Wounds in Horses

Despite owners providing excellent facilities, wounds are common in all types of horses. An owner should have an excellent working relationship with his/her veterinarian to provide optimal care.

While waiting for your veterinarian, there are a number of things a horse owner should not do. Placing fingers in the wound can contaminate it, as can hair from clipping around the wound. Do not apply medication to the wound as many antiseptics, detergents, greasy ointments, and powders interfere with healing (see "Antimicrobials and Wound Healing," article #4280 at www.TheHorse.com). Direct pressure can be applied to the wound to stop bleeding using a thick bandage, but a tourniquet should not be applied.

Many factors must be taken into account to determine the best treatment choice. When there is excessive tension, motion, contamination, or tissue loss, suturing might not be successful and could lead to increased costs for treatment and risks of complications. Some wounds can be sutured a few days after swelling and contamination are reduced, while excessive tissue loss dictates some wounds must heal without suturing. Typically, open wounds on the body heal faster and with less complications than leg wounds.

Bandages help protect wounds from further contamination and trauma, and they provide a warm, moist environment that promotes rapid wound repair. However, bandaging body wounds is difficult, and often impossible. Therefore, veterinarians frequently recommend hydrotherapy (hosing) to cleanse the wound, increase wound circulation, and stimulate healing. An ointment might be applied afterward to the wound to prevent desiccation (drying out). Bandages stimulate proud flesh production on leg wounds, so numerous methods are used to control or prevent proud flesh, including the daily application of a topical corticosteroid cream. Severe wounds in areas of excessive motion often require a cast to facilitate healing.

Puncture wounds can result in devastating infections if bacteria are carried into a joint or tendon sheath. These cavities need to be flushed--usually using an arthroscope with the horse under general anesthesia--and regional perfusion (pumping of fluid and antibiotics into the area) performed. Then a high concentration of antibiotics is administered to the distal limb through a vein or a hole drilled into the cannon bone while a tourniquet is temporarily applied. The regional perfusion is usually repeated daily for two to four days with the horse standing.

Punctures of the sole of the foot can cause abscessation, but respond well to draining and have an excellent prognosis. Punctures of the frog or lateral sulci of the foot can result in infection of either the navicular bursa and/or the coffin joint. Both have a guarded prognosis for survival, especially if not identified immediately and treated aggressively.

Laceration of a horse's tendons certainly is a frightening thought for owners. If the extensor tendons are severed, the leg will knuckle forward at the fetlock. Rarely is it possible (or necessary) to suture the tendon ends. The fetlock should be maintained in a normal position with a bandage and splint for three to four weeks for the ends of the tendons to scar down, and to prevent a secondary contraction of the flexor tendons. The prognosis is generally very good, with many athletic horses returning to normal activities. The flexor tendons are very important for maintaining normal angulation of the fetlock during weight bearing and to keep the foot flat on the ground. When they are lacerated, they must be sutured and a cast applied. The prognosis for survival is guarded and the likelihood of a return to athletic activity is poor.

Wood, often from fences or trees, can be forced deep into the chest or thigh. If not removed, the wound fails to drain, or it breaks open later and has large volumes of purulent exudate. Since wood cannot be seen on an X ray, special imaging techniques--such as contrast radiography or ultrasound--are required to locate the foreign body before it can be removed.

Many serious wounds on horses can be successfully treated if they are identified early by the owner and receive prompt attention from a veterinarian.

About the Author

Spencer M. Barber, DVM, Dipl. ACVS

Spencer M. Barber, DVM, Dipl. ACVS, is the professor of Large Animal Surgery at the Western College of Veterinary Medicine at the University of Saskatchewan. While Dr. Barber is interested in all aspects of equine surgery, he has a particular interest in orthopedic and wound management topics. He has spoken, published and done research on various aspects of orthopedic and soft tissue surgery, besides numerous clinical investigations. His research in soft tissue includes studies on wound management and repair, and healing over-exposed corticol bone. Dr. Barber has also investigated the prevention and control of exuberant granulation tissue, as well as the role of cytokines in wound healing and their role in the formation of exuberant granulation tissue.

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