Nail insertion, nail pressure and bruised nail

The nail is the farrier's most important fastening and greatest risk. Placed correctly, it sits in the insensitive horn wall and holds the shoe in place for weeks. Placed incorrectly, it hits the sensitive, blood-supplying structures inside — and then the horse has a problem that can develop from irritation to serious infection. The education's learning objectives require that the apprentice can place the nails correctly and can apply their knowledge of nail insertion and nail pressure, including diagnosis and treatment. It's for good reason: nail-related injuries are something a farrier is most often called out for.

§Nail insertion — damage happens immediately

Nail insertion occurs when a nail during nailing penetrates the sensitive tissue within the white line. The horse often reacts immediately — it pulls the leg to itself and there may be bleeding at the nail hole. The nail must be removed immediately and the hole must be disinfected and kept under observation. A recognised nail insertion that is treated immediately often heals without problems; the danger is insertions that are not detected because bacteria are then locked in the hoof and can develop into a hoof abscess.

§Nail pressure — damage comes sneaking

Nail pressure is sneakier: the nail hasn't hit living tissue directly but sits so close that it presses against sensitive structures when the hoof is loaded and works. The horse typically becomes gradually lame in the days after shoeing — often two to four days later — and the hoof may show increased pulsation and heat. The diagnosis is made with a hoof tester: systematic pressure along the hoof edge reveals which nail is causing pain. The treatment is to remove the nail in question and relieve the pressure; if inflammation develops, it needs drainage and the vet may need to be involved.

§Embedded nail — foreign object from outside

A horse can also step a nail screw or other sharp object into its hoof itself. Here an important main rule applies which vets also emphasize: if the object is still in the hoof you should as a general rule let it stay and call a vet if the placement is critical — the object's direction and depth are crucial to assess which structures may be affected. The learning objectives require that the apprentice can perform ray abscess extraction and handle inserted nails as well as apply dressings and use the ray's appearance and damage location to assess the condition including assessing the need for a vet. Punctures in the centre of the ray and the back third of the hoof are particularly serious because deep structures such as the flexor tendon hoof joint and ray bone's bursa lie here.

§The systematic examination

• 01Take history: when did the horse become lame, when was it last shoed, what has it been used for?
• 02Check for increased pulsation on the arteries at the fetlock — a classic sign of pain and inflammation in the foot.
• 03Systematically inspect the hoof with an inspection tool all the way around before you conclude.
• 04Read the old attachment and nail holes — they tell where the nails have been.
• 05Document findings with photos and note in the hoof journal what you did.

§The boundary to the veterinarian

The regulation's competency objectives state it directly: the apprentice must be able to assess whether there is a need to call a veterinarian when observing acute conditions in the horse. With nail punctures, the rule of thumb is that superficial, recognized and fresh injuries can be handled by the farrier, while deep punctures, punctures in critical zones, strong or increasing lameness and signs of deep infection belong with the veterinarian. The farrier who calls one time too many loses nothing — the one who calls one time too few can cost the horse its usability.

“A nail costs a krona. An overlooked nail prick can cost a horse.”

— Speaking style in the trade