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  Discussion on Leg cast for severe leg lasceration
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New Member:
helenr

Posted on Thursday, Nov 11, 2010 - 7:41 pm:

almost two weeks ago our mares hind leg became entangled in a rope fence, she struggled and the resulting injury was pretty horrendous. about 5 inches of her cannon bone was left exposed with the flap of skin hanging down her leg,the extensor tendon was also severed.we had her patched up by a local vet and the following day she was taken to a clinic about 3 hours away.she has been stitched ,although there wasnt enough flesh to cover the whole wound,and bandaged and splinted daily since then.we are told granulation tissue is starting to form but the stitches were loose and the clinic would now like to plaster cast the leg to aid healing .i have never heard of this approach to large wound healing,has anyone had any experience ,is it beneficial or would it be better to bring her home and carry on bandaging ourselves.
Moderator:
DrO

Posted on Thursday, Nov 11, 2010 - 8:07 pm:

Hello Helen,
Take heart, these horrible injuries to the front of the leg heal surprisingly well. That said I have never been a fan of casting over open wounds but this is a tried and true method in others hands. I have not examined this wound so cannot really express a opinion on proper treatment but if you feel uncomfortable with this decision you should seek a second opinion.
DrO
New Member:
helenr

Posted on Thursday, Nov 11, 2010 - 10:57 pm:

Hi,thanks for the advice DrO,i am at my wits end at the moment i dont know what to do for the best.i have spoken to the original vet who patched her up and she is all for bringing her back here and to continue bandaging even though she hasnt seen the wound for 2 weeks.the clinic are telling me the reason for casting is for safety as well as healing ,she comes round from sedation very quickly and can still kick out while under (is that unusual)and they are concerned that someone will get in the line of fire if they continue bandaging daily. are there any risks involved with this treatment ,have you seen any success with casting wounds and would the casting help any in the repair of the severed extensor tendon.
Moderator:
DrO

Posted on Friday, Nov 12, 2010 - 8:06 am:

The chief risk of casting is that you cannot examine the wound for complications, like a spreading infection, and sometimes the cast itself causes rub problems. The extensor tendon is likely to heal fine with or without the cast.
DrO
PS Helen it is more difficult to read postings that do not have proper capitilization and punctuation. In general you will get more responses with it.
Member:
cheryl

Posted on Friday, Nov 12, 2010 - 10:08 am:

Helen - fwiw - my gelding stepped through a piece of sheet metal in the pasture - (before he was rescued) hind foot - was a horrible looking wound - he was taken to UTenn Vet Clinic - was put in a cast - because she was afraid of him - the idiot owner put him back in pasture with the cast on - it ended up healing with a huge lump across the whole cut area - after he was rescued - either he or another horse stepped on the lump - ripping the whole area open - He was again taken to UTenn - another cast applied - the cast was removable for cleaning and treatment and was then reapplied - It took about five years for the lump to finally go away - he is sound on that foot - altho the hoof is 1/4 inch larger than his other hind hoof - I would not choose that treatment method - I think it would have healed better - with much less scar tissue - if it had been treated using Dr.O's method -- However - it did heal - he is sound - but given a choice I would say no - sounds to me the casting is more for their convenience than for the good of your horse.
Member:
lynnland

Posted on Friday, Nov 12, 2010 - 12:18 pm:

Hi Helen,

If the mare is behaving in a way that makes it very difficult to maintain the bandage (being sedated then kicking out) then casting might be better than the potential danger to her and those working with her. However, knowing the mare, if you think that you can manage to maintain the bandage properly without adding any significant amount of stress or danger to the mare (and yourself!) then it sounds like bandaging is the answer. The bandage won't be better than a cast if it cannot be done properly and regularly. It is, after all, about getting the job done.

Good luck
Lynn
Member:
judyhens

Posted on Saturday, Nov 13, 2010 - 12:03 am:

Hi Helen, your posting sounds much like we experienced with a 9 month old colt several years ago. He also had exposed cannon bone. I posted on this site and received wonderful help. I included pictures of his progress and ultimate healing. I think you would be encouraged by looking at what started out horrible in appearance and ended up pretty much perfect. The colt is now 4 and has won best movement awards and championships. He is also competing in open dressage shows. He is Andalusian and will end up snow white, which is good because the hair came in white where he was injured. :-) You can see the pictures by searching "5" cannon bone 9 month colt" and going to the thread. We used bandages and avoided petroleum products. Thankfully he was a great patient. - Anyway, our thoughts and prayers are with you and your horse. I think that the sequence of pictures will help give you hope for a full recovery. Blessings, Judy
New Member:
helenr

Posted on Wednesday, Nov 17, 2010 - 6:01 pm:

Hi,and thanks to those of you who replied to my original post,it has given me some hope that our girl may make some sort of recovery.We decided after much soul searching to leave her at the clinic as we dont feel able as yet to deal with such an horrendous injury ourselves,better to leave it to the experts for now.The clinic have started to bandage every other day now and for the moment have ruled out a half limb cast as the top of the wound would be too close to the top of the cast.Yesterday they removed the splint as it had been causing some discomfort rubbing,she was fine without it last night ,however today she is not putting weight on that foot at all,and is very sore .The extensor tendon was severed during the accident and she was having difficulty placing the foot properly at times ,knuckling over ,but with the splint she was slightly better to the point she was being walked maybe 20 feet and was fairly ok on it.The accident was almost 3 weeks ago ,should we expect to have seen more of an improvement,is this pain common after removing the splint, should it have been left on or is it something that may never heal,X-rays and a scan today show no other damage to the leg.The wound itself is starting to heal slowly and doesnt seem to be causing concern.
Moderator:
DrO

Posted on Thursday, Nov 18, 2010 - 4:27 pm:

Helen without examining the wound, the rub from the splint, and the horse we cannot really answer what would be normal for your wound at this point. These are questions that should be directed at those who can examine the wound...what do they say?

The extensor tendon laceration and concurrent knuckling will take more time perhaps months to resolve for more on tendon lacerations see, HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Lower Limb » Tendon Lacerations.
DrO
Member:
dres

Posted on Thursday, Nov 18, 2010 - 7:08 pm:

Helen, my mare severed her DDFT hind leg , she wore a split for weeks we would have to go look at my post for the exact time, 8-10 weeks i think ... then we put a stiff standing wrap on her with specially made shoes > pictures on my post< on her for another several months.. she was on complete stall rest for over 7 months..
These grave injures take a lot of time... i rehabbed my mare for 2 years... she is completely sound now..

On the first day God created horses, on the second day he painted them with spots..
New Member:
helenr

Posted on Tuesday, Nov 23, 2010 - 11:57 pm:

Hi,after our mare started to get sore in the splint and refused to walk the clinic knocked her out and put a cast on on friday.The trouble is she still wont put her foot down ,spending a lot of time lying down.The vet doesnt seem to have any answers(we live 3 hours away and i have to be persistant to get them to even call me back),at the moment all they can do is try different pain killers and sedatives, they cant explain why she wont walk as x-rays and ultrasound scan have shown nothing and the wound is starting to heal well we are told, any idea why she would still be in such pain.
Moderator:
DrO

Posted on Wednesday, Nov 24, 2010 - 6:26 pm:

What treatments are being given helen? Infection can be a cause of pain. Have you checked your horses temperature? Horses react very differently to restraint, this may be unwillingness to use the casted leg.
DrO
New Member:
helenr

Posted on Wednesday, Nov 24, 2010 - 8:59 pm:

Hi,at the moment they are trying out various pain killers including KETAPROFEN instead of bute, and sedatives such as ACE to try to relax her into walking on the leg.She has had antibiotics since day one ,both tablet and injectable.There was no sign of infection ,the only thing that did show on x-ray was a bone sequestrum forming which they attempted to scrape off when the cast went on,it wouldnt come away though.The really worrying thing was that she was already getting lamer before the cast went on.
Moderator:
DrO

Posted on Thursday, Nov 25, 2010 - 8:57 am:

And her temperature?
DrO
Member:
helenr

Posted on Thursday, Nov 25, 2010 - 11:09 pm:

As far as i know it is normal.she is at a clinic,
they should be checking it i would think.Its now almost a week since the cast went on and she still isnt bearing any weight on the bad leg.
Member:
cmatexas

Posted on Wednesday, Dec 1, 2010 - 4:34 pm:

How is your girl doing? We had a 2 yr old that cut the bulb of her heal off almost completely on smooth wire. We started with bandaging, and got poor results, and ended up in a cast. It STUNK and was a pain to take care of, but take heart - she healed totally. It took almost a year for her to be sound, but she is under saddle now and her new owner is in love! I hope you get the same type of results.
Member:
helenr

Posted on Monday, Dec 20, 2010 - 10:34 pm:

Hi,Just a quick update to let you know how our girl is doing.After almost ten days with the cast on she finally started to put weight on the leg,the cast was then left on for a total of three and a half weeks.Last monday it was removed ,there was really good granulation on the wound underneath,only one small area where a bone sequestrum had to be removed,even that granulated over after 24 hours.We finally ,after 7 weeks,got the ok to take her home friday.we are changing her bandages every other day as per vets instructions,but we are finding that she stands on the tip of the hoof and the slams the heel to the ground to move or knuckles over(due to the severed extensor tendon).I have read the articles on bandaging on this site and while its similar to what we are doing our vet didnt tell us to bandage over the coronet band,they left it higher(although the bandage used in the clinic was lower and thicker).Do you think the bandage is not giving enough support for the tendon injury ,or does it not make a huge difference at this point?how long before we can see some small improvement with the knuckling and should we be putting a stable bandage on the other hind leg as well?
Member:
canter

Posted on Tuesday, Dec 21, 2010 - 6:54 am:

Helen, I'll leave the bandaging questions to DrO, but just wanted to say how glad I am for you that the wound is finally healing well and that your mare is improving. I hope the knuckling starts to improve as well. Best wishes for continued healing!
Moderator:
DrO

Posted on Wednesday, Dec 22, 2010 - 7:02 pm:

Hello helen,
At over 6 weeks out from the extensor transection with a horse still knuckling over frequently I would begin to look for ways to support the foot in a way that keeps the foot from knuckling over in the hopes to get extensor function reestablished.

Standing raps on the opposite leg will not support the legs supportive tissues (flexor tendons and hoof wall laminae being the two most fragile) but may help with any edema that is occurring. Some of the neoprene fetlock bandages have evidence of supporting the tendons but if the horse can stand squarely on the injured leg this should not be a problem.
DrO
Member:
helenr

Posted on Thursday, Dec 23, 2010 - 1:18 pm:

Hi DrO, the reason at the time we were given for the extensor tendon not being able to repair itself was because of the wound on the leg being so big.The area where the tendon should have been was clean off to the bone and then the sequestrum started.As i said this has now granulated over completely and piece of bone was removed .we are finding that she puts much of her weight on that leg now ,the knuckling seems to happen when she forgets to place her foot ,usually when she is in a hurry to get across the stall when its feeding time,when she thinks about where to step she can do it quite well .Are there any other methods of supporting the foot/leg that we should consider? ,we are bandaging still ,and will be for quite some time,but are open to any suggestions either medical or through farriery.Given the length of time do you think now that any function will return to the tendon? or is it too late to expect any real improvement.Helen.
Member:
rein

Posted on Thursday, Dec 23, 2010 - 1:48 pm:

Hello,

Did not read your whole thing here but have been following it some. We too had a mare that severed that tendon with a huge nasty cut. The vet wanted to cast hers too, but I refrained worried about infection and wanted to change bandages every day. She too needed the bone scrapped and of course that was after the meaty part had started to grow back in. So back to step 2...

Anyway, we tried a shoe with a long piece of scrap metal welded onto the front so she could just shuffle. Ended up worse than nothing. Seemed to be best if we just wrapped her thick and snug to keep her leg straight for her.

She ended up in the stall for about 4 months is all. I was told to not let her move for 6, but in my thoughts I did not want it to tare so I would hand walk her slow and she was in a big enough pen to move around. After that 4 months she would rip and tare after all the cooped up time and I cringed every time! But all was great and other than a nasty scare she was as sound as they come and did not seem to have any limited movement.

Best of luck, you can do it!
Moderator:
DrO

Posted on Saturday, Dec 25, 2010 - 11:05 am:

No I do not see a hopeless situation, in fact I have never seen one of these that did not eventually heal and your last post sounds a little more encouraging. I would first try to avoid those situations that cause knuckling. A medium heavy well padded bandage running from the distal cannon down to the ground that has strips of flexible tape running down the front that resist knuckling might help. For this bandage to be most effective it should be applied with the limb weighted then when done strips of Elastikon run down the front and taped to the toe.
DrO
Member:
helenr

Posted on Tuesday, Mar 1, 2011 - 10:11 pm:

Hi, as i as saying ,our mare has shown quite a bit of improvement since i last posted 2 months ago,she no longer knuckles over and walks pretty well and the wound is looking healthy,although we have had to aggressively trim back proud flesh twice,we are still firmly bandaging the leg to help with support and minimize proud flesh.We havent walked her much as we were advised strict stall rest,but have started to walk about 50 meters every other day to hose the leg down.When i questioned the clinic as to what to do next,rehab/excercise, the reply was ask the local vet who is now treating her,however this type of injury is new to her (i guess the animal is usually destroyed )and she wasnt sure what to do next.I was wondering if anyone has any advice or experience with this type of injury.We dont want to rush things as the exstensor tendon was severed ,but are we making things worse by not moving her around.one thing we have noticed is we did take her down to hose the leg 2 days on the run last week,on the way back to the stall,(always bandaged in both directions), on the second day she began to hitch her leg up higher than the rest and place it down quite hard,she has also been lifting the leg when standing in her stall although both of these have improved a bit this week,again our vet couldnt offer any explanation for it,any ideas?.Also any advice on proud flesh would be great ,at the moment we use green wound cream when the proud flesh looks as if its getting bigger,the rest of the time we are using something called vulketan.Thanks
Moderator:
DrO

Posted on Wednesday, Mar 2, 2011 - 8:20 am:

Hi helen,
The leg lifting may be a front limb form of stringhalt which is a form of nerve damage and not completely understood. Though fairly common in the rear and is often associated with an injury front limb stringhalt is uncommon. Does the lifting seem involuntary? For more see HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Upper Rear Limb » Stringhalt.

Concerning the proud flesh we have a whole article on it see, HorseAdvice.com » Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns » The Treatment of Proud Flesh or Exuberant Granulation Tissue.

Without examining the horse I cannot give specific recommendations on rehab. Ultrasound examination of the tendon would be the best way to monitor healing. Without such help you generally start at a low level of walking and every 3 weeks increase the amount of walking by 50 to 100%. Run this by your vet and the clinic and see if they think this might work for your horse.
DrO
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