Your first instinct when you see a foreign object sticking out of your horse is to pull it out immediately, but veterinarians warn, “Wait, not so fast!”

Treat a Puncture Wound as an Emergency

“An injury with an embedded object is an emergency and must be seen that day,” says Sam Crosby, DVM, whose equine veterinary practice is based in Arcadia, Okla.

Crosby has treated many horses injured in tornadoes with all manner of embedded objects, including wood, glass, small rocks, tree branches and fencing pipe. He says one of the most unusual foreign object puncture wounds he’s seen was sustained by a horse rolling on a deer antler in the pasture.

Use Technology First

Immediately take a close-up photo of the injury with your phone. Call your veterinarian and text the photo so they can quickly assess the injury.

“Get photos, call your veterinarian and have them assess it,” says Woodrow Friend, DVM, who has been a veterinarian with Rood and Riddle Equine Hospital in Lexington, Ky., for 20 years. “In some instances, they may say, ‘Go ahead and pull it out,’ but let them assess it. Telemedicine has changed how I do things. I get a lot of FaceTime videos, and it’s easier for me to triage these injuries.”

Of course, if you live in a very remote area and you can’t get a veterinarian out for days, this changes things.

“You could end up doing FaceTime with a veterinarian and they can give you advice on what to do,” recommends Friend.

Don’t Give Drugs Before.the Veterinarian

Do your best to restrain the horse and keep him still and calm to avoid further injury, but don’t administer any drugs while waiting for the veterinarian.

“Acepromazine is a common sedative that many people have on hand, but don’t give the horse any drugs,” says Crosby. “Ace causes blood vessels to dilate, and in stress situations, this decreases blood pressure and can cause the horse to go into hypovolemic shock.”

If the puncture wound is bleeding, you can use a folded towel to apply pressure around the injury—just not on top of the embedded piece.

Friend points out that in some cases the embedded object may be stopping blood flow, and pulling it out could cause serious bleeding.

Why Wait?

There are two important reasons to wait for the veterinarian to remove an embedded object:

◆ To determine any damage of internal structures
◆ To make sure all of the object is safely removed

Depending on the injury, the veterinarian may use X-rays or ultrasound to observe internal structures around the embedded object and any resulting damage.

“Sometimes a wound can look small, but it depends on where it is,” says Friend. “If it’s near a joint capsule, you can get an infected joint.”

“If the wound is close to a joint, it’s especially important to take radiographs,” notes Crosby. “If you just pull the object out and it was near a joint, infection could set in and get a head. However, if the veterinarian knows it’s touching the joint, they can flush the joint, sew up any tear in the membrane, and treat as needed.”

Often an embedded object, such as a board or tree branch, breaks upon impact with the horse. Making sure all of it gets removed is crucial.

“Even if it’s just a piece of wood, I want to be able to assess if we got all of it out,” says Friend. “Sometimes you have the other end of the item, and you want to match the piece that came out. For example, with a broken fence board, you may think you got all of it out of the horse, but when comparing pieces, you can see there’s some missing.”

Friend relates the story of one horse who reared up in the barn and shattered a halogen light bulb with his head. When the wound kept draining and wouldn’t heal after 10 days, the owners called Friend. He found and removed a large piece of glass that was still embedded in the horse’s poll, which reinforces why it’s important for a veterinarian to initially assess puncture wounds.

Puncture Wounds in the Hoof

The most common hoof puncture wounds occur when a horse steps on a nail or fence staple.

“With the hoof, there are many internal structures,” says Friend. “You need to make sure you know where the object went.” He notes that any puncture wound of the hoof should be seen by a veterinarian, even if it seems small.

“If there’s a nail in a foot, I want to know where that nail goes,” adds Friend. “The frog will seal right up when you pull out a nail.”

“The problem with hoof wounds is that they close up quickly,” says Crosby. “If your horse steps on a nail or staple and you pull it out, then the veterinarian can’t see on X-rays how close it was to internal structures in the hoof.”

Treating Puncture Wounds

After your veterinarian has assessed the injury and taken any necessary X-rays or ultrasound images, they will remove the embedded object and begin treating the wound.

Depending on the injury, sutures may be needed. Medication to manage inflammation and pain will likely be part of the protocol.

Antibiotics may also be necessary to combat infection.

“In a tornado, pretty much anything that’s driven into a horse’s body is accompanied by debris and bacteria, and there is almost always infection involved,” says Crosby.

After initial treatment, your veterinarian will instruct you on how to continue treating the wound. Serious puncture wounds typically require a follow-up visit from the veterinarian.

With any wound—especially with punctures—it’s important for the horse to be up to date on his tetanus vaccine, so check your records. If it’s been longer than six months, your veterinarian will likely recommend a booster vaccination.

A Common Mistake

Beyond pulling out an embedded object before the veterinarian can assess it, improper wound cleaning is another common mistake.

“People get overzealous and try to do more than they should,” says Friend, who has seen horse owners flush wounds with alcohol, peroxide—even diesel fuel.

“You want to avoid anything that could be caustic to the tissues,” he explains. “The substance used to flush a wound can ‘pocket’ in the wound or be pushed into a space where it could cause more problems. [Additionally,] don’t ‘pressure wash’ the wound. Just rinse it off and keep it clean. Don’t try to do too much before the veterinarian gets there.”

Cleaning Puncture Wounds

Skip the spray nozzle when cleaning wounds. Just use a hose and normal pressure to move dirt and debris out of the injured area. You should keep a surgical scrub or mild iodine soap on hand to help clean wounds. Lacking this, a mild dish soap, such as Ivory, will suffice.

Stay Vigilant

Any of the following indicate a wound is not healing properly. Call your veterinarian promptly if you notice:

◆ Oozing/draining from wound 10 days or longer post injury
◆ Persistent heat or swelling
◆ Horse has a fever
◆ Horse shows signs of lameness

This article about the treatment of puncture wounds in horses appeared in the August 2022 issue of Horse Illustrated magazine. Click here to subscribe!

The post Treating Puncture Wounds in Horses appeared first on Horse Illustrated Magazine.

The hooves of horses are a remarkable thing. Strong and tough, yet also delicate, their health affects your entire horse’s wellbeing. That’s why it’s a good idea to keep a close eye on your horse’s feet. Craig Lesser, DVM, a podiatry veterinarian at Rood & Riddle Equine Hospital in Lexington, Ky., shares with us 5 serious hoof conditions to look out for. While some are more common than others, all require a conversation with your veterinarian for diagnosis and treatment.

Keratoma

WHAT IT LOOKS LIKE: There are two types of keratomas: conical and spherical. The conical keratoma is a tumor that begins at the coronary band and grows out all the way out to the sole of the foot. The spherical keratoma grows from the sole, causing a defect in the hoof as it grows into a large sphere within the foot.

EFFECT: This outsized tumor causes pressure necrosis, according to Lesser.

“As the keratoma grows, it puts pressure on the bone and will cause the bone to remodel,” says Lesser. “With time, it can cause lameness.”

The first sign of this hoof condition is often a chronic abscess on the affected foot or lameness.

“A lot of times, especially with a conical keratoma, you’ll see a change in the white line of the foot, which can be an indication,” says Lesser. “With a spherical one, there aren’t always changes on the outside of the sole. We usually see it as an abscess, but the actual pressure itself from bone remodeling can cause lameness.”

DIAGNOSIS: Radiographs can show the defect on the bone, and Lesser says this is the most common way veterinarians diagnose this hoof condition. They can also be diagnosed after an MRI or CT scan.

TREATMENT: Lesser says the only real option is surgical removal. Depending on the type of lesion, surgery can result in a significant layup time ranging from two or three months to up to a full year for a hoof to grow out if the lesion was removed from the coronary band.

Quittor

WHAT IT LOOKS LIKE: A bacterial infection that embeds behind collateral cartilage in the hoof, resulting in what looks like an abscess that has blown out of the coronary band, except it’s about a finger’s width higher than the coronary band, where the collateral cartilage ends. This cartilage is the firm-yet-elastic portion of the back half of the hoof that helps give it shape.

Lesser explains that quittor is very hard to clear up.

“It’s a tough infection to get rid of because drainage isn’t as easy as with a normal abscess,” he says.

EFFECT: The horse will usually be lame from the abscess, and once the quittor ruptures, there will be residual lameness.

DIAGNOSIS: The telltale abscess a thumbs-width above the coronary band is the first indication. X-rays with a contrast study will confirm, or an MRI will reveal the extent of the infection.

TREATMENT: A range of options are available for this hoof condition, including systemic and regional antibiotics. If the condition is bad enough, your veterinarian may put in a drain behind the collateral cartilage to allow for drainage. Lesser has also used larval therapy—incorporating fly maggots—and surgical debridement of the area as needed.

Canker

WHAT IT LOOKS LIKE: Canker looks like a really bad case of thrush at the onset.

“It forms a cauliflower-looking structure as it grows,” says Lesser. “When it gets scraped, it bleeds easily.”

It usually starts in the center of the foot and will then envelop the entire frog and sometimes the sole of the foot, in time.

“It’s a hyper-proliferation of keratin,” says Lesser.

EFFECT: Lameness is sometimes present, but if left untreated, it can cause permanent structural damage to the hoof capsule.

DIAGNOSIS: Canker is diagnosed off gross evaluation. Because the cause of the disease hasn’t been identified—it has been suggested that it comes from viruses or bacteria, and it’s also been called a cancer—it’s difficult to get a solid diagnosis.

“Canker is one of the most frustrating diseases of the foot that I deal with, because we don’t quite know what causes it,” says Lesser.

Veterinarians diagnose canker from a growth evaluation and visual examination.

TREATMENT: Lesser typically starts by blocking the hoof and doing a gross debridement to take the hoof back to healthy tissue. He will then cauterize the remaining tissue to make sure the infected tissue has been killed. He’s also used cryotherapy, laser surgical debridement, and a variety of other methods to debride the material as needed.

“The after-care is really what makes treatment successful or not,” says Lesser. “That involves months of bandaging, with or without shoes and treatment plates to make sure the disease does not come back in the future.”

Coffin Bone Infection

WHAT IT LOOKS LIKE: A coffin bone infection can affect horses of all ages. It usually starts as chronic abscesses or an abscess that has gone into the bone, causing an infection. If it worsens, it can form a sequestrum.

“A sequestrum is when a piece of the bone actually breaks off and the body starts fighting it as if it’s a foreign object,” says Lesser.

EFFECT: Severe lameness.

“It’s like an abscess that won’t go away, even if you have it open and draining,” adds Lesser.

DIAGNOSIS: Radiographs are the most common method.

TREATMENT: If the coffin bone infection creates a sequestrum, your veterinarian will surgically remove the dead piece of bone. If the coffin bone itself is affected and it’s not too bad, Lesser will treat the infection with antibiotics and larval therapy.

“If caught early and it’s fairly minor, once we get the infection under control, the horses don’t look back,” says Lesser. “But we do hit them very hard with treatment because it can be a such a bad disease.”

If a large piece of the coffin bone is removed that destabilizes the bone, it may take longer to heal. But with a smaller piece, Lesser says horses can heal nicely with no further issues.

Puncture Wound

WHAT IT LOOKS LIKE: If your horse steps on a sharp object like a nail, the nail may embed in the hoof. This is a serious injury that should be handled by your veterinarian.

EFFECT: “If the nail goes into certain structures in the hoof, it could be life-threatening for the horse,” says Lesser. “Don’t pull the nail out before the vet shows up. Make sure you call a vet right away. It’s very important.”

DIAGNOSIS: Lesser prefers to take radiographs before making a move to see what the nail is affecting inside the hoof.

TREATMENT: Lesser says the most important thing is not to pull the nail out without waiting for your veterinarian.

“If it’s sticking out of the hoof quite a bit and your horse is moving around, you can build a donut around it until your veterinarian can get out to your place,” says Lesser. You can build that donut with material at your barn—leg wraps are a great option.

If the nail isn’t touching an important structure, the veterinarian will carefully remove it, treat the horse with antibiotics and all should be well. It can be much worse—if the nail punctures the coffin bone, it can fracture the bone.

“Worst-case scenario, if it’s involving a joint or tendon sheath, those structures will need to be flushed out and [the horse given] systemic antibiotics, possibly regional limb perfusions, to treat that infection,” says Lesser.

If the puncture wound is mild, the horse could be back to work within a week. If it’s deeper or has hit a sensitive structure, it could be two to three weeks of recovery. If the nail has gotten into a joint, it could require at least a month of recovery for this hoof condition.

This article about hoof conditions appeared in the June 2020 issue of Horse Illustrated magazine. Click here to subscribe!

Further Reading

• Don’t Obsess Over a Hoof Abscess
• Stomp Out Thrush
• Treating Thrush
• Hoof Care for Horses

The post Funky Feet: 5 Serious Hoof Conditions appeared first on Horse Illustrated Magazine.