Rare Keratoma Case Presents Equally Rare Challenges

Although an uncommon condition, keratoma formation beneath the horse’s hoof wall or sole can cause lameness, recurrent abscesses and damage to the laminae and coffin bone.

Because of the potential for serious medical consequences, keratoma diagnosis, removal and treatment requires either the close collaboration between farrier and veterinarian or the involvement of a veterinarian skilled in farriery.

The Condition


  • Keratoma is a non-cancerous mass that grows slowly under the hoof wall or sole. Lameness slowly advances as the keratoma presses against sensitive tissues.
  • Diagnosis, removal and treatment of keratoma require that a farrier and veterinarian work closely in concert to avoid serious medical problems.
  • The formation must be completely removed surgically and support must be provided for the hoof and off-limb. Infection prevention methods also must be employed.
  • The therapeutic shoeing plan for a horse after hoof wall or sole resection requires a skilled farrier.

The name keratoma implies a keratin-derived tumor, but while the involved tissues are generally mostly keratin, the cells themselves are hyperplastic rather than neoplastic — meaning they have multiplied but aren’t truly cancerous. Keratomas grow slowly over time, but do not spread to other parts of the body.

The keratoma is a spherical or cylindrical mass of keratin that grows between the hoof wall and sensitive laminae or beneath the sole. Lameness develops slowly and sometimes intermittently as the mass begins to press against sensitive structures.

While most keratoma formations are thought to be associated with injury or irritation to the hoof…

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