• Rough cleaning and washing with a disinfectant soap solution (Betadine, chlorhexidine)

• Debridement/irrigation of the puncture channel with lactated Ringer’s solution or chlorhexidine, with the horse standing or under general anaesthetic

• Irrigation if the synovial structures are involved: absolute minimum of 1L, but frequently much higher volumes of lactated Ringer’s solution per synovial structure followed by local antibiotic therapy (gentamicin or amikacin)

• Disinfection of the defect (Betadine, chlorhexidine), after which the defect should be covered with a swab soaked in a disinfectant solution (Betadine, chlorhexidine) 

• (Compression) hoof dressings or hospital plate until horn has grown back over the defect

• Analgesic and anti-inflammatory drugs (e.g. phenylbutazone)

• Systemic antibiotic therapy (penicillin/gentamicin i.v. or trimethoprim/sulfonamide p.o.)

• Prophylactic immunisation with tetanus toxoid/tetanus serum, depending on immunisation status.