Poultices have been around in human medicine for hundreds if not thousands of years. They were traditionally made of a soft moist concoction involving various plants, grains and herbs that was often warmed and then applied to a body part. It would then be held in place with a bandage or cloth dressing. Poultices were used for a variety of maladies, especially those involving inflammation, pain or infection, even serious diseases such as TB might traditionally be treated with a poultice of some form. But do they have any place in treatment today?
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With the advent of modern medical science their use has fallen out of favour for all but a few specific applications. In veterinary medicine, poultices are most commonly used for infections that involve the foot or toes. The idea is that the poultice helps “draw out” infection although it is more likely that the application and sealing in of moisture over the affected area works by softening the skin, giving the infection a route out of the body.
The materials used for poultices have also changed somewhat
These days special pre-made poultice dressings are most commonly used for the purpose. These dressings are sterile and contain ingredients such as boric acid, which is antiseptic; and tragacanth which forms a gel when mixed with water, holding the moisture against the skin or sole. The dressings also have a layer of cotton wool or padding which holds more liquid and helps absorb discharge; and a plastic backing that keeps moisture in and dirt out. They are generally available in flat rectangles and hoof shaped pads. Other poulticing materials such as clay are also occasionally used, sometimes for their antibacterial properties.
By far the most common use for poultices in veterinary medicine is to treat hoof abscesses
A hoof abscess is a build-up of infection within the hard hoof capsule. Abscesses are often extremely painful and can cause severe lameness in affected animals. Poulticing is generally accepted to be an effective way of encouraging the infected material (pus) to break through the hard sole and drain away. Poultices for this purpose are usually left on for 12 hours. And they are then reapplied several times until the infection has started to drain. Anecdotally they appear to be an effective treatment for this condition. However there is surprisingly little scientific evidence for (or against) their use. As well as softening the sole, it’s likely that the padding from the poultice dressing also helps to make the horse more comfortable when weight bearing.
Poultices can be used in a similar way in dogs
This is primarily if there is a build-up of infection in a paw pad or between the toes. These types of infections are quite commonly caused by foreign material such as a grass awn or thorn entering through the skin. Poultices are used over these swollen and painful areas to try and “draw out” the infection along with any foreign material. Again, it is likely that the main effect of the poultice is to soften the overlying skin allowing the infection and any other material present to drain away passively.
Other traditional uses for poultices in veterinary medicine have become less common and are being replaced by more modern methods. For example, cold poultices are still occasionally used for acute injuries to relieve soreness and inflammation in horses’ limbs; but cold hosing is generally considered to be more effective.
Poultices should not be left on for extended periods of time
The pre-made pads can theoretically be used either dry or more commonly wet, and either cold or hot/warm depending on the reason for use. Any water used should be boiled first and then cooled to no hotter than 38°C. The poultice pad is applied with the plastic backing outermost; and generally then covered with bandages to hold it in place. For hoof abscesses a thick layer of protective tape is then applied across the sole; this is to make the dressing more hard-wearing.
Any poultice should only be used under the direction of a veterinary surgeon or, for horses, a farrier. It is important that the cause of lameness, pain or swelling is confirmed as infection and that a poultice is a suitable course of treatment. Sometimes additional treatments such as pain relief will be needed, and if the condition fails to improve with poulticing, further investigations or treatments may need to be considered.
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