or download our app 📱 to connect with Dr Duncan Houston for expert diagnosis and recovery planning. 🩺🐴
