What you see. The starting point for addressing any equine health related issue is your observation.


High Nail on Hoof Wall


Your horse was recently shod, and you notice that a horse shoe nail is high on the hoof wall. Whether this is a problem or not depends on other factors.

A nail that is too close to sensitive tissue within the hoof - a "hot nail" - can cause severe and sudden lameness that can progress to a non-weight bearing lameness as pressure is put on sensitive tissue in the hoof. A hot nail can also progress into a full foot abscess. A horse with a hot nail is usually very lame, has heat and digital pulse detectable in the limb, and may have swelling of the lower limb.

However, many high nails are not hot. A nail that appears high in a horse with no lameness or other abnormalities is probably not hot, and you can ignore it unless you notice other problems.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If there is severe lameness accompanying this sign.
  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If lameness is noticeable at the walk.
    • If digital pulse is obvious in the limbs.
  • Code Green

    Contact Your Vet to Obtain Useful Advice & Resources
    • If you do not notice lameness.

your role


What To Do

If you believe the nail is causing a problem, check the foot for digital pulse and heat in the hoof wall. In most cases, if the high nail is also hot, there will be heat and increased digital pulse in the foot. Assess lameness at the walk and trot. Contact your vet with your findings and concerns.

You can also pull the nail or the shoe yourself and monitor the horse's response for a day. However, if the horse has not greatly improved after 24 hours, you should immediately contact your vet or farrier.

What Not To Do

Do not simply assume that your horse is lame due to a high nail, because this isn't always the cause.

your vet's role

Your vet or farrier may recommend soaking the foot and resting the horse for several days, and advise you to repeatedly assess lameness at the walk during this time and monitor the foot for digital pulse and heat.

Your vet assesses a high nail as a potential cause of lameness using hoof testers and clinical exam. If there is a doubt, your vet will pull the nail and search for a hoof abscess to open and drain. In rare cases, a greatly misdirected horseshoe nail puncture can reach critical deeper structures like the coffin bone, causing fracture or infection.
Questions Your Vet Might Ask:
  • When was the shoeing performed?
  • How lame is the horse?
  • Do you notice digital pulse and heat in the foot?
  • Do you notice any lameness?
  • Is there a visibly high nail?
  • Do you notice swelling of the lower limb?
  • Does the horse have a fever?

Author: Doug Thal DVM Dipl. ABVP