Vet Tips 2025: Chronic Hoof Abscesses in Horses—When It’s More Than Just a Bruise 🐴🦶

By Dr Duncan Houston BVSc

Most horse owners will deal with a hoof abscess at some point. These painful pockets of infection inside the hoof capsule often cause sudden lameness but usually heal quickly with proper care. However, when an abscess doesn’t go away—or keeps coming back—it's time to ask a deeper question: what’s really going on? 🧠🐎

What Is a Hoof Abscess? 🦠🦶

A hoof abscess is a bacterial infection inside the hoof. Pus builds up under pressure, causing pain and inflammation. Most commonly, bacteria enter through the white line—the soft junction between the sole and the hoof wall—especially if hooves are not trimmed regularly or properly. ✂️

Common Abscess Triggers:

• 🧱 Dirt and bacteria entering via overgrown or cracked hooves
• 🔩 Penetrating injuries (e.g., thorns or nails)
• 🌧️ Wet-to-dry cycles that weaken hoof structure

Most abscesses resolve with drainage, soaking, bandaging, and pain management. But if your horse still limps weeks later, or keeps getting abscesses in the same hoof, something more serious may be hiding inside. ❗

When an Abscess Isn’t Just an Abscess 🚨🩺

If your horse has an abscess that:

• ⏳ Lasts longer than 2–3 weeks
• 🔁 Keeps recurring in the same hoof
• 🩺 Doesn’t respond to standard care

Then it’s likely there’s an underlying structural or systemic issue. You’ll need your vet—and imaging tools—to find the real cause. 🧠📸

3 Major Causes of Chronic Hoof Abscesses 🧬🐎

1. Laminitis 🔥

Laminitis causes inflammation and breakdown of the laminae—delicate tissues that attach the hoof wall to the coffin bone. This disruption creates unstable hoof structure and increased pressure, making abscesses more likely. ⚠️

2. Infection of the Coffin Bone 🦴

If bacteria from an abscess reach the coffin bone (P3), they can cause osteomyelitis (bone infection). This deep infection is much harder to clear and may require:

• 📸 Radiographs (X-rays) or venograms
• 💊 Long-term antibiotics
• 🔪 Surgical curettage (removal of infected bone)

3. Keratoma 🧱

A keratoma is a non-cancerous tumor-like mass that forms inside the hoof wall, usually between the coffin bone and hoof capsule. It can disrupt normal hoof function and cause recurrent abscesses. 🧠

Visible on X-rays as a pressure defect in the coffin bone, keratomas are often missed without imaging. Surgical removal is the only cure. ⚒️

What to Expect From a Diagnostic Workup 🧪📋

Your vet will typically recommend:

• 📸 Radiographs to visualize bone defects or keratomas
• 🩸 Bloodwork if systemic infection is suspected
• 🧬 Venogram in advanced cases to evaluate blood flow to the hoof

These tools help distinguish between a stubborn abscess and something much more serious. 🔍

Treatment Options for Complex Abscesses 🛠️🧠

🔬 If Bone Infection Is Found:

• 💊 Antibiotics (local or systemic)
• 🔪 Surgery to debride infected tissue
• 📦 Specialized shoeing for support and protection

🧱 If Keratoma Is Diagnosed:

• 🪚 Removal of a to access the mass
• 🔬 Full surgical excision of the keratoma
• 🧽 Post-op care: bandaging, clean stalls, careful monitoring

🔥 If Laminitis Is Involved:

• 🧊 Ice therapy and pain control
• 📏 Corrective trimming and therapeutic shoeing
• 📉 Diet adjustments to reduce inflammation

Don’t Wait Months for Healing—Get a Diagnosis 📆⏱️

Owners sometimes say, “It took three months to drain,” or “He’s had abscesses for a year.” That’s not normal. If your horse isn’t healing within 3–4 weeks, it’s time for diagnostic imaging. 🧠

Need Help With a Chronic Hoof Abscess Case? Ask A Vet 📱🐴

Still dealing with an abscess weeks later? Not sure if it's laminitis or something deeper? Connect with a hoof expert at Ask A Vet today.

Download the Ask A Vet app for 24/7 guidance on imaging, abscess management, surgical options, and long-term hoof care. 🐎🦶

Final Thoughts: Don’t Let Abscesses Become a Chronic Pain 🧠🛑

Most hoof abscesses heal quickly. If yours doesn’t, it’s time to dig deeper—literally. Imaging, diagnostics, and surgical care may be necessary to get your horse sound again. Your horse deserves a pain-free stride. 🐎💙

Need help now? Visit Ask A Vet for real-time support. 🩺🦶