My horse stepped on a nail and it went into the frog. My farrier removed it, and my vet has supplied me with antiobiotics and a tetnus booster. We are on day 9 since the nail was removed. He is still not completely weight bearing on the foot, mostly walking on his toe and occasionally setting the foot down at rest. I am seeing some improvement, the swelling is going down, no heat left in the foot and the wound is draining. I am doing epsom salt soaks and bandaging. The foot is very clean and the wound is draining well. But, I am concerned because the foot is still draining a lot of thick, stinky fluid! Anyone have experience with something similar? Is it worrisome that it is still draining so much after 9 days? Or good that it is still open and draining? Thanks for any advice! Also - does anyone have advice on great products to use to help heal the wound?
Have you called the vet to do a follow-up?
Yes, he said to try another round of antibiotics, which we just started.
I would recommend x-rays as soon as possible to ensure that the nail has not penetrated any structures. Infections can spread and affect bones, tendon sheaths, etc. Is the horse on broad spectrum antibiotics, or has the fluid been cultured? Non weight bearing with thick, stinky discharge sounds like infection. You need to know what bugs are in there and therefore, which antibiotic to fight them with. It is good that there has been some improvement, and it may just be taking its time, but if I this was my horse I would be wanting x-rays and targeted antibiotics. Good luck, I hope he continues to improve. There are heaps of posts in this forum about similar injuries if you do a search.
Get radiographs now.
X-rays and stronger antibiotics.Get the vet involved again now. I would soak with a white lightning/vinegar and quit the Epsom salt/water after I’ve scrubbed the foot clean. what are you using to wrap the foot? Do you have boots on the other foot to help prevent laminitis in the good foot?
IMO and experience the most important question, information that hasn’t been given nor asked. How big/long was the nail?
Was it aluminum like a roofing nail, galvanized or plain metal, which can be rusty? Any idea how long it was in there. Is the horse stalled or 24/7 turn out. Was it bought in or checked daily, groomed, feet picked etc? So you know how long the nail was in there.
You have had your vet check things. That person is working hands on. Either you trust your vet or you don’t. No one from cyperland is really in a position to give you better advise.
I agree that you should trust the treating vet but I am really surprised after 9 days that he hasn’t mentioned x-rays, a perfusion or a street nail procedure. Oral or injected antibiotics are often ineffective for infections deep in the foot. If the nail hit any internal structures it can quickly turn into a life threatening situation. Been there, done that.
The cardinal rule with nails, or anything that penetrates the hoof, is NOT to remove it. Not even by the farrier. If it is especially long you could cut it down some but leave enough so it can be pulled out. You have to wait it out until the vet arrives, and the horse can’t stand on that foot.
The only way to determine what the nature and extent of the injury is to have it x-rayed by the vet before removal. If it hit internal structures, such as bone, you can’t know that without the x-ray, and there’s no way the vet can figure out what the appropriate treatment is. If it’s draining stinky pus after 9 days, I’d be really concerned that there is a deep-seated infection that is going to be very difficult to cure. Have the vet out immediately. My fingers are crossed.
For future reference, anything penetrating the foot is an emergency. You can;t go back in time, but if it ever happens again, try to radiograph with the nail still in. You need radiographs RIGHT now to determine if the nail penetrated the coffin joint. You may need regional perfusions of antibiotics or even surgical intervention.
I’ve had horses step on nails several times; the ground seems to grow them here. Our vet swears by mixing sugar with betadine until it becomes rather thick, like thick pasta sauce. Put that in a diaper and duct tape to the horse’s clean foot. Change every day or every other day for about five days. He says the sugardine helps pull the infection out. I don’t know if that’s truly the case, but it’s done the trick every time for us.
I hope your vet pulls through for you. Seems like he/she needs to see the horse in person again. (or, at least, that’s what make me feel better, if I were wearing your moccasins.)
Yes you want radiographs first with the nail still in so the vet can see where the damage is. Then the vet takes out the nail. Of course you want all the antibiotics internally and also externally. Nails in hooves are very dangerous.
Good luck.
We had one older horse, he was for sale with a trainer’s friend, come in from turnout with a big nail on his hoof.
The trainer found the nail and pulled it and hauled the horse right then to the vet.
The vet could follow the nail track with a long surgical needle, took x-rays and the nail had gone thru the navicular bursa and half way into the coffin bone.
They consulted all along with TX A+M, put a hospital shoe with a plate they could remove to clean and treat the hoof, cultured and then perfused the leg locally with all kinds of antibiotics, etc.
In those situations, you have to be very aggressive to have any chance things don’t get worse and even then, some times nothing works if the injury is too serious and/or infection sets in.
In some cases, surgery to clean the site out may help, but that is a specialist job not every vet can handle, or was at that time.
Since the OP’s horse is under veterinary care already, guessing at what they need to do without being there is hard to do.
Get rads YESTERDAY. First, your farrier should never remove a nail in the frog without an xray. Second, get a new vet. You don’t treat frog punctures with systemic antibiotics. I am six months into rehab of a frog puncture that wasn’t properly addressed by the BO. You could EASILY be looking at pedal osteitis or worse, navicular bursa infection AND pedal osteitis. I’m not needlessly sounding a panic alarm. Very few horses who aren’t properly treated with in 48 hours survive a septic joint and this needs to be ruled out ASAP. I would get radiographs and have an equine surgeon evaluate them Emergently! There is no way for your vet to tell what that nail hit without an X-ray. No vet that didn’t at least sort of panic over a frog puncture would ever touch my horse again. And no farrier that pulled a nail from a frog without an X-ray would either. Dexter’s X-rays are on here and I think you can see them from my profile. That’s what a frog puncture does to a horse.
I am baffled as to why (most) hoof/leg issues are usually handled very carefully, but it seems that a lot of the horse world doesn’t know how to deal with puncture wounds in the foot. Especially because they can cause so much damage
It AMAZES me how many horse people equate a nail puncture to the frog with a horse that has been nailed by a Farrier. That’s what happened with Dex. The barn owner found the nail and pulled it while we were away and then misrepresented or miscommunicated the injury as a cut on his bulb that abscessed when he didn’t heal from soaks and PCN injections after five weeks we finally found out the true nature of the injury.
I guess I can understand a lay person not immediately understanding the issue but a farrier pulling the nail AND a vet treating it so conservatively??? That boggles my mind. At the very least regional perfusion antibiotics are called for. I am quite serious that both the vet and the farrier would be replaced. If that nail punctured internal structures, this treatment method has possibly cost valuable time and is money wasted. The nail doesn’t have to go in very far to do damage and many just don’t understand that. I suppose it’s difficult to imagine a 1000 plus pound animal dying from a little nail prick on the foot.
Oh my lord… I hope you gave HELL to the barn owner/vet/everyone involved! Recently a horse I knew was on stall rest for days because they were ‘off’…nobody noticed the horse had MULTIPLE nails in the foot and then proceeded to pull them without vet first. Obviously its infected and I’m praying the horse just survives.
