Pedal osteitis in horses is a condition characterized by inflammation and damage to the pedal (coffin) bone within the hoof. Affected horses can experience pain and lameness, which may be worse after exercise or hoof trimming. [1]

Pedal osteitis typically develops as a result of chronic and repetitive trauma to the hoof, including exercising on hard surfaces, poor conformation or persistent laminitis. [1] It can also result from bacterial infections in the hoof capsule. [2]

Treatment aims to address the underlying cause of the hoof inflammation. This may involve antibiotics to treat infections, corrective trimming and shoeing to improve hoof balance, and anti-inflammatory medications or pain relief. In severe cases, surgery may be required to remove damaged tissue. [2][3]

The prognosis for horses with pedal osteitis depends on the underlying cause and the extent of the damage to the pedal bone. If the condition is treated promptly, many horses can return to normal function. Severe or advanced cases may lead to long-term lameness or complications. [3]

Pedal Osteitis in Horses

Pedal osteitis (PO) refers to inflammation of the pedal bone, also known as the coffin bone. This bone is located within the hoof capsule, and is the insertion point of the deep digital flexor tendon. [1]

Inflammation of the pedal bone causes demineralization, or loss of mineral within the bone structure. This can cause weakening of the bone, lameness, and even bone fractures. [1]

Pedal osteitis is more common in a mature horse’s front limbs, which bear more weight than the hind limbs. The condition can affect one limb (unilateral) or both limbs (bilateral) depending on the underlying cause of the condition. [1]


Pedal osteitis can be either septic (related to bacterial infection) or non-septic (no bacteria involved). Most cases are septic and occur due to spread of infection from a hoof abscess. [1]

Non-septic Pedal Osteitis

Non-septic pedal osteitis results from chronic inflammation within the hoof, not related to bacterial infections. Causes of non-septic PO include: [1]

Conformational traits and trimming mistakes that predispose to non-septic PO include: [4]

  • Low heels or long toes that lead to flat soles
  • Upright foot conformation
  • Club feet

Septic Pedal Osteitis

Septic pedal osteitis refers to a bacterial infection of the pedal bone. [1]

In adult horses, septic PO typically requires introduction of bacteria into the hoof capsule, allowing the bacteria to infect the bone. Causes include: [1]


Septic PO can also occur in foals, usually from the spread of bloodborne bacteria to the pedal bone. [1] The most common bacteria causing PO in foals include: [5]

  • Escherichia coli
  • Actinobacillus
  • Streptococcus
  • Enterobacter
  • Salmonella

Foals experiencing failure of passive transfer have a higher risk of septic PO. [6] The pedal bone may have a higher risk of developing infection over other bones as there are several vessels that make sharp turns within the pedal bone, encouraging bacteria to proliferate at these sites. [5]

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