One afternoon in December, my gelding George lurched into the barn with a hole where his knee used to be. The emergency veterinarian, Dr. Zimmerman, soon confirmed our worst fears: George's extensor tendon was severed, his tendon sheath damaged, and his joint capsule punctured. Our best guess, since his left side was covered in mud, was that he'd fallen while running and slid into a fence post.

Dr. Zimmerman cleaned and stitched George's wounds, saying the sutures would fall out as dead tissue sloughed off and new tissue filled in. He prescribed Banamine and antibiotics (Tucoprim) and told us to cold-hose the leg every few hours to minimize swelling.

Our regular veterinarian, Dr. Carstensen, was upbeat. "If you're going to sever a tendon, the extensor tendon is the one. Because of the way a horse stands, he's constantly pushing the two ends of that tendon together. It's not like a flexor tendon on the back of the leg, which is always being stretched. But this is still long-term recovery. The only thing that will make a difference is diligent nursing."

As expected, the sutures fell out and his knee again became a gaping hole. Bandages stuck to the wound, so I changed them before they adhered--every four hours around the clock. Securely wrapping a knee is not easy, but six sessions a day improved my skills.

In early January, Dr. Carstensen approved George for a few minutes of hand-walking every other day. But George, instead of bending at the knee, slid his leg forward from the shoulder and then lurched over it, trembling. Those few minutes exhausted him.

In late January, Dr. Carstensen said George's healing was "truly excellent" and suggested wet bandaging and scrubbing the wound edges daily to minimize sticking and proud flesh. He also said that George had a good prognosis, with a chance of full recovery.

With George more stable, our farrier Ken Konrad pulled his shoes and trimmed his hooves, which drastically improved how he moved. Our equine massage technician Diane Schuette gave George a full body massage, helping him relax and to lie down for the first time since his injury.

By late February George was walking 10 minutes a day and stumbling less. Dr. Carstensen said to leave the bandages off except for hand-walking and brief turn-out.

We started turn-out with a small pen, supervised by my old gelding Nak in the neighboring paddock. George's leg was still twisted and puffy, but Dr. Carstensen assured me it would improve.

George graduated to a small paddock, then to a full-size pasture. In late May, he started light longeing, then long-lining and under-saddle work. Over the next three months we built up to a one-hour session that included cantering.

Then one corner of his wound broke open, and within days raw tissue bulged out. My five-year-old daughter dubbed it a "blood golfball." Dr. Carstenson said it was probably just proud flesh, but since scrubbing and wet bandaging didn't work, he removed it surgically. Instead of healing, though, George's knee shed two bone fragments. X rays showed no further chips, but the "blood golfball" returned.

I called Dr. Carstenson in a panic when I found George huddled in the corner of his stall, dangling his leg and refusing to move. He remained lame despite treatment, so we set a second date for surgery.

Dr. Carstenson excavated the knee under general anesthesia to avoid interference from George, who was getting increasingly resentful. He prescribed wet bandaging until it healed (hopefully only about a week).

Six weeks slipped by, with tense updates to Dr. Carstenson each Monday before the knee finally began to close.

When George was released from stall rest, he still limped horribly. My frantic call to Dr. Carstenson was met quietly; wait a little longer. Sure enough, George improved in small increments. George's knee completely closed by the end of June 2004 (18-month recovery).

Today George's knee looks completely normal except for a small scar visible at close range, and he is completely sound. Dr. Carstenson is quick to point out the value of diligent nursing care and wound management. But I think that without the skilled efforts of himself and our other providers, along with George's sensible nature, we would have had a very different outcome.

About the Author

Kandace York

Kandace York is a two-time American Horse Publications national journalism award winner whose work has appeared in Equine Journal, Paint Horse Journal and Horse Illustrated, along with many other breed-specific and regional publications. She graduated magna cum laude from the University of Maryland system with a bachelor of arts degree in communication studies and a minor in journalism.

A long-time horse owner and competitor, Kandace lives with her husband and daughters in Luckey, Ohio. Together they run Fieldstone Farm, a multi-use, all- breed facility in the middle of what was once Northwest Ohio's Great Black Swamp.

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