Horse wounds: Why size isn't everything

Martin Hume of Torch Equine Vets,  an XLEquine Vets member, explains a tale of two wounds that he was called to recently. 

We're always trying to remind horse owners that the size of a wound is no indication of how serious it might be. 

I recently had two horses to see on consecutive days that demonstrated this.

Felix and the large wound 

Felix, a Dutch Warmblood dressage horse, had competed very well and was due to compete at Hartpury in the next few weeks.

During a training exercise in his school, he was full of the joys of spring and bucked against the surrounding post and rail fencing, catching his left rump on one of the posts.

His rider was horrified to see a large horizontal wound through the skin and tearing a large section of his rump muscle. There was a lot of blood. 

>> See the wound here (warning - graphic image) 

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Not one to panic, his rider called and said that he had quite a large wound on the rump and suggested that we might want to see him in the hospital.

I was near his yard and called in to assess him before deciding whether he'd need to go to the hospital for treatment.

The bleeding had stopped, but the wound was extensive. Despite looking horrendous, the good news was that it didn't involve any vital structures and would repair well under sedation and local anaesthetic with a very favourable outcome.

In the hospital, Felix's wound was cleaned and flushed with sterile saline. Damaged tissue was removed and the wound was stitched together with a multi-layered closure with a drain.

We gave Felix a short course of antibiotics and pain relief to limit the risk of infection.

He recovered over the next three weeks and was able to compete in his competition.

Molly and the tiny wound 

Molly is a lovely warmblood mare with a six-month-old foal at foot. She'd been in her very large,   deeply-bedded stable and somehow got herself cast overnight.

Her owner had managed to get her up and noticed some minor scrapes and a tiny wound over Molly's right knee.

She called for some advice and due to the position of the wound, I decided to visit and assure her that all was well.

On arrival Molly was comfortable, sound at the walk and trot and had one or two minor scrapes. The wound on the knee was only 2-3mm, but the knee joint was a little swollen.

Flexion of the knee produced a clear egg-white like fluid. It looked very much like the first knee joint had been penetrated.

I performed a joint tap (the sterile removal of fluid) and flush with saline, confirming that the joint had been penetrated and examination at the lab showed that inflammatory cells were massing within the joint.

What appeared to be an innocuous, small wound was a potentially serious injury.

Molly was admitted to the hospital and underwent a general anaesthetic and an arthroscopic joint exploration and flush.

This is essentially a key-hole procedure where a camera is inserted into the joint.

The damage can be assessed and a large volume (15L) of sterile saline is flushed through the joint, exiting through an exit cannula.

I could see a strand of hair within the joint. This is common in puncture wounds and, if not removed, would provide a continuous source of infection.

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Molly remained in the hospital for three days on intravenous antibiotics before returning home for Christmas following a clear joint tap.

Injuries over joints or other synovial structures (tendons and tendon sheaths) are potentially very serious.

We vets are always banging on about the need to ask for advice and assessment of wounds. Quick and professional assessments help to bring about very good outcomes. 

In these two horses, the apparently minor, innocuous wound was by far the most dangerous. 

The take home message is always to please consult your vet for advice on wounds no matter how minor they may appear. 

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