Here's the Scenario
Your horse is limping and upon investigation, you discover an object lodged in their hoof. This object could be a nail, screw, wood bedding, a piece of gravel or whatever other debris that your horse has stepped across. Regardless of how quickly you discover the puncture wound, you must understand that once the object or piece of debris enters the hoof, so has bacteria. All puncture wounds should be treated as a medical emergency because they can threaten the career or even the life of your horse.
When encountering a puncture wound, it's important to remind yourself not to panic. It's common for your first instinct to be to remove the object. However, make your first move a phone call to us. Let our veterinarians instruct you on exactly how to handle the situation. In most cases, it's best for the veterinarian to remove the object or debris. Radiographs taken on site with the nail in place are helpful in determining the angle of entry, the depth of penetration and if the object affected critical synovial structures.
If you have already removed the object make sure to save it and note the exact location of removal. Snapping a quick photo for the veterinarian can also be helpful. For wounds that penetrate deeper structures, immediate and aggressive treatment is necessary. The horse will be placed on antibiotics and trailered to our clinic for advanced surgical and medical techniques.
Did You Know?
A horse's foot contains 2 important synovial structures - the navicular bursa and the coffin joint. When healthy, these structures permit free and easy movement of the joint. In an average size horse, the navicular bursa is only 3 cm (just over an inch) from the sole of the hoof - it's even less in a pony! It doesn't take much for a nail or object to puncture the bursa. If the navicular bursa or coffin joint is punctured, potentially life-threatening infection (synovial sepsis) almost alway occurs.
Street Nail Procedure:
In most cases, soreness and lameness is not visible until several days after the nail (or other debris) is removed from the hoof. Even though the object is removed, the bacteria that entered is still present and leads to infection and painful pressure.
As stressed before, infections of the navicular bursa or coffin bone must be treated early and aggressively. In the case pictured, the horse underwent a street nail procedure for a navicular bursa infection.
The entry tract of the nail was located and a regional limb perfusion was performed. This delivered a high concentration of antibiotics to the navicular bursa. Surgical flushing of the navicular bursa (lavage of the navicular bursa) and intensive antibiotics were also required for treatment.
A swab was taken for culture to determine what antibiotic would be most effective. Aggressive veterinary treatment led to the successful outcome of this case.