“A simple heel bulb laceration may look like a regular ‘nothing’ cut, but it could be life-threatening if it’s in the coffin joint, so you need to get it evaluated right away,” said Robin M. Dabareiner, DVM, PhD, Dipl. ACVS, while describing a study she completed recently with colleagues at Texas A&M University (TAMU) College of Veterinary Medicine. “Ninety-five percent of horses with this injury go back to being athletes with no hoof defect if they’re caught early.”

Heel bulb lacerations are a common equine injury in Texas because of the abundance of barbed wire and structures and barriers made out of tin and metal pipe. Dabareiner said horses often step on pieces of sharp-edged tin that have fallen from the barn, or they will kick through walls or barriers and slice their heel bulbs on the metal. (She recommends covering tin walls with plywood to reduce the likelihood of injury.)

The retrospective study involved 101 horses evaluated and treated for heel bulb lacerations between 1988 and 1994 (the data was compiled by a TAMU resident in the mid-1990s, but it hadn’t been analyzed). The results appeared in a February edition of the Journal of the American Veterinary Medical Association. Most of the horses were not treated with antimicrobial drugs prior to TAMU referral. In 17 of the horses, synovial (joint) structures were involved, and the coffin joint was most commonly affected. The veterinarians euthanatized one of the horses after his initial examination because of severe joint infection. 

In examining the cases in the study, Dabareiner noted that little has changed in the way veterinarians evaluate and treat heel bulb lacerations since 1988. To assess a heel bulb laceration, TAMU veterinarians block the foot with local anesthesia. If the laceration is close to a synovial (joint) structure, which should be sterile inside, the vet injects sterile fluid through the injury into the coffin joint so it distends the area. If the fluid squirts out of the wound, the vet knows the joint is involved and the wound is cleaned and debrided before a hoof cast is applied. In cases that don’t involve the joints, typically the wounds are sutured (if fresh enough) and a foot bandage is applied