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  Discussion on Deep cut on anterior hock - progression
Author Message
Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:28 am:

**This is a summary of a prior post, now deleted**

Hi!

My daughter's pony cut himself just below the front of his hock sometime between Friday evening and Saturday morning. He would put weight on it and it was bleeding midly when I found him. The vet came out around 10:00am and washed it, said it was only through the skin, and instructed me to leave it alone until Monday evening unless it gets soiled. Then instructed me to rewrap after cleansing it w/betadine and applying furazone ointment. Then change every other day. After the 3rd change, switch to shreiner's spray.

I've attached pictures of how it looked tonight (Monday - day 2.5) after a 10 minute pressure water treatment.

I was surprised to see so much gunk in there. Im' pretty green to cuts like this..does it look okay?

By pressure rinsing, do you mean like a forceful spray or like if you plugged the end of the hose with your finger? Or just letting the hose run as normal w/o any attachments?

Should I follow the vets advice and leave the bandage for 2 days prior to cold-hosing?

He's also on sulfa tabs - 12 tablets per day, bute 2grams am/pm for 4 days then 1gram am/pm.

I've confined him to a stall.

I've purchased a human neoprene/velco knee brace to help keep the wrap in place. Does this look safe to do? The vet had him wrapped in an entire roll of 18" gamgee from hoofline to hock, then covered in vet rap and elastikon. That will run me about $30 each change. Will my alternative suffice or am I risking something by going this route? Certainly if it doesn't stay put I will revert back.

I'd appreciate any additional advice or even a 'good job' to know I'm doing this correctly.

Here's the cut - day 2.5
Day 2 cut
Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:31 am:

Here are subsequent posts:

From Dr. O:
Welcome Debra,
Wow that is a human knee brace? It appears to fit pretty good. The one thing I might add would be thick cotton padding held in place with 6 inch cotton gauze under the brace to prevent pressure sores.

I think the picture of the wound looks good: clean with no exudate. There does appear to be some minor damage to the tendons and ligaments that course in the front of the hock but this is a difficult evaluation from a photo. The critical factor is whether a joint capsule has been entered. This should be hosed with your the kind of pressure you can develop with your finger and your photo suggests this is what you have done. I would prefer to clean the wound daily, primarily to prevent infection from getting into a joint but also because I think you will have less excessive granulation tissue and a smaller scar.

Hi Dr0!

Yes..that is a human knee brace. It doesn't have any metal hinges like some do and I bought it for $17 at target. I thought it fit well, too, and I have HA to thank for the idea (searching prior posts).

I agree that daily changing is a better way to go and if this brace works, I can use considerably less materials to keep the wound covered. I'll add the extra cotton tonight.

Does the treatment remain the same regardless of whether the joints/ligaments were injured?

I'll post more pics as this progresses. Thanks again!

FROM DR. O:}

Yes the treatment remains the same as long as the joint capsule is not entered. These are the extensor groups and not as sensitive to damage as the flexor groups in the back: usually they heal fine.
DrO
Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:33 am:

Hi!
We're on day 5. I'd love to report the knee brace was successful at keeping everything in place, but I can't. I think it could, if combined with a full boot/wrap below. Perhaps sew this to a SMB type boot or attach them together somehow. So I reverted back to wrapping the hole leg to hoof w/gamgee and vetrap. I've rinsed it every day, washed with betadine, rinsed, then coated w/furazone and the wraps. He had his last dose of sulfa tabs tonight. He's still on bute 2x day. He puts weight on it readily and walks pretty good.

Here are some pictures from tonight.

How do things look?
Should I be concerned about the swelling?
At what point should I let it go w/o wrapping?
Should I stop using furazone and if so, when?
What product would you recommend if I stop using furazone but still wrap?

Okay..enough questions for now. He has been such a trooper, although he is feeling full of himself after being locked up for 5 days.

Thanks again for all the help.






Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:35 am:

DR O's Reply to my questions:
Taking them in order:
• Pretty good.
• Looks about normal for a wound on this type.
• Once the wound has completely granulated in you can discontinue wrapping. This wound is not there yet.
• We don't use furacin but it acceptable, see out article on wound care for our recommendations.
Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:37 am:

Hi Dr. O.

I'm at day 9. He's still on full stall rest and getting daily bandage changes. I'm trying to find some nolvasan creme and i've quit using the nitrofurozone ointment. Rather, I'm spraying it with a product called Quick-heal. I have also heard of a product called Cothi-vet from a friend but know nothing about it.

Should I continue my search for nolvasan creme and use that?

How do things look?



DR O'S REPLY:
Hmmm, It is granulating in but I would prefer the granulation tissue look "fresher": pink and bleeds easily. What is in the Quick-heal?
DrO

I would quit the rotating antimicrobials Debra. Even if tissue friendly alone the combinations, even if cleaned between uses, may well cause trouble. I would try to follow by recommendations in the article but if you are currently using nfz ointment that is ok.
DrO
Member:
mardeebo

Posted on Monday, Mar 19, 2007 - 9:45 am:

It's been a year now and I'm happy to report the pony's leg has completely healed and he has no issues whatsoever.

I have to thank Dr. O for his advice and this website. I do not believe it would have healed as quickly if I had not kept up with the simple instructions he provided - cold hosing, cold hosing, and more cold hosing.

To help offset the cost of wrapping this everyday, I used a baby diaper directly over the wound, and bought some Wrangler cotton pad leg wraps - the tall ones. I'd wrap that over the diaper with nearly an entire roll of co-flex (ie vetrap). I got a case of co-flex from country supply online for less than $20.

I initially tried to keep it in place with this knee brace..it works in a pinch, but after a night it would still slide down. Still, I'd give it a try if you're dealing with a cut in this location, too. Here's a picture of that:

Moderator:
DrO

Posted on Monday, Mar 19, 2007 - 6:43 pm:

Hello Mardeebo,
Do you have a image of the healed wound? These type wounds where there is a lot of skin missing on the front of the hock which is constantly flexing, are some of the most difficult wounds to get healed functionally. Your wound was further complicated by major damage to underlying connective tissue, even some extensor tendon damage. I would love a recent photo if you have the time.
DrO
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