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Wound ManagementWound Management

 

As every horse owner knows, lacerations and traumatic injuries are not uncommon in horses, particularly involving the lower limbs.  These are usually related to mishaps with fences, gates or wire.  Wounds on the lower limb – below the knee or hock – are always a potential problem.  This is due to the unique anatomy of this region.  There is very little soft tissue or muscle between the skin and underlying tendons and bones, combined with very little skin mobility.  These factors mean that wounds cannot contract well, and blood supply is poor. It is important if functional and cosmetic healing is to be achieved, that appropriate and aggressive initial treatment of these injuries is carried out.

The time between the wound occurring and primary treatment is critical – the so-called “golden hour” - so please do not hesitate in calling your vet if you feel that an injury is serious enough to warrant veterinary intervention.  After about four to six hours, primary suturing of a wound in a horse is far less likely to be successful.

 

Bleeding should be controlled by applying direct pressure to the wound and keeping the horse as quiet as possible.  Arterial bleeding can be fairly impressive and it is important to stay calm.  A pressure bandage can be fashioned out of a wad of gamgee, held on to the limb with crepe or vetwrap bandage.  Do not apply cotton wool directly to the wound, as the fibres, which adhere to the exposed tissue, will delay wound healing.  If the bleeding continues through the bandage, do not remove it, but place another over the top.  Using digital pressure on the skin directly above a bleeding superficial artery will often help stem the blood flow.  Where absolutely necessary, a tourniquet can be placed above the laceration while the pressure bandage is applied.  Never leave a tourniquet on for more than a few minutes.

 

Lavage (flushing) of any contaminated wound is very important, as this markedly reduces the bacterial load in the wound, hence reducing the chance of infection.  Furthermore, thorough lavage will remove any organic or inorganic debris present in the wound, allowing the healing process to proceed rapidly.  Wound powders or pepper should be avoided at all costs, as the particles act as a foreign body and will greatly delay healing.

 

We usually use an isotonic sterile saline solution for wound lavage, but where a delay in veterinary assistance is unavoidable, a saline solution can be made up.  Using boiled water, which has been allowed to cool, dissolve one heaped teaspoon of salt per litre of water.  The easiest and most effective method of flushing a wound is to use a large syringe.  The volume of liquid used is the most important factor, at least one litre, and preferable two or three litres, depending on the extent of the injury.

Depending on the nature, location and size of the wound, we may suture the wound.  Often this will involve sedation and the use of local anaesthetic.  A degree of surgical debridement (trimming) of non-viable tissue may be necessary, and where large flaps of skin are encountered, surgical drains may be placed.

Bandaging following primary wound care is important for a number of reasons:

 

  • Protection of the wound from further contamination
  • Tissue support and wound immobilisation, reducing soft tissue trauma
  • Control of bleeding
  • Prevention of tissue swelling
  • Absorption of exudate, and provision of drainage
  • Reduce risk of proud flesh

 

Bandages should be checked regularly.  Any sudden increase in lameness, swelling above the bandage or coolness of the limb below may all be indicative of a problem, and the bandage should be removed and replaced.

Where suturing of a wound is not feasible, wounds are left to heal by granulation or “second intention” healing.  Proper debridement and flushing of these wounds is no less important, and bandaging in the early stages of healing is highly beneficial.

Where exudation is present, use of petroleum jelly on the surrounding skin, especially below the wound, will protect the healthy skin.

Tetanus prophylaxis is advisable with all open wounds in horses, due to their susceptibility to this disease.  Antibiotics may also be prescribed. 

Proud flesh is seldom a problem where lower leg wounds are correctly handled, but in occasional cases may occur despite the best treatment.  Proud flesh is excessive granulation tissue, which, once raised higher than the skin edges, prevents wound contraction and continued healing.  Various topical preparations are available for management of proud flesh, although surgical excision to below the wound edges is the most effective method of dealing with this problem.

Skin grafting is sometimes used in cases where a large area of scar tissue remains once wound contracture and healing have occurred. 

Tiny pieces of skin are sourced from elsewhere on the horse, usually behind the girth, and implanted into the prepared wound bed.  This tissue provides skin cells that spread out and cover the defect.

Wounds near synovial structures (joints and tendon sheaths) can be disastrous if not recognised ASAP. Joint and tendon sheath infections need special attention, with aggressive treatment and often referral to a hospital; a joint infection left for a few days may end a horse’s career.

 

If faced with a wound, play it safe – get it checked out by one of our vets as soon as possible.

 

 


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First is the finding of a suitable horse/pony, then follows the input from friends/family, your trainer or coach, and the seller; you can be left feeling a little overwhelmed. Throw in a dishonest seller, and you can be left in a real situation.


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Read more >Monday 18th of November 2019: Many people know the importance of insuring their items, their house or car, even their own health. Fortunately we are also able to insure pets, for not only medical and surgical care but in some cases routine visits can be covered (including vaccinations and wellness checks/blood tests).


Retired Working Dogs

Read more >Monday 18th of November 2019: Retired Working Dogs NZ is a registered charity that works to find homes for working farm dogs if they are unable to work due to age, injury or have no interest in stock. Retired pig dogs and hunting dogs are also included!


Dogs in Hot Cars - New regulations

Read more >Monday 18th of November 2019: New regulations are in force meaning that if you leave your dog in a parked car and it is showing signs of heat distress you can receive a fine and a broken car window. Dogs quickly suffer and die in hot cars, so please leave your dogs at home.


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Read more >Monday 18th of November 2019: We always fear losing our pets. Nevertheless, sometimes it is inevitable that we need to make this decision.

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Hyperthyroidism

Read more >Thursday 5th of September 2019: To be skinny despite continuously eating, is that not the dream for a lot of people? Unfortunately for our furry friends it can be a sign of something more sinister lurking beneath the surface - hyperthyroidism.


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Pyometra (pyo) is effectively a pus filled uterus that can develop in an ovary intact bitch.


When being cuddly is not cute…

Read more >Friday 30th of August 2019: Much like the human population, companion animals are becoming increasingly overweight. In New Zealand the statistics are alarmingly high and a significant proportion of the patients we see on a day to day basis are overweight.


High blood pressure in cats – the silent danger

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Read more >Tuesday 27th of August 2019: The most common form of Rat Poison used is one that contains a warfarin type anti-coagulant compound, which causes fatal haemorrhage in the rat, or a dog, about 5-10 days after ingestion.


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Often it is in the region of wither or saddle and can be associated with a poor saddle fit or trauma/damage often from as far back as when the horse was being broken in or weaning. Horses that rear up and over backwards and land on their withers is a common "accident" that can cause injury in this area. Sometimes we'll never know the cause.


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Read more >Thursday 18th of July 2019: Vaccination provides your horse with important protection against some serious and potentially life-threatening diseases. Vaccines act to stimulate the body's natural response to a disease, allowing a rapid and effective response if that disease is encountered later in life. This could be the difference between severe clinical disease and a healthy horse!

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