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Discussion on Puncture wound how long to soak?
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Member:
winger
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Posted on Monday, Nov 24, 2008 - 12:16 pm:
My mare picked up a nail in her foot..The vet has seen it..I have been soaking it in epson salts and Hibitane soap and warm water mostly 2x a day for 2 weeks..the pus seems to be gone no swelling and no need for antibiotics..How long do I need to soak it to make sure I got all the infection out? I am assuming it must be healing from the inside now..I am afraid to stop because we are doing so well I don't want to go backwards with it..but if its healing I shouldn't need to do any more..maybe just bandaging it for a while.thanks
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Member:
scooter
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Posted on Monday, Nov 24, 2008 - 7:25 pm:
Hi winger, there is a section on nails in the hoof and some discussions here...I hope you made sure her tetnus vaccination is up to date.
https://www.horseadvice.com/horse/messages/4/5252.html
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Member:
winger
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Posted on Monday, Nov 24, 2008 - 8:06 pm:
thank-you for the info..yes she has had her shots they were done in the spring.
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Moderator:
DrO
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Posted on Monday, Nov 24, 2008 - 8:18 pm:
That would be a question for someone who examined the horse winger as it will depend on the details of the case.
DrO
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Member:
winger
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Posted on Monday, Nov 24, 2008 - 11:07 pm:
Thank-you Dr.O I thought it would be a general question..I will give my vet a call..
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Moderator:
DrO
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Posted on Tuesday, Nov 25, 2008 - 6:58 am:
No, it is a case by case deal. How long will depend on the location, depth, contamination and maybe most important how well initial drainage was established.
DrO
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Member:
stek
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Posted on Tuesday, Nov 25, 2008 - 10:51 am:
I'm sure this was covered in the article but the only way you can get a good idea what you're dealing with is to get x-rays done with the nail still in place.
I've been unlucky enough to have this happen twice and the first I was in the same boat as you: hadn't had x-rays done as the nail was small and not very deep in the hoof. I just pulled it and wrapped and soaked. I spent the next month obsessing each time my gelding took an off step, though his recovery was uncomplicated.
The second time I called the vet out first thing and did x-rays, and was very glad I did. X-rays showed that the nail had come within a quarter inch of puncturing the navicular bursa which would have had a much poorer prognosis. As it was my mare had infection and abscessed and took about a month to get over it.
I don't want to cause you undue alarm, and hopefully since two weeks have passed and I assume you see no signs of lameness or infection, your case was more like my first than second. I just can't stress enough how important it is to get x-rays done so you know what you're dealing with.
Regarding how long to keep your horse wrapped, I would suggest as mentioned above to speak to your vet and follow his advice. Best of luck for a complete and speedy recovery!
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Member:
stek
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Posted on Tuesday, Nov 25, 2008 - 10:57 am:
**I should add, I couldn't tell by your post if you had had x-rays done on your mare or not, just wanted to stress the importance for others who may come across this post.
Again, happy healing 
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Member:
winger
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Posted on Tuesday, Nov 25, 2008 - 12:31 pm:
Thanks everyone..No she didn't have an X-ray the vet didn't seem too worried about it just to clean in 2x a day and if it swells get antibiotics immediately.
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Member:
stek
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Posted on Tuesday, Nov 25, 2008 - 12:55 pm:
Winger, now I'm curious .. my vet and others I've talked to about this are adamant about x-raying with the nail in place. Could you give any other details about the puncture (location, depth etc)? And did the vet see it with the nail in place .. so maybe he was able to tell by looking at it that the path it was taking was not dangerous?
Thanks!
Shannon
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Member:
winger
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Posted on Tuesday, Nov 25, 2008 - 5:24 pm:
Hi again..
The nail was in the frog groove it penetrated approximately 1 inch..we pulled the nail as we only have a part time vet and he wasn't here, we are on our own with our animals up here we don't live in town..
It was bleeding for several minutes and I cleaned it with hose pressure and soaked it in epson salts and wrapped it..
The vet didn't seem to concerned because he saw it 3 days later and she wasn't lame and her leg wasn't swollen but he did say if it did swell to get her on antibiotics immediatly..I put hibitane ointment on a pad at the wound site every time I cleaned her foot..thanks again
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Moderator:
DrO
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Posted on Tuesday, Nov 25, 2008 - 7:14 pm:
Shannon, few nail punctures need to be radiographed but there is an area and depth where it becomes very important. For more on this see Diseases of Horses » Lameness » Diseases of the Hoof » First Aid for Foot Disease in Horses.
DrO
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Member:
winger
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Posted on Tuesday, Nov 25, 2008 - 8:16 pm:
thanks everyone for the advice..she seems to be doing good so far..keep your fingers crossed for me OK.
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Member:
stek
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Posted on Wednesday, Nov 26, 2008 - 10:31 am:
Winger, as well as she is doing so far I would think the prognosis is good. Will keep my fingers crossed for you anyway ;) I know what it's like to be out of vet range, you do what you can and hope for the best. It is amazing what you can teach yourself how to do out of necessity!
Dr. O, not to be contrary, but I would think you couldn't tell how deep a puncture was until after the nail was out .. and at that point it's too late to radiograph. Granted the location and path the object takes could tell you a lot but I wouldn't want to make that call as a lay-person if I had the option to x-ray. Also considering how different each horse's internal hoof structures are (different coffin bone angles, sole thickness, etc) I would think even if you did get a good idea of the depth and angle, you would still have a hard time guessing how close you were coming to critical structures.
Of course if the horse is in danger of driving the nail in deeper the first thing I would do is pull it regardless.
When presented with this case, could you offer some guidelines about when radiographs are called for and when they are not? (I did read the article and didn't see any) We lived on a property for a while that had bits of trash (including nails) forever coming up out of the ground and I lived in constant fear of hoof punctures .. spent many an afternoon sweeping the field with a magnet!
Thanks!
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Moderator:
DrO
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Posted on Wednesday, Nov 26, 2008 - 7:42 pm:
Shannon, we like contrary here. I am uncertain if you are confusing "allowing the veterinarian to examine the nail in place" with "all nail punctures should be radiographed". The veterinarian should know what structures lie under the nail and when he pulls the nail out he will know how deep it went and its general angulation. When there is doubt about the involvement of underlying structures prone to complications radiography should be done. However I only find a small fracture of nail wounds require such further definition.
These structures, complications and their approximate location is described in the last paragraph of the subtopic Nail Punctures of the article I reference above.
DrO
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