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Discussion on Heel Bulb Cut - Conflicting Vet Advice
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New Member:
chelhunt
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Posted on Saturday, Aug 28, 2010 - 11:27 pm:
I'm at my wits end. I have a mare who cut into the heel bulb of her front left foot. The cut is about 1 1/2 inches deep from the top of the heel bulb down into the flesh, but it doesn't seem to have damaged anything major. I have 3 vets that come by our stables regularly and all 3 just happened to be out visiting other horses when we brought this mare in from pasture and noticed the wound. She is not lame and doesn't seem to be in any pain - but the treatment suggestions are making me crazy. They are as follows:
1. Put on a boot and soak in Hypertonic Saline solution for 5 days, using Tucoprim daily, then re-evaluate to see if the wound should be sutured or the skin and flesh removed.
2. Hose it off, apply ointment and wrap with vetwrap, using duct tape on the areas that make contact with the ground, change dressing every other day for 10 days, use Tucoprim daily.
3. Clean the wound, suture the cut area, dress as above and use Tucoprim daily.
I've never had a horse with a heel bulb injury and I'm no expert. Are any of these methods better than the other? I've read through the other discussions, but I'm not sure they are the same as mine, considering this cut is hours old vs days old. Any help is appreciated.
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Member:
shirl
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Posted on Saturday, Aug 28, 2010 - 11:37 pm:
I'm certainly no expert, but if it is that deep into the flesh I think it needs to be sutured, but again I'm certainly not a vet.
What does your own Vet say?
Good Luck
Shirley
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New Member:
chelhunt
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Posted on Sunday, Aug 29, 2010 - 1:21 am:
Unfortunately, my vet is way back in Texas and we haven't established a relationship with a local vet as of yet (just moved here).
The hardest part of this is that 2 of the vets say don't suture it because you would end up suturing in possible infection. At this very moment she's standing in a box stall with a boot with hypertonic saline and I've already started her on Tucoprim. I'm just not convinced that this is the best route to take so I'm seeking advice on all methods so I can make a more informed decision. I'll be checking on her again first thing in the morning to see how she's doing. For now, she's standing calmly and showing no signs of fever or lameness - just impatience with being locked up. 
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Member:
gramsey1
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Posted on Sunday, Aug 29, 2010 - 8:17 am:
1. makes no sense to me.
3. makes sense but it is too late now, and might have been too late when the wound was discovered.
I choose number 2.
Perhaps the most valuable part of of this site, the advice already given, often goes unnoticed by new members looking for immediate answers.
check these links.
Bandaging horses
https://www.horseadvice.com/horse/messages/4/8542.html
Wound first aid
https://www.horseadvice.com/horse/messages/4/1048.html
Deep wound care
https://www.horseadvice.com/horse/messages/4/16049.html
And this because you may need it, on proud flesh.
https://www.horseadvice.com/horse/messages/4/16050.html
How does she do with stall rest and hand walking?
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Moderator:
DrO
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Posted on Sunday, Aug 29, 2010 - 10:03 am:
Welcome Michelle,
We have an article on coronary band injuries which have similar complications and healing as heel bulb injuries. For our recommendations check out HorseAdvice.com » Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns » Coronary Band Injury.
DrO
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Member:
zoey
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Posted on Sunday, Aug 29, 2010 - 10:19 am:
Is this an injury or did she possibly have a abcess that blew out at the bulb at her heel. I have had some pretty nasty abcesses in the hoof that blew out the bulb, and it split about 1 1/2" ,, we put on a medicated pad, wrapped with vetwrap/duc tape, gave tucromprim for 5 days,,, put topical dressing on for a few days after dressing was removed.
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New Member:
chelhunt
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Posted on Sunday, Aug 29, 2010 - 11:01 am:
Guy - I actually have to agree with you, I don't care much for any but option 2, though I tend to let people con me into trying things.
I checked on her very early this morning and she seemed fine. No fever, no heat on the leg (a little around the actual injury). She doesn't care much for being stalled in the barn, but she'll get over it. She HATES the boot.
I'll be changing her out of the boot and into the recommended dressing as soon as I finish eating my breakfast and typing this post.
Sherri - definitely not an abscess. The cut comes down the leg (you can see the scraping along the lower leg) and then cuts directly into the heel bulb continuing down into the flesh.
Thanks for the understanding with a new member. I tried to read through everything, but obviously missed quite a bit.
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Member:
gramsey1
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Posted on Sunday, Aug 29, 2010 - 11:32 am:
Welcome.
There is so much information on this site. After reading Dr. O's post and the article, it looks like you ended up with the best choice. Our horse was stomping flies and caught his heel on a rock or something. It was a nasty injury. Nearly knocked a half dollar size piece off his bulb.
I wish I had seen the electrical tape advice.
I bet it would have worked. Instead, our effort to hold it in place with vet wrap failed and we ended up with a big open sore, proud flesh and now a scar.
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Member:
rtrotter
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Posted on Sunday, Aug 29, 2010 - 1:48 pm:
Michelle,
I agree with number two. I have had similar cuts that healed extremely well using Icathamol, a gauze roll, a small amount of vet wrap and electrical tape, no antibiotics.
The important thing is to make sure the cut stays clean and as long as she is staying in, to clean it every day, it will help heal it more quickly. I am not sure I'd go with any sutures as this is an extremely difficult area to stitch. If you see it healing well after a few days you might want to go to a dry treatment such as furazone spray or bluing (Blue-cote). If you could get some exercise into her, or let her walk around in a small paddock without her going nuts, the walking will stimulate her circulation to work at the healing.
Rachelle
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Member:
boots
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Posted on Sunday, Aug 29, 2010 - 2:47 pm:
My gelding cut his heel bulb up almost to the bone.We think it was a wire. It required a lengthy stay in the hospital with surgery, a cast, and daily voluntary visits from us. He healed up beatifully with only the loss of one nerve that could not be repaired. He is fine today, you can't see any damage and he can do everything. Please stick with your best vet of choice.
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New Member:
chelhunt
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Posted on Monday, Aug 30, 2010 - 9:05 pm:
Well, we have found the vet we are going to stick with! He came out today and took a really good look at the cut. He pointed out where she had cut into the nerve and the artery and commended me for my bandaging job (thanks to everyone for helping me with this!) He was very polite when he gave his opinion of soaking injuries like this. He actually hauled her back to his clinic where he will be placing a cast on her first thing tomorrow morning. She can come back home on Wednesday and she'll be on stall rest for 3-4 weeks. Boy is she going to be a grump!
Thanks to everyone for your experiences with this, it helped me to keep her going long enough to find the right vet for us.
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