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  Discussion on Swollen Hock from a Kick
Author Message
Member:
Mwebster

Posted on Tuesday, Sep 2, 2003 - 10:31 pm:

Dear DrO,

My husband turned my mare out with his gelding on Sunday afternoon, they have been buddies over a fence for a year and she turns out just fine with my older gelding, and he said he'd "be there" with them. Well, they felt they needed to renegotiate pecking order, and got in about 5 kicks before he was able to separate them. His horse kicked my mare in (among other places) her right hock, leaving a short laceration on the proximal anterior medial area of the hock. She was immediately lame on that leg, though not profoundly: he said she held up the leg at the time it happened, then walked out normally, and she looked sound at the walk to me after the fact, but when I trotted her up she hesitated on that leg and looked sore, and she turns just slightly awkwardly on it.

The laceration seemed superficial, but there was a section 1" long that I can't swear was only a partial thickness cut, though I am sure nothing below the skin layer was cut. I thought about calling the vet because of that, thinking "full thickness cut means suture", but I couldn't see what a vet could suture here, and it was Labor Day weekend and it was doubtful I could get someone out before the next day, so I hosed, washed with saline, smeared with 1/4" of triple antibiotic, and bandaged with gauze and vetwrap to keep it clean. And I gave her a gram of meclofenamate to stave off inflammation.

Yesterday, everything looked fine. I remember thinking that calling the vet out for a little cut would have been silly... no swellings anywhere, all the little cuts and scrapes looked like they were just abrasions. I gave her the day off (of course!), thinking we'd ride the next day (today). I figured it was a good day to worm the horses, they were due. I discontinued the NSAIDs.

This am, the hock was very swollen, and hot. She stood patiently for the farrier, but when asked to bend that poor swollen hock she would crank her leg up high and out from the hip, as though it just felt too weird to bend it. I gave her another gram of meclo, and called the vet, thinking "xrays!".

The vet who looked at her this afternoon was worried about infection (saying any full-thickness tear -- even a pinpoint -- could allow infection, and it's so close to a joint...) and recommended a tetanus booster and 8 days SMZ/TMP, also NSAIDs. So we're giving her 13 tabs of SMZ 2x/day (she's 16.1h) plus 1g meclo 2x/day since meclo is what I've got around.

My questions are: 1) could an infection happen this quickly? We're talking about 36 hours. The vet thought maybe a small section of the laceration was faintly moist, indicating there may have been a tiny area that was full-thickness.
2) if she has an infection, should she have a fever? Her temp is normal at 99.4, though she had had 1g meclo 6 hrs prior to me taking her temp (oops!).
3) The article notes that a bad bruise can cause heat (as well as swelling), and I'm inclined to think that it's a bad bruise rather than an infection (note, I don't mind giving her the antibiotics just in case). Other than cold-hosing her hock frequently, and the NSAIDs, should I be attempting a pressure wrap? Should I be confining her or letting her wander around in her pasture? She really isn't very lame on it, but she's very athletic and fit, so I think she tolerates some discomfort and swelling without complaint. I want to make sure I avoid any chronic problem.

Thanks,
Melissa


Moderator:
DrO

Posted on Wednesday, Sep 3, 2003 - 7:22 am:

Rapidly worsening symptoms more than a day after a wound occurs is suggestive of infection. Kicks usually do much damage to the tissues and they imbed dirt and bacteria. Both of these predispose to infection. Yes it is a bit quick and yes you would expect fever but as you note there are confounding variables. Considering the history and location antibiotics seem prudent.

I think the choice of meclofenamate was poor. It appears to have a delayed onset of action (see article on drug) when you needed immediate anti-inflammatory action, bute or Banamine would be better.

If a infectious cellulitis is suspected, rest is best: moving around can also spread the infection around. I would wait for pressure bandaging until the area is no longer hot and painful.
DrO
Member:
Mwebster

Posted on Wednesday, Sep 3, 2003 - 12:13 pm:

Thanks, DrO.

Can/should I switch her to bute now? She had 1g meclo yesterday am, yesterday pm, and this am. The hock is just as swollen, though feels a little less hot. Still no fever, but I'm thinking infection too at this point.

Would a hock ice boot (assuming I can find one) be a good idea to help bring the inflammation down?

M
Member:
Canyon28

Posted on Wednesday, Sep 3, 2003 - 12:33 pm:

Your mare needs to be xrayed asap. she may have a large bone chip or even a broken leg. I had to put a foal down two years ago when it got kicked in the front of the hock by another foal or a mare. It swelled up immediately like your mares did and I had a vet out to look at it. I dont recall what the vet did, but the foal stayed lame on the leg for several more weeks and it stayed swollen, I finally took him in to a better vetand they xrayed the joint immediately, finding a large bone chip off the "knuckle" of the upper bone in the joint, right were it bends and moves. My vet told me he had never had good luck with operating in this area, and suggested I take the colt to CSU, almost 300 miles away, and the cost would have been about 1500 for the surgery. Even then he said the colt may have never been sound. He was not a stallion quality colt, so I made the sad decision to have him put down. It was the hardest thing I have ever done. It was also his dams last foal, she was old and was unbreedable after that. Anyway, get your mares leg xrayed now for possble joint chips or a fracture.
Member:
Mwebster

Posted on Wednesday, Sep 3, 2003 - 1:00 pm:

Thanks, Christine. What a sad tale. Yes, I am still thinking I'd like to be able to rule out a chip or any other kind of fracture. I've got a call in to the vet.

M


Moderator:
DrO

Posted on Wednesday, Sep 3, 2003 - 5:36 pm:

These are all questions for the vet who has seen the horse Melissa. I dont use meclofenamate (don't feel the extra expense is worthwhile) and in general you do not ice infections.
DrO
Member:
Mwebster

Posted on Saturday, Sep 6, 2003 - 10:25 am:

Xrays are clean, and the swelling/heat are decreasing steadily at this point. She's not lame and it seems like she's on the mend.
Whew!
M
Moderator:
DrO

Posted on Monday, Sep 8, 2003 - 7:10 am:

Very good Melissa.
DrO
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