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HomeTreating Wounds



Basic Horse Wound Treatment For Lacerations & Punctures

By Kenneth L. Marcella, DVM Not much else grabs you like bleeding tissue, torn hide and ugly gashes. Unfortunately, cuts and punctures and lacerations are a fact of life when you have a horse.

The potential causes of equine wounds are almost endless: lacerations and punctures from sharp objects like metal and glass; shear wounds from barbed wire, sticks, nails and bites; kicks; collision injuries from falling or running into an object; and entrapment, such as getting a leg hung up in a rope or in a cattle guard. This list comes from Dr. Ted Stashak's book Equine Wound Management.

Here are five scenarios to help you know what to do when a wound injury occurs:

Small puncture wounds Abrasions (skinning) Small lacerations & cuts in muscles and tendons Skin flap lacerations Deep punctures or cuts in joint areas A basic trauma treatment kit Small Puncture Wounds

The problem

Your 10-year-old thoroughbred gelding was fine this morning when you turned him out. But you noticed this evening when you brought him in that there was dried blood on his hip. On further examination, you find a dime-sized hole or puncture in the muscle over his hip. The horse is not lame, but seems stiff and is tender when you examine the area. (A puncture over thick muscle, such as our example, is much less serious than a similar wound over the lower leg or the chest or belly.

What to do

First, get an idea of the puncture's depth and of the structures that may be damaged. If the puncture is not bleeding and no tissue is visible, use a Q-tip to check its depth. If there is bleeding, apply pressure using gauze squares, bandages or clean towels. If tissue protrudes from the wound, do not remove it. Wrap the area in gauze or clean towels (preferably moistened with warm water).

Initially, try to clean or flush uncomplicated wounds with clean fluid. Sterile solution is best, and many contact wetting solutions work well. The goal in wound flushing is to remove bacteria; even water from a barn hose is better than bacterial infection.

Avoid putting thick, sticky ointments or sprays on the wound. They make it harder to fully clean the area. A spray bottle can be helpful in forcing hair and dirt out of a wound, but be careful in dealing with punctures. If you feel cleansing will push the debris in farther, leave that job to the vet.

In the case of puncture wounds, always consult your vet. If the puncture is in the chest or abdomen, is more than a few inches deep or won't stop bleeding, it needs immediate veterinary attention. Often the horse will need antibiotics. Also, be sure that the horse has a current tetanus shot. It is sad to successfully heal a deep puncture wound only to lose a horse to tetanus. Horses should be vaccinated for tetanus twice yearly.

If the wound still has the wood, metal or wire in it, leave the object in the wound, if possible. The area can be radiographed to determine the depth of the object and potential structural damage. Sometimes more trauma can be caused by inappropriate removal of an object.

Most uncomplicated punctures heal well and leave no scars if kept open and allowed to heal slowly.

Abrasions (skinning)

The problem

It was your second barrel run of the day and you had a great chance to finish in the top three. But on the last barrel, your horse's hind end slipped out just as you turned. You both went down and skidded in the arena dirt. You are unhurt, but your mare has a large abrasion on the point of her left hip and another raw, rubbed area along the shoulder. She has skinned up -- but not cut -- the skin on the front of her left fore cannon bone. She is not lame walking out of the arena, but you can tell she is sore and becoming stiffer.

What to do

First, evaluate the extent of the damage. There is probably excessive but superficial skin trauma without any significant breaks in the skin. Be alert for small but sharp punctures that may be hard to see. Even though the surface wound may be minor, look for deeper damage done by the force of the injury; broken or chipped bone may lie under minimally damaged skin.

If no deeper injuries exist, clean the wounds by using large volumes of flush and use a solution of diluted betadine or Nolvasan or a mild liniment, such as Absorbine, to help clean the area. These disinfectants will help remove debris and kill surface bacteria. Do not rub or scrub these tender areas too vigorously or you may increase the damage.

It's not necessary to call a veterinarian unless you suspect a puncture wound, or chipped or broken bones.

The wound will be sore for a few days and cool hosing will help reduce the swelling and ease the burning pain. Most superficial skin wounds heal well, but if extensive areas are involved, the horse may be out of competition two weeks or longer. You might also want to provide pain relief and inflammation reduction with vet-prescribed phenylbutazolidin.

Keep the area treated with an ointment that will keep the tissue moistened, protected from debris and which will aid in the healing process. There are a host of ointments, including Nolvasan, Furacin, Morumide, and vitamins A, D and E. The function of most is the same, although ingredients may vary. Some horses have sensitive skin, and deep tissue damage may result in scarring. Bickmore's' Gall Salve seems to work well in reducing white hair regrowth. New research shows that low-level laser light and superluminescent light-emitting diodes can really reduce scar tissue formation.

Small lacerations & cuts in muscles and tendons

The problem

Your 12-year-old hunter will not walk up to the gate, and you know something is wrong. On examination, you find a one-inch cut in the middle of the cannon bone toward the back of the leg. You slowly lead the hopping horse back to the barn. It is a small cut, and there is no blood and minimal swelling. You can see the tendon below the edge of the cut, and it doesn't look damaged, but the horse is definitely lame.

What to do

Lacerations over tendons and ligaments can cause significant lameness and should be taken seriously. Stabilize the horse and provide support for the opposite leg with a standing wrap, since it may be taking a substantial amount of the animal's weight.

Evaluate the cut. These lacerations are usually from a sharp object, such as metal, wire or glass. Often the horse is running when they occur. Even though the cut looks only skin-deep, there is potential for damage to the ligaments and tendons below.

Hold the leg off the ground and flex the limb through a normal range of motion while observing the wound area. If you find an area with a deeper tendon or ligament cut, you have a serious situation.

As soon as the leg has been stabilized and you have examined the wound, call the vet. The horse will probably need antibiotics and, possibly, sutures.

Antibiotics are important, even if the tendon has not been cut. Lacerations of this type often involve the tendon sheaths, the thin tissues that cover the tendon and ligament. Bacterial contamination in these sheaths produces excessive swelling and pain. If not treated aggressively, it can also lead to permanent, severe lameness.

Your vet can provide you with the nutrition management of wounds, since they need appropriate protein, vitamins and minerals.

The horse will have to remain bandaged and stall-rested. Light hand-walking may be allowed after a few days, depending on the extent of the injury. Pain relief will be used as directed by your vet.

Skin flap lacerations

The problem

It takes you about two seconds to realize you need a vet when you see your horse standing in its stall with an eight-inch flap of skin hanging off its forehead and face. The corner of the feeder is broken, and blood is liberally splattered around that area.

What to do

Although these wounds are frightening to look at, they usually are not as serious as a small wound over a tendon. Initial cleaning, flap and all, will help reduce bacterial contamination. Use a spray bottle to flush and clean debris from the skin flap and underlying tissue. Do not cut or tear away any tissues until the vet arrives. Often the skin can be pieced back together.

It's important to have the vet assess the situation. He may need to suture the wound. He may also need to tranquilize the animal if it won't let you clean and inspect the wound.

Allowing your vet to tranquilize the horse for a proper exam may reveal you have a superficial problem that you can now treat yourself, or it might uncover a serious problem.

The location and severity of a laceration depends on how much post-care it needs. If the wound is sutured but not bandaged, and won't be leaking any serum, use some Vaseline on the healing edges.

Very weepy wounds may need daily bandage changes. If an unbandaged wound has a lot of discharge, use a layer of Vaseline to protect any point where the serum may drip. Your vet should provide you with appropriate follow-up instructions.

Deep punctures or cuts in joint areas

The problem

At a recent show you thought the distance was four strides, but your horse decided that five was better, and you plowed through the fence. On immediate examination, you notice a puncture or deep cut over the horse's knee.

What to do

Flush and clean the wound, but be careful not to push debris deeper into the injury. If the horse is lame, support the opposite limb.

Trauma over joints carries the potential risk of damage or infection to the joint.

Your veterinarian should be called immediately. He may want to take radiographs to evaluate the damage in the joint.

It may also be necessary for him to stick needles in the joint from the area other than where the puncture is. He will flush sterile fluid through the needle and look to see if the fluid exits through the wound. If it doesn't, the prognosis is better. Antibiotics and suturing may complete the job. If the wound is into the joint, aggressive flushing and long-term antibiotics will be necessary.

Hand-walking and physical therapy help reduce scarring and keep athletic motion in that joint.

A basic trauma treatment kit

Keep a trauma kit in your barn and another in your horse trailer.

Sterile saline solution (obtain from your vet) Gauze (4x4 squares) Gauze roll Hand towels and larger towels for bigger wounds White tape, duct tape Scissors Vet Wrap or equivalent (Coflex, Flexus, Equiflex) Q-tips Spray bottle Large syringe for flushing Leg wraps and cotton or flannel Vaseline Wound care ointment of choice and Tweezers.
 
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