You’re getting ready to go for a trail ride or do some arena work. You lift your horse’s hoof and start to clean it – when you see a nail. A hoof puncture wound may seem like such a minor problem – a nail or splinter lodged in tough hoof. The solution also seems very simple. Just remove the object, clean the hoof, and give the horse a day or two off, right?
In minor or superficial hoof puncture wound cases, this course of action might work. But a deeper puncture that penetrates underlying structures may be more complex and difficult – even life threatening – if not treated by a veterinarian. So let’s explore a no nonsense approach to hoof puncture wounds.
ASSESS THE DAMAGE
Early recognition of the problem is important in determining the outcome of any hoof puncture wound. If the sharp object is still in the hoof, it is easy to determine that the issue is a puncture wound. Another easy history comes from watching the horse step on something sharp and pull off of it (such as a board with a protruding nail or screw). Other times, the diagnosis is not as clear unless you can visually see the damage. But the most common clinical sign of a puncture wound to the hoof is lameness. So start out by performing a thorough inspection.
If the object is still in place, where is it? What do you see? What kind of damage to the hoof is visible? The further away the puncture is from the hoof wall, the more chance there is that it may have damaged deeper structures. The same is true if the object penetrated the frog and/or the rear portion of the hoof where softer structures lie.
As you assess the damage, be mindful of where the object is imbedded. It’s helpful if you know how long the object is, but unless you know specifi cally what it is, you will likely not have this information. This is a good time to take a picture with your cell phone to send to your farrier or vet.
FOR THE MINOR INJURY
Hoof puncture wounds in the sole near the hoof wall can be removed. If they are relatively “short” and there is no active bleeding or other obvious injury, the wound should be thoroughly cleansed. This will involve soaking with a solution such as Epsom salts and warm water several times a day. You might consult with your farrier, who may expand more of an area for drainage. Poultice may also be recommended, and wrapping the foot or using a boot as suggested by your farrier may help keep manure, urine and dirt out of the wound. Your horse should be allowed to move freely to promote good circulation to the affected area.
FOR THE MORE EXTENSIVE OR SERIOUS INJURY
Deep hoof puncture wounds may affect the underlying structures of the hoof. Tendon injuries or navicular bursa injuries are serious. With trauma to deeper structures, damaged blood supply and devitalized tissue can promote bacterial growth deep in the hoof, compounding the problem. The horse may even become septic, and this can be life threatening.
If you suspect a deep injury – one that involves the central or rear part of the hoof and associated soft structures such as the frog – or if you know the sharp item is/was very long, the vet should be contacted immediately. There are mixed reviews about whether the foreign body should be removed, but either way, a picture is worth a thousand words. Snap a photo, send it to your vet with an SOS message, and he will advise you. He may wish to take an x-ray with the offending object still in place, but if he cannot get to you promptly, he may recommend removal.
If the wound has been undetected for a time, the limb may already be swollen with some drainage of pus from the wound. This should also be treated as an emergency and the vet called at once.
If the injury was minor or superficial, you may expect an abscess to result. You will need to be faithful about keeping the area clean and open to drainage. Any concerns of a deeper infection should result in a call to the vet.
If the hoof puncture wound was more significant, the vet will remove the object, debride the area, irrigate, and perhaps give antibiotics. At times, packing may be used. In extreme injuries, surgery may be required. Time is of the essence in deep or severe injuries. Septic conditions can occur in a matter of hours.
It is always recommended that tetanus immunizations be kept up to date. If the horse has not been immunized, there are short-term tetanus preventives. Even if the injury is minor, you may need to update your horse’s tetanus status.
At times, it may not be obvious that lameness is due to a hoof puncture wound. In the absence of a visible penetrating object in a lame horse, the vet will nevertheless include evaluation for a possible puncture. Hoof testers, pain response, and/or nerve blocks may lead to an in-depth search for a puncture wound. Additional testing may be utilized, when indicated, to determine the depth, direction and structure involvement of the wound.
PROGNOSIS IS VARIED
The prognosis for a full recovery for a minor hoof puncutre wound is good and your horse can resume his normal activity in five to seven days. It’s important to note, however, that he should be allowed turnout to keep circulation optimal at all times.
For the hoof puncture wound that penetrates deeper structures, the outlook may not be as optimistic. Severe injuries can take months to resolve, and residual damage is always possible. A lot rides on accurate diagnosis and prompt treatment. Lameness that progresses or does not resolve quickly should be given serious and timely attention.
As mentioned previously, catching a hoof puncture wound at an early stage is crucial. Check your horse’s feet regularly, address lameness issues promptly, and help prevent a hoof puncture wound by keeping barns and arenas clear of debris, and watching where your horse walks.
Sherri Pennanen of Better Be Barefoot is a veteran natural trim farrier serving western New York and southern Ontario. She offers balanced barefoot trims, lameness evaluations, and holistic/rehabilitation services on her farm. BetterBebareFoot.com