By: Dr. Suzanne Mund
Tips for optimal wound healing.
Because horses tend to become frightened easily, and they’re naturally curious animals that often react without thinking, they are susceptible to wounds of all kinds. Some are trickier than others to treat, so a one-size-fits-all approach is not ideal.
Have a first aid kit on hand at the barn. You can buy one or ask your veterinarian for advice on assembling your own kit. (See the 2018 Canadian Horse Annual for a list of first aid kit must haves.) When dealing with wounds you’ll need a thermometer, clean quilts, sterile wraps, scissors and items such as baby diapers or feminine napkins that can be used for absorbent dressings. Sterile (or Normal) saline is best for cleaning debris from a wound, but should be done gently so no debris is pushed inside. Normal saline is a mixture of salt and water. It is called normal because its salt concentration is similar to tears, blood and other body fluids (0.9% saline). In a pinch, use plain water. Some disinfectants can be irritating to healing wound tissue and should be left to the discretion of your vet. Store these items in a clean bucket that can be used for water once the vet arrives. You should also include a set of wire cutters in the kit so you’ll always know where they are in an emergency. They are good to have in case a horse gets tangled in wire, for example, and needs to be cut free.
Location, location, location
The size of the wound isn’t as important as the location. Call your vet any time a wound is in a high-risk spot such as over or near joints, or on the back of the leg. Wounds in these areas can jeopardize important structures like tendons, ligaments, vessels and nerves. If these structures become infected, they can cause chronic lameness. In addition, horses have major blood vessels high up between the hind legs, along the armpit and under the chin. Wounds in these spots can result in heavy bleeding as well as infection.
Any wounds in high motion areas are also risky. If the wound separates during movement, air can get in under the skin leading to subcutaneous emphysema, a painful condition that can result in serious complications such as a pneumothorax or collapsed lung.
Minor partial thickness abrasions (scrapes) that are not over a joint or tendon can be managed by gentle cleansing to remove debris and cold hosed once or twice a day to prevent serum scald. They can be bandaged for a few days and then left to heal open. Full thickness abrasions (all the way through the skin), or abrasions over a joint or tendon should always be examined by a vet for appropriate treatment.
Minor lacerations (tears or cuts) on the body not near any major vital structures can be managed acutely by putting pressure on the laceration to stop bleeding and then gently cleansed. The vet should be called if the laceration is very deep, is near a vital structure such as the jugular vein on the neck, tendons on the legs, over a joint, between the legs, or if it is bleeding profusely. Lacerations on the limbs should always be examined by a vet, even if they look minor, because there are many vital structures involved.
Once a laceration has been sutured shut, it can heal quite well as long as it hasn’t affected any vital structures. Wounds that expose bones need to be treated as quickly as possible to prevent the bone from dying. Exposed ligaments and tendons also need immediate treatment. Cuts on the horse’s body and head tend to heal better than those on the legs. Wounds on the legs need to be treated as quickly as possible in order to avoid the excessive growth of granulation issue (aka proud flesh). Most lacerations require a thorough cleaning and an antibiotic to prevent infection.
Punctures are potentially more dangerous than even large lacerations since debris can travel deep into the wound, so you are best to call your vet for them. Antibiotics are often required for puncture wounds, and tetanus can be a complication for animals that don’t have up-to-date tetanus shots. There’s also a risk associated with the outside of the wound healing before the inside – a situation that sets up an environment for abscesses and increases the risk for diseases such as tetanus and clostridial myositis (gas gangrene).
If you see any penetrating foreign bodies in the wound, leave them for the vet to examine. A practitioner can use an x-ray to determine the structures that are involved and make preparations to stop bleeding once the object has been removed. Small puncture wounds are easy to miss, especially if swelling has developed around the hole, so you need to look closely if you suspect one.
Hoof abscesses can result from puncture wounds that have entered the soft tissues, so it is crucial to call your vet if you find a penetrating foot injury.
Any time a horse doesn’t want to put weight on a foot, you should call the vet, regardless of whether you found a puncture. Although such severe lameness can result from a foot abscess, it can also be a symptom of a serious joint injury, a septic joint or a broken bone.
While you’re waiting for the vet
If your horse can walk, lead him to a quiet area. Unless your vet advises, don’t clean the wound. If it’s a puncture wound, you might push debris further into it – that’s especially serious if the wound involves a joint.
If the wound is bleeding heavily, your vet may recommend that you apply a compression bandage. Place an absorbent pad over it and apply direct pressure as you keep adding material on top. Even if the wound continues to bleed through the bandage, keep adding material and don’t remove it – you may disrupt a clot that’s forming. Never place a tourniquet on your horse unless your vet directs you to do so