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Discussion on ~ 5" cut on front of cannon bone on 9 month old -bone exposed
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New Member:
Judyhens
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Posted on Tuesday, Jan 16, 2007 - 11:11 am:
One of our babies was fine at feeding time (8:30 AM) Sat. morning. When we went to move him at 10:30 or 11 AM, from one pasture to another, we were shocked to see a huge laceration and exposed bone on one lower front leg. It has been very cold. We expect that he attempted to jump the fence (which has "safe" horse wire)to get to his mom during a storm. He was pastured with another foal.
Anyway, we loaded him in the trailer and took him to a nearby vet hospital. The skin flap was not sufficient to cover the wound because of swelling and tissue damage. They did clip it to the bleeding point and covered the bone with it. Dardanus (Andalusian colt) was bandaged, put on Tucaprim and Banamine, given a shot of antibiotics, and was sent home with instructions to return in 10 days for suture removal, re-bandage daily, use antibiotic ointment daily, and continue oral antibiotics and Banamine.
Dardanus is wonderful to work with, but is now bored and ripping the elastikon apart with his teeth and the bandage is therefore slipping. His mother is in the stall next to him.
We plan to use Dardanus as both a breeding and show stallion. We had his dam in Ca. for 18 months (we live in Texas) to achieve the pregnancy to a twice national champion of Spain and twice national champion of Mexico. Therefore we would like to do everything possible to minimize scarring, prevent infection, and facilitate healing. We love this little guy and consider him a family member. I have read your article on wound care. Our vet was adamantly against washing the wound, but did want antibiotic on it daily and dressing changes daily. She did not want antibiotic ointment to touch the stitches. We contacted a vet at A & M to get a second opinion re: ways to minimize scarring/ infection. He suggested hosing every day, using antibiotics, banamine, and bandaging very snugly over the cotton padding. We are using triple anti}biotic ointment which has a petroleum base - which you advise against re: proud flesh development.
Questions: Is hosing a problem with exposed bone?
How do we keep the baby from ripping his bandage off? What antibiotic (topical) is an alternative to triple antibiotic for humans (petroleum base)? What dressings are readily available that don't stick so badly to the wound as gauze? A & M suggested Telfa as a possible alternative. If we can get our hands on placentas, is amnion a good dressing and does it go straight over the wound? I have directions on preparation. What about silicon gel pads? Where do you get them? They are expensive. Do you change them every day? How to keep the baby from getting bored? (We have a ball and hanging treat thing in the stall...) What about hand walking? Good or bad? He is not limping much at all.
We do love, scratch, pet, talk to him repeatedly throughout the day. We have his stall on closed circuit tv to our beDrOom so we can view him during the night.
Your suggestions would be greatly appreciated! - Oh... Right now, even though we are in Central Texas, we are in the midst of an ice storm. We are breaking up ice in water buckets and the automatic waterers are frozen. Hosing right now might not be a good option, because everything that hits the ground freezes} and we would have an ice skating rink....
Judy
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Member:
Scooter
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Posted on Tuesday, Jan 16, 2007 - 11:19 am:
Hi Judy welcome to HA I can't comment on how to treat this, but years ago I had the same problem with a mare ripping her leg bandage off. I put a shipping boot on it and she left it alone. Good Luck with your colt
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Member:
Dres
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Posted on Tuesday, Jan 16, 2007 - 12:37 pm:
Hi Judy, I like the shopping boot idea, but watch him or he could get tangled up if he tries to 'play' with it..
I have used the gel pads and had wonderful results with them, I got them from the vet and you can cut them to size so you save money..I had a filly that cut her leg to the bone on a hind outside leg just above the fetlock.. A hard spot to stitch and keep wraps on too.. I used the gel pad on that, changed her bandage daily for the first two weeks, till the stitches were removed then after cold hosed and changed the dressing every other day.. You can barely see the scar now..
Now that Filly is 3 and we are treating a serious tendon injury, again we used the gel pads on the nasty heel bulb laceration.. That too has healed up remarkably..
Young ones on stall rest is difficult.. Try hanging his hay in a hay bag so he has something to play with while eating.. It can make feeding times last a whole lot longer...
Good luck..
On the first day God created horses, on the second day he painted them with spots.
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Member:
Kstud
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Posted on Tuesday, Jan 16, 2007 - 2:43 pm:
Hi Judy, I had exactly the same problems last year with a colt foal and I have posted the pictures on this site showing how it went from exposed bone to fully healed in 8 weeks. There was no problems with proud flesh and there are absolutely no scars at all now, in fact no-one would believe the foal was ever cut if you looked at him. Look under Badly Cut Foal in the skin wounds section. The posts were in July, Aug and Sept. 06.
Best of luck
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New Member:
Judyhens
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Posted on Tuesday, Jan 16, 2007 - 7:32 pm:
Hi Diane, Ann, and Catherine,
Thank you for your support and input. We do have shipping boots although they are probably too big. We might try that (or something like it) if my husband's efforts at putting more Elastikon above the bandage doesn't work. :-) This is day 3 and we still don't see any miraculous change. However, the stitches are still holding and there doesn't appear to be any excessive swelling, bad odor, or excessive drainage.
Dardanus is alert and happy, although bored. But then everyone else is bored because they are stalled.... ice continues to be everywhere. These guys were slipping and sliding when we attempted to give them "out" time this morning, so back they went. 25+ horses to hay and feed and clean.... Can't wait to get them back out to their pastures!
Ann, our vet didn't seem to have the gel pads. Do you know the actual name of them? Are they available over the net?
Catherine, I read all the posts re: your colt. The healing appears miraculous! The pictures are worth a lot re: making me feel hopeful of a very good outcome.
Oh - one more thing. The leg may have a hair line fracture. The x-ray made the vet decide not to anesthetize Dardanus to try to stretch the skin. She was worried that he might thrash when he woke up and potentially cause devastating injury to the leg. He really is pretty sound, though. Is a possible fracture something that would change the treatment plan at all?
Judy
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Moderator:
DrO
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Posted on Wednesday, Jan 17, 2007 - 6:47 am:
Hello Judy,
Many of our recommendations for taking care of this wound in the First Aid article and Long Term Wound Care article address your questions directly but to put a fine point on some of the issues:
We have hosed many wounds with extensive bone exposure and always have had good results. This should not be considered optimum treatment and should be looked upon as a fall back when large scale sterile saline debridement under pressure is not available in areas of high contamination, like a barn. I believe it to be best therapy is such situations however you should follow the recommendations of the veterinarian who can examine the wound.
Often wounds like this become quite weepy and absorbent dressing help absorb this fluid along with debriding clotted serum and blood. If your wound is staying so dry that by the time you come back to change the dressing it is very dry and stuck on the wound hmmm I would wonder why is the tissue not releasing more in the way of serum and blood. A little bit of sticking is the debriding action at work.
DrO
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New Member:
Judyhens
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Posted on Wednesday, Jan 17, 2007 - 5:50 pm:
There is some oozing. I think the gauze is not sticking as much as it did at the first bandage change. Hopefully everything is ok. I will try to post a picture over the next day or two. I would appreciate reassurance that it looks ok. It won't be 10 days old and time to remove the stitches until the 23rd. That is the next time we plan to take him to the vet.
Re: Contamination - Our barn is shaped like a "U" with stalls facing a grass arena and with paddocks behind each stall. So the horses have fresh air from both directions. They are cleaned twice daily. Dardanus has a 20 X 10 foaling stall and is still not really limping. He is rarely lying down though. We have a breeding stock in one corner of the barn where hosing would be feasible when the ice melts. Should we Nolvasan or Clorox the whole area prior to hosing him? Are the barn contaminants typically bad enough to contraindicate hosing if the foal must be kept in a barn situation?
The vet at Tx. A & M does recommend hosing, despite exposed bone. It's the Elgin vet (who saw him) that preferred to keep it dry (perhaps only until the stitches are removed???).
We will clarify this with her and hopefully get her blessing.
I don't know when it is appropriate to let the little guy back out with another foal. When the bone is covered with tissue?
Thanks for your input.
Judy
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Member:
Judyhens
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Posted on Friday, Jan 19, 2007 - 7:44 pm:
Hi Everyone and Dr. O.,
Would appreciate feedback on the healing of this wound. We took a close-up of the baby's leg. This is the front of his right fore. The wound is now 6 days old. The stitches are on the left side and are still holding. The skin flap was stitched over the exposed bone. My husband, who has changed the bandage daily, feels that the drainage was significantly more today. However, it has no odor and the baby doesn't appear to be any more painful on the leg. He is walking normally. Does excessive drainage indicate an impending infection? We both feel that there is significantly more tissue now than a few days ago. Originally this was pretty much down to bone. He is scheduled to have the stitches out next Wednesday the 24th, which will be the 11th day.
Current protocol: Tucaprim 3/4 scoop 1 x day. Banamine - 500 lb. dose 1 X day. Triple Antibiotic ointment applied topically to gauze, Gamgee around leg, vet wrap around Gamgee, Elastikon around top of leg. Lots of scratches, loves, treats, and human inter-action.
How does this look to you? Normal for 6 days post injury? Starting to get infected? We plan to ask the vet about hosing on Wednesday. Any feedback would be helpful. Any suggested changes in treatment?
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Moderator:
DrO
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Posted on Saturday, Jan 20, 2007 - 9:59 am:
It has definitely granulated in rapidly and the picture seems to even indicate excessive granulation already starting on the left side of the image. The heavy exudate does not mean that you are getting infection established deep in the wound. Concerning care there are many differences between what you are doing and what we recommend in the The Long Term Wound Care article referenced above. Of course there are many ways to get a wound healed up but review our suggestions and discuss with your veterinarian these differences. We give reasons for our recommendations. I have heavily edited the article this morning to better address your questions about infection.
DrO
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Member:
Judyhens
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Posted on Saturday, Jan 20, 2007 - 10:58 pm:
Thank you for your response Dr. O. Today, the stitches appear to be pulling out a bit from the top and you could once again see bone. However, it is substantially less than when it occurred. We did read your article again, including infection and proud flesh treatments. Then we printed it out and re-read it in the car on the way into Austin to buy some Nolvasan Ointment. There continues to be a lot of exudate. It doesn't have an odor, though, and the baby is still happy and alert.
We called the vet's office to talk with the vet who saw the colt. She is out of town until Tuesday. Our appointment is Wednesday. We do plan to switch from petroleum based triple antibiotic to Nolvasan tomorrow. We would like to go on and hose it, but my husband is somewhat hesitant because he feels the bottom of the wound, which is still open, will trap the water and cause problems. Is this an issue? We did purchase a new hose and new nozzle, so we are good to go. Just hope our vet will buy into it. If the stitches were her major issue (which she thought might not hold anyway) they are pulling out without adding water...so I guess I am confused re: her reasoning. Since it is cold and this is just a little guy, is warm water ok? Does it have to be cold water? We have both hot and cold running water at the barn.
Walter plans to take another picture of the wound tomorrow and would appreciate your feedback after posting.
Thanks again for your guidance.
Judy
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Member:
Judyhens
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Posted on Saturday, Jan 20, 2007 - 11:01 pm:
Thank you for your response Dr. O. Today, the stitches appear to be pulling out a bit from the top and you could once again see bone. However, it is substantially less than when it occurred. We did read your article again, including infection and proud flesh treatments. Then we printed it out and re-read it in the car on the way into Austin to buy some Nolvasan Ointment. There continues to be a lot of exudate. It doesn't have an odor, though, and the baby is still happy and alert.
We called the vet's office to talk with the vet who saw the colt. She is out of town until Tuesday. Our appointment is Wednesday. We do plan to switch from petroleum based triple antibiotic to Nolvasan tomorrow. We would like to go on and hose it, but my husband is somewhat hesitant because he feels the bottom of the wound, which is still open, will trap the water and cause problems. Is this an issue? We did purchase a new hose and new nozzle, so we are good to go. Just hope our vet will buy into it. If the stitches were her major issue (which she thought might not hold anyway) they are pulling out without adding water...so I guess I am confused re: her reasoning. Since it is cold and this is just a little guy, is warm water ok? Does it have to be cold water? We have both hot and cold running water at the barn.
Walter plans to take another picture of the wound tomorrow and would appreciate your feedback after posting.
Thanks again for your guidance.
Judy
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Moderator:
DrO
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Posted on Sunday, Jan 21, 2007 - 10:00 am:
No it is pockets like you describe that will most benefit from hosing: does your husband think there are more bacteria in the water from the hose or on the puss from the infected surface of the wound. This puss is also caustic to the surrounding healthy tissue. I would try to careful express a pocket of water remaining after hosing, however. The hosing will greatly decrease the amount of exudate. One not about the Nolvasan creme: it is difficult to get it to stick to wet surfaces like a granulation bed so I usually incorporate it in the first few layers of bandage material.
DrO
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Member:
Christel
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Posted on Sunday, Jan 21, 2007 - 10:32 am:
Hi Judy, to try and make you feel better about hosing, I thought I would post. I call it hyDrO therapy- sounds much more official-lol.
My local vets are 'old school' vets, I have been using them on my horses since 1988, and have hosed many wounds per their instructions, several much worse than the one you are reporting. While hosing does alot of debriding, it also helps to stimulate blood flow to the wound, which helps to speed up healing. I think you and your husband would be pleasantly surprized on how well it works. After a good hosing I always put betadine on wound then a powder antiobiotic, to my knowledge the hosing has never caused more infection, it has always seemed to be of much help to the wound.
Hope this helps,
Chris
Wanted to add, while the first hosing the horse may get a little upset for a moment or two, I have never had a horse that didn't like it once they got use to it- they seem to realize that it is helping them. I have used hyDrO therapy on foals as young as 1 week, they dance around a bit at first, but I would keep the water on them at all times, they soon realize dancing around does no good and will remain still for the most part.
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Member:
Judyhens
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Posted on Sunday, Jan 21, 2007 - 11:25 am:
Thanks for your input, Chris and Dr. O. I think we will go on and hyDrOtherapy today. Your comments both make sense. We will photograph the wound today also, and post. Thanks for taking the time to write. You know, we so desperately want to do what is best for the little one. Since the A & M vet whom we trust also recommended hosing, the concensus is with hosing. The problem is that the only vet who actually saw the wound recommended against it, not even wanting antibiotic near the stitches. She is out of town. So we go with hosing.... Is warm water ok??? Hot? Cold?
:-)
Judy
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Member:
Christel
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Posted on Sunday, Jan 21, 2007 - 11:51 am:
Judy, I think you will like the results. I have never had access to warm water, and have always used straight from faucet. I use a pretty forceful stream too, when the wound is early you will cause wound to bleed a little, which is not anything to be alarmed about.
Chris
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Member:
judyhens
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Posted on Sunday, Jan 21, 2007 - 10:45 pm:
Ok. Here are some pictures 8 days post injury. Yesterday you could see about a 1/4" line of bone running all the way down the cannon bone. Today it is hard to see bone. (Praise the Lord!)
We hosed it for the first time this afternoon and took these pictures after hosing and prior to bandaging. Changed to Nolvasan today. The colt seems happy, alert, and is eating everything in sight.
We look forward to your impression. Dardanos' appointment is Wednesday. The office staff called today to check on him. Said they would work him in to someone other than the vet who sutured him if we were worried before she gets back into town.
Thanks,
Judy
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Member:
judyhens
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Posted on Sunday, Jan 21, 2007 - 10:49 pm:
Here is one other view. Look forward to feedback.
Judy
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Moderator:
DrO
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Posted on Monday, Jan 22, 2007 - 7:02 am:
Judy the wound looks quite a bit larger than the earlier picture or is it just the angle of the photo. Other than that and that is looks a bit cleaner than above not much has changed and it is going through expected healing stages as described in the article on long term wound care.
DrO
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Member:
judyhens
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Posted on Monday, Jan 22, 2007 - 9:54 am:
I think it looks bigger because the skin that was stretched over the left half of the wound (to cover the bone) has pulled loose and is no longer covering the left side of the wound. The vet thought that skin might not be viable. The bone made a complete division down the wound, with a possible hairline fracture by x-ray. Now the bone is barely visible, if at all. Does that make sense re: larger wound? Is it something to especially worry about?
Judy
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Member:
judyhens
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Posted on Wednesday, Jan 24, 2007 - 11:07 pm:
Took the baby to the vet today. She thought the wound looked good. She hosed it and used Betadine, then trimmed away excessive granulation tissue. Although the stitches had pulled away, she said the skin flap was still alive. She trimmed some of it, then apparently pulled it back up in the center of the wound. According to my husband (I had to work and couldn't go), she then put some kind of gel bandage around the leg and put some kind of pressure bandage on top of it. She wants to see it again on Friday. We are leaving town Friday for 10 days. Our dressage trainer will take him back to her. If the wound is responding to whatever this special stuff is, she will keep him there and continue treatment in our absence. If it doesn't seem to be making much difference, he will return here to our routine daily treatment (i.e., hosing, Nolvasan, bandaging). Dardanos was extremely cooperative according to Walter. The vet is hopeful this will minimize any scaring. Apparently the wound was clean. - Since I really don't completely know what is being done, I will update you when I better understand... Anyway, things seem to be going well.
Thanks for everything! You are appreciated!
Judy
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Member:
judyhens
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Posted on Wednesday, Jan 24, 2007 - 11:13 pm:
Took the baby to the vet today. She thought the wound looked good. She hosed it and used Betadine, then trimmed away excessive granulation tissue. Although the stitches had pulled away, she said the skin flap was still alive. She trimmed some of it, then apparently pulled it back up in the center of the wound. According to my husband (I had to work and couldn't go), she then put some kind of gel bandage around the leg and put some kind of pressure bandage on top of it. She wants to see it again on Friday. We are leaving town Friday for 10 days. Our dressage trainer will take him back to her. If the wound is responding to whatever this special stuff is, she will keep him there and continue treatment in our absence. If it doesn't seem to be making much difference, he will return here to our routine daily treatment (i.e., hosing, Nolvasan, bandaging). Dardanos was extremely cooperative according to Walter. The vet is hopeful this will minimize any scaring. Apparently the wound was clean. - Since I really don't completely know what is being done, I will update you when I better understand... Anyway, things seem to be going well.
Thanks for everything! You are appreciated!
Judy
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Moderator:
DrO
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Posted on Thursday, Jan 25, 2007 - 6:06 am:
It sounds fine. I recommend you repeat the veterinarians attempt to place the skin back across the wound as you bandage. In some cases where the skin wants to pull away under the bandage we have used "Steri Strips" (a human surgical tape) to hold it is place. The problem is for this to work takes quite a effort to get the skin completely dry and even apply benzoin to the skin to increase the stickiness of the strips.
Be sure you gently but thoroughly hose under the flap as long as any exudate accumulates there. Unless there is an indication of infection being a problem there, I also don't place ointment or creams between the flap and granulation bed, just on top of the rest of the wound. Some make the mistake of thinking that hosing under the flap delays healing by dislodging the flap. What delays healing and promotes proud flesh is the accumulation of exudate. The flap heals from the the inside edge where the granulation tissue touches the skin.
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Member:
judyhens
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Posted on Thursday, Jan 25, 2007 - 9:37 am:
Thanks so much!
Judy
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P.S. I notice the time of your posts. Do you ever sleep?????
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Member:
judyhens
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Posted on Monday, Feb 12, 2007 - 12:36 am:
Hi,
We have been out of town. I am posting some follow-up photos of Dardanos' leg from 2/7 and 2/9. As you can see, the 2/9 shows more of a split than 2/7. The vet thinks it looks great and that the slit was probably just occluded by drainage. That it needs to heal from the inside out and is doing just fine. What is your opinion?
We left town in Jan. Our trainers took Dardanos to the vet who hosed it with Betadine, removed excessive granulation tissue, and bandaged it without using antibiotic cream. Instead placed some kind of gel pad directly on the wound, then put a pressure bandage over it, wrapping with brown gauze vet wrap, and finally some elastikon. She has us changing the bandage every three days. No antibiotic, no hosing, just gel pad, pressure bandage, etc. The baby is getting way too full of himself. Still no lameness. We are hoping to get this rascal healed and out of the large foaling stall before a mare needs it.
Anyway, any feedback you might have re: the appearance, presence of the split, etc., would be appreciated. The wound is now over 3 weeks old I think.
Judy
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Member:
judyhens
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Posted on Monday, Feb 12, 2007 - 12:42 am:
Here is the 2/09/07 picture showing the open split. You cannot see the bone in the split. Since it wasn't pronounced on the 2/07 photo, we are a little concerned that everything is ok. The vet thinks it was only appearing closed because of accumulated drainage material. Have you seen this before?
Judy
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Moderator:
DrO
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Posted on Monday, Feb 12, 2007 - 6:52 am:
I concur with your vet, believe this was apparent on the earlier photos and with good care will fill in rapidly. Though it is not how I would care for this wound, I am sure with time this will heal using the methods your vet has chosen.
DrO
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Member:
judyhens
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Posted on Thursday, Feb 15, 2007 - 9:35 pm:
I am posting today's pictures of Dardanos's leg. As you thought, the gap is filling in. There is a little raised area under the skin flap that was originally sewn, then popped loose, and is now reattaching. What has been your experience with these ultimately resolving?
The baby is really becoming a handful when you go in re: playing, leaping, jumping. He is totally used to being out in a pasture running with babies. When we let him out in his paddock, he is toooooo full of himself. Definitely feels great. No lameness. Bandage change every three days. At what point in healing is it typically fine to let a baby back out?
So...2 main questions: 1. If it heals with a raised area, is it your experience that the bump resolves with time? and 2. At what point in healing, in general, is it fine to let a baby (about 10 mo. old colt)back out in the pasture with other horses?
Thanks,
Judy
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Member:
judyhens
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Posted on Thursday, Feb 15, 2007 - 9:39 pm:
Another view from today. Closer up. We are to continue with the pressure bandage.
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Member:
dres
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Posted on Thursday, Feb 15, 2007 - 10:02 pm:
Judy that is impressive healing.. Can't say but I had a filly that had a pretty nasty wound on her hind leg when it looked this good she was able to be out with her buddy with wraps on.. There is a small scar on her leg that can be felt more then seen.. if you look closely you can see it..
On the first day God created horses , on the second day he painted them with spots.
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Moderator:
DrO
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Posted on Friday, Feb 16, 2007 - 7:35 am:
The pictures are a good example of the contraction phase, where the granulation tissue contracts to pull the margins of the wound together. For more on this see the article on long term wound healing.
I cannot judge how much enlargement you have from the above perspective perhaps a view from the side would help but the above wound with good care should heal with a small scar and minimal distortion of the normal appearance.
You can turn out when the skin is secured well enough to the granulation bed that exercise will not pull it off, sometimes a tough call to make.
DrO
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Member:
judyhens
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Posted on Friday, Feb 16, 2007 - 9:41 am:
Thanks for your quick response. We finally feel things are going to be ok. When we first saw this wound a month ago, with lots of bone exposed, my husband's first response was I'm not even sure he will survive. Having never seen anything like this, we had no reference for how soundness threatening or life-threatening this could be. Seeing the progression of the healing process and having the on-going support of this site has helped us tremendously. In addition, it makes one realize the true miracle of healing and, at least in my belief, is yet another example of the wonderful works of God. We will take a side view the next time we change the bandage. You, Dr. O., and everyone who posted on this thread are greatly appreciated!
Ann, thanks for your input. Its encouraging to know that others have been there and done that with good outcome!!!!
Judy
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Member:
judyhens
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Posted on Wednesday, Feb 21, 2007 - 11:28 pm:
Ok. Here is a photo from today. It seems pretty flat from the side, but the picture didn't turn out well. The bump we were seeing was apparently a small bubble of blood. It had oozed out at the last dressing change (3 days ago) and was flat at that time. It looks like it is continuing to heal normally to me, but we have never dealt with anything like this and would just like your continuing opinion (AKA hand holding....). Thanks again. Our thoughts and prayers are with your family.
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Moderator:
DrO
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Posted on Thursday, Feb 22, 2007 - 6:52 am:
The different perspectives in the images, makes it hard to compare one with the other Judy but the image above show evidence of a wound healing well. I would have expected the vertical crack to have filled in with granulation tissue by now so I wonder why it is moving a bit slow, but if there is no excessive drainage from the crevasse it is a small issue.
DrO
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Member:
judyhens
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Posted on Friday, Feb 23, 2007 - 1:28 pm:
There is no excessive drainage. We will try to get better pictures at the next dressing change. Hopefully it will be filling in better then. I didn't see it in person (the dressings are changed while I am at work), but my husband and the trainer felt it was continuing to improve. I will also try to get them to take a side view. Thank you for your on-going review of Dardanos's leg. It means a lot to us and we will follow-up any time you think things are not progressing normally.
Have a great day!
Judy
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Member:
judyhens
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Posted on Saturday, Feb 24, 2007 - 1:25 pm:
Ok. The wound is redder today. No odor or exudate. No increase in discharge. No swelling or pain. No lameness. However, the split is still visible and the color is redder. We have changed a couple of things. We have been letting Dardanos out into a small paddock adjoining his stall. He bucks, rears, and moves around like crazy. Unfortunately, sand has been infiltrating the bandage. The wound was embedded with sand today. We are having to hose it now in order to keep the sand out. They tried to increase the elastikon today to reduce the problem. Maybe that will help.
So....if the redness is secondary to infection, then we probably need to rethink antibiotics and topical antibiotics. if the redness is due to sand and vigorous hosing, then maybe there is no major problem. What do you think?
Also, re: the split. When the wound occurred over a month ago the entire bone was exposed. The vet hosed the bone and felt around the bone with her fingers to be certain no fragments were missed with the hosing and to examine the integrity of the tendons, etc.. She also x-rayed it, which is when she thought she saw a hairline fracture. No fragments showed up on x-ray. Could something be missed since the gap is not completely filled in? It appears to be healing from the inside out.
Is it time to take Dardanos back to the vet? We e-mailed her pictures also. Not sure she will be back until Monday.
Thanks,
Judy
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Moderator:
DrO
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Posted on Sunday, Feb 25, 2007 - 10:01 am:
I think you are seeing the irritation from the sand and not infection and I think your crack looks smaller still. Without purulent drainage I would put dead or foreign tissue very low on the possibility list. Give it a good hosing to remove contamination and treat it with your topical products and if it is going to get so contaminated while out bandaging is indicted.
DrO
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Member:
judyhens
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Posted on Wednesday, Feb 28, 2007 - 9:03 am:
Here's yesterdays pictures. We are keeping it bandaged because sand remains a problem. It appears to be continuing to heal, and the redness is less. Thanks for your continuing support and comments.
Judy
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Member:
judyhens
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Posted on Wednesday, Feb 28, 2007 - 9:09 am:
Here is the front view:
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Member:
judyhens
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Posted on Wednesday, Feb 28, 2007 - 9:11 am:
Front view:
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Member:
tuckern
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Posted on Wednesday, Feb 28, 2007 - 9:22 am:
Looks like the wound is healing very nicely!
Good job! :o)
Nicole
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Member:
freshman
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Posted on Thursday, Mar 1, 2007 - 1:31 am:
I think that it is a great looking wound!
The new redness could be at least partially due to the sand that was introduced into wound, but I'd also wonder about proud flesh from the appearance. Your vet should should know or perhaps Dr. O can give his opinion.
Best of luck!
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Moderator:
DrO
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Posted on Thursday, Mar 1, 2007 - 6:33 am:
I agree with the above assessments, the wound is pulling together well Judy. There is a little lipping of the granulation bed in the top image but I don't think it looks ready to trim back yet.
DrO
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Member:
judyhens
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Posted on Thursday, Mar 1, 2007 - 8:57 am:
Thank you all for your input! Walter thought the same thing about possible granulation tissue. However, since we haven't been through this, we really don't know what is expected vs. what is not, and when to seek help. Will re-post in a couple of days. When you feel it is time for the vet to trim, we will get him to the clinic.
Thanks again. Your support means a tremendous amount to us!
Judy
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Member:
judyhens
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Posted on Tuesday, Mar 13, 2007 - 12:03 pm:
Ok. Here are pictures from the 11th. We are almost two months out now. When the storms pass, (heavy, heavy rain), hopefully in the next day or two, we plan to let him loose in a one acre paddock. We are still keeping pressure dressings on it. During one dressing change about 10 days ago, there was a tremendous amount of bleeding. (As in running down the leg...) It was quite frightening. Not something we expected at all at this stage of healing. The vet said that granulation tissue bled easily. Anyway, it hasn't happened since. Here are pictures from the 11th. Do we need to have any granulation tissue trimmed? Do anything else? Seem ok to return to pasture?
Judy
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Member:
judyhens
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Posted on Tuesday, Mar 13, 2007 - 12:10 pm:
another...
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Member:
judyhens
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Posted on Tuesday, Mar 13, 2007 - 12:12 pm:
One more perspective...
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Moderator:
DrO
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Posted on Wednesday, Mar 14, 2007 - 5:48 am:
The bleeding probably represents a larger vessel than the capillaries that are the body of the granulation bed organized and burst. This is not a bad thing as the vascularity is needed so that re-epithelisation can continue.
The wound appears stable enough to not pull apart but you will have to judge as you can get a better idea through manipulating the wound. What does your veterinarian say? If you are unsure you may want to limit exercise at first with sedation before turn out.
DrO
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Member:
judyhens
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Posted on Wednesday, Mar 14, 2007 - 9:39 am:
Thanks. We will call her today. We are amazed that hair is actually growing on the new skin. How can anyone witness healing and not know that God exists! Thanks for the info on the bleeding. It was a lot of bleeding. We were frightened and it initiated an emergency call to the clinic, high blood pressure in both of us, extra grey hairs (as if we don't have enough), etc. It's nice to have your site as a resource. Lets you get a better perspective of things.
And....what are you doing posting at 3 AM?
Judy
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Member:
judyhens
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Posted on Thursday, Jul 26, 2007 - 4:43 pm:
Just wanted to finish this thread with a very positive report. Within 4 months, everything was pretty much closed. By June the skin was tough enough and the hair was growing back that we were comfortable putting him back out in an acre paddock. He was never, not even when the cut originally occurred, lame. Praise the Lord that all significant structures were untouched.
Presently, with his normal, self determined exercise regime in the paddock, the last hints of slight swelling/ scar tissue is virtually gone. The only thing documenting the incident is the presence of white hairs, rather than dark ones. However, since he is graying and his sir is white, this should not be a problem long term.
:-) He was treated using pressure bandages changed every few days. When we ended the treatment, the bandage was removed for a few hours per day, then replaced with decreasing pressure, per the vet. That resolved the small amount of swelling we initially saw when we simply removed the pressure bandage. Anyway, this yearling colt is now healthy, happy, and galloping all over the place! Thought you might enjoy the June pictures. 
Judy
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Member:
dres
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Posted on Thursday, Jul 26, 2007 - 5:13 pm:
BEAUTIFUL..
On the first day God created horses, on the second day he painted them with spots.
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Member:
canter
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Posted on Thursday, Jul 26, 2007 - 10:06 pm:
Wonderful outcome, Judy - I am so glad that there is no long term damage. Kudos to you for great care!
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Member:
corinne
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Posted on Friday, Jul 27, 2007 - 12:40 am:
Wow. The virtues of cold hosing. Judy, your horse looks fabulous. Thanks for the updates. The other day I got bit by a friend's adorable rescue dog on the lip (she has a horrible history poor thing and I should not have had my face that close) but my first and initial reaction was to cleanse plentifully with water. After calling my provider I did my own wound care and got a tetnus shot first thing in the morning. It's healing nicely. I had to laugh because Holly had the pleasure of seeing me the day after all steri stripped and benzoined up and asked with a smile if I had been cold hosing. LOL. She made me laugh.
Anyway, I sware, I personally can not tout the benefits of HA's wound care recommendations for horses, especially the hyDrOtherapy, I now carry a roll up hose and sprayers in my first aid kit....for the horse that is! A syringe will work for me but water seems to be one of the best treatments there is! LOL congrats once again Judy!
P.S. Isn't it funny when you need some first aide items for you, can't find any in the house but your horse's first aid kit (at the barn) could support a small army of horses?
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