"Who here has never stuck a horse (driven a nail into sensitive areas when shoeing)?" asked host Ric Redden, DVM, founder of the International Equine Podiatry Center in Versailles, Ky., during the 16th annual Bluegrass Laminitis Symposium. Only a very few out of the 550-plus attendees (mostly farriers) raised their hands, showing that the following problem could happen to anyone.

Julie Grohs, DVM, of the Alaska Equine and Small Animal Hospital in Chugiak, Alaska, presented the following case study of complications following a misplaced nail in a Thoroughbred hunter/jumper mare. Initially the 7-year-old mare was in excellent physical condition with no history of lameness, but became sore the evening of a reset with commonly used, very wide-web shoes. The farrier returned that evening to reset the shoes and lower the nail holes, and commented to the trainer that the previous holes might have been too high in the feet.

The mare seemed more comfortable after the reset, and the trainer administered a non-steroidal anti-inflammatory medication (NSAID) following veterinary consultation. The mare responded well, but two days later the right front shoe came off and she was acutely lame on that foot. At this point Grohs first examined the mare