Most of us have long believed that if a horse has an abscess in the hoof, the best course of action is to stick that foot in a bucket and soak it – over and over again. The traditional soak of warm water and Epsom salts is supposed to be done for at least 15 minutes, two to three times a day, for as many days as it takes for the abscess to rupture. The purported purpose of the soaks is to soften the hoof and “draw out” the abscess, which is thought to allow it to mature and break out faster.

However, this time-honoured practice has fallen out of favour with many hoof experts in recent years, and their arguments against it are hard to ignore; first being the fact there is no evidence at all that abscesses resolve any faster than they would have otherwise because of soaking.

In fact, some equine podiatry experts say that soaking can actually slow the healing process and prolong the horse’s pain. They explain that horn material expands as it absorbs water, which can choke off the draining tract of an abscess, trapping the exudate (fluid) inside. As an abscess needs to drain and dry out to heal, anything that keeps it wet and prevents drainage would be detrimental. In addition, repeated soaking is known to be damaging to both hoof wall and sole horn, and may cause widening of the white line, allowing more harmful organisms to invade the sole-wall juncture.

Critics of repeated soaking only recommend it as a short-term application to soften a very hard foot to make it possible to pare the sole or frog to create a drainage channel. They also emphasize that the fastest way to relieve the often-excruciating pain caused by an abscess is to open and drain it, which can usually be accomplished very quickly by a skilled veterinarian or hoof-care professional. Leaving the horse in pain for days and doing nothing but soaking the foot is, in their opinion, allowing unnecessary suffering.

Finally, they argue that abscesses not drained therapeutically are more likely to migrate up under the hoof wall and exit at the coronary band, which can potentially cause a permanent disorganization of the horn tubules that grow from that area. While most abscesses that pop out at the coronary don’t cause a permanent problem, it does happen and can leave the horse with a weakened hoof wall vulnerable to cracking or splitting in the future. Even worse, a migrating abscess can move deep into the foot where it may damage the internal structures, possibly leading to permanent lameness.

Of course, people will always tell you they soaked their horse’s foot and the abscess popped out the very same day without issues, but as they have no way of knowing whether the abscess would have ruptured that day on its own, they cannot say that the maturing of the abscess was the result of the soaking.

Every horse owner must decide who to listen to when it comes to treating their horse’s ailments, but it is always wise to at least consider the science – or lack thereof – before choosing a course of action.

One adjunct to treatment that almost everyone agrees on is giving a horse with an abscess a tetanus shot. Even if your horse has had a regular tetanus shot within the last year or so, your veterinarian will likely recommend a booster to maximize your horse’s resistance to the potentially fatal Clostridium tetani bacterium, which is widespread in the soil of just about every environment your horse is likely to be in. Secondary tetanus infection is a real risk when your horse has an opening in the foot, so best not to take any chances with this easily preventable problem.

It is also universally accepted that once drainage is established, it is important to keep the opening clean, so wrapping the foot in a medicated poultice is recommended. There are commercially available poultice products that are moistened in hot water, applied and then left on for approximately 48 hours. Poultices can also be made at home out of cotton bandage materials saturated with a “drawing agent,” such as a combination of Epsom salts and a topical antiseptic. Any poultice will need to be covered and held in place with a bandage.

The last thing any of us want is to prolong the tremendous pain abscesses cause our horses or increase the risk of serious complications. Therefore, while it might feel strange to go against the conventional protocol of repeated soaking, your horse might very well be better off if you do.