A common syndrome seen in horses is inflammation of the skin at the area of the heel and pastern just above the horse's foot. This is called pastern and heel dermatitis but has also been called scratches, and there can be many different causes. One of the major factors is that the skin gets wet while walking in grass and being damp, especially if hair is long in this area, and causes the skin to be damaged. Inflammation and infection can develop that can be extremely painful. Scabs and crusts form in the area that further increase the pain. These cases may look simple but can be difficult to treat and your veterinarian should be contacted.
Cultures of the area should be performed to determine if bacteria or fungi are involved and a skin scraping should be performed to check for parasites that can also be involved. Treatment of the condition involves removing all the hair from the area and then removing all the scabs. These scabs can be firmly attached to the skin and removal can be extremely painful so sedation may be required. Removal works best by soaking the area in antibacterial scrub solution for several minutes and then carefully removing the scabs. Initially, these horses need to be treated with an antibiotic cream with cortisone to reduce the inflammation and kill the infection. Wrapping the area keeps the ointment in contact with the skin and helps reduce the inflammation. After the inflammation and pain are reduced, wrapping the area is not required as this keeps the area too moist. Topical application of cortisone-antibiotic ointment is used only as needed to keep the inflammation under control but allows healing to occur. Oral antibiotics are also indicated in many cases.