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Discussion on My 71/2 mo. pregnant mare cut her leg pretty bad.
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Member:
Heidih
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Posted on Monday, Oct 28, 2002 - 9:02 am:
I went to the barn where I board yesterday and discovered my mare limping slightly. It's pretty muddy, so I didn't see anything initially. After I sprayed off her legs, I discovered a gaping V-shaped wound on the front of her rt hind fetlock joint. The wound was fairly old (probably over 24 hours). I hadn't been out the day before, and with all the mud and muck, nobody else noticed it.
Anyway, I called the vet out because I was worried about infection. I knew it was too late for stitching. He cleaned it out really good and didn't see any puss so far. The wound also did not affect any joint structures or tendons. It is just full thickness through the skin. He did put her on TMS powder (2 scoops once a day) for 10 days. And I'm pressure wrapping it until healed. I remembered reading that the Sulfa can cause folic acid problems for the foal, so I asked him about it. He said in long term use there could be a problem but 10 days shouldn't cause any negative effects at this point in her pregnancy.
I just wanted to double check that with you. I read through the articles on TMS and on EPM about how the sulfa can block the folic acid breakdown, but that oral supplementation actually does more harm than good. Do I need to worry?
Thanks again for any help.
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Member:
Heidih
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Posted on Wednesday, Oct 30, 2002 - 8:25 am:
Hello, I just wanted this to show up again on the new discussions. I posted it a couple of days ago and I suspect it got missed.
Thanks.
Heidi
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Moderator:
DrO
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Posted on Thursday, Oct 31, 2002 - 7:48 am:
Thanks Heidi,
Actually I read and replied but apparently my answer got gobbled up in cyberspace.
Your vet is probably right and this is not a big concern. However, I wanted to point out that only oral supplementation with the more commonly available inactive form, folic acid, is harmful. If you can get a hold of the active form, folinic acid, it can be supplemented at 7 times the human adult minimum daily requirement which should be on the bottle. If should be in the local pharmacy.
DrO
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Member:
Heidih
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Posted on Thursday, Oct 31, 2002 - 8:27 am:
Those computer gremlins seem to be at work alot lately  Not just here, but on other boards as well.
Thanks for the info. I will see if I can find some Folinic acid anywhere. I guess I wasn't clear that it was actually sold in the active form. Thanks again.
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Member:
Heidih
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Posted on Tuesday, Dec 17, 2002 - 10:07 pm:
Hi again Dr. O, I'm back with another question about my mare. It's now about 7 weeks since my mare cut her leg. She's been pressure wrapped the entire time, with regular bandage changes and hosing off of the wound.
I've had my vet out to check on her, because the healing seems to be going slowly. The local vet (he's not a reproduction specialist) is recommending that I put a steroid ointment on the wound to inhibit the proud flesh. She has a little proud flesh, but I don't think it's terrible yet. I'm concerned about using a steroid at this point in her pregnancy. She just passed 9 mos. I'll try to attach a couple of pictures of the wound that I took at her last bandage change. Is the proud flesh something I should be worried about right now? I apologize if the pictures are dark, but she's a bay and It was in the barn in the late afternoon.
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Member:
Heidih
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Posted on Tuesday, Dec 17, 2002 - 10:11 pm:
2nd view
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Member:
Heidih
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Posted on Tuesday, Dec 17, 2002 - 10:14 pm:
View 3
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Moderator:
DrO
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Posted on Wednesday, Dec 18, 2002 - 7:35 am:
Hello Heidi,
No those pictures are fine. We know topical glucocorticoids are absorbed, and we know they are abortifacient in most species, and we know horses are more resistant to these effects, but you can find two cases in our boards of abortion in horses following the administration of dexamethasone orally or by injection.
It seems unlikely that the small amount of steroid from a topical product would cause abortion but I am with you, I would not do it. The wound is well granulated in and in the last picture the granulation tissue appears to be poking out of the wound a little farther than I would like, you can see the new skin around the edges but the excessive granulation tissue will slow down further growth. Have you had a contraction phase yet? See our article on Long Term Wound Care and on Proud Flesh for a complete description of this and our recommendations.
DrO
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Member:
Bevpolo
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Posted on Wednesday, Dec 18, 2002 - 8:22 am:
Heidi,
I had a mare that had a wound for about four months. Those legs wounds are so tough. I know how frustrated you must be...I'll tell you what worked for me. The problem with bandages is that it doesn't get the air on the wound to get it to heal but not bandaging it can get it dirty and keep it from healing. It is a vicious cycle. I alternated wrapping and not wrapping, depending on how much blood was present, or if it had rained, or if it was looking dirty and needed cleaning up. When I wrapped it, I put Preparation-H and that did the trick. It was better than what any of the vets gave me, it helped fill the wound from the inside out and it did not promote proud flesh. However, at one point, I had too much proud flesh, so I cut it flat with a sharp razor blade (remember, there are no nerves in proud flesh, but it will bleed) then put Preparation-H on it and wrapped it. Two days later it was beautiful. Then I left it uncovered to get it to scab. That finally worked. So play around with what you do. If you think it has gotten worse from leaving it uncovered, clean it up and wrap it. Anything you do could help and nothing will hurt it. So try different combinations and you will get it to heal. Just keep at it!
Good luck, Bev
Oh, and the pictures do look good. You almost have it tackled. It is sticking out a little so if you put Preparation-H on it now and wrap it, in two days it will be a nice light pink and probably will have digressed.
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Member:
Heidih
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Posted on Wednesday, Dec 18, 2002 - 1:20 pm:
Thanks to both of you for the information.
Dr.O, yes, I think the wound has already gone through the contraction phase. However I'm not absolutely sure. The wound hasn't changed hardly at all over the last 4 weeks or so. I think I did see a contraction before that though.
Does Preparation H contain cortisone? If it does, I probably don't want to use it. I think I will talk to the vet again, and see if he will trim off the excess granulation tissue.
If I wait until after the holidays (the first or second week of Jan.) when she's due to be vaccinated, will it make a noticeable difference to the outcome?
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Moderator:
DrO
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Posted on Thursday, Dec 19, 2002 - 6:24 am:
I do disagree with Bev's thoughts that experimentation is best. I have treated hundreds of such wounds and strongly suggest you stick with the suggestions in the article. Preparation H is a thick but mild emmolient with some antibacterial properties that has uncertain properties on full skin thickness, open wounds. Many have extolled the virtues on open sores, but that really is not the same thing.
DrO
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Member:
Sross
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Posted on Friday, Dec 20, 2002 - 8:20 pm:
Last January an old mare at the barn where I board turned up with a nasty full skin thickness, open wound, 2 inch square minimum, right in the middle of her chest (no idea how it happened). We had the vet out to take a look. He didn't think that stitching or bandaging were going to be very effective in this case. He cut off the flap of loose skin, and told us to make sure the wound was clean, then treat by hosing with water and applying Prep H. I did this 2x a day for the first week, then 1x a day for the second week, gradually tapering off the treatments. The wound healed beautifully. Would the wound have healed as well without the Prep H? I can't say. But after that experience, I always keep a tube of Prep H on hand for such emergencies. It has become a staple in the medicine kit of our barn. (Shortly after the incident with the mare, my husband cut his hand in the kitchen and the first thing I thought to look for was Prep H ; )
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Moderator:
DrO
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Posted on Saturday, Dec 21, 2002 - 12:58 pm:
Did the flap go all the way through the skin or was it a partial skin thickness wound Sandra? Chest wounds do heal well, probably a combination of loser skin and good circulation.
Heidi's wound is always a bit of a bugger: tight skin that is stretched with every step to further abduct the edges of the wound, poor circulation, and an area that is easily contaminated with dirt. But it will heal with good care and patience.
DrO
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Member:
Heidih
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Posted on Saturday, Dec 21, 2002 - 3:17 pm:
Thanks everyone for the great advice. The vet was out today, for someone else's horse, and I talked to him again about her leg. He went along with my reluctance to use the steroid creme, and cut off the extra granulation tissue. Boy did it bleed.
After the bleeding stopped, the vet had me spray it with the furacin spray and put another pressure wrap on. He said to keep doing what I've been doing (which is twice weekly pressure wrap changes).
I forgot to ask him, should I change the bandages more frequently than twice a week because the wound was freshened? Also, should I continue on with the spray or switch back to the Novalsan creme at some point?
Again, thanks for all the help. I'll try to take more pictures when I change the bandage next time.
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Moderator:
DrO
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Posted on Sunday, Dec 22, 2002 - 4:06 am:
I recommend changing and the bandage and hosing daily Heidi, with the first layer of the bandage being a absorbant cotton qauze: it is the purulent gunk forming under the bandage that helps promote the proud flesh and when the gauze is removed it debrides (cleans) the surface of the wound. If the wound is covered, and that is best, I prefer the Nolvasan creme because I think the moist environment further promotes rapid healing.
DrO
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Member:
Heidih
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Posted on Monday, Dec 23, 2002 - 10:24 am:
Thanks again Dr. O. I will be changing the wrap daily. I guess I should go buy stock in Fort Dodge, I've been using so much novalsan lately. Besides the creme, I used the Novalsan solution to disinfect the broodmare stall before moving my mare in there.
Thanks again.
Heidi
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Member:
Sross
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Posted on Wednesday, Dec 25, 2002 - 9:43 pm:
DrO-
Yep, it was a full skin thickness wound. I was startled when my vet recommended the Prep H, but he says he's used it for years as a wound treatment.
And I fully agree with your comment that leg wounds like Heidi's mare's are a bugger (to say the very least) 
Merry Christmas, everyone!
Sandy & Pacino
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Member:
Bevpolo
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Posted on Tuesday, Dec 31, 2002 - 12:41 pm:
I know Dr. O, disagreed with my comments...I have been reluctant to respond as I didn't want to get attacked or start an arguement...however, my point on experimentation, not meaning to try everything on the market, but to try the recommendations by the vets in different ways. Maybe there is something about this horse that requires different care than another horse. I also realize that not everyone has the same ideas on what to use on wounds, but my suggestion of Preparation H is what has worked for me. I do a lot of my own vet work as a breeder and have used a lot of different medications, all with the concern of what is safe on a broodmare. I consult with about three different veterinarians. Not every vet will agree on the same things. The point is, Heidi needs to do what is best for her horse and what works for her situation. I was just trying to throw out another idea, as I said, because it worked for me. Best of luck Heidi. Bev
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Member:
Heidih
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Posted on Friday, Feb 21, 2003 - 9:23 pm:
I wanted to post an update. My mare's let has almost completely healed. She has a scar, but I guess that's to be expected. Between the vet and I we trimmed the proud flesh 3 times. He did the first and I did the last 2, with his approval. I did end up trying the preparation H, because I figured it couldn't hurt. Between the trimming and the ointment, I think I got the best possible outcome.
The best news is that my mare delivered a big healthy colt on 2/19/03 (day 345). I'll try to post a picture of him. He's Half Arab/ Half Saddlebred.
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Moderator:
DrO
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Posted on Saturday, Feb 22, 2003 - 7:56 am:
Very nice. Lets see a picture of the wound too Heidi.
DrO
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Member:
Westks
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Posted on Saturday, Feb 22, 2003 - 9:07 am:
LOL Dr O ,
Beautiful Baby ! Congrats!
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