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Discussion on Puncture wound on joint
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New Member:
cinn
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Posted on Sunday, Nov 21, 2010 - 11:37 am:
DrO, hi! I am hoping you can give me some advice on a wound I’ve been treating for 10-days now. I trust in my vet and believe we are on the right track, but I figure it wouldn’t hurt to get your opinion in case maybe you’ve dealt with something similar. Sorry in advance for the length this might end up being.
Thursday before last, typical morning shenanigans going on in my pasture in the 9-10 am time frame. Around noon, went to take one of them out for a ride and noticed his knee was swollen. Noticed a scrape and smaller cut on the inside of his leg, but these seemed pretty minor. Limped him back up to the barn, cut all the fur away so I could see what was going on, applied cold hose and gave him Bute. He was very lethargic during this process.
Called my vet and told her what was going on, primary focus being the swelling since the cuts looks so minor. She suggested ice over the next 24-hours, which we did. He was still lethargic and very sore by the end of the day. Decided vet would come next day.
Next day, Friday, swelling has gone down some, but the wounds are now oozing yellow bubbles. Vet arrives and gives him a shot of DexMex and starts him on antibiotics, says she’s very glad she’s there & determines possible venomous snake bite (it will look obvious when you get to the pictures, but seriously it did not look this way in the beginning, and even so, we were still considering a puncture with something stuck in there).
Start twice a day cleaning consisting of heavy spray with warm hose & irrigation w/Sodium Chloride.
Saturday I decided to start taking pictures. You can see the wound on the right, which was the smaller of the 2 cuts, pressing within about an inch and a half would make it erupt. The “scratch” to the left appeared to be just that.
Tuesday, Day 5 – second vet check, seems to be on track. Flexion is good, but showing lameness at the trot, joint area is still very sensitive to the touch and hot, still oozing.
Wednesday, Day 6 – wounds start getting a little bigger, scratch starts oozing too.
The other horses have been very concerned, and have been trying to help lick it!
Thursday, 1 Week later – loosing more fur around cuts.
Friday, Day – cut Bute down to once a day, antibiotics, and wound cleaning still twice a day.
Saturday, Day 9 – both cuts more open, still oozing, hot, lame at trot, still very sensitive to touch the area.
Sunday (today), Day 10 – this is how it looks before I clean it up twice a day. The goo dripping down his leg is very thick/sticky/hard (like sap) and does not hose off. I use a comb to scrape it off.
Here it is today after the clean-up. Joint is still hot, oozing, and sensitive.
So, being in NC, which I am also, have you dealt with a snake bite like this? I have not been able to find much online to compare to, and none of my horse friends have experienced this. The venomous snakes I’ve seen around here are copperheads, but from what I’ve found on CES-NCSU there are others.
From your perspective, does it look and sound like it’s healing properly? At what point would I want to let it scab over? Any thoughts on the matter are much appreciated.
Thanks.
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New Member:
cinn
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Posted on Monday, Nov 22, 2010 - 10:09 am:
Here it is today, Day 11 - it looks better on the surface, but when you bend his leg it oozes thick yellow.
I'm getting a little frustrated and discouraged as I just can't tell if it's healing properly anymore.
Looking forward to hearing from you!
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Member:
vickiann
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Posted on Monday, Nov 22, 2010 - 1:04 pm:
Dr. O is certainly needed to look at these photos and advise.
This looks really nasty to me. You didn't say what is currently being used for antibiotics?
One of mine got cellulitis due to puncture wounds (animal bite) to the fetlock/tendon sheath.
He was put on two different IV antibiotics and had a port in his neck for delivery.
I cannot help but think your horse may need additional or different medication and treatment than he has been receiving.
Good luck to you.
Let us know how it goes as things progress.
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New Member:
cinn
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Posted on Monday, Nov 22, 2010 - 2:04 pm:
Yeah, the waiting is killing me! Just made another check-up appointment with my vet for tonight.
Antibiotics he's on are SMZs, 11 tabs twice a day (he's only about 900 lbs).
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Member:
theresab
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Posted on Monday, Nov 22, 2010 - 6:25 pm:
I can understand your anxiety, I'd be having fits myself. Before I offer any advice, I'm no vet, nor have I had any medical training. I will defer to Dr. O and to your vet in their expert opinions. Also I've never had a horse suffer a snakebite (knock on wood). My only experience is my husband's recluse bite on his leg that we treated at home because he was too stubborn to go to the doctor. His bite took about 3-4 weeks to heal but didn't get much bigger than nickel sized hole. (Stubborn, stubborn man)
Disclaimer said:
My gut instinct says as long as it's oozing, keep it open. I would think the venom from the snake bite would cause the tissue to necrotize. Cold hosing, cold hosing and more cold hosing to keep washing it out and flushing the area, as strong of a stream as your horse will tolerate. I would possibly go get saline and fill up a syringe and flush it out with that as well. I would think some type of antibiotic ointment would do well on there as well. I used a sugar and honey poultice on my husband's leg. I think I read about it on here and figured I'd give it a shot on him before I'd try it on my horses. NSAIDS as to help with the swelling (and of course antibiotics).
Not being able to examine the leg make it difficult to say - but a small part of me almost thinks opening it up to do a through cleaning may be in order (I would use the vet on that one though). I opened my husbands up just along the soft, spongy tissue and squeezed/massaged out some of the nastiest stuff I've ever seen, both of us about passed out. His only took about a 1/2 inch cut though. We soaked it really well and put antibiotic ointment on it. I had to do it a couple of times but it did start to heal pretty well after that.
I know I sound like I live miles from civilization but I couldn't get my husband to the doctor for the life of of me. We have insurance, good jobs etc...but he wouldn't go to the doctor for a nickel sized hole, with tissue softening all around it on in his leg. This is the first time I've told anyone the story. He healed up nicely, though. Anyway I digress...
Good luck and keep us posted.
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Member:
scooter
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Posted on Monday, Nov 22, 2010 - 6:45 pm:
My horse Hank had something very similar on his fetlock summer before last, I couldn't get very good pics because of the low location.. I still don't know what caused it, It still is different then his other fetlock, and his hair doesn't grow right there...I suspect a bite of some sort.
If you are interested
https://www.horseadvice.com/horse/messages/4/327187.html
I always have 2 parts or more!
https://www.horseadvice.com/horse/messages/4/342002.html
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New Member:
cinn
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Posted on Monday, Nov 22, 2010 - 7:15 pm:
Just got back from the vet and it seems we are in good shape!
Flexion of injured leg is not as good as in the other leg and still makes the wound ooze, but it's starting to get some granulation and the heat is more localized.
There is a bump on the bone we'll be keeping an eye on now, and he's off on the other leg when trotting circles.
We're going to continue Bute once a day, along with SMZs and cleaning w/hard spray from hose and Sodium Chloride irrigation twice a day. Will try to shave his leg tomorrow so all the icky stuff doesn't stick so bad. I've also been putting a derma gel on the wound, forget the name of it, but it's in a red and white pump.
TheresaB, hope your husband is all healed because I couldn't help but laugh at your story!
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Member:
kpaint
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Posted on Monday, Nov 22, 2010 - 10:16 pm:
I have an idiot who won't go to the doc either Theresa...he gets a syringe/needle (formerly used on HOGS around here), sterilizes it with MATCHES and then procedures to draw fluid off of his knee. He has done this several times and gets a full syringe of fluid. !!!! No antibiotics... He drives me crazy. I run to the doc of course with a sniffle...lol
Sure hope your horse is going to be ok Cinn.
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Member:
theresab
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Posted on Tuesday, Nov 23, 2010 - 12:36 am:
Good to hear you are on the road to recovery. Hopefully you'll have smooth sailing.
Vicki- The part that irritated me most is if gets bronchitis or a sinus infection, he'll make a Dr. app't right away, but a hole that is rapidly expanding in his leg...nope. I think he was being macho because I didn't go to the Dr. when I had mine a few years ago. Mine stayed fairly small (dime-sized) and didn't nectratize like his did. He healed up pretty well considering the only numbing agent we used was ambasol. The skin is smooth but he has a dark spot about 2" wide and 3" long where the tissue died underneath. I guess it was a good learning experience for what to do with first aid for my horses though.
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New Member:
cinn
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Posted on Tuesday, Nov 23, 2010 - 10:02 am:
I guess maybe the Dr is on vacation? Oh well, part of my reason for posting this was to get some form of reference out there for others.
Here is today's (Day 12) wound pic, I'm very happy with how it's looking! Much less ooze this morning.
And here are both his knees, hard to get an angle that shows the bump without being deceiving. It's his left leg (pictured on the right).
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Moderator:
DrO
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Posted on Tuesday, Nov 23, 2010 - 1:41 pm:
Hello cinnamon,
Glad to hear the vet likes what he saw. His complete exam is far better than what we can tell by looking at a few images. Besides the simple appearance, you watch the swelling, heat, and pain level to determine if things are going south. Also body temperature is a helpful guide. DrO
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Member:
cinn
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Posted on Tuesday, Nov 23, 2010 - 6:56 pm:
How long have you seen these things take to heal?
Does it look like other bites you've seen, would you think copperhead, or is there really no way to know?
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Moderator:
DrO
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Posted on Wednesday, Nov 24, 2010 - 6:37 pm:
I would say unlikely to the copperhead, the nose and lower legs are the common sites for snake bites. As to how long I really do not have a comment as I have not personally examined the wound. The important thing is that the swelling and pain resolve, the drainage become serous, and then the wound heal. Any back up or worsening should be viewed with suspicion of infection or foreign body.
DrO
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