The past few blogs have looked at hoof conditions like navicular, laminitis and club foot; hoof problems thought to be the result of genetic and/or management issues. This month we’re going to turn our attention to the damages horses can do to their own feet, or each others’. Even when riding and turnout spaces are free from equipment, metal, debris, loose wire and other objects that can cause injury, horses can still find the most remarkable ways to hurt themselves. As an owner or farrier, it’s good to keep up with the best practices in treating hoof injuries so if you’re confronted with a foot that is a literal bloody mess, you’ll know what the next steps should be.
Severe lacerations are most likely to happen in the field, whether they’re from a knock against a sharp corner of a run-in shed or from herdmates trampling on each other’s feet. Lacerations can affect the coronary band and/or the bulb of the heel. It’s not uncommon for horses who overreach to sustain lacerations on the heel bulb while in work, especially when they’re working at speed.
In both cases, the wound should be cleaned and lightly bandaged and a veterinarian called so the depth of the injury can be assessed. Very deep wounds can damage the inner structures of the hoof, so it’s crucial to know how deep the wound goes. Depending on the severity of the wound, x-rays could be needed. In any case, you can expect the vet to clean and disinfect the wound. Suturing could be recommended for very recent lacerations, with some opening left for drainage. Older ones, which can’t be sutured, will likely be bandaged and left to heal. Very severe lacerations might require a cast or reconstructive surgery.
The foot will need to be kept clean and the bandages changed to avoid infection. If the laceration was particularly dirty, antibiotics might be suggested. Farriers should be prepared to see some abnormalities in hoof growth at the site of the injury. Dr. Ric Redden suggests that chronic quarter cracks could become a feature of life for horses who’ve recovered from a serious laceration.
Avulsions are injuries in which some or all of the hoof wall is separated from the rest of the foot. They are exactly as serious and gross as they sound. They can be caused by herdmates or by a horse, for example, getting a foot caught in or under something and then pulling it free. Overgrown hooves are also factors in avulsion injuries – if a shoe is pulled off or a chip occurs, a piece of the hoof wall can be torn loose. They’re more common on the quarters and the heel.
You can expect the vet to remove all of the separated hoof wall in order to promote healing. Hoof wall that has separated from the hoof itself and cut off from its blood supply becomes necrotic, putting the foot at risk for infection. The vet will clean and irrigate the wound and the affected hoof wall will be debrided. Depending on how deep the injury goes, x-rays could be recommended.
Since normal hoof growth depends on a normal coronary band, the vet will work to make sure it’s as intact as possible, meaning surgery might be on the table, depending on the severity of the injury. Whether the coronary band is intact or not, avulsion injuries will need to be bandaged and kept meticulously clean. Antibiotics might be prescribed.
Farriers are an integral part in a horse’s recovery from an avulsion injury. The compromised section of hoof will need to be non-weight bearing while it heals. Some advise resecting the bottom of the affected area (if it hasn’t been removed already) before shoeing to make sure there’s no pressure on the new hoof growth. A bar shoe with toe clips on either side of the injured area can help to stabilize it, although the injury might call for a full plate shoe that spreads the weight across the rest of the foot.
Once any exposed sensitive tissue has begun to heal and has keratinized, farriers can use a number of newer options to reconstruct a hoof. Drs. G. Kent Carter and Jason Maki tell us that reconstruction materials like polymethylmethacrylate, spectra, fiberglass and even Kevlar can be used to stabilize an area of hoof that’s been compromised. The affected section can be filled, either with the synthetic material alone or with a fabric lacing or wire suture for added stability. The area can be sanded and treated like normal hoof once the composite material cures. It’s pretty amazing. Synthetics can be applied to recent injuries, but in those cases the repair procedure will usually involve leaving a drainage channel underneath to help with infection. The shoeing regimen that follows will depend on the kind and extent of reconstruction, but owners should expect to see their farriers more frequently as the repair grows out.
Puncture wounds need no explanation, but it should be noted that they’re sometimes difficult to see, so it’s worth the time to clean a horse’s feet out every day. They can also be difficult to treat because they can affect structures deep within the foot and because these wounds are usually hotbeds for bacteria. As contrary as it sounds, best practice in an emergency is to leave the object in the foot and pack and bandage around it while you wait for the vet so it can be radiographed. Unless, of course, the horse risks driving the object in deeper. If the object is removed, keep it to give the vet an idea of what they’re dealing with.
If the puncture isn’t too deep, the vet will clean and irrigate the wound, and will likely give the horse a tetanus shot and some antibiotics. The wound will probably be opened so it can drain, but the foot will be bandaged to keep everything as clean as possible. If infection has set in, or if the joint structures have been damaged, surgery could be required. Dead tissue, including any damaged bone, will need to be debrided, drainage channels created to avoid (or treat) sepsis, and any tendon damage evaluated. After surgery, antibiotics are often delivered right into the affected area.
Farriers who are called in to deal with puncture wounds can determine the affected area with hoof testers and/or by rasping the area to reveal the location of the puncture. Because these wounds are prone to abscess, it’s not uncommon for farriers to have to treat the secondary damage done by the puncture.
As always, a good vet and farrier team can work wonders to get horses out of whatever trouble they find themselves in. In each case, though, prevention is an awful lot easier than treatment, so pasture management, farmyard maintenance and good barn sweeping abilities are the best practices of all.