What to do when your horse has a puncture wound

They may look harmless enough on the surface, but puncture wounds can lead to serious infections and other complications.
Nails are common culprits but any puncture wound—one that is deeper than it is wide—can be bad news for a horse.

A puncture wound—any wound that is deeper than it is wide—can be bad news for a horse. At the surface, the wound may appear minor, and it can heal over quickly. But bacteria or other contaminants trapped inside the wound can cause infections that affect joints, tendons, bones or other structures. Puncture wounds in the sole of the hoof can be especially serious. Without prompt treatment, the infection can easily spread into the interior structures of the foot and even become life-threatening before it is detected. For all of these reasons, it’s wise to call in your veterinarian for any puncture wound.


• You find your horse with an object protruding from any wound.• You witness your horse impaling himself on an object, even if he pulls himself free.• You discover a recent small wound and you can’t see all the way to the bottom of it.• You find an area of heat and soft swelling on your horse’s body, and on closer examination, you notice what appears to be a small, healed wound.• Your horse turns up lame, and you find evidence of a recently healed wound on his leg.• You find any penetrating injury under his hoof, no matter how small.


• Leave any embedded objects in place. Your veterinarian will remove the penetrating object to determine how deep the wound is as well as what structures might have been affected. Especially in the case of the hoof, an x-ray with the object in place may be needed to determine the tract and extent of the injury. 

• Save the object, if it is not still embedded. The width and depth of the object, as well as how dirty or rusty it is, can provide clues to the injury. But it’s even more important to determine whether the object appears to be whole or whether broken bits may remain inside the wound.

• Keep the horse quiet and calm. Avoid unnecessary movement that may exacerbate the wound or drive the object deeper. If a nail or other penetrating object is still lodged in the underside of the hoof, do your best to hold the foot up until the veterinarian arrives. If you can’t keep the hoof elevated that long, get a helper to bring several small blocks of wood. With a careful wrap job, you can tape the blocks in place in a way that allows the horse to put the foot down without driving the object in deeper; of course you’ll need to supervise the horse wearing such a wrap until the veterinarian arrives. 

• Rinse the area, gently, with clean water or isotonic saline solution, and apply a topical antiseptic. Use only a water-based product at this stage so your veterinarian can remove it easily, if necessary. If the hair is long, you may try clipping the area around the wound, if the horse will allow it.


• Keep your horse’s tetanus vaccines up to date. Tetanus is an often-fatal disease caused when Clostridium tetani bacteria, which are normal residents of manure and soil, are able to multiply in the anaerobic environment of a puncture wound. C. tetani releases a neurotoxin that can lead to rigid muscle spasms severe enough to fracture bones and prevent breathing. 

• Inspect your stalls, run-ins and turnouts periodically. Look for loose nails or screws that are protruding from walls or fences, fallen branches or loose debris, splinters or other hazards that could injure your horse.

• Have your farrier come out regularly. The nails from lost shoes are a common source of puncture wounds to the foot. Examine your horse’s shoes as you pick out his hooves, and call your farrier if you find one coming loose.

• Work smart on farm projects and repairs. Put down a drop cloth to catch hardware and other hazards. When cleaning up after projects, use a magnet to find dropped nails or screws.

• Don’t park tractors, manure spreaders or other equipment in pastures, aisles or riding arenas.


• Do not apply pressure to the wound. Even if it’s bleeding a little, you want the wound to drain, which will also carry out contaminants. If the bleeding is heavy, check with your veterinarian about whether to apply pressure—it may help to take and share a photo of the wound with your smartphone because your idea of a lot of blood may be different from that of your veterinarian.

• Do not spray the wound under high pressure. You could drive any contaminants deeper into the tissue. 

• Do not “wait and see.” Especially with a wound under the hoof or near a joint, never assume that the injury is shallow enough for you to manage on your own. The horse may seem fine when the injury occurs, but serious and irreversible damage may develop if you wait even a day or two to call for help.

This article first appeared in EQUUS issue #466.

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