I would like this to be both a journal for myself, as well as an interesting read for those who may find this sort of thing… interesting.
To that end, I think I will organize it in a “case study” manner. Each entry will discuss a case (with photos, if available), or update on a previous case. Hopefully that will accomplish the above goals.
Let’s start with a heel bulb laceration, now about 4 weeks old. I first saw the horse on December 6, and my first impression was not a good one. She had caught herself on a smooth wire fence and had a deep laceration that not only cut through her lateral collateral cartilage (which comes off the coffin bone – “side-bones” are when this cartilage becomes boney), but it was also likely that it got into her tendon sheath. It was too old and dirty to suture it, and referral to a hospital (which would have been ideal) was not an option. Cleaned her up real well and bandaged it. Antibiotics, anti-inflammatories, tetanus booster, and stall rest.
The next day I pulled fluid out of that tendon sheath, and sure enough the white cell count was high. Began injecting antibiotic directly into the tendon sheath. She did amazingly well. By the end of the week, the white cell count had returned to normal, she was basically sound on the foot, and the wound looked good.
We put a foot cast on her for 10 days, which reduces the motion of the heels expanding and contracting. When the cast came off, the wound had granulated over completely. That was one week ago. She’s had a light bandage on since then, and I’m very pleased with her progress. It’s possible that a piece of the cartilage will need to be removed eventually, but for now she’s walking great, healing great, and she’s sick of being stuck in a stall.
Photos are after the break. *graphic*
December 8, 2009 (Day 3)
December 31, 2009 (Day 26)
Today – January 5, 2010 (Day 31)
Hi Dr. Jen,
My filly did a very similar thing 2 days ago, it was still bleeding although the vet had tied off as muh as he could approx. ten hours later.
Have the bleeding under control since yesterday and it now looks very clean although seems to be deeper than the image in photo one. Have her on antibiotics, wound is packed and bandaged. She isnt in any pain and keeps trying to bounce around the stable on it.
My friend has a horse with similar injuries we used Manuka Honey and aloe vera gel in conjunction with the usual methods and she was left with hardly any scar.
Thanks for sharing your experiences. I’m glad your filly is doing well so far, and I’m really glad that your friends horse healed up so well! I sympathize with you about hte bleeding – those things can bleed a LOT! Luckily, horses have a lot of blood 🙂
This is a very common laceration for horses to get, and they can be tricky. The biggest concern is that there are a lot of really important structures in the foot that can cause big problems if they are involved. We worry most about the involvement of the coffin joint or the tendon sheath because these normally sterile structures can result in chronic lameness or even life-threatening complications if they are involved. Other structures include the coffin bone itself, numerous ligaments, and the collateral cartilage. The depth of a laceration can be a bit deceiving because you can have a deep laceration that misses all these structures, or you can have a relatively shallow or small laceration that goes right into the joint or causes significant damage to tendons or ligaments that are very, very close to the surface. These can certainly be life-threatening situations.
If the horse is lucky and manages to miss all of these structures (which it sounds like your filly did!), they heal up quite well, although proud flesh formation is possible with any distal limb wounds. Depending on the horse and laceration, some can be sewed up and/or put in a foot cast, and others do great with just what you’re doing – keeping it clean and bandaged and (trying) to minimize motion.
Honey has some very interesting properties that aid wound healing and provide resistence to infection. It’s hard to say how much it helps because many wounds heal up just fine without it, but there is sound scientific evidence that it is beneficial. I’m glad your friend had good luck with it!
Thanks again for sharing! If you remember, let me know how your filly heals up.