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  Discussion on Wrapping a six week old leg swelling
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Member:
corinne

Posted on Saturday, Oct 16, 2010 - 1:03 pm:

Dr O,
Approximately six weeks ago after a wonderful training session my horse was turned out and injured his right fore leg. The injury didn't result in lameness so I didn't notice the swelling until the next morning when I went out to ride. The swelling was immediately apparent. It was located on the lateral side of the left fore leg around the area of the volar pouch (looking at your diagrams on leg anatomy). The swelling was hard to touch and cool. It extended up an over the splint bone button and right to the fetlock below. The swelling was unilateral. He was not lame at all during the lameness exam or anytime thereafter.
For the first 48 hours, the horse was put on stall/paddock rest. NSAIDS were given Q 24 for the first 48 hrs. Cold therapy was also started with ice boots and cold water lavage. The vet took a series of five xrays and there was no bone involvement, nor was the fetlock involved. She noted some soft tissue opacity. Horse was given Surpass to be applied BID for the duration of the injury remodeling and we were told to gradually progress back up to full work. We took three weeks to work back up to full training. We are currently riding third level dressage and getting ready for a show next month. His work has not been affecting.
The vet reassessed at the two week mark and said it could have been a hemorrhage of the tendon sheath without tendon involvement. It remains hard but the edges of the swelling seem to be softening (6 weeks out). The size however has remained the same...about a half a small lemon. One of the instructors/trainers at the barn recently inquired about standing him up during the day to decrease the size of the swelling. I told her I inquired about wrapping early on but was told by my vet that that would decrease circulation and inhibit the healing process which he said could take up to three months. I agreed with the vet. She said high level dressage horses are wrapped to increase circulation. I am confused as to how any form of constriction could increase circulation unless she was referring to the subsequent influx of blood flow when the wraps are removed. I don't want to impede the healing process, albeit a slow process, we have going, at the same rate if there is something I should doing I want to do it. To stand him up or not? If the lump stays a blemish I am fine with that since his performance is not affected. If increased circulation from wrapping can help the remodeling process this far out as she states then I will do that. Either way I wanted to get your opinion. Also at this level of training I could use those ceramic wraps that warm up (back on track) to increase blood flow prior to exercise. A friend allowed me to try them today and they do create a nice warmth to be used before exercise. Opinion?


v/r
Corinne
Moderator:
DrO

Posted on Monday, Oct 18, 2010 - 4:38 am:

I don't wrap firm swellings Corinne. As you note pressure bandaging can have a constrictive effect. There are cases however where bandaging has a beneficial effect on circulation and that is when it is used to control passive edema. Left uncontrolled this also adversely effects circulation so the control of the passive edema can result in a net positive effect on circulation.
DrO
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