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Discussion on WARNING! Graphic pics.
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Member:
cmatexas
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Posted on Thursday, Mar 4, 2010 - 11:40 am:
Our neighbor took in a very nice quarter horse mare last fall with a very severe leg wound. They have used our barn for stall rest when needed. The leg is grotesque!! However, the mare seems otherwise sound. She has been lightly ridden when not on vet ordered stall rest. She moves very well, obviously some pleasure blood in her somewhere. She bucks and kicks and moves freely at walk and lope, but does seem to be a little stiff at the trot, but not enough to cause head bob or obvious limp. I haven't paid attention to whether or not she moves well at either lead; I don't know if the neighbor asks for a lead, or lets the mare choose.
Anyway......she asked if I would post this, see if anyone has suggestions. This is the timeline she gave me on the care for the horse:
July 09 – Harley’s leg is caught in a gap
July - Rec’d vet care one time only (as I was told)
July – Nov. – No vet care and little was done to wound in any way. Some hyDrO treatment??
Nov. ’09 – retrieved horse and began cleaning the wound and hyDrO’ing daily until vet was seen
Nov. – Harley was taken to vet and Dr. cut off large amounts of proud flesh, bandaged and was given Dexamethasone for inflammation. X ray done. No bone damage
Dec. ’09 – taken back for recheck. No improvement. Setup appt for skin plugs @ A&M. Dr. put her on Thermazene with Dexamethasone mixed. Continued oral Dex.
Jan. 29th ’10 – skin plugs were inserted. Stall rest and constant bandage changing for 30 days. Taken off Dex.
Mar. 6th – Rechecked. Plug did not survive or at least most did not. Harley ate huge portion of proud flesh along with any plugs that were there. Put back on Dexamethasone and Panalog. Returned to pasture.
Told by a soft tissue specialist @ A&M that scar tissue and proud flesh could be cut off and large skin graph completed, but did not really think it would work. (about a 50% chance and VERY expensive)
Maybe a suggestion of immune issues with mare? Mare also has developed some hair loss on shoulder. Looks like fungus, but vet said more like systemic problem related to leg?? Treated with MTG, seems to be better in my opinion.
I will post pics next
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Member:
cmatexas
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Posted on Thursday, Mar 4, 2010 - 11:44 am:
Most recent picture
Picture last week before she ate proud flesh.
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Member:
cmatexas
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Posted on Thursday, Mar 4, 2010 - 11:45 am:
Has anyone ever seen anything like this? Is there any course of treatment?
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Member:
canter
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Posted on Thursday, Mar 4, 2010 - 12:50 pm:
Wow, Michelle. That's one horrific looking wound. I have no useful advice, but am amazed that the mare is not obviously lame! Good luck to you and your friend in getting this healed properly.
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Member:
scooter
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Posted on Thursday, Mar 4, 2010 - 2:20 pm:
Be careful with the chewing of the proud flesh. I had a gelding years ago that cut himself up pretty bad on barbed wire, the wound was healing well, then one night he decided to chew at it...he actually chewed through all his muscles and I had to put him down. His injury was on the shoulder, and there was no way to wrap it. I had never heard of a horse doing this, otherwise I would have put a collar of some sort on him..
As far as the wound on this horse, no idea what should be done...that is a dandy. I wonder since she now has removed the proud flesh you should treat it as a fresh wound in the articles...don't know.
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New Member:
spryte
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Posted on Thursday, Mar 4, 2010 - 5:46 pm:
Hello, there is a treatment you could try.. its called Equaide. A friend of mine used it on her horse that de-gloved his leg.. Her Vet now stocks it on the strength of how well it worked on proud flesh..!!. Im about to start using it on my mare who has an awful injury to her offside hind..she did it on Saturday.. you could see bone sheath and tendon.. i will try to send a pic (taken 4 days later).. the vet said it is un-stichable and because of her temperament my options are limited.
Im in Scotland UK.. but Equaide is an American product and readily available there.
Lots of Luck.
Rosie
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New Member:
spryte
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Posted on Thursday, Mar 4, 2010 - 5:57 pm:
Just realised this may look like I have left the wound open.. It has been heavily dressed since the moment I saw it and called the vet. This was taken just after taking one dressing off and applying the next.
Rosie
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Member:
stek
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Posted on Thursday, Mar 4, 2010 - 6:42 pm:
Rosie a mare on a farm I worked on once had a leg that looked very similar to that. The injury occurred several months before I started working there and was treated routinely before I started and religiously by me for about 18 months.
Took several surgeries to remove the proud flesh which kept coming back, and several attempts at skin plugs before some took. At the end of a year and a half it was pretty well closed over. The mare was on stall rest and hand walking for a long time but showed no lameness after the first month or so.
Good luck to your friend, and don't give up on the mare!
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Member:
stek
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Posted on Thursday, Mar 4, 2010 - 6:42 pm:
oops, sorry meant to address that post to you Michelle =)
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Member:
ginny
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Posted on Thursday, Mar 4, 2010 - 6:53 pm:
To those of you fighting horrific wounds, I wish to say that there is hope. My Quarter Horse Mare, Fancy, cut her knee on a culvert. She sliced the skin right off of the knee and shredded her left extensor tendon. It was only by the grace of God that she didn't cut the joint capsule. Anyway, I am including some photos that were taken as the healing took place. I never had a proud flesh problem because I followed a technique given to me by a vet whose name is Dr. Jolly, from Little Rock, Arkansas. This vet has developed a cream that contains equine stem cells and the cream assists in healing and growing skin back, even hair. The idea is to leave the wound open to the air but covered by a piece of absorbant paper towel which will absorb the effluent from the skin. The wound is cleaned daily and a small bit of cream is placed on the growing edges of the skin.The name of the cream is Eclipse. A piece of paper towel is cut to just cover the wound. Then the knee, in this case, was covered by a ladies knee high with the foot cut out. The knee high put just enough pressure on the wound to discourage proud flesh. The knee high was kept in place with some velcro dots glued to the leg top and bottom and then some vet wrap top and bottom also. I will include pictures so that you can see the healing process. The first pic was taken one week out ( I forgot to take a picture of the wound initially because I was so upset), and the following pictures were taken several weeks apart. Needless to say, the knee healed very well, no unsoundness, and covered with hair. There is just a small thin line of scar tissue where the skin finally came together. I hope that this helps. Sorry, just found out that I cannot get pics to upload. I will try again.
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Member:
gramsey1
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Posted on Friday, Mar 5, 2010 - 6:52 am:
We had a very good response to an proud flesh problem using Equaide too.
Our vet removed the excess flesh and said she would probably need to do it again. She asked us to try Equaide and let her know how it worked.
Six weeks later the wound was completely healed with no scare and without further surgery.
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 9:42 am:
Thanks for all the suggestions. Do you think Equaide or Eclipse will work on a wound almost 9 months old, that was uncared for for quite a while?
We need to include pictures of the entire leg. The swelling extends will up into her thigh, not just right on the wound. I think Dana (my neighbor) joined ha, so she will probably jump in here today.
When treating it, did you keep it covered constantly? Stalled? The vet recommended turning her out, and keeping it uncovered. However, if I understand Dana correctly, the vets are on new ground with this leg wound. No one is really sure what to do next.
A few other things: she is a rescue, and money is not unlimited. Also, good equine vets are not available for farm calls; they have to haul her quite a ways for reliable care.
On another note - did anyone see the newest article in America's Horse Daily concerning message boards?
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Member:
gramsey1
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Posted on Friday, Mar 5, 2010 - 9:53 am:
I think you need to discuss this with a vet.
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 10:04 am:
They have discussed is with a vet. They have discussed it with MANY vets, including those at A&M who performed the skin grafts. Nothing has worked. The leg is no better, and may actually be worse. The last suggestion was to "try a powder to remove the proud flesh and turn her out. We'll see what that does".
Our hope was that someone out there has seen something like this, and may be able to give some suggestions, or maybe point us to whomever helped them conquer this kind of wound.
I assure you this is not a substitution for good vet care.
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 10:06 am:
Maybe Dr. O or someone will have a suggestion that they can discuss with the vet? Maybe something he is not familiar with, or has not tried in his practice.
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Member:
corinne
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Posted on Friday, Mar 5, 2010 - 10:20 am:
Michelle, we can see from your post that good vet care has been obtained since your friend took in the Mare. Hopefully Dr. O will respond with his opinion shortly. Tell her to keep up the daily water lavage and the good work!
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Member:
stek
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Posted on Friday, Mar 5, 2010 - 10:58 am:
Michelle the mare I mentioned above at one point was treated by using different substances to eat back the proud flesh with the wound left open. One was granulex (a spray), another was wonder dust (a powder). The wonder dust seemed to do a better job of shrinking the proud flesh.
I'm not sure what the best course of action is regarding leaving it open or closed, but I can tell you that the mare with a similar wound was kept wrapped for many months, and when we finally got to the point where we wanted to leave it open it would swell terribly every time it was left un-bandaged. I guess the leg got used to being kept under pressure so it would blow up every time that pressure was removed.
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New Member:
spryte
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Posted on Friday, Mar 5, 2010 - 11:14 am:
Hi Michelle, have a look at the Equaide web site www.equaide.com Im sure the Eclipse product has one too. I do think that the Equaide product could help.. What my friend said to me was that as Josh s leg began to heal the vets came out every 3 weeks or so to cut cauliflower like lumps of proud flesh off.. she researched and found the Equaide.. she tried it.. 3 weeks later when her vet returned there was no re growth of proud flesh..he was so surprised he DIDNT charge her for the visit!!! (this was 3 MONTHS after the initial incident.. so it does seem effective quite some time after the event.
By strange co -incidence my mare was sort of rescued as well.. In my case I HAVE to leave her out or bring her in with the others because her behaviour if separated or confined without them is violent! So I am hoping that it will work without box rest.
Rosie
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 11:39 am:
I've seen that stuff at many horse shows lately......hmmm! That's something to try.
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Member:
frances
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Posted on Friday, Mar 5, 2010 - 1:52 pm:
Another useful product for preventing proud flesh among other things is Lotagen (you can find it on google). It was incredibly effective on my mare's knee which she split open one or two years ago (see Lacerated Knee).
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Member:
hpyhaulr
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Posted on Friday, Mar 5, 2010 - 5:15 pm:
I don't have first hand experience here like most of you folks. I have had some small injuries here which have all responded very well with a bit of wonder dust. However, I recently bought a new product which I had seen in Equus and then happened to meet up with the owner of the company which produces this product. It is called Banixx. www.banixx.com It is an antifungal, antibacterial spray which debrides the necrotic tissue and heals from the inside out. Odorless and tasteless, it has no adverse feeling or obnoxious feeling. I tried it on myself (just to see how it felt/smelled and the dog's hot spots (very quick response). I have not had the opportunity or need to try it on a horse yet Thank God, BUT it is in my barn medicine cabinet. The pix I saw in the pamphlet rivaled those you posted here, with remarkable results. I have talked to other haulers who keep it on board and now we do as well. Tx for:open wounds, Rain rot, proud flesh,WLD, thrush, hot spots....not exactly world peace, but not too far behind it! 1-888-282-4599. I paid $25 for 32oz spray bottle.
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Member:
ajudson1
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Posted on Friday, Mar 5, 2010 - 6:48 pm:
Cyndy,
What's in the Banixx? I didn't see any ingredient list on the web site which seems suspicious to me. Unless of course I missed it.
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Moderator:
DrO
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Posted on Friday, Mar 5, 2010 - 7:22 pm:
Hello Michelle,
For many reasons I avoid third person consults. I will say I don't think the wound hopeless and I would recommend the principles applied in the articles on treating proud flesh and long term wound care are how I would care for this. You are welcome to print off the articles and present them to the folks of the unfortunate horse illustrated above.
DrO
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Member:
gramsey1
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Posted on Friday, Mar 5, 2010 - 7:24 pm:
Our vet was of the opinion that the excess tissue had to be removed and then proper healing initiated. She was not at all certain that the Equaide would help.
It did. Healing was fast, tissue production controlled and left no scar.
I was totally impressed.
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 7:42 pm:
Dr. O, the good news is that Dana joined HA earlier this week. But.....she accidentally signed up for the membership that can't post. She emailed today to try to fix it.
Hopefully by tomorrow she will be able to discuss it with you and take over the posts. She is keeping it bandaged in the mean time and changing daily I think, plus using a powder to treat proud flesh (I don't can't remember stupid name for the life of me!!!) She emailed today that she is ordering equaide. We don't know if we should be hyDrOing it at this point? Couldn't decide from the articles since this wound is so old, and proud flesh is so out of control. Don't want to do any more harm.
Thanks!
Michelle
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Member:
hpyhaulr
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Posted on Friday, Mar 5, 2010 - 8:30 pm:
The bottle only says Active ingredients 2.5% HyDrOnium Solution (H9O4) I have NO clue what that means, Dr.O???
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Member:
cmatexas
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Posted on Friday, Mar 5, 2010 - 9:06 pm:
Going to go out on a limb here...have no idea how hyDrOnium is useful in medications. pH is a measure of the hyDrOnium concentration of a solution. So maybe they are implying it works because of it's pH???????
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Member:
juliem
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Posted on Friday, Mar 5, 2010 - 11:53 pm:
I think we've had discussions about Wonder Dust and how it's caustic to healthy, healing tissues. My vet threw a can that was at the barn my horse used to be at in the trash--vehemently!
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Member:
juliem
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Posted on Friday, Mar 5, 2010 - 11:54 pm:
I really think most of your questions are answered in the articles about long term wound care and proud flesh. You follow those protocols until there's healing regardless of the age of the wound I believe. Good luck and keep us posted.
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Member:
vickiann
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Posted on Saturday, Mar 6, 2010 - 4:48 pm:
I have used the Granulex on "deleterious tissue" for similar looking deep wounds, but nothing of such a large size.
My wound care program aims to normalize the hydration level of the tissue so that if it is too dry, use a product that moistens, or if too wet, use a drying product. This seems to be determined by the stage of the healing and also the climactic conditions to some degree.
Depending upon the stage of a deep wound I have had success with Nitrofurazone (salve, or for drying action, use a related spray on product), scarlet oil, blue lotion, granulex.
One reason that I don't like Wonder Dust is because of what it could do to a horses' eye if it gets from leg to eye area.
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New Member:
DrOb
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Posted on Monday, Mar 8, 2010 - 12:43 pm:
Testing
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New Member:
DrOb
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Posted on Monday, Mar 8, 2010 - 12:45 pm:
I am the owner of the mare with the severe leg wound. I wanted to let everyone know there is light at the end of this long tunnel. We are seeing improvement in the healthy tissue. It is slowly growing upward and downward. Has anyone ever used Panalog to treat wounds?
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New Member:
DrOb
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Posted on Monday, Mar 8, 2010 - 1:55 pm:
I have a question for Dr. O about the eating of proud flesh. I realize that horses naturally remove proud flesh in the wild. My question is why is the mare suddenly more determined to bite at the wound? It was left uncovered when we 1st brought her home and had a tremendous amount of proud flesh and she pretty much left it alone. Now she even tears through the bandaging to get to the proud flesh? Why the change? Any advice? Last time she dug in pretty deeply.
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Member:
vickiann
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Posted on Monday, Mar 8, 2010 - 2:08 pm:
Good news, Dana.
My thinking about the horse biting at and removing the proud flesh tissue now is that the horse is feeling an uncomfortable sensation at the current stage of healing, such as itching or a sense of tightening?
A relative of mine was severely burned in a plane crash and the greatest misery that he felt during the long hospitalization and recuperation was when the healing actually progressed to an improved condition, including itching.
Hopefully Dr. O will have a professional opinion for your question.
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Member:
hpyhaulr
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Posted on Monday, Mar 8, 2010 - 4:28 pm:
2 years ago was the first time I used panalog on a horse, a rope burn on one of my geldings. It did VERY well, but I had to get it from a small animal vet and it came in a VERY small tube.I had to drive to NC every week to get it, as they would only dispense 2 1oz tubes at a time. A month's supply for a chihuahua, but not nearly enough for a horse. Years ago when I was in vet med in NY, we got it by the half gallon and dispensed in 2oz and 4oz. containers. It was not the tube cream, but a thick yellow liquid. It was always in my 'critter care cabinet', just in case. Worked great.
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New Member:
DrOb
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Posted on Tuesday, Mar 9, 2010 - 10:09 am:
Okay, will try to get the Panalog today. Will take pictures this afternoon and post them to show what little progress we have. Progress is progress!
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Member:
hpyhaulr
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Posted on Tuesday, Mar 9, 2010 - 10:40 am:
and I probably will get my wrist slapped for this, but when I contracted a bad case of poison ivy, panalog worked better than any human meds available. Almost instant relief from the pain and it looked alot better within 24 hours. Gosh, I had forgotten about that til this post.
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New Member:
DrOb
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Posted on Tuesday, Mar 9, 2010 - 12:40 pm:
Wow! That is cool. Have you ever used Themazene? it is actually for humans, but my vet recommended it for proud flesh...for infection. It has helped a great deal. Nothing will help like the passing of healing-time. I am just hoping the healthy tissue will be strong enough and not constantly be cut or strained.
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Moderator:
DrO
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Posted on Tuesday, Mar 9, 2010 - 6:21 pm:
Welcome Dana,
It is not a typical response to a wound with simple, though severe, proud flesh problem and suggests to me it is either painful or maybe is pruritic. This could be caused by a deeper unresolved infection or possibly a reaction to something you are putting on the wound. Is there any fever, increased lameness or swelling not associated with the increased granulation tissue. If it persists I would have it evaluated by the veterinarian.
DrO
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Member:
DrOb
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Posted on Wednesday, Mar 10, 2010 - 11:26 am:
Will do. No fever or lameness. She runs around and bucks and kicks up. Seems to feel great. Switched to Panalog and she is still on a very low dose of Dexamethasone for the inflammation. Will keep an eye on it. If you have any more information just let me know. Will upload pictures later if I have time.
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Member:
DrOb
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Posted on Wednesday, Mar 10, 2010 - 11:29 am:
You know the day she really ate into the proud flesh, I had put Copper Sulphate on it. Only one application and decided against it. ??? Wonder if this is connected?
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Member:
DrOb
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Posted on Wednesday, Mar 10, 2010 - 10:27 pm:
testing
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Member:
DrOb
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Posted on Wednesday, Mar 10, 2010 - 10:29 pm:
The above picture shows some of the progress that has been made, esp if you look back at the initial pictures in November.
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Member:
cmatexas
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Posted on Thursday, Mar 11, 2010 - 8:38 am:
Dana,
Leg looks great!! Well...not "great" lol, but better. No more chewing?
She and Dee have been having a good time out there. She seems VERY glad to be out of stall.
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Member:
cmatexas
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Posted on Thursday, Mar 11, 2010 - 8:43 am:
You should post a full body pic so people can see what a gorgeous horse she is!
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Member:
DrOb
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Posted on Thursday, Mar 11, 2010 - 8:58 am:
Will try. I have had a hard time getting pics to upload. I am not very technical.
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