As far back as I can remember, soaking the equine foot has
played a major role in the treatment of common foot ailments such
as abscesses, puncture wounds, corns, foot bruising and laminitis.
Over the years, I have questioned the therapeutic value of this
practice. Does soaking the foot actually draw infection out,
increase circulation or does it just plain soften the foot? In my
opinion, the principle indication for soaking feet is to soften
hard hooves so that it is easier to pare the sole to expose and
drain an abscess. In this circumstance, foot soaking is performed
over a very limited time period (12 to 24 hours). What happens to
the foot during chronic foot soaking to draw out an abscess or
treat sole bruising, etc.? By chronic foot soaking, we mean
soaking on a regular basis for days or even weeks.
There is no question that excessive moisture will damage the hoof
wall. The more the foot is soaked, the more the hoof softens. The
hoof wall quickly deteriorates, the wall begins to flake and
separate and the loss of integrity allows it to expand or bend
outward. At the same time, the white line width increases and the
sole begins to drop and become closer to the ground. As the
softening process continues, the horse begins to walk on the sole,
creating another source of discomfort. Many times, this will mimic
an abscess that has not completely resolved. It is believed that
soaking damages the protective barrier on the foot (periople) and
the widened sole wall junction thereby allowing additional
microorganisms to penetrate and further damage the wall.
Over-softening of the foot can potentially weaken it. The softened
hoof wall does not hold nails well so it is difficult to replace
or maintain a shoe on a chronically soaked foot.
Chronic foot soaking for an abscess can actually prolong the
healing process. In many cases, the pocket resulting from the
accumulation of exudate from the abscess will be prevented from
draining and drying up as the softened structures of the
chronically soaked foot compress the affected area.
An alternative method of localizing abscesses or drawing out
inflammation is through the use of a poultice. The poultice
provides a warm moist hydroscopic environment which stays in
contact with the foot twenty-four hours a day but does not have
the detrimental effects of continuous soaking. There are many good
commercial poultices on the market. A medicated poultice [Animalintex®]
is an excellent first choice when a poultice is indicated. The
Animalintex® poultice, made of multiple layers of
medication-impregnated cotton sheets, is immersed in hot water,
the excess water is squeezed out and the poultice is applied to
the foot, covering the ground surface and extending over the
coronary band. The poultice has its own plastic outer covering to
maintain heat. It is left in place for at least 48 hours. Moist
heat applied to the coronary band may also help an abscess to
break out spontaneously.
Another useful form of poultice is a combination of wheat bran and
Epsom Salts (2 parts bran and 1 part salts). This poultice is
cumbersome but has certainly withstood the test of time. Packing
the foot with Ichthammol or a combination of Ichthammol and
glycerin is also used frequently with good results reported.
Whichever poultice is used, it must be held in place with a
bandage. An ideal foot bandage is a medium-sized disposable diaper
covering the enclosed medication. For more padding, use multiple
diapers. For a sweating effect, use plastic-covered diapers and
duct tape. For more breathing, use non-plastic covered diapers and
gauze bandage. The bandaged foot is protected as well as
medicated. A rubber Easy Boot® can also be used for protection,
but is difficult to place over a hoof that is bandaged with
Two clinical situations in which foot soaking has traditionally
been a major part of treatment are hoof abscess and foot bruising.
When a hoof abscess is opened, foot soaking has been the
time-honored method to "draw" out the infection. Similarly, with
chronic subsolar foot bruising, foot soaking has been prescribed
to draw out the inflammation and discomfort.
When presented with a horse that is acutely lame and shows pain
everywhere on hoof testers, soaking in hot water during the first
12 to 24 hours may be useful to localize the abscess. When the
hoof is extremely dry and hard, soaking will also soften the foot
to the point where it can be explored with a hoof knife and
drainage established. In the case of an extremely dry, hard foot
where a puncture wound to the frog area is suspected, soaking will
allow the frog to be pared so that the point of entry can be
Subsolar abscesses gain entry to the underlying corium through a
defect or separation in the white line or a penetrating wound
through the sole. The horse may be acutely lame or the lameness
may develop over a few days as in the case of an improperly placed
or "close" nail. The area of pain is localized with hoof testers
and then explored superficially with a hoof knife until the point
of entry is located. In the case of suspected nail abscess, the
foot is poulticed until soft enough to explore or until the nail
abscess has "ripened" and can be drained. When the tract is
located in the white line, the abscess is drained by notching out
the adjacent wall using a bone curette rather than removing any
sole. By using a small bone curette, the tract can be followed at
an angle under the sole. The sole is left intact for protection
and no sensitive tissue is exposed. A large opening is not
necessary for drainage. If pressure is applied to the adjacent
sole and additional exudate is expressed or if a bubble is
observed, there is adequate drainage. When weight is borne on the
affected foot, exudate will be continually forced out and drainage
will be maintained. Soaking the foot in a hypertonic solution once
at the time an abscess is drained may also have some merit.
However, in order for any solution to draw infection or clean up
the affected area, the solution must be hypertonic which can be
achieved by saturating it with a salt. To make a saturated
solution, MgSO4 (Epsom salts) is added to hot water until no more
salt can be dissolved.
Alternatively, my preference is to flush the wound under pressure
with a dilute solution of povidone iodine (Betadine®). Betadine®
is an antiseptic but also has antimicrobial and astringent
(drying) properties. Gauze sponges saturated with Betadine® are
applied to the bottom of the foot and a bandage is applied. A
poultice can also be used for the first few days following
drainage of an abscess. Tetanus prophylaxis should always be
administered. The antiseptic pack or poultice is changed on a
daily or every-other-day basis until the tract is dry and
soundness has returned. The shoe is then replaced. Alternatively,
once marked improvement has been observed, a wide web shoe with a
5/16 inch hole drilled directly over the draining tract in the
while line may be applied. The hole is tapped using a 3/8 inch BSW
tap. Cotton saturated with an antiseptic is packed in the drilled
hole and a stud guard is screwed in the hole to keep the
medication in place. The medication is changed on a daily basis.
Work can resume as soon as full soundness is attained.
If a puncture wound in the sole has occurred, veterinary care is
indicated. In the case of a puncture wound to the sole, whether
acute or chronic, drainage must be established. When the puncture
is accompanied by severe lameness, radiographs should be taken to
rule out a fracture of the third phalanx (P3). Again using a bone
curette, a small circular opening is created at the site of the
puncture wound to allow drainage. Any diseased or necrotic tissue
is removed. The smallest possible opening is always made. If a
large wound is created, excess granulation tissue will prolong the
healing and cornification of the tissue in the defect. The wound
is flushed as before and placed in an antiseptic pack until
drainage ceases and the wound is dry. The horse is then shod.
Depending on the size of the wound or the need for continued
treatment, either a shoe and pad or a shoe with a treatment plate
is used. Antibiotics are seldom used.
Subsolar bruising may be a cause and effect situation in that
there is usually a predisposing factor causing the bruising.
Bruising results from repetitive trauma to the sole when there is
insufficient sole depth. The sole is not designed to support
weight and flat footed horses are prone to chronic foot bruising.
Flat soles may be normal for a particular horse or may be caused
by a disease process, such as flexure deformities and previous or
chronic laminitis, or by farrier care as in the case of the long
toe-low heel conformation, by excess removal of hoof wall leading
to sole pressure, or by excessive removal of horny sole.
Foot soaking has traditionally played a major role in the
treatment of bruised soles in an attempt to draw out or relieve
inflammation. In reality, chronic soaking may worsen the problem
by softening the foot to the point where the sole provides even
less protection to the sensitive corium above. In fact, foot
bruising is a common problem in show horses during the warmer
months when they are frequently bathed and the feet are therefore
continually in water. The excessive moisture weakens the hoof
wall. As it weakens, cracks and begins to spread, the sole gets
closer to the ground and becomes more prone to bruising.
It is this author's opinion that treatment of foot bruises should
be directed toward toughening the hoof capsule, relieving
inflammation systemically (using Butazolidin and possibly a
vasodilator) and correcting the cause of the bruising. Instead of
soaking, the horse is placed in a stall with shavings or sawdust
which allows the feet to dry out. Preparations which toughen the
hoof capsule and sole can be applied daily if desired. Foot care
is directed at correcting abnormal conformation of the foot as
much as possible. This may consist of not removing any sole from
the ground surface, backing up the toe from the dorsal wall and
moving the plane of support in a palmer direction. The shoe of
choice advocated over the years by Dr. Bill Moyer is a square-toe
egg bar with the sole surface of the shoe well concaved using a
There has been very little if any veterinary research on the
therapeutic value of soaking horses' feet. It may be one of those
age-old traditions that have been passed down from horseman to
horseman or maybe somebody once said it was a good thing to do and
no one has wanted to contradict that. If we look at the anatomy of
the foot, its physiology and the thickness of the hoof capsule, it
becomes questionable if soaking in water provides any beneficial
effects. As foot soaking remains a controversial issue between the
veterinary and farrier professions, continued communication
between both parties is essential to assess its continuing
Stephen E. O'Grady, DVM, MRCVS
Dr. Stephen E. O'Grady is an equine
practitioner and farrier practicing in the Northern Virginia area.
He is also a member of the Farrier's Liaison Committee of the
American Association of Equine Practitioners.
1 Turner, TA, personal communication, St. Paul MN.
2. Animalintex—Robinson Animal Healthcare, Chesterfield, England.
Distributed in the U.S. by Kustom Enterprises in Kentucky.
3. Mansmann RA, personal communication, Raleigh NC.
4. Moyer W, personal communication, College Station TX.
5. Keratex Hoof Hardener, Advanced Equine Products, Versailles KY.