How to help your Horse recover from Pedal Osteitis

Inflammation in the pedal bone can be the cause of severe lameness in your horse and the prognosis for “pedal osteitis” is often dire. However, there are ways to help your horse manage the pain and even in some cases recover from pedal osteitis, by treating the cause rather than the symptoms.


By Helle Maigaard Erhardsen


Pedal Osteitis is inflammation in the pedal bone, also known as the coffin bone or distal phalanx, which is the very bottom bone inside the horse’s hooves. The inflammation leading to pedal osteitis is most often non-septic, meaning that it is the result of chronic sole bruising from repeated concussion during work on hard surfaces.


Septic causes are infections such as abscesses, puncture wounds in the sole and laminitis. Improper trimming and shoeing as well as navicular disease can also lead to pedal osteitis. The symptoms of pedal osteitis are lameness, heat and foot soreness. These symptoms are similar to laminitis and navicular disease, which can make the condition tricky to diagnose accurately. 


Moreover, pedal osteitis is usually diagnosed following an x-ray revealing demineralisation – seen as uneven edges - of the pedal bone inside your horse’s hoof. Although the edges on healthy pedal bones are rarely perfect either, whereas the veterinarian needs to carefully investigate the horse’s work history in order to diagnose more precisely, rather than merely relying on x-rays.


In the following, we will take a closer look at the causes of pedal osteitis. Knowing the causes will provide you with valuable knowledge about what to avoid, in order to prevent pedal osteitis from developing in the first place, or help your horse recover from pedal osteitis before it becomes chronic.


Hoof inside illustration scoot boots

The pedal bone, also known as the coffin bone or distal phalanx, is the fingertip of the horse.


Prevention and Causes of Pedal Osteitis in Horses


Trauma is believed to be the main cause of pedal osteitis in horses. As such, horses that are worked, ridden or driving a carriage, on hard surfaces such as roads, or horses that continuously land on hard ground after a jump, are more likely to develop the condition if these types of concussions are repeated over time.


Horses that are landing toe-first are also at high risk of doing permanent damage to the pedal bone and other structures in the lower limb. Heel pain/caudal foot pain is usually what’s causing toe-first landings. If your horse isn’t landing on his heels as he was intended to by nature, it is very important to address this as soon as you notice it.


The solution to toe-first landings could be as simple as helping your horse to rebuild the strength in his heels. Wearing hoof boot is a great place to start his recovery, as the superior shock absorption from Scoot Boots in particular, will encourage heel-first landings and help regain the strength in the heels by stimulating the frogs. Read more about rehabilitation from heel/caudal pain in our article about navicular here.


hard landing scoot boots

Wearing highly shock absorbant hoof boots such as Scoot Boots, will reduce the amount of concussion your horse’s feet are subjected to and will protect his hoof soles from bruising - like wearing a pair of sneakers. 


As for repeated concussion on solid ground, there tends to be some contradictory beliefs on how to protect the horse’s hooves from hard surfaces. Traditionally, farriers recommend putting shoes on a horse that works on roads, as it is believed the hooves would wear down too fast if not shod. Although according to Nic Barker and Sarah Braithwaite in Feet First, it has long been proven that healthy barefoot hooves adapt their growth to the speed of which they are being worn.


Moreover, metal shoes are significantly restricting the hooves' ability to absorb shock, letting more than double the amount of concussive force up through the limb. That is also the reason why remediate shoeing hasn’t been very successful in helping horses with pedal osteitis.



How to Treat Pedal Osteitis and help your Horse Recover


barefoot equine vet 


Common treatment of pedal osteitis in horses involves remediate shoeing, sometimes with a pad inserted to protect the sole of the hoof from concussion. Although this might lift the sore foot off the ground but does not treat the cause of the soreness. In fact, the hoof needs to be used, if it is to regain its health.


That is, nonetheless, what Professor Robert M Bowker, VMD and director of the Equine Foot Laboratory at the Veterinary Medicine College at Michigan State University, has found in his comprehensive research. According to Dr Bowker, metal shoes are like wearing high heels, which unevenly distribute pressure and decrease the foot’s ability to absorb shock.


Mark Bailey, a UK based Equine Podiatrist, also believes in treating the cause of the disease instead of the symptoms. An example is one of Marks clients, a Thoroughbred named Rooney, who was diagnosed with septic pedal osteitis. The suggestions from the veterinarian to rehabilitate this, was a wall resection and remedial shoes with a wider inside branch.


Although in agreement with Rooney’s owner, Mark chose a different approach. He reduced all potential forms of inflammation - nutritional, environmental and mechanical. Rooney’s diet was tweaked to include good amounts of anti-inflammatories and was kept barefoot in a covered barn with a sand surface (with company to encourage movement and natural behaviours) for half of the day.


The other half of the day, Rooney was turned out in hoof boots and therapeutic pads, which he was also wearing whenever walked across a hard surface. Only twelve weeks later, a follow-up MRI showed substantial improvement in the condition of the margin of Rooney’s pedal bone.


If you would like to read more about the advantages of taking your horse barefoot, see our step-by-step guide on how to transition your horse to barefoot.



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About the author

Helle Maigaard Erhardsen is an investigative journalist specialising in environmental issues. Her devotion to the outdoors includes a life long passion for horses of which she has two: Pannigan, an off-the-track Thoroughbred and Audrey, a Shetland pony, who are both bitless and barefoot. Helle is born in Denmark, where she graduated from the Danish School of Media and Journalism in 2015. Her work is characterised by comprehensive research and she was nominated for the special media award Bording Prisen for her investigative reporting with the newspaper She later obtained a Master’s degree in Journalism, Media and Communication from UTAS, when she relocated to Tasmania.