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Discussion on Nail in Laminae
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Member:
sunny66
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Posted on Saturday, Mar 1, 2008 - 8:45 am:
Hi Dr. O, a boarder's horse pulled his shoe then stepped back on it with the nail going all the way in the laminae. We pulled the shoe and immediately doused with betadine and wrapped with cotton and duct tape. The foot did not get dirty. After giving the horse time to rest, we soaked for 20 minutes in epsom salts then re-wrapped. Per the vet, the horse is on antibiotics, twice daily soakings and bute twice a day.
His owner is leaving for four days and I'll be taking care of this horse.
He'll go down to once a day bute tomorrow. If he gets worse on once a day, what then? Back up to two days? Vet said it could take two weeks or two months, could this mean wrapping for two weeks? She forgot to ask for the signs that would indicate no wrapping or bute is needed.
When can the shoe be put back on? This horse has pulled his shoe four times in the last four weeks. I'm advocating leaving it off for a while, but if that is the case, when is wrapping no longer necessary? This happened Thursday.
He's lame without a shoe on (I think there may be something underlying here - he is very contracted/coke can feet) so it's hard to determine when he feels better. He's walking fine on bute.
Thanks for your help on this!
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Member:
sunny66
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Posted on Saturday, Mar 1, 2008 - 12:40 pm:
I can see the hole, so ignore my previous questions unless we're doing something wrong or you have a better way. I assume it stays wrapped until I can't see the hole. Thanks!!
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Member:
sunny66
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Posted on Saturday, Mar 1, 2008 - 11:49 pm:
I need some help. Owner missed the vet's call. Has anyone dealt with this before? He's doing fine. Was lethargic the first 36 hours or so, but he's back to normal now.
Instead of wrapping the foot in cotton, would duct taping a few betadined soaked gauze strips and then putting a boot on be ok to do? If so, our highs right now are in the 60s to 70s; will this keep the foot too hot? This horse does have a history of thrush. Being stall kept is an option and it would be easier on me, but I think it would be better for the horse if he could get out.
Right now he's wrapped in cotton and duct tape and allowed in his 16' run at night. This morning he was soaked, wrapped in gauze then cotton padding then we put one of Brave's boots on (boarder has tiny feet so it worked out) so he could walk about and graze. This evening the foot was not sweaty, neither the cotton nor gauze was wet except from the betadine that we could tell.
I reread your article and I'll get a syringe and get betadine IN the hole tomorrow am. She has been squirting the betadine on the hole but your note on using a syringe makes more sense.
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Member:
scooter
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Posted on Sunday, Mar 2, 2008 - 6:03 am:
Hi Aileen I'm sure Dr.O. can help you more than me.
The questions that run through my mind is exactly where did the nail go in and how deep? Is he UTD on his tetnus shots? Hank did the same thing a couple winters ago. It was determined it didn't go in deep enough, nor in a crucial spot in his sole where it could have hit any critical structures. The vet then said I didn't need to do anything and he was fine.
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Moderator:
DrO
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Posted on Sunday, Mar 2, 2008 - 7:28 am:
Good Morning Aileen,
Our recommended treatment regimen for a nail that penetrates into sensitive tissue is in the article but whether this has happened is not clear in your post. There is a sensitive and insensitive laminae and penetration into the insensitive sole, laminae. or wall will require no treatment at all other than perhaps some prevention for the formation of thrush in the defect.
Signs of penetration to sensitive tissue is a while the nail was in the sole is increased or blood on the nail when pulled. There is more on the diagnosis and treatment for a nail that penetrated the horn of the hoof and is described in the article.
DrO
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Member:
sunny66
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Posted on Sunday, Mar 2, 2008 - 9:24 am:
Thank you both, yes he's up to date on his tetanus. The nail went all the way in, about 3/4 of an inch.
I'll take a picture, if it was on Brave's foot I could tell you for sure where it is, but I don't know this horses foot. My best guess is it went in his white line/laminae. The hole is at the toe to the inside, no where near the frog. It bled when it penetrated, owner was off the horse (had been riding), blood again when we pulled the shoe, but not since.
I'll be back with a picture in a couple of hours. THANK YOU! 
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Member:
sunny66
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Posted on Sunday, Mar 2, 2008 - 8:23 pm:
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Member:
sunny66
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Posted on Sunday, Mar 2, 2008 - 8:34 pm:
Sorry it took so long, I typed the word Here. Directly to the left of the "H" you'll see it looks blacker than other portions of the foot. This is the hole.
It appears to be granulating from the inside, I tried the syringe and barely any stayed in the hole, so that leads me to believe it's healing correctly... I hope?
He had big cowpaddies this am, so no antibiotics or bute. But when I went down to feed lunch, he had no manure piles in the pasture or his stall. 6 hours later, still none. So took his temp (97.9), grazed long green grass (versus the 3/4 inch in his pasture) and soaked him at the same time, pulse is 32. Brought him back to the stall and he let out a stinky fart, then about 10 minutes later a rank pile of a mix of soft/normal bms.
Called vet, they said to give him antibiotics and bute again tonight and see what he does or doesn't do.... does this seem right to you? This horses' bms consistency normally doesn't change at all. He's been in my barn for 4 years with no impactions/colic, nothing.
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Moderator:
DrO
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Posted on Monday, Mar 3, 2008 - 6:52 am:
Aileen, in an uncomplicated puncture like the one described in your posts I would be following the treatment described in the article. Whether I would be using antibiotics would be determined on a case by case basis and depends mainly on how deeply the soft tissues were penetrated. I don't ever use bute on nail punctures.
Without examining your horse I cannot recommend therapy for your horse and suggest you follow the recommendations of those who can. But you certainly can engage them in the differences in therapy.
DrO
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Member:
sunny66
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Posted on Monday, Mar 3, 2008 - 10:48 am:
Thanks so much Dr. O! I truly appreciate your input on this
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