The treatments of a “hot nail” vary, depending on the type of injury and the time that has passed between the injury and first treatment. This page demonstrates an alternative treatment of a low and direct pricking of the hoof, in which case horses usually go lame immediately, or few hours after or the next day. It is therefore very important that we implement this procedure immediately, in order to prevent more serious complications. If the horse is pricked low, this treatment will get the horse sound within one day in most cases, providing no serious infection and inflammation of the laminae has sat in.
The proper diagnosis is very important in order to identify the nail that caused the injury. First are used the hoof testers to approximately localize the effected part of the hoof. The shoe is then removed, however, not the same way as the farrier usually does it. Often when we try to remove the shoe with the “shoe pullers”, it causes a lot of pain to the hoof as the pullers press against the sole, which is usually very sensitive, since the laminae above is already inflamed and swollen next day. When removing the shoe, it is best to use the nail pullers and remove one nail at a time. This will help us to identify the nail in question, as the horse will respond to the pulling of that nail by flinching or jumping (be careful, especially by the hind legs as the horse could respond to the pain by kicking). If the horse does not react to any of the nails when pulled out, then there is a good chance that the pain in the hoof may be caused by something else other than the pricking, often the heels can be bruised, hoof abscess etc. In any case, horses for most part react strongly when the hot nail is pulled out.
Once when the hot nail is identified and removed, the following method can be implemented, providing that this is feasible and one can manage it, or better said the horse let us do it. Using a small drill the nail hole is enlarged and opened up to allow drainage. The enlarged hole is flushed first with peroxide and than with 7% iodine. If it is important that the horse goes sound next day for a show or a race, it is better to use a lesser strength iodine. In other words dilute the iodine half and half with water and then flush out the hole. After flushing, the hole is sealed with Povidone ointment and the shoe is put back on. Often, the sole is somewhat swollen, which is hardly noticeable, but the horse will feel pain when there is a pressure against it. Therefore, before the shoe is nailed back on, removing more of the sole and wall between the affected area and the shoe is prudent, as well as avoiding putting a nail in the same hole, the latter is to insure drainage. When drilling the hoof, one should follow the nail hole and not deviate from the direction and end up going deeper into the laminae. It is best if the wound bleeds, because this will help remove the pressure as well as all the impurities of the injury. This is often a problem as it is very painful for the horse. Attention must be paid, so the drill does not accidentally break off. In many cases the veterinarians use the knife to expose the injury, which often causes more problems later than the pricked nail did originally. For best results do not call your veterinarian, but call you farrier to do this for you. Please, do not use the Bute to lesser the pain, since the Bute will hinder the body in fighting possible infection. If your horse received a tetanus vaccine within a year then there is no need to worry about tetanus, though often I have seen vets injecting tetanus antitoxin as a precaution. No opinion on the latter. Should the infection set in, which can be noticed in a slight swelling above the hoof in the pastern and fetlock area, then putting the horse for five days on penicillin is prudent. (20 cm per day for five days, not less than five days.)
If you are not comfortable with the drilling procedure and/or the nail hole bleeds well after the nail is removed, then flush out the nail hole same as above but using a needle on the syringe and inserting it into the hole (not too deep and be careful not to break the needle off in the hoof). This is very practical if we treat the hot nail the same day (within hours) of the injury, in which case the drilling is unnecessary.
After the shoe is put back on, the foot is packed with ichthammol and wrapped. See the packing and wrapping on the alternative treatment of hoof abscess no. 1 here. Soaking of the hoof is not recommended, only in the case of a high prick, in which case we will present a different treatment. The high pricks are very noticeable, since they usually bleed right away at the top of the clinch and horses are sore immediately.