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  Discussion on Deep puncture wound on hock & achilles tendon injury
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Member:
Jchadola

Posted on Tuesday, Apr 26, 2005 - 12:20 am:

It appears that my 23-year old horse impaled his hock on a piece of metal farm fence that was sticking out. It appears he may have kicked out at a board injuring his achilles tendon or it could simply be the effect of the deep laceration. My question relates to the normal course for this injury and if there is anything else I can do to help him.

He was standing for maybe a couple of hours unable to move before it was realized he was very injured. The vet on call came out at 10:45 at night, was concerned about how long he had been injured. He said that the tissue can die and the horse get the equine equivalent of flesh-eating disease and die. He cleaned the wound - it was at least 3" but appeared to extend along the tendon rather than going straight in. The vet said the tendon did not appear to be ruptured. My horse was in extreme pain, on 3 legs and pawing at the ground. His tendon was swollen. The vet gave him a shot of banamine and a tetanus shot. He injected him with Excenel. He said we were to give him the Excenel injections, cold-hose his leg ad clean out the wound plus give him bute. He did not know if my horse would make it. The next morning, my horse was putting weight on it and was much brighter. His temperature was normal. The vet was surprised at how well he was doing and said he could go out in a small paddock. All the treatments and medications were continued.

Two evenings later, he see,\med to feel quite good. I put him in a field to have some grass. He walked and walked before grazing on grass. He went to the mud and had a big roll. He appeared to hurt getting up. Within 45 minutes, he was on 3 legs again.

By Saturday (2 days later), when my regular vet came out to vaccinate my 2 horses, he examined the injured one - he was not tender on the laceration - it was oozing which the vet said was good. He was not lame walking straight in the small paddock or turning. His temperature was normal. We were to continue with all the same treatments excep my regular vet felt that the iodine solution the other vet gave us to irrigate the wound was too potentially irritating so he gave me a liquid furacin/peroxide I believe solution to use instead. He gave him his West Nile and flu/rhino vaccination.

My horse was doing well until today (Monday) - 2 days later. Today we took him off Bute as we were concerned it could hurt his stomach - he had been getting it for 6 days. His leg was more swollen and there was more yellow stuff oozing out of the wound than there had been. After we pressed out the yellow stuff and cold-hozed it, he was very sore and on 3 legs again. When we used the furacin/peroxide solution, it obviously stung him whereas the iodine solution did not. His appetite is normal.

(1) Is this the normal progress of this type of injury - he appears to have ups and downs.
(2) Was the increase in swelling and oozing and pain related to not giving him bute today?
(3) Should we continue with the bute?
(4) His last dose of Excenel is tomorrow. Should he continue on it given he has never had a fever since his injury and has been on it 8 days as of tomorrow?
(5) Could he be more sore because of getting the vaccinations 2 days ago - my vet thought it was fine to give it to him because he had no fever and seemed to be doing well.
(6) Is there anything else I could give him or do for him to help in his recovery?
Moderator:
DrO

Posted on Tuesday, Apr 26, 2005 - 11:33 am:

1) I think the "downs" may represent a poorly draining wound where infection is pocketing up. This wound needs to be thoroughly explored and all infected tissues identified and opened so that they can be easily flushed clean and drain well, this is the most important step.

2) Possibly but the number 1 cause needs examination.

3) Yes if OK'ed by your vet. 3 legged horses are at risk of breaking down the opposite leg.

4) This is a clinical decision that should be made following an exam.

5) Generally sore yes, lamer in that one leg no.

6) I do not like the choice of topical treatments you have been given for the wound. For our suggestions see the article associated with this discussion.
DrO
Member:
Jchadola

Posted on Tuesday, Apr 26, 2005 - 2:07 pm:

Thank you so much Dr. O. The article on long term wound care was excellent. I called my vet and he cannot get out today to look at the wound and open it up and clean it if necessary; however, I have a call into another vet I have used to see if he can come out. I am going to keep him on Excenel for another 4 days. I am also going to try to get some nitrofurazone spray as you recommend in your article and I am going to increase the pressure on the hose when I cold-hose the wound as I have been mostly letting the water run over the wound and when I directed the water directly at the wound, the pressure was not very strong. I feel much better now because between your reply to my post and your article, I understand what is going on, what the proper treatment is and what to expect as it heals. This website and the information you provide on it for the small price of a membership is priceless - not only does it assist in giving our equine companions the best care but it goes a long way to relieving the huge stress associated with having an injured or sick horse.
Moderator:
DrO

Posted on Wednesday, Apr 27, 2005 - 6:56 am:

Don't forget the bute until sounder, thanks for the kudos.
DrO
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