Finding and treating puncture wounds in horse hooves

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If a puncture wound is suspected, radiographs may be used to determine the location and depth of the injury.
If a puncture wound is suspected, radiographs may be used to determine the location and depth of the injury. A metal probe inserted into the wound tract shows as a bright white object. © Oklahoma State University

Oklahoma State University equine surgeon Daniel Burba looks at the identification of puncture wounds in the horse’s hoof, and the course of treatment.

Horse hooves are formed of insensitive, cornified material called horn and can be very resilient to penetration by an object. Inside the hoof capsule lies bone, joints, tendons, ligaments and other soft tissues.

While the hoof capsule is designed to protect these structures and provide the horse with a platform to support its weight, traumatic events can puncture the hoof and affect the deeper sensitive tissues. Puncture wounds often occur from stepping on nails, screws, or other such objects.

Sustaining deep puncture wounds to the foot causes lameness in horses. The opening of the puncture wound may or may not be evident during physical examination. The veterinarian examining the foot must try to determine if the horse is experiencing a common foot abscess or a puncture wound.

If a puncture wound is suspected, radiographs may be used to determine the location and depth of the injury. The veterinarian will place a metal probe into the wound tract and take radiographs of the foot. This helps determine the location and depth of the puncture, as the metal probe will be seen as a bright white object on the radiographs.

To treat deep hoof puncture wounds, remove the foreign object, if it is still present, and debris from the puncture wound. This may involve surgery to clean and debride the wound. Horses who have sustained a deep puncture wound of the foot are treated with antibiotics to fight the likelihood of infection.

A tetanus toxoid vaccine is also given as early as possible after the injury occurs. Deep punctures create the ideal environment for the tetanus organism to grow and release its deadly toxin. Anti-inflammatory drugs, such as phenylbutazone, are also administered to relieve inflammation and pain.

Daniel J. Burba, DVM, Dipl. ACVS,
Daniel J. Burba, DVM, Dipl. ACVS. © Oklahoma State University

During the healing time, the foot is wrapped in a clean, dry-medicated bandage. If extensive removal (debridement) of the sole and deep tissues of the hoof was necessary to treat the puncture wound, a special shoe with a protective plate on the bottom called a medicine plate shoe is placed on the foot to protect the wound.

The plate is made so that bolts can be unscrewed to remove the plate from the shoe to medicate the wound. This treatment is continued until the wound is totally healed. Treatment could take several weeks. The prognosis for soundness is dependent on what underlying structures were involved and if the infection was controlled.

Take-home message: If your horse suddenly becomes lame, a deep puncture wound to the hoof should be considered. If left untreated, puncture wounds to the foot may be disastrous. Call your veterinarian early. Prompt diagnosis and treatment may lead to a better outcome.

Article courtesy Oklahoma State University’s College of Veterinary Medicine

Dr Daniel Burba completed an undergraduate study in Biology at Morehead State University, Morehead, KY and earned his DVM from the College of Veterinary Medicine at Auburn University in 1986. He was accepted into an internship program in Large Animal Medicine and Surgery at Oklahoma State University and subsequently completed a residency in Equine Surgery in 1990. Burba joined the Louisiana State University’s School of Veterinary Medicine as an assistant professor of equine surgery in 1990. After 25 years at LSU SVM, he joined the Center for Veterinary Health Sciences at Oklahoma State University in 2015.

Burba became a Diplomate of the American College of Veterinary Surgeons in 1995. He is a member of Phi Zeta Veterinary Medicine Honor Society, Gamma Sigma Delta Agriculture Honor Society, Veterinary Wound Management Society, American Association of Equine Practitioners and American Association of Veterinary Clinicians. His research and clinical interests include orthopedics and laser cribbing surgeries. Dr. Burba holds the McCasland Professorship in Biomedical Laser Surgery and is the department head for the CVHS Department of Veterinary Clinical Sciences.

Daniel J. Burba

Daniel J. Burba, DVM, Dipl. ACVS, is a professor of equine surgery at Oklahoma State University’s College of Veterinary Medicine. He is a diplomate of the American College of Veterinary Surgeons and head of the Department of Veterinary Clinical Sciences at the college’s Veterinary Medical Hospital.

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