• Do not remove the penetrating object
• Call your vet immediately
• Photograph the hoof from every angle before anything is touched
• Stabilise the horse and limit their movement
• If the object must be removed for safety, document everything first
13th of November, 2016. I got a call that I'll never forget.
The call came from my neighbour, friend and client.
Let's call her horse "Frank" to protect the innocent.
"Julie, can you come now. "Frank" has a block of wood attached to his hoof!"
Say no more. Off I hurdled.
A nail puncture wound into a horses hoof is an emergency.
"Frank's" owner had gone out to bring the horses in from the backyard.
Her husband had let them in there for a graze. A rural backyard with a burn pile of old timber stacked neatly and waiting for the next bonfire night. Something you might find on most acerage properties.
What she found when she got to "Frank" was less than ideal.
Frank was holding his leg up. Unable to bear weight. Attached to his hoof was a significant block of wood, driven on via a 3-inch rusty nail that had penetrated up through his hoof.
He couldn't put it down. He couldn't move.
She'd just joined the "oh shit" club.
With a nail penetration into a horses hoof - having it attached via a block of wood made the regular process of padding the hoof difficult.
This was an emergency. Not a "let's see how he goes" situation. Not a "maybe it'll be right in the morning" situation.
"Frank" needed a vet. Immediately.
The standard advice for a horse hoof puncture wound is never to pull out the penetrating object. Leaving it in place allows the vet to see exactly where it has travelled and what structures may be involved. The correct approach is to pad the hoof around the nail so it cannot be load bearing, stabilising the horse until the vet arrives for assessment.
But this situation was different.
The vet was 45 minutes away.
With a significant block of timber attached to "Frank's" hoof, every movement he made risked driving the nail deeper or causing further structural damage. In this case, the vet advised us to remove the wood prior to his arrival.
Before we did anything, we photographed the hoof from every angle, documenting the exact position and depth of the nail. We kept the offending block of wood and also photographed the angle the nail had come out of the hoof. It was slightly bent and very obviously old and rusty.
Once the wood was removed, we marked the penetration hole clearly with a marker pen so the vet could identify it immediately on arrival, wrapped the hoof and slid a padded hoof boot on over the top.
Nail punctures into horses hooves require immediate attention. The hoof must be protected.
Then we waited. A very long wait for the anxious client. I knew it wasn't good.
Upon arrival, the vet assessed Frank, loaded him up on antibiotics, gave a tetanus update and followed all the usual protocol. We re-wrapped the hoof and covered it again with the hoof boot. I had plenty on hand as I was actively fitting hoof boots as part of my everyday work at the time. "Frank" was booked into the veterinary centre for the next morning for full assessment and radiographs by the equine veterinary team.
Aside from supporting a very anxious owner, this was a valuable opportunity to see how the vet team handled the x-rays without the nail still in the hoof. They located the penetration hole and carefully inserted a metal probe into the tract. With the probe in place, the radiograph could show exactly which structures the nail had travelled through or come close to. The navicular bone, the deep digital flexor tendon, navicular bursa, the impar ligament and the coffin joint (distal interphalangeal joint). The structures you absolutely do not want a rusty nail near.
They were assessing for internal damage and to guide them for their next steps.
The vital internal structures of a horses hoof that we were concerned about in this case.
Metal probe inserted into horse hoof nail puncture wound post nail removal to assess via radiograph which direction the 3 inch nail had tracked.
"Frank" spent two weeks at the veterinary clinic. Surgery was performed to debride the penetration tract, essentially cleaning out the wound channel completely to remove any contaminated tissue and reduce the risk of infection tracking into the deeper structures of the hoof.
During surgery, the hoof was fully cleaned and tissue cleaned up. The surgical site was much larger than the initial nail penetration into the hoof.
In the weeks following surgery, "Frank's" hoof was packed with medicinal maggots to work their magic on the wound. This isn't as confronting as it sounds. Medicinal maggot therapy is a recognised and highly effective wound debridement treatment. The maggots consume only necrotic (dead) tissue, leaving healthy tissue untouched, and produce secretions that actively support healing.
For a deep puncture wound like "Frank's" - they were invaluable.
The radiograph told us more than just the nail's path through "Frank's" hoof.
It confirmed something I had always suspected. "Frank" had significant sidebone.
Sidebone is the ossification of the lateral cartilages of the hoof. In a healthy hoof, these cartilages sit either side of the pedal bone and should remain flexible, playing an important role in shock absorption and blood circulation within the hoof capsule.
It's most commonly seen in heavier horses, horses with poor hoof balance, those with a long trim cycle, or those doing regular work on hard ground. Many horses with sidebone show no obvious lameness at all, which is exactly why owners often have no idea it's there.
"Frank" had never been lame from his sidebone. But it was there.
Sidebone in horses - very evident on this radiograph.
This is one of the reasons I talk so much about regular hoof assessment. Not just picking and looking, but really looking and feeling the hooves and lower legs. Because what you can't see from the outside, whether it's sidebone, early white line separation, or a niggling issue you can't quite work through, can matter enormously to your horse's long term soundness.
"Frank" came home after two weeks at the vet, but his recovery was far from over.
He spent three months stabled. A significant change for a horse used to paddock life. His hoof required consistent wrapping and daily attention to keep the wound clean and monitor progress.
"Frank now confined to a stable for hoof recovery.
After wrapping was no longer needed, we moved on to an Easyboot Glove to protect the sole and recovering wound from any further penetration.
Not "Franks" hoof - (one of my own) the Easyboot Glove hoof boot to reduces bulk on the hoof and provides full sole protection. Being a long distance hoof boot, (less chance of rub points) - the Easyboot Glove was an ideal choice for "Frank" wearing this 24/7 with reduced turnout after the wrapping was removed.
Throughout the rehabilitation, cleaning and hygiene of the hoof were paramount. The constant bandaging created warm, moist conditions. Exactly what you don't want when you're trying to maintain hoof hygiene.
During the first few weeks of healing, hoof hygiene was paramount. You can see why.
Today, products like our Hoof Pack Clay and Hoof IX Pink, made with high MGO Manuka Honey and hoof supporting minerals and clay, would be part of a routine like "Frank's".
Applied into the grooves and crevices of the hoof between bandage changes, they support hoof hygiene in exactly the conditions that make cleanliness so challenging. Hoof Spray would be used to cleanse the hoof daily in between wrapping prior to applying the Manuka hoof products and hoof powder can be used to support dryness while the hoof is wrapped.
Here's the part of "Frank's" story I often think about.
Before November 13, 2016, "Frank's" owner was what I'd call a typical horse owner. She loved her horses deeply. She relied on me (a hoof care professional) for her hoof care knowledge. Hoof picking happened maybe once a week, if that.
She'd never needed to know more than that, because I was always there to support her.
Thankfully, "Frank" was on a regular trim schedule and his feet had not long been done. That bought us through the first 6 weeks of bandaging without needing to go near the hoof with a blade. A blade near a healing wound risks introducing bacteria directly into the tract. Keeping that environment clean and sterile is everything. Introducing bacteria in the early stages risks the entire recovery.
But I wasn't there every day to support her now.
When "Frank" needed her to step up, she was out of her depth. The horse was difficult to handle with the bandaging. She wasn't used to handling his hooves daily. The rehabilitation was a steep, tearful, expensive learning curve that cost thousands of dollars and months of worry.
She told me afterwards that she realised, through all of it, how important having even a basic level of hoof care knowledge would have been. Not to replace her farrier or trimmer. Not to diagnose or treat. Just to know what she was looking at. To notice things early, to know when things weren't progressing as planned. To have a routine and more importantly - be used to her handling his legs for lengthy periods while hygiene products and bandaging were applied.
"Frank's" recovery changed her. She became one of the hoof obsessed horse owners I've ever worked with.
4 months post surgery. You wouldn't know what this hoof had been through until you took a good look at the sole and abnormal growth at the surgery site.
4 months post surgery for nail puncture wound into hoof. The frog tells a different story of this horses' hoof and its needs. Whereas the hoof wall and external hoof look "fine".
1. Know what a normal hoof looks like, so you can spot when something isn't. Even a small puncture wound to your horse's hoof can be life threatening.
Frank's owner found him because she went to bring the horses in. What if she'd left them out overnight? Early discovery made a critical difference.
2. Never pull a penetrating object from a horse's hoof.
Stabilise it. Call your vet. The position of the object gives your vet vital information about what structures may be affected. With today's technology, photos can quickly be sent to your vet for advice in situations like this while you wait for them to arrive.
3. Hoof hygiene during rehabilitation is as important as the surgery itself.
The weeks and months after a veterinary procedure are when consistent, daily hoof care makes the difference between a clean recovery and complications.
4. Have a hoof care kit ready, and know how to use it.
"Frank's" owner had nothing prepared. No hoof boot, no wrapping, no wound or hoof hygiene products. No experience handling her horse's hooves under pressure. The time to build that knowledge and kit is before you need it. Build the kit now.
5. It's never too early to learn, but it can be too late.
"Frank" was lucky. The nail missed the critical structures of his hoof by millimetres. Not every horse is that lucky.
But even with luck on their side, the recovery was harder than it needed to be. Not because of the injury itself. Because the horse wasn't used to having his leg held.
Daily wrapping, applying hygiene products, cleaning a wound under pressure - none of that works if your horse won't stand for it. And most horses won't stand for it if they've never been asked to.
Start now. Pick up your horse's hooves regularly. Hold the leg a little longer than you need to. Let them get comfortable with it. Mimic what you'd need to do in an emergency - a slow clean, a practice wrap, a bit of product worked into the grooves.
It takes minutes. It costs nothing. And if you ever find yourself in a "Frank" situation, you will be grateful you did it.
Frank is approximately 24 years old. He returned to full soundness and a ridden career without any setbacks. A remarkable outcome given the severity of his injury.
These days he's a paddock horse. A beloved family horse. A trail rider, nothing fancy, just deeply loved by the family who almost lost him.
And hubby? ....... He's now permanently banned from opening any gates.
I've relayed "Frank's" story a few times over the years. To clients, at workshops, in consultations. I tell it because it captures everything I believe about hoof care education.
You don't need to be an expert. You don't need to know everything. But you do need to know enough to notice when something is wrong, to act quickly, and to support your horse's hooves through whatever is thrown at them. Regular, consistent hoof handling by horse owners can relieve the stress of difficult situations if they ever arrive.
"Frank's" owner knows that now. I hope his story helps you know it too.
Have a "Frank" story of your own? Leave a comment below. I'd love to hear it.
Not sure what's going on with your horse's hooves? The Hoof Co team is staffed by Certified Hoof Care Professionals. Get in touch and we'll do our best to support you.
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Julie Wright |
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