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Discussion on Tendon Laceration
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New Member:
Moser
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Posted on Sunday, Nov 5, 2006 - 10:02 pm:
Hi Dr. O -
I have a horse that severed an extensor tendon and cut the bone on the fetlock. He had surgery the night it happened. It has been 2 1/2 months and he just went down for another check. I am still dealing with an open wound, and bandaging daily - he is still draining stuff out of the wound. He had gouged the bone when the injury happened. His latest x-ray showed 2 tiny bone spurs. The surgeon suggested that when the tendon heals, that he opened it up and remove the bone spurs. I just had another vet out to give him is fall shots, and he suggested a cortisone shot to where the bone spurs are to stop it? Have you ever heard of this type of procedure? Is there something I can be giving him for the bone spur?
Thanks, Maureen
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Moderator:
DrO
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Posted on Monday, Nov 6, 2006 - 7:31 am:
Yes the cortisone may well slow down the rate of osteophyte (spur) formation which is the end result of a inflammatory reaction. However I think its use around a open wound contraindicated as it predisposes to infection.
DrO
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New Member:
Moser
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Posted on Monday, Nov 6, 2006 - 9:05 pm:
Hi Dr. O -
Sorry - but can you explain this to me? I don't understand what you mean.
"However I think its use around a open wound contraindicated as it predisposes to infection"
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Member:
Paul303
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Posted on Wednesday, Nov 8, 2006 - 12:26 am:
The purpose of cortisone is to suppress the immune ( inflammatory )reaction. This is desired in many instances, especially chronic autoimmune disease. However, in the presence of a serious wound which could still be threatened by infection, would the benefit of slowing bone spur growth be worth suppressing the ability of the immune system to respond to a chance contamination of the open wound?
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Moderator:
DrO
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Posted on Wednesday, Nov 8, 2006 - 7:11 am:
Lee has it right. For more on this and other steroid related topics see, Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Overview of the Steroidal Anti-inflammatory Drugs.
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New Member:
Moser
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Posted on Wednesday, Nov 8, 2006 - 1:08 pm:
Thank you Dr.O and Lee -
I will post a picture of the wound. It is a wound that was open to the bone and has grown in. No proud flesh - it actually looks like it is closed but it still leaks. I have been wrapping the wound for 3 months. Does anyone know how long it takes for a wound to close on the fetlock? Is it still oozing, is it because of the bone spur?
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Moderator:
DrO
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Posted on Thursday, Nov 9, 2006 - 7:04 am:
How quickly a wound heals depends on many factors Maureen besides location and unless the spur is infected or I misunderstand its size it is not the cause of the oozing. For more information on wounds and wound care see, Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns.
DrO
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Member:
Moser
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Posted on Wednesday, Nov 22, 2006 - 1:19 am:
Hi Dr. O -
I am going to upload an attachment of the wound. My wound I have left to heal is about a size of a dime. The spurs are small, but it is swollen where the spurs are. Also that is were the tendon was severed. I still have a little leakage, and he has no fever. He has never had an infection at all, or proud flesh. Please see the swelling and let me know if that is normal or not? And once the wound and tendon heals, would I be better off going to try the cortisone shots for the spurs, or should I do the operation to remove the spurs? Thank you.
popjpeg{122048,Dakota wound 1
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Member:
Moser
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Posted on Wednesday, Nov 22, 2006 - 2:33 am:
That first one was a little small - this was a 3 inch gash to the bone 3 months ago.
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Moderator:
DrO
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Posted on Wednesday, Nov 22, 2006 - 7:02 am:
Maureen to accurately answer your questions requires a complete knowledge of the history of the wound, a thorough exam of the pastern and fetlock, and review of the radiographs. Obviously the swelling is not normal but is it appropriate for this wound? If you are doing all you can to heal it and address the swelling I would have to say the swelling is appropriate. As long as you have an open wound on the lower leg you will have some swelling.
I am skeptical that there are "spurs" where surgical removal is indicated or even that steroid injections are indicated. Before committing to any plan for any expensive course of action I would send the radiographs to a veterinary radiologist for review.
DrO
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