Horse hoof puncture wounds

Why hoof punctures are emergencies, and steps you and your veterinarian can take to help your horse

Don’t pull the nail. This is a sentiment I’ll repeat. Because if you take away just one thing from reading this article, it’s that.

Hoof punctures are common and almost always emergencies (and, it seems, rarely does a horse’s sole find a horseshoe nail during normal business hours). Objects penetrating the hoof can introduce bacteria, causing infection within the foot and pastern. “Hoof punctures are one of those ‘It’s no big deal,’ or ‘It’s horribly devastating’ type of injuries,” says Cathy Lombardi, DVM, CVA, of the The Oaks Veterinary Clinic’s Equine and Farm Services, in Smithfield, Virginia.

In this article we’ll explain why you must treat hoof punctures with urgency, steps you can take prior to the veterinarian’s arrival, and what he or she can do for the horse.

What’s at Risk

Anatomically, the hoof is more complicated than meets the eye. While the third phalange, or the coffin bone, occupies most of the hoof capsule, many other structures reside here. “When a foreign object penetrates the hoof capsule, it may come into contact with the coffin bone, deep digital flexor tendon, navicular bone, navicular bursa, or even the coffin joint,” says Allie Catalino, DVM, veterinarian at the Equine Clinic at Oakencroft, in upstate New York. “These structures can be physically disrupted (fractured or torn) by the penetrating object as well as seeded with bacteria.

“The (coffin) bone is only 1.5 centimeters away from the visible external sole,” she continues. “At a similar depth, under the horse’s frog is the attachment of the deep digital flexor tendon to the coffin bone. The small navicular bone sits between the deep digital flexor tendon and the coffin bone at the horse’s heels and is surrounded by the navicular bursa, a synovial structure.”

Joints, bursas, and tendon sheaths are examples of synovial structures. They produce synovial fluid, which helps lubricate and support the neighboring bones and soft tissues. “When inflammation or infection is introduced into a synovial structure, the synovial fluid loses its viscosity and ability to lubricate, which can result in damage to underlying bone or soft tissue,” says Catalino. “With minimal blood supply to a synovial structure, infection is treated with aggressive intervention in the form of flushing surgically, followed by deposition of antibiotics within the structure.”

What To Do

Don’t pull the nail.

After calling your veterinarian, keep your horse in a stall or contained area, if possible. Your horse will likely be able to shift weight off the affected foot for the duration of time it takes for your veterinarian to arrive.

This story requires a subscription to The Horse magazine.

Current magazine subscribers can click here to and continue reading.

Subscribe now for $1.25 a month and gain unlimited access to premium content.

Billed as $15/annually*

Subscribe Now

We at The Horse work to provide you with the latest and most reliable news and information on equine health, care, management, and welfare through our magazine and Our explanatory journalism provides an understandable resource on important and sometimes complex health issues. Your subscription will help The Horse continue to offer this vital resource to horse owners of all breeds, disciplines, and experience levels.

*Discounted subscription rate valid for delivery to U.S. addresses or digital delivery. One-year (12 issues) subscription billed as a one-time payment of $15. For print delivery rates outside of the U.S., click here.