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


Penetrating Nail or other Object in Sole, Hoof or Frog


A foreign body penetrating into the foot is a fairly common, and potentially life-threatening problem. Nails and screws are commonly scattered around construction areas, and horses step on them and drive them through the ground surface of the hoof. Nail punctures are potentially serious because the critical structures of the lower limb lie within the hoof. The severity of the problem depends on what structures are penetrated.

Occasionally a shallow, simple nail puncture results in no problems once removed. Sometimes the object does not involve critical structures but results in a sub-solar abscess that, once drained, causes no long term complications. In contrast, sometimes the object may penetrate bone, joint, bursa or tendon sheath resulting in massive infection, severe lameness, and life-threatening complications. The absence or degree of lameness is a helpful indicator of severity and infection.

Typically these injuries are discovered when you pick up your horse's foot and see the offending object.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours

your role


What To Do

Leave it in your horse's foot and call your vet immediately. If your vet can examine the horse promptly, they may advise you to leave the foreign body in place until they arrive.

If your vet instructs you to remove the object, first take a picture of the nail in place. Then clean the hoof well with antiseptics, and remove the object with your hands or pliers. The photo will help your vet determine the severity of the injury (location, angle, depth of penetration), cleaning will lessen contamination, and removal of the object may prevent it from penetrating further.

However, keep in mind that it is often helpful for your vet to see the object in place and remove it themselves. This gives them the best opportunity to assess the severity of the injury.

What Not To Do

Do not attempt to remove the foreign body, unless advised to do so by your vet.

your vet's role

Your vet assesses the situation and degree of lameness. If the nail is still in place, they may take several radiographs to determine in 3 dimensions the depth and direction of penetration and the anatomic structures probably involved.

Once the nail has been removed, the vet may open the external part of the wound up to encourage drainage, and may gently flush the tract to remove debris. Depending upon the specifics of the wound, they will advise you of a treatment plan.
Questions Your Vet Might Ask:
  • How long ago do you think this happened?
  • When did you first notice this?
  • Where, exactly, is it located? Can you provide a photo?
  • How lame is the horse?
  • Where specifically on the sole of the foot did it penetrate?
  • Have you given any medications to the horse, what and when?
  • If so, when?
  • When was the horse last given a tetanus vaccination?
  • Did you leave the screw, nail or other object in the foot?
  • What are the results of the Whole Horse Exam (WHE)?

Diagnostics Your Vet May Perform

Figuring out the cause of the problem. These are tests or procedures used by your vet to determine what’s wrong.

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Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

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further reading & resources

Author: Doug Thal DVM Dipl. ABVP