Nail In Hoof

With this type of injury, it is truly location, location, location.
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With this type of injury, it is truly location, location, location.

Sadly, a nail in the foot isn’t all that uncommon, especially in horses out trail riding in some areas or being ridden along roads. While you do not need to panic (that’s never a good idea!), you do need to take immediate action.

nail-in-hoof

If you’re at your barn or trailer, leave the nail in place unless it’s likely your horse will push it in farther while you wait for your veterinarian. If you’re away from home, you may need to remove the nail to make it back.

Do three things right away: 

  1. Take a photo. Use your cell phone camera to take a photo showing how far the nail is in before you pull it. Then take another photo showing the wound hole after you pull the nail. Save the nail. 
  2. Wrap it. Immediately cover the wound area (generally you need to wrap the entire hoof to keep a covering on) with duct tape. You should have a roll of duct tape in your saddle bag on trail rides and in your barn at all times. 
  3. Call your veterinarian. This usually is not an immediate emergency like a major bleeding wound or trouble foaling but your horse should be seen within 24 hours if at all possible. The sooner the better. 

Your veterinarian will try and determine just how far the nail went into your horse’s hoof and how much damage has been done. Don’t be fooled by your horse walking soundly after you have removed the nail. Puncture wounds quickly seal over on the outside trapping bacteria inside. An abscess may brew inside and end up traveling up your horse’s leg. 

Your veterinarian may take x-rays (radiographs) of the hoof with the nail still in it, if possible. If the nail has been removed, a special dye may be injected into the wound hole to see just how far the nail went. The dye will also show if any joint spaces, including the navicular bursa, have been penetrated. 

If the bursa has been opened, your veterinarian will trim out the frog, opening up the bursa to allow for drainage, cleaning and slow healing from the inside out. A special horseshoe, called a “hospital plate” may be put on to allow for treatment while providing extra protection for the area.

Your job will be to keep the wound clean, rebandage as necessary and keep your horse on clean, dry footing. Your horse will also be on systemic antibiotics to help treat and/or prevent any infection from traveling up the leg. 

With luck, your horse will only have a superficial wound. You will still need to keep the area clean and dry as it heals. Your veterinarian may choose to open the area a bit to allow air in and encourage healing from inside out. Expect your horse may need a tetanus booster and/or antitoxin. 

A study reported at the 2010 American Association of Equine Practitioners conference by Isabelle Kilcoyne MVB looked at the location of punctures and which were most serious. Wounds that went into the frog any where from the middle to the rear area generally had the greatest chance of damaging joint structures. Rear foot injuries tended to heal better, resulting in a sound horse more often than front foot injuries. This is probably because horses carry more of their weight on the forehand. Results were most likely to be positive if a veterinarian saw the horse within 48 hours. 

It can be almost impossible to prevent an injury like this. Small things you can do are to sweep up any farrier nails right after the farrier leaves and dispose of them carefully. Inexpensive large sweeper magnets to pick up metal debris are a good idea in every horse barn.

Try to avoid trail riding in areas where people dump trash or old building materials. Always pick up nails from any building projects on your property. 

Article by Contributing Veterinary Editor Deb M. Eldredge, DVM.