Q. I have a 3-year-old Oldenburg that just got his first pair of shoes and pads. He was lame on a front hoof for two weeks. I worked with my vet and farrier to get my horse some relief and sound. We were treating an abcess at first, then figured it was a stone bruise. Hoof testers reveled a sore sole in one area.
No bruising or blow out yet. The vet nor the farrier could not come to a decision, abcess or bruise. The vet recommended that we put shoes and pads on my horse because my horse is lame, his soles are low, needed cushion and time to heal. He was 100% sound after the shoes and pads were put on
"Should I be concerned about putting shoes on a horse that young?"
How do I know the difference if nothing develops?
A. The difference between a sole bruise and a sole abscess, as you found out, can be difficult for even the best veterinarian to diagnosis. That fact that your horse is now sound should be of great relief.
Before I answer specifically your questions you need to have a basic understanding of a bruise and an abscess.
A bruise on the bottom of a horse's foot is the result of a trauma or insult to the bottom of a horse's foot. Cells die, capillaries are damaged and they leak small amounts of blood. The blood stains the insensitive sole and makes a red spot that won't be seen, on the ground surface of the sole, for several months. One or two more trims may be needed before this stain grows down to the ground surface and is noticeable.
A foot abscess is a fluid filled pocket that develops between the sensitive and insensitive sole. The fluid filled pocket is created by trauma to the foot, puncture wound, bruise, etc. More cells dies, releasing fluid.
In addition, there is a colony of bacteria that naturally reside in the horse and that bacteria localize in trauma sites. As scavengers they consume dead material with gas and fluid a byproduct of their existence.
When a horse places weight on the hoof the fluid performs a hydraulic action, mechanically separating the sensitive and insensitive sole. This tearing is the pain.
To better understand they dynamics of what is occurring in the horse's foot with an abscess place a drop of water on a piece of glass. Then place another piece of glass on top and watch how much the drop of water spreads. This is the hydraulic action that occurs in the horse's foot.
The fluid is seeking a route to exit, or blow out as you called it. The weakest section of hoof is the connection between sensitive and insensitive structures. If the farrier or veterinarian does not pare out the sole and make an exit point for the fluid to drain then the fluid will continue to tear the connection until it either exits the bottom of the foot, the heel/bulb area or out the coronary band.
As you can tell a bruise may or may not lead to an abscess. There is no way for the veterinarian or farrier to predict the course of the bruise.
The answer to your question, "How do I know the difference if nothing develops?", is you won't.
There is one other lameness that can create pain in a specific area of the sole, mimic an abscess or bruise and not have a "blow out". That would be a hairline fracture of the coffin bone, usually in the wings.
This is a relatively common occurrence and nothing to be alarmed about. The bone will heal perfectly in six weeks and the only time there are complications are when the fracture is in the coffin joint. Since your horse went immediately sound with a shoe and pad you can safely rule out joint involvement.
These extremely small fractures can be very difficult, if not impossible, to detect on a radiograph. The horse would react to hoof testers placed on the sole, about two-thirds toward the heels. The lameness would mimic a bad bruise or an abscess.
As you can tell a bruise, abscess and a hairline fracture of the wings of the coffin bone will all present in a similar fashion. Shoeing with a pad would be an appropriate remedy.
Shoeing two and three-year old horses is a very common practice in the race industry and futurity horses in cutting and reining world. Warm bloods mature a little slower because of their size but shoeing at three should not create any problems for you or your horse. Your three-year old should be trimmed and shoed every six weeks until he is late in his four-year old year and the shoes should be set full. This will prevent the feet from being constricted and not allowed to grow to their full potential. He will then be able to go a full eight weeks between shoeings.