The fall has been busy here at All West, but we did have an interesting case in September we still wanted to post as our patient of the month.
This horse is a 6 year old Missouri Fox Trotter. He was seen in the field for lameness that was present for several days in his left hindlimb. Prior to being seen, he had somehow stepped on a nail about 3 weeks earlier. After that he was sore for several days but then improved and went out to pasture.
When we looked at this horse, he was able to walk on his left hindlimb but was pretty sore, and would prefer to toe-touch in order to rest it while he was standing still. His vitals were normal. He was positive to hoof testers – meaning when we applied hoof testers to his foot, he had a painful response.
Given his history of stepping on a nail several weeks earlier, we were suspicious that this may not just be your average, run of the mill foot abscess. He was given a pain medication and came into the hospital for x-rays and a further work up. Once in the hospital, his shoe was removed and a lateral x-ray was taken that showed a large gas pocket between his coffin bone and his sole.
His foot was soaked to soften it, and then he was sedated so that we could fully explore his foot without it being too uncomfortable for him. Our farrier was able to find that the area where the nail had been actually communicated with a large region of undermined sole. What likely happened is that the nail and/or nail hole caused an infection in the sensitive sole tissues of the foot and there was a pocket of infection that likely initially filled with fluid and then gas on our radiographs.
The treatment was not much different compared to other abscesses we see – the foot needed to be soaked and poulticed, bandaged and the patient was put on antibiotics and pain medications and received a tetanus booster. However, his owners had to be especially careful to keep his foot clean and bandaged while the sole was growing out in order to make sure that it did not get reinfected.
If you ever find that your horse has stepped on a nail – call your veterinarian right away. If we can take a radiograph with the nail in place, we can get a better idea of what structures may be involved and what treatment may be necessary.