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  Discussion on Possible sequestrum after a kick
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New Member:
Scrupi1

Posted on Monday, Jan 1, 2007 - 2:06 pm:

4 weeks ago my 4 year old was kicked on the lateral aspect of his right proximal cannon bone, it left an small open wound that the vet felt did not penetrate beyond the soft tissue, there was mild diffuse swelling in the lower leg but not up into the hock. We cold hosed and placed standing wraps for 4 days and it looked significantly better but a day later the entire lower leg and up into the hock was swollen, the wound had closed up but reopened and started to drain. I was told to continue to ride him at the walk to help with the swelling and we placed him on antibiotics for 10 days (he had already had 5 days of bute prior). A week later we trotted him on concrete and he trotted sound so we started back to light walk and trot work and than added canter work, the area around the wound was still quite swollen and has slowly started to go down. I still felt that he was not quite sound, he was handeling canter to trot transitions differently: it felt like he was shifting his weight quickly from the effected leg and I was concerned that it was still so swollen and asked the vet to take x-rays, she did not see a fracture but was concerned that a sequestrum may develop based on the x-rays. She said to start back to normal level of work, not to worry and that we would take another x-ray in 4 weeks. My question is: Can I make this situation worse by riding him? How do I know what level of work we should be at (walk vs. trot vs. canter vs. hill work)? She mentioned surgery if it was a sequestrum, Is the surgery done arthroscopically? What kind of rehab is required after such a surgery? Thanks so muck!
Moderator:
DrO

Posted on Monday, Jan 1, 2007 - 6:57 pm:

Welcome Susanne,
Not being able to examine your horse I really cannot answer the questions about your specific horse. However I would not work him if you think he is lame or if there is infection present. In this area arthroscopy would not be indicated and recovery is usually 45 days following a uncomplicated sequestrum removal.
DrO
New Member:
Scrupi1

Posted on Monday, Jan 1, 2007 - 8:31 pm:

Thanks Dr. Oglesby; this site is wonderful.
My vet performed a lameness exam (this was after 4 days of no riding just turn out in a small pasture) and he trotted/lunged completely sound. How do I know if the wound is still infected? The swollen area surrounding the wound is no longer warm and is not tender to the touch, the original wound has closed and looks to be healing (as far as soft tissue healing goes). I have been searching for information on starting back to work after this kind of injury but have not found much, there was no tendon involvement so am I right to think that as long as you feel no soreness, the work can increase in intensity/duration a bit faster than the guidelines set for a tendon/ligament injury? Thanks!
Moderator:
DrO

Posted on Tuesday, Jan 2, 2007 - 7:13 am:

Closed, cool, and not painful all are good indications that there is no local infection and yes skin wounds can be brought back to work much quicker than tendon or ligament injuries.
DrO
New Member:
Scrupi1

Posted on Tuesday, Jan 2, 2007 - 10:35 am:

Dr. O,

My vet has suggested using DMSO to help decrease the remaining swelling that surrounds only the wound site (I don't know that swelling is the correct term since the tissues are no longer inflamed, maybe soft tissue changes would be more accurate). She says that this area on his leg may not return to previous size, does this mean that the overall circulation capabilities in the right hind will be affected, should I expect him to stock up more when having to stay in for extended periods or after strenuous work(once we build back up to the strenuous work)? Is there any other product I could use to improve the cosmetic appearance of the leg (the increase size does not look like a splint at all rather it extends in a band around the wound site which is near the top of the lateral cannon bone) and facilitate improved soft tissue remodeling?
Moderator:
DrO

Posted on Wednesday, Jan 3, 2007 - 8:24 am:

Swelling is an ok term but as you suggest nonspecific. For a classification of swellings see, Diseases of Horses » Skin Diseases, Wounds, and Swellings » Swellings / Localized Infection / Abscesses » Diagnosing and Assessing Swellings in Horses.

Concerning the particulars of your horse these are questions you really are going to have to ask your veterinarian who can examine your horse. If you are concerned about getting the swelling down and preventing future stocking up episodes see, Diseases of Horses » Lameness » Leg Swellings where you will find both diagnostic and therapeutic information on managing horses with swollen legs, which for cool swelling consists mainly of pressure wraps.
DrO
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