Hoof injuries

Major surgery for wounds of the foot, compared with other parts of the body, requires a more detailed preparation and a more persistent aftercare. To approach severe hoof wounds with a routine applicable to drainage of a subsolar abscess is doomed to failure! Yet, in dealing with referral cases of hoof wounds, particularly those that have become chronic, the author has observed that the principles have been ignored and/or the routines inadequate. The hoof has a suitable capacity to heal, with complete reformation of hoof structures, if a healing environment is maintained for a long enough period of time. For severe wounds, such time must be measured in months. A lack of attentiveness to the principles of hoof wound care and impatience during convalescence are the reasons for persistent lameness or for the formation of chronic hoof defects. The amount of hoof loss or the presence of distal phalangeal and/or deep digital flexor tendon exposure are not limiting factors to a successful outcome. Also, the initial assessment of the wound may not present an accurate picture of the eventual outcome. Both the veterinarian and the client may need to be committed to the horse's care for weeks or months before the final result is apparent; however, experience and faithful commitment help to avoid misjudgments in the selection of cases for follow-through. After healing, the resultant hoof frequently has far less functional or cosmetic impairment than might seem apparent at the outset. Most hoof wounds respond to proper therapy and recover without a hoof wall defect. The time lapse between injury and definitive care is critical. The amount of hoof loss and the exposure of deep foot structures are less critical. Such cases should be handled as a high priority, if not on an emergency basis. Prolonged delay is to be feared; contamination becomes infection, which extends, over time, to deeper, vital structures of the foot, with an unfavorable impact on the prognosis. Deep, penetrating wounds that invade the podotrochlea require early, even emergency, attention in order to avoid permanent debility, mortality, or euthanasia.