Veterinary advice should be sought before applying any treatment or vaccine.


A keratoma is a benign tumor of the hoof that grows inside the horse's foot. It originates from the keratin-containing tissue, usually underneath the coronet, and between the hoof wall and third phalanx. As the size of the keratoma increases, it will exert pressure on the horse's sensitive laminae and surrounding structures in the hoof, causing pain and lameness.

When keratomas reach the white line area at the toe of the foot, it will cause separation of the bond between the hoof wall and sole of the foot. If bacteria gets into the foot, it causes an abscess to develop, which look just like any other foot abscess. However, when horses have an underlying keratoma it will cause the abscess to keep recurring.

Clinical Signs

Horses with a keratoma often have a history of a recurring abscess in the same foot. They often show progressive lameness in the affected foot, graded at 3 to 4 out of 5. Some affected horses may have a visible deviation or bulge at the coronary band or abnormal hoof growth overlying the region containing the mass. The bulge will also be very painful when touched.


Keratomas are diagnosed based on history (of recurring abscesses in the same foot), clinical signs, and radiographs of the foot. Radiographs will show the appearance of an indentation in the coffin bone inside the hoof, due to the loss of calcium in the bone.


Treatment for a keratoma is surgical removal, either under general anesthesia or standing sedation. MRI-guided surgery can help reduce healing time by allowing for a more accurate determination of the tumor's location. Prolonged post-surgical care is required, since the hoof takes at least 10 to 12 months to grow back. Frequent bandage changes are required, with wound dressings applied regularly to control bleeding and infection. A special shoe is often applied to help stabilize the weakened hoof during the recovery period.

Once removed, keratomas don't usually grow back, and since they are a benign tumor, they don't spread.


Bulge in the hoof wall
Progressive lameness
Abnormal hoof growth
Recurring hoof abscesses in the same foot


  • History
  • Clinical signs
  • Radiographs - Visible semicircular to circular well-demarcated area of radiolucency along the solar margin of the third phalanx, caused by pressure necrosis fromt he karatoma.
  • Magnetic resonance imaging (MRI)



SurgerySurgical removal of the keratoma, either under general anesthesia or standing sedation.
Systemic antimicrobial drugsto reduce postoperative infections.
NSAIDsto reduce pain and inflammation
Hoof ManagementApplying an eggbar or heartbar shoe for postoperative stabilization



Good, however it can take up to a year before regrowth of the hoof.

Scientific Research

General Overviews

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Risk Factors

  • Previous trauma to the hoof

Horse Case Stories