Few horses escape puncture wounds in their careers. A nail left near a stall, a sliver of glass on the trail, a piece of wire near a fence line: exposure to objects that can penetrate a hoof or another part of the horse's body are part of the environment.
When a puncture wound occurs, treatment depends on the depth of the wound, the location, and the origin of the penetrating object. If the puncture wound is to the hoof, it may be difficult to determine which of the vital structures of the foot have been injured and contaminated with microorganisms. .
The deeper the penetration is, the more likely that the pedal bone, the navicular bursa, the coffin joint, the flexor tendon, and other finely-tuned parts of the foot may be affected.
In some cases, the object that created the wound may be pulled out, but if pulling it out would cause further damage, it is best left in until the veterinarian arrives.
The veterinarian or farrier should be called in as soon as possible. An X-ray the foot before the penetrating object is removed is often recommended. For many horseowners it is difficult to face further suffering for the horse during a trailer ride or while waiting for the farrier or veterinarian, but the safest course is to leave it in until an X-ray can show how deep it goes and exactly what is punctured.
If the horse has not been vaccinated for tetanus, or if the vaccination history is unknown, tetanus toxoid and tetanus antitoxin should be given, with a booster following in four weeks.
After the puncture wound is treated, the horse should be kept in a clean stall and the veterinarian or farrier's directions followed regarding further monitoring and treatment, as well as how soon the horse returns to normal activities.