🐎 Vet’s 2025 Guide to Equine Scratches (Pastern Dermatitis)

By Dr Duncan Houston BVSc

1. Introduction: Why Pastern Care Matters

“Scratches”—or pastern dermatitis—is a common but often underappreciated condition affecting a horse’s lower legs, typically the pastern area. Often used interchangeably with terms like “mud fever,” “greasy heel,” or “dew poisoning,” scratches involve inflammation, infection, crusting, and discomfort around the pasterns and heels. Without timely recognition and management, it can cause pain, lameness, and chronic changes. In this updated 2025 vet guide, we delve deep into causes, diagnosis, treatments, and prevention strategies to support your horse’s pastern health. 👍

2. What Are Scratches?

Pastern dermatitis describes inflammation of the skin on the back of the pastern and heel area. It often represents a complex mix of contributing factors—those include bacterial and fungal infections, environmental exposure, allergies, sun-induced changes, and even parasites :contentReference[oaicite:3]{index=3}.

3. Who Is at Risk?

• Feathered breeds: Draft horses, Clydesdales, Gypsy Cobs and others with long hair on the lower legs trap moisture and debris.
• Horses living in wet environments: Pasture turnout during rain, persistently damp bedding or seasonal dew.
• Light-coloured legs: White-leg exposure may increase risk of sun‐linked vasculitis—a condition that complicates scratches :contentReference[oaicite:4]{index=4}.
• Frequent wraps or boots: Traps moisture and heat, creating ideal conditions for skin breakdown.

4. Clinical Signs & Spectrum of Disease

Symptoms range from mild redness to severe infection:

• Early signs: Patchy redness, swelling, mild itching.
• Progression: Crusting, scaling, erosion, foul odor, bleeding, discomfort, and lameness.
• Severe or chronic cases: Ulceration, thickened or leathery skin, and even spread to cannon region :contentReference[oaicite:5]{index=5}.

5. How Veterinarians Diagnose

Diagnosis involves:

• Clinical signs & history: Wet environment, feathering, seasonality.
• Physical exam: Palpation, checking for sensitivity, and assessing extent.
• Lab tests: Skin scrapings to rule out mites; cultures for bacteria/fungus; biopsy for chronic or atypical presentations :contentReference[oaicite:6]{index=6}.
• Lameness evaluation: If horse is uncomfortable.

6. Treatment Options

6.1 Environmental Management

• Keep pasterns clean, dry, and trimmed.
• Avoid turnout in mud or deep bedding.
• Clip long hair around pasterns and heels.
• Use breathable protective gear if needed.

6.2 Topical Therapies

• Antibacterial & antifungal ointments: Broad spectrum treatments—apply daily after gentle cleaning.
• Barrier salves: Products such as zinc oxide or water-repellent formulations.
• Anti-inflammatory creams: Low-potency corticosteroids for itchy lesions.
• Soaks: Consider dilute chlorhexidine or epsom salt.

6.3 Systemic Medications

• Oral antibiotics: Trimethoprim-sulfa commonly prescribed when deep infection is present :contentReference[oaicite:7]{index=7}.
• Anti-inflammatories: NSAIDs if swelling or discomfort present.
• Sun-induced cases: Use sun protection or oral supplements if vasculitis suspected.

6.4 Managing Complications

• Surgical debridement for chronic lesions.
• Bandaging if wounds are open—but only under veterinary guidance.
• Ongoing monitoring for resolution and recurrence.

7. Prognosis & Healing Patterns

With early intervention, most horses respond within 7–14 days. Deep or chronic lesions require several weeks of therapy. Left untreated, these can develop into chronic dermatitis with thickened skin and repeated flare-ups. Ongoing vigilance and preventive routines support long-term success.

8. Preventive Strategies

• Keep pastern hair clipped short.
• Maintain dry turnout surfaces—provide shelter or sacrifice paddocks.
• Use breathable leg boots or barrier creams pre-turnout.
• Ensure regular hoof trimming and cleaning.
• Monitor for early signs and act quickly.

9. Common Pitfalls & When to Call the Vet

• Over-cleaning or vigorous scrubbing—this can worsen skin barrier damage.
• Bandaging without assessment—it may trap moisture if used incorrectly.
• Persistent or spreading lesions—indicates need for further diagnostics.
• Atypical or ulcerated cases—may need biopsy to rule out autoimmune disease or rare infections.

10. Case Study: “Maggie” the Draft Mix

Maggie, a 6-year-old draft cross, presented in spring with crusting and oozing on both pasterns. Initial treatment included daily clipping, soaks, antibacterial salve, barrier cream, and adjustment of turnout. Deep cultures showed Gram-positive cocci, so a 10-day round of trimethoprim-sulfa was added. She healed within three weeks and remained clear with preventive measures into the next season.

11. Ask A Vet Involvement 🩺

At Ask A Vet, we support owners with targeted pastern dermatitis plans—including environment evaluation, medication protocols, follow-up monitoring, and flare-up support. Our app offers quick access to veterinary advice when early signs emerge. Download today for peace of mind and expert guidance.

12. Quick Reference Table

13. FAQs

❓ Is scratch contagious to other horses?

Not directly—but wet group turnout or shared gear can spread bacteria/fungus.

❓ Can I ride through scratches?

Only if lesions are superficial; deeper or painful cases should rest until healed.

❓ Will feathered horses always get scratches?

Not necessarily. With proactive management—clipping, hygiene, barrier measures—they can often avoid it altogether.

14. Final Thoughts

Scratches may seem simple—but they deserve veterinary care to prevent pain, chronicity, and complications. Combining cleaning, owner vigilance, targeted medication, and environmental control ensures healthy pasterns year-round. For expert assistance and tailored plans, partner with us at Ask A Vet. Download the Ask A Vet app today for trusted support at every step! ❤️