Cracked Heels in Horses

There are many factors that can cause the skin to soften or crack, allowing bacteria or other infectious things in. Skin irritation, trauma, excessive moisture, fungus, mites, or even a congenital predisposition such as feathered breeds, can suffer lesions that usually start at the heel and may progress up the leg. This infection can cause hair loss, a greasy appearance as discharge oozes out, scaling or thick crusts, and can even lead to lameness if the condition becomes too painful. Treatment is successful in many cases, though some causes of cracked heels can require longer and more intensive treatments.

Cracked heels, also called mud fever, pastern dermatitis, or greasy heel, refers to a condition of the skin on the legs becoming susceptible to infection. It generally results from exposure to wet weather conditions that can soften the skin, allowing infection to seep in. This can cause itchiness, pain and scabs on the back of the leg, from the heel to the knee.

Symptoms of this condition are most commonly seen on the hind legs, from the heel to the knee, and include:

• Lesions on leg
• Hair loss
• Scaling skin
• Itchy skin
• Crusting over lesions
• Skin folds
• Fluid accumulation in skin
• Serum discharge 
• Skin ulcers
• Thick, hardened crusts
• Pain
• Swelling
• Self-trauma, as horse bites and scratches at limbs
• Stamping feet
• Lameness

The condition of cracked heels is caused by irritated skin that can allow bacteria in to infect the foot and leg. Some factors that can lead to this irritation are:

• Wet conditions that cause the skin to soften
• Abrasions or trauma, such as mud rubbing on soft skin
• Bacterial infection, such as from Dermatophilus congolensis, Staphylococcus or pseudomonas specie
• Fungal infection
• Mites, such as Chorioptic mange  
• Certain soils and pastures, such as sandy arenas, or rough vegetation
• Excessive leg washing 
• Bedding that causes irritation 
• Incorrect placement of bandages or boots 
• Immune-mediated conditions, such as pastern and cannon leukocytoclastic vasculitis, or pemphigus foliaceous
• Any disease or condition that lowers the immune system
• Photosensitization 
• Genetic predisposition, such as with feathered breeds
• Allergy 
• Tumor 

To diagnose cracked heels, your veterinarian will need to examine your horse. Any information about your horse’s management and living conditions, and about other horses in the population, such as those that may have mites, can help your veterinarian in a diagnosis. 

Your vet may take acetate tape impressions, hair samples, direct smears of collected serum, a skin scrape or samples of any scabs to test for fungus, bacteria, or mites. Mites can best be found in a sample of deep dermal skin located at the edges of a lesion. A skin biopsy may be taken if a tumor or an immune mediated condition is suspected.

Treatment will depend on the cause of the cracked heels. The base treatment is to remove the infection and allow the skin to heal, while treating the underlying condition.

First, hair is usually clipped away to better manage the area. Scab removal is not generally recommended, but may help in cases of Dermatophilus congolensis, as it cannot survive with the presence of oxygen. This can be done after the legs are soaked in an antibacterial and antifungal solution every 3 to 4 days, or washed in an antibacterial shampoo. Only take scabs that are soft and ready to fall off. Afterwards, rinse well and dry the legs thoroughly, using a clean towel. An antibacterial cream may be used daily after washing the legs.

During treatment, your horse should be stabled and removed from any wet conditions or mud contamination. Cleaning the area with a medicated, iodine, or chlorhexidine shampoo can promote normal skin bacteria. A barrier cream to repel water can be used if you cannot stable your horse. You can also use bandages to keep the affected areas clean.

Other treatments that can be prescribed depending on yourFIN horse’s specific case can include anti-inflammatory and pain relieving medications, vitamin E and omega fatty acid supplementation, topical or systemic steroids for cases of photosensitization, chorioptic mange, and leucocytoclastic vasculitis, or the use of ultraviolet socks and sunlight restriction for horses with light sensitivities.

Recovery is wholly dependent on the cause of the cracked heels, and may be a lifetime condition in some cases. Most cases respond well to treatment, although the underlying condition needs to be treated as well.

You may be given medications to administer at home, as well as a treatment plan that includes washing the area with special solutions and shampoos, and applying antibacterial ointments. Keep your horse’s affected leg clean and dry, waterproofing if needed. Minimize or restrict your horse’s exposure to wet conditions and muddy areas. 

Though in many cases, cracked heels cannot be prevented, you can reduce your horse’s chances by keeping your horse from conditions that can cause moisture to linger on the legs. Some ways to accomplish this are to dry the legs thoroughly after exercise, avoid oily preparations, and brush off dried mud later rather than washing it off right away.