Kaydence Sports Medicine & Rehab

11 Equine Lameness Prevention Tips

Proactive strategies can go a long way toward helping your equine partner stay sound, whether he’s a favorite trail buddy or a top competition horse. So in this article, three equine veterinarians and members of the academic community have weighed in with practical tips for maintaining a comfortable and happy horse.

1. Maintain a Team
While it might seem obvious, our sources can’t stress it enough: Be deliberate about maintaining a consistent relationship with your farrier and veterinary teams. “One of the biggest things for keeping horses sound and healthy is to establish a good working relationship with your veterinarian and farrier for regular maintenance and health care,” says Carolyn Hammer, DVM, PhD, associate dean of animal sciences at North Dakota State University, in Fargo. Ideally, your farrier and veterinarian should be able to communicate with one another when concerns arise.

2. One Size Doesn’t Fit All
When it comes to shoeing options, different lameness or hoof conditions require different hoof care strategies. Key to keep in mind, says Tena Ursini, DVM, PhD, CERP, Dipl. ACVSMR, clinical assistant professor of equine sports medicine and rehabilitation at the University of Tennessee, Knoxville, is the applied shoeing setup provides the mechanics the horse needs to maintain soundness.

“I think a lot of discrepancy between farriers and vets is based on veterinarians trying to prescribe an exact shoeing package: If the veterinarian’s recommendation is one that the farrier is familiar with and can be successfully applied to that individual horse, everything is great,” she explains. “If it’s a shoe type that the farrier is either not comfortable with or cannot actually be applied to that particular horse for whatever reason, things go poorly, and the horse never gets sound. At that point the owner is unhappy, the farrier is unhappy, the veterinarian is unhappy, and the horse is definitely unhappy.”

3. No Two Horses Are the Exact Same
Conformation is also unique to each horse. “The most important thing to realize is that not every horse is built the same; there is no single number for ideal hoof angle,” Ursini says. “It depends on how that horse moves and its conformation. Some horses are more upright, some have more angulation—so they will have a different foot angle in order to maintain an ideal hoof-pastern axis. Many people get fixated on a certain angle and try to fit every horse into the same box.”

In other words, horses are all individuals and must be treated that way.

4. Spinoff Effects
Don’t underestimate the importance of proper hoof balance, says Ursini. “The saying ‘no hoof, no horse’ is not an exaggeration,” she says. “Literally every mechanical aspect of how a horse moves can be altered by the shape and condition of their hooves. It is well proven in both the literature and clinical experience that horses with certain attributes—specifically, negative plantar or palmar angles of P3 (the angle the coffin bone makes with the ground; a negative angle means the back of the coffin bone is lower than the front of the bone, rather than both ends being level)—are associated with lameness and pain originating from the proximal suspensory, hock, stifle, sacroiliac (SI joint), and lumbar region.”

Ursini says in her experience, trying to treat all those sources of pain without addressing foot angles is impossible. “Corrective shoeing to improve the angles oftentimes removes the strain to certain structures, and after a short period of time I don’t even have to address those other issues, as the pain is secondary to the feet.”

5. Look Deeper
What you can see does not tell the whole story. “The outside of the foot can definitely lie to you,” says Ursini. “While some horses have obvious signs of imbalance just by looking at them, I’ve been surprised several times by the degree of imbalance a horse has on radiographs.

“For horses being asked to perform at a high level, I would strongly encourage people to have all four feet radiographed on a routine basis—every six months to a year—in order to try and find imbalances early, before they cause other problems,” she adds.

Hoof radiographs play a key role in long-term soundness for any horse, says Ursini: “I’d like to reinforce the importance of radiographs to truly evaluate the balance and angles of the feet.” She lists specific factors your veterinarian and farrier should look for, including:
* The angle the wings of the coffin bone make with the ground (palmar/plantar angle).
* Sole depth.
* Dorsopalmar/plantar (toward the front/back) hoof balance (relative to the coffin joint and vertical forces of the limb).
* Signs of arthritis, laminitis, navicular disease (aka podotrochlosis), or other hoof conditions.

6. Walk On
Don’t skimp on time spent walking, says Bruce Mandeville, JD, associate professor in Otterbein University’s Department of Equine Science, in Westerville, Ohio: “I don’t think we walk our horses enough. Horses are meant to be walking the majority of the day, yet many horses are stabled, ridden for 40 minutes, and stabled again.”

Mandeville, who represented Canada in three-day eventing at the 2000 and 2004 Olympic Games, as well as at the World Championships and Pan-American Games, notes that while actively competing, he would regularly walk his horses for up to an hour prior to gallops and again after galloping. “By walking long and low, the nuchal ligament that runs from the poll down the neck is engaged; this brings the spinal processes of the withers forward, putting positive tension on the nuchal ligament and, in turn, on (the) supraspinous ligament along the spine. This causes the back to raise and supports the weight of the horse’s torso.”

To that end Mandeville urges owners to gain as much biomechanical understanding of the horse’s anatomy as possible. “Be cognizant of the horse’s shape and postures for optimal use of structures like muscles, ligaments, and tendons,” he says. “It would help our industry if we had more exposure to biomechanics—we could help our horses use their bodies more efficiently.”

7. Leg Protection and Heat
Boots and wraps have long been mainstays for exercising horses. More recently they’ve become, literally, a hot topic. “Many owners are familiar with the recent study from Middle Tennessee State University concerning heat under boots and bandages,” notes Hammer. “There is obviously concern, but also in some events the need for protection. I think we’ll see more research looking at tendon temperature versus surface temperature.”

“I think we have overbooted in the past,” adds Mandeville. “Unless you have a specific need to boot, such as a horse that brushes (one foot or limb against the other during movement), the current approach is steering away from boots and wraps. This may be a case when we think we are doing something beneficial for the horse, but we’re not.”

Both Hammer and Mandeville note we might see more research surrounding cryotherapy techniques—icing, ice boots, and cold hosing—in the future to investigate the consistency of temperatures and the efficacy of various modalities and applications. They urge, as always, to consult your veterinarian if you have questions about leg protection and cryotherapy applications.

8. Therapeutic Products
Many barns employ popular modalities designed to keep horses as comfortable as possible, such as pulsed electromagnetic field therapy (PEMF), vibration plates, and gel boots. These modalities are worth considering, says Mandeville, based on his experiences leading classes on equine noninvasive therapies in which students tested various products on the university’s horses, measuring facial expressions and cortisol (stress hormone) levels in saliva.

“We see different effects on different horses. It’s worth exploring what brings comfort to your horse (after consulting your veterinarian, of course),” he says. “I would suggest horse owners try various therapies and see what the horse responds to the best before making an investment; each horse is different. You may also want to consider learning acupressure, which you can take as an online course.”

9. Arena Surfaces
Arena footing is a hot topic among riders and big business, as well, with a spectrum of surface options at various price points serving the needs of different sports and scenarios. Without doubt, arena surface construction and maintenance play roles in both performance and safety.

“Footing has evolved over the years and is very discipline specific,” says Mandeville. More recently “the main considerations are the condition and uniformity of the footing, drainage, dragging, and watering. The right conditions are a blend of art and science.”

Inconsistent footing can also be problematic. Mandeville cites the eventing cross-country course at the 2004 Athens Olympics, where surfaces changed from grass to dirt to arena footing, and many horses struggled to adjust to those changes, which can contribute to injuries.

For the average horse owner, however, “problems arise when the footing has degraded,” he explains. “Plan to replace your footing as needed. As much as possible, match your training footing to the type of footing you’ll be competing on.”

10. Do Your Research
From nutritional supplements to therapeutic boots and blankets, you’ll find many manufacturers (and horse owners and trainers) claiming their products support equine soundness. But don’t take what you hear at face value.

“I think it’s really important for owners to do their due diligence to find information,” says Hammer. She offers two points to consider:
1. Work with an equine nutritionist or veterinarian to establish a dietary program, including forage, concentrates, and supplements, to ensure both ingredients and levels are efficacious for your horse.
2. Alternative therapies of various types have grown in popularity, and some have better science behind them than others. “Chiropractic and massage can be great options for keeping horses comfortable,” says Hammer. “This is where a good relationship with your veterinarian comes into play; these therapies can’t fix every problem. Also, licensing requirements vary by state. When alternative therapies are appropriate, reach out to your veterinarian for recommendations.”

11. Last But Not Least: Lifestyle
Remember, overall lifestyle can also contribute to soundness. Being too heavy—as commonly seen in many horses and other pets these days—puts a burden of stress on joints, ligaments, and tendons, says Hammer. In addition, says Mandeville, owners should consider exploring ways to allow horses to live more naturally, including as much turnout as is feasible for the individual situation.

Take-Home Message
Start by establishing a supportive equine care team and determining your horse’s individual needs. Then, these simple steps can go a long way toward keeping your horse sound and can save you time and money in the long run.

The Horse

Recognizing Pain in Senior Horses

Horse owners might assume an aging horse that takes longer to finish his feed, no longer runs with his pasturemates, or acts grumpy while being groomed is simply getting old. But these behavior changes can signal ongoing pain in older horses.

Senior horses, generally considered more than 15 years of age, might experience chronic discomfort from conditions such as arthritis or deteriorating teeth yet show only subtle signs of pain. As prey animals that depend on flight for survival, equids are hardwired to hide signs of weakness.

How to Recognize Ongoing Pain in Senior Horses
“Chronic pain can be difficult to recognize in horses because it often develops gradually, over time, and the clinical signs may be subtle and variable—with good and bad days,” says Alex Bianco, DVM, MS, Dipl. ACVIM, an associate professor at the University of Minnesota College of Veterinary Medicine, in St. Paul. “Identifying a horse with chronic pain requires an intimate knowledge of what’s normal for the individual—subtle signs of pain can be easy to overlook.”

Sue Dyson, VetMB, PhD, has devoted much of her career to studying lameness and equine behavior. Her pain ethogramshelp equestrians recognize pain in ridden horses. She shares some key observations that might indicate pain in an older horse.

“Pain-related behavior changes in prey animals can be fairly subtle, so close observation is vital,” Dyson says. “However, we also know that horses can alter their behavior depending on the presence or absence of people. Some are much more likely to show abnormal behavior when alone, so a review of CCTV footage can be valuable for identifying otherwise hidden behavioral changes.”

Bianco adds that recognizing discomfort can be especially challenging in retired horses because owners or riders often detect pain during exercise, when changes in performance or behavior become more apparent.

Pain, Not Bad Behavior in Horses
“A horse that suddenly becomes irritable when groomed or pins his ears when approached might not be developing a bad attitude,” Dyson says. “And a horse that spends less time playing with pasturemates or seems quieter than usual might be in pain. Most so-called ‘slowing down’ reflects discomfort.”

That can make it difficult for owners to distinguish between normal aging and pain. Because many painful conditions develop gradually, changes often become normalized over time. Bianco encourages horse owners to think differently about changes in mobility. “Commonly used terms such as ‘lame,’ ‘stiff,’ or ‘less flexible’ should all be investigated as potential signs of pain.”

Common Pain-Causing Senior Health Issues
Arthritis remains a main source of pain in older horses. “Most geriatric horses should be assumed to have some degree of orthopedic disease, namely osteoarthritis affecting one or more joints,” Bianco explains. She adds that pain associated with chronic osteoarthritis can fluctuate depending on exercise, body condition, diet, and medical treatment.

“Older horses are also at increased risk of pituitary pars intermedia dysfunction(PPID, formerly known as equine Cushing’s disease), which can increase the likelihood of developing the painful, debilitating hoof disease laminitis,” Dyson adds.

Dental disease also becomes more common with age as horses wear out their teeth. Difficulty chewing can affect both comfort and body condition, potentially leading to weight loss. “Observing eating patterns is critical,” Dyson says. Note what and how much your horse eats, how long meals take, and whether his eating habits have changed. If he’s losing weight, quidding (dropping wads of partially chewed feed), or having difficulty chewing, have your veterinarian examine him, she adds.

Owners should also monitor changes in resting behavior. “Paying attention to how often a horse is lying down is also useful,” Bianco says. “While it’s easy to recognize pain in a horse that is spending excessive time lying down, it may not be noticed if a horse is not lying down enough. Older horses with mobility issues may be less willing to lie down, which prevents REM sleep and leads to sleep deprivation.”

Pain, muscle loss, and aging in horses

Age-related loss of muscle mass (sarcopenia) is normal in horses, but pain can accelerate the process. “Muscle atrophy can also be exacerbated by decreased exercise and by underlying PPID,” Bianco explains. “While diet plays a role, exercise is equally important for maintaining muscle mass. Chronic pain contributes to muscle atrophy through a decrease in movement, which can exacerbate mobility loss and contribute to more chronic pain.” She recommends regular PPID screening in older horses because early diagnosis and treatment can help preserve muscle mass and reduce laminitis risk.

Improving Quality of Life for Senior Horses
You can manage many painful conditions affecting older horses, making an accurate diagnosis the first step. Bianco says successful management does not necessarily mean eliminating every ache and pain. “Our goal is not for geriatric horses to be pain-free all the time; this isn’t realistic for horses just as it isn’t realistic for geriatric (or even middle-aged) humans. With noncurable, chronic conditions, such as osteoarthritis, our goal is to manage pain in a way that facilitates a good quality of life for the animal.”

Bianco encourages owners to work closely with their veterinarians as soon as subtle changes appear, rather than waiting until the horse’s body condition score declines. Management changes might include strategic use of non-steroidal anti-inflammatory drugs (NSAIDs), targeted therapies, exercise and dietary modifications, and corrective shoeing, she says.

Take-Home Message
While some age-related physical changes are inevitable in senior horses, you should not write off your horse’s stiffness, irritability, weight loss, reduced appetite, and declining performance as him “just getting old.” Recognizing those subtle signs of underlying chronic pain and investigating and managing their cause can help you improve your older horse’s comfort, mobility, and quality of life.

Huge congrats to Kayla Dill and Penny Whize! Thank you for allowing us to be a part of your team 💕💕

5 Common Horse Feeding Mistakes

Every day, multiple times a day, you feed your horse. It’s part of the lifestyle of owning horses, and we’ve all learned to appreciate the smell of freshly baled hay and molasses-flavored grain before we’ve had our own morning coffee.

And while you certainly take feeding your horse seriously, it’s easy to overlook some keys to success. Below, we’ll talk about five common mistakes you might be making and how to rectify the situation to improve your horse’s gut health and overall well-being.

1. Feeding by scoop or flake instead of by weight.
Raise your hand if you have ever defaulted to the statement, “My horse gets a scoop of that.”

If you’ve been a horse owner for any amount of time, you probably have your hand up. Everyone has made this mistake at one time or another, either with grain or hay (“He gets two flakes.”).

Here’s the problem with feeding horses by the scoop: Each concentrate or complete feed, while similar in volume, differs in weight. Commercial grain mixes are formulated to be fed at a specific rate; this information is always located on the bag or feed tag. Feeding rates ensure horses receive the correct ratio of micronutrients, such as vitamins and minerals, which are required in small amounts but have major health implications.

As for hay, one flake of grass hay, on average, weighs 3 to 5 pounds and one flake of alfalfa hay weighs 5 to 7 pounds. Given that a horse requires at least 1% of its body weight in hay or other forage every day, these 2-pound fluctuations in “flakes” can add up to a big difference in your horse’s diet, which affects microbes in the gut that thrive on fiber found in forage.

Jessica Leatherwood, PhD, associate professor at Tarleton State University, in Stephenville, Texas, says, “While it may not be practical to weigh your hay on a daily basis, it would be beneficial to weigh hay routinely in response to either new shipments or sources.”

Do this instead:
* Consult the feed tag for feeding rates based on your horse’s age and activity level.
* Use a scale (it could be a small kitchen or luggage scale) to measure out the recommended amount of that particular concentrate or complete feed.
* Pour that grain into the scoop you use so you know how much you need to feed each day. Don’t forget to zero-out the scale first. Divide into the number of times per day you feed and voila! you know exactly how much grain you must give your horse each feeding for optimal nutrition in scoops. “Consider a single meal of grain to be offered at 0.5% (and up to 0.75%) of the horse’s body weight,” says Leatherwood. If you change the scoop you’re using or switch grains, repeat this process. Once you measure it out by weight once or twice, you won’t have to use the scale.
* Weigh a few flakes of each batch of hay so you know how much they weigh or if the weight fluctuates. Of course, this varies by bale, so don’t get too obsessive. If you are new to this, weigh flakes periodically to get an idea of what different weights feel like. This practical step will help you offer your horse a consistent amount of hay; with time, your arm will start to become your scale.

2. Feeding senior feed ­unnecessarily.
A common mistake horse owners make is feeding senior feed to a horse that does not yet have a need for it. While it shouldn’t cause health problems, senior feed is designed to be used as a complete feed. Complete feeds include the fiber portion of a horse’s diet and are designed to be fed to older horses who can no longer chew or digest hay.

Rather than classifying an animal as senior based on his numeric age, consider aging a horse by his physiological changes. One telltale sign is failing dentition and the inability to consume hay efficiently. For this reason, senior horse feeds are formulated to be fed at very high feeding rates, typically upward of 10 pounds per day to account for the forage portion of a horse’s diet.

If you are feeding a nonsenior horse a scoop of senior feed, you’re doing him a disservice by not meeting his micronutrient requirements.

Do this instead:
* Ask yourself why you’re feeding your horse a senior feed. Is it just to give her a grain treat? Is it for added calories and energy?
* If you are using senior feed as a treat, a better option might be a ration balancer, which you can feed at low rates of 1 to 2 pounds per day while offering your horse all the required vitamins and minerals. If your horse needs added calories, fat, protein, or energy, choosing a performance horse feed designed to be fed at 3 to 7 pounds per day might be a better option.
* Talk to an equine nutritionist to be sure your horse’s hay and grain are meeting his nutrient requirements.

3. Overestimating how much work your horse does.
Considering domestic horses evolved from wild predecessors who traveled 20 to 30 miles per day to meet their feed and water needs, it’s clear that most domestic horses are not getting as much exercise as they used to. Further, we tend to overestimate the amount of exercise they do get.

While an unpopular opinion among some, it’s better to be able to see a hint of a horse’s ribs than fat deposits.

“It is challenging to have horse owners feed their horse in a manner that encourages an appropriate body condition score, as people are used to seeing overweight horses and believe it looks good,” says Nielsen. “There is an old saying that ‘fat hides a lot of sins.’ A large number of individuals in the horse industry believe they are knowledgeable but often mistake a horse that is fat for one with good muscling. That being said, it has been known for about 100 years that calorie restriction can lead to a longer life.

“As often happens with horses, dogs, and other pets, many people fall into the trap of ‘killing them with kindness’ by allowing their animals to become overweight,” he continues. “Many health problems could be avoided if horse owners were more diligent in regulating the body condition score of their animals.”

Nielsen is not advocating for skinny animals but, rather, bringing awareness to the fact that fat horses are at significantly higher risk for developing serious and painful health conditions than a slightly ribby horse.

Do this instead:
* Get real about and classify your horse’s activity level based on the National Research Council’s Nutrient Requirements of Horses recommendations. Keep in mind that most horses fall into the light or moderate work category.
* Maintenance: Nonworking horses
* Light work: 1-3 hours of work per week
* Moderate work: 3-5 hours of work per week
* Heavy work: 4-5 hours of work per week with significant amounts of time spent cantering
* Very heavy work: 6-12 hours of work per week
* Feed at rates that match your horse’s true activity level and increase the ration based on his metabolism.
* Be cognizant of a horse that is putting on too much weight or getting too thin. Aim for a body condition score between 4 and 6, and adjust the amount you feed accordingly. Remember, if you change your grain or hay rations, weigh them and feed at a rate that meets your horse’s micronutrient requirements.

“If a horse is no longer performing well on feed, go back to your forage source first and evaluate both the quality and quantity that you are providing,” adds Leatherwood. “In some cases a horse might not require additional grain but, rather, a higher-quality fiber source.”

4. Oversupplementing or changing supplements frequently.
If you’re currently feeding your horse Betty-Crocker-style (i.e., mixing up a whole recipe of grain and supplements at mealtime), you could be doing more harm than good.

A bunch of supplements that were not designed to be fed together can create competitive inhibition and interactions between macro- and micronutrients in the horse’s gastrointestinal tract. For example, excess zinc in a horse’s diet can negatively impact the body’s ability to absorb and use copper. It’s all a balancing act.

At the very least, this means some or most of what you’re feeding your horse might not be used, translating to wasted money. At worst, your horse’s body is overwhelmed and not absorbing the nutrients it needs.

“Supplements are one of the ways in which horse owners often waste money,” says Nielsen. “The number of supplements on the market that have never been proven to do anything far exceeds those that have been proven to be ­efficacious.”

Do this instead:
* If you are feeding more than two supplements, work with an equine nutritionist to make sure the products don’t have negative interactions and/or side effects when used together.
* When adding a new supplement to a horse’s ration, be sure to give it ample time to work. In many cases supplement companies say it takes a minimum of 60-90 days to realize a product’s full benefits. Don’t give up too quickly or change supplements too frequently, which could cause GI upset and overwhelm the horse’s body.
* If you decide to make changes to your horse’s diet, be they in the form of hay, grain, or supplements, do so slowly to minimize digestive disturbances. Leatherwood suggests “a seven- to 10-day transition period in which you add and replace 25% old with 25% new hay or grain. For example, you might feed 25% new with 75% old for two to three days, then 50% new with 50% old for two to three days, and finally 75% new with 25% old for two to three days.”

5. Feeding in meals instead of continually.
Horses’ digestive tracts were designed for slow, continuous feeding rather than the two to three meals per day the domestic lifestyle has normalized. While constant feeding isn’t typically conducive to human schedules, you do have options.

Do this instead:
* Find a way to offer your horse the most natural lifestyle possible. Some ideas include slow feeders or haynets or keeping your horse on pasture for as many hours per day as is appropriate.
* Invest in automated feeding stations that distribute customized amounts of feed and forage to individual horses at multiple intervals throughout the day.

Take-Home Message
As horse owners, we’re always trying to do our best for our horses, including at feeding time. Just like our diets sometimes need a tune-up, these recommendations can serve as the level-up you need to ensure your horses’ optimal health.

You might be surprised at the differences you see in your horse’s attitude, condition, and performance when you tighten the nutritional bolts.

The Horse

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Puncture Wounds of the Hoof in Horses

Q:
My horse recently suffered a puncture wound through the frog of his foot. Under my veterinarian’s direction I’m bandaging the foot each day to keep the wound dry and prevent infection as it heals. Because I can’t really see the wound, how do I know it’s healing well? Are there any complications that I should be concerned about?

A:
Puncture wounds of the sole and frog by nails, screws, or other sharp objects are common hoof injuries in horses. The penetrating object might be contaminated with soil, manure, or rust, which can lead to infection. Clinically, puncture wounds can be misleading, because they can appear small and insignificant, and aggressive medical therapy or appropriate surgical treatment might be delayed until signs of infection or lameness occur.

Depending on the depth and location of the puncture wound, several hoof structures can be affected. Puncture wounds are critical injuries if anatomical structures such as the coffin (third phalanx) bone, coffin (distal interphalangeal) joint, digital cushion, deep digital flexor tendon, navicular bursa, or navicular bone are involved. Deep puncture wounds of the sole and middle third of the frog are emergencies and should be treated aggressively to prevent infection of bones, joints, and soft tissue structures in the hoof. These cases are challenging to treat and should be referred to an equine hospital for surgical treatment, if needed.

Wound management and treatment options are based on the location, depth, and direction of the penetrating wound. Minimally invasive penetrating sole and frog injuries can be managed conservatively with broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), tetanus toxoid, hoof soaking, and bandaging treatments. If the injury appears to pe*****te deeper hoof structures, such as the navicular bone or bursa, deep digital flexor tendon or sheath, or coffin joint, then the horse should be promptly referred to an equine hospital for more aggressive treatment, such as surgical curettage and wound lavage. The “street nail” surgical procedure is used to create a surgical window or fenestration between the frog surface and navicular bursa, thereby promoting adequate wound drainage and allowing for subsequent treatment of the affected area. Surgical management can also involve the use of supportive care, antimicrobial and anti-inflammatory treatments, wound care lavage techniques, sterile bandage changes, and a medicine plate shoe to promote healing.

Consult your veterinarian for supervision regarding the clinical care and resolution of penetrating hoof wounds. Their assessment will consider the horse’s overall condition and time since initial injury, treatment protocol, soundness evaluation, wound healing complications, and diagnostic imaging and laboratory findings. Ongoing clinical evaluation is needed to direct patient management decisions, such as when to adjust the use of antibiotics and anti-inflammatory medications, wound care options, and bandaging. With hoof puncture wounds, some of the complications, such as lameness, swelling, heat, and infection occur when the sound surface hole seals over underlying pathology, restricting draining. Therefore, veterinary care is needed for ongoing supervision and intervention.

The prognosis for penetrating wounds of the hoof sole and frog is guarded but generally, those horses that have fewer deep structures involved and receive timely and appropriate treatment experience more favorable outcomes.