Deep Wound Near the Knee

[sp2813]

Looking for opinions on my mares wound. She got caught up in the wire fencing in her field (I HATE wire fencing) three weeks ago and got herself a deep wound on the inside of her right leg in two spots, one larger wound and the other smaller but both deep. My vet was on vacation and the other vet on call in her office was on another emergency call the night it happened so I called another vet I’ve used in the past as I wanted it treated asap. He said the wound was in a good location and didn’t see any catastrophic damage done as it wasn’t over the front of the knee and was off to the side and mentioned he sees a full recovery although the wound did go bone deep, although he didn’t mention that until a week later? He flushed it out and I’ve kept it wrapped with silver cream on it up until the last few days as she continues to rub the wraps off. She just finished a second round of antibiotics as well. Shes off slightly on the leg and late last week didn’t want to bend the knee when my vet picked it up. The swelling went majorly down within two days of the vet being out after the injury, but I’m still continuing to feel some warmth over the knee and slight swelling. My vet (my normal vet, not the one who initially treated her) told me to put her back on bute and continue stall rest, that it may just be inflammation from the wound still healing. She is scheduled to be back out early next week to remove proud flesh and said we can look at ultrasound or xrays that day if she is still off in the leg, although she has greatly improved since inital injury. I’m mainly worried about the slight warmth and swelling over the knee still, wire did rub the front of the knee as you can see in photos but didn’t break skin. Is it possible that although it didn’t break the skin that it rubbed a tendon sheath? Looking for any opinions or thoughts, I havent dealt with this deep of a wound before. I did call my vet this morning again and am waiting for a call back.

The first photo was immediately after I brought her in from her field, within two hours of injury I suspect, the second photo about two weeks ago and so you can see location of wound better, third was taken yesterday.

[Highflyer1]

I actually think it looks really good. She may just be stiff/stocked upat this point. I think if the joint were involved you would likely see much worse problems by now.

[sp2813]

Thank you that’s encouraging to hear. It makes me very nervous being by a joint. Upon injury and the days immediately after she really didn’t want to do even the three inch step up or down into her stall, but is going in and out without hesitation this entire week. This wound just has me a nervous wreck!

[JB]

Wow I did not expect that major of a wound!

I also think the outside at least looks quite good. There’s still a lot of healing going on, lots of “stuff” moving in and out to clean up dead/dying tissue and other junk, there’s probably some bit of scar tissue forming already

What does your vet say about physical therapy to keep mobility?

Keep an eye on that last bit of wound healing, it look like it could get into proud flesh territory fairly quickly (not that I see it yet, just keep an eye).

[sp2813]

My vet mentioned PT when she was working with her to bend and lift the knee, my mare certainly didn’t like that. But the next day I noticed that she was flexing it much more and walking nearly normal, so I plan to chat with her more about that when she’s out.

[Catherine616]

Our mare got a bad scrape inside/around her knee in pasture 3 weeks ago (still don’t know what happened). Not deep like your horse’s wound but It became infected and was very swollen. I put her on antibiotics and treated the wound but it took a long time (weeks) for the swelling to go down. Cold hosing helped but it took 3 days of Banamine for the inflammation to resolve. I also was very worried about it being so close to the joint! Hope your horse is better soon!

[sp2813]

Did you immediately put her on ab’s or not until she showed signs of infection?

[SuzieQNutter]

To try and stop her taking the bandaging off put on a wire muzzle. Our boy is being stabled for about the same type of wound on his inside hock. Our vet has said to use off the roadside honey.

He was given bute for a few days and antibiotics for 5 days.

[sp2813]

Thanks for the tip! My vet gave me the OK to spray it with Aluspray or Scarlet oil since it’s starting to form proud flesh. Any one care to share their proud flesh tips? I’ve start applying Schreiners to the wound, allowing it to dry and applying the spray bandage. I have wonder dust and vetericyn on hand as well and my vet will be out next week to trim it back.

[Catherine616]

Not until she showed signs of infection. Unfortunately, it happened when I was out of town and the caretakers didn’t see the scrape. I was very upset when I got home to see her entire leg swollen and the wound oozing pus. I did 9 days of SMZs but as I said it took a long time for the warmth and swelling to go down. Vet said to stop the SMZs and try to sweat the leg to reduce the fluid; however, that didn’t help. Banamine really helped with the inflammation (her daily Previcox didn’t seem to make any difference).

[JB]

@sp2813

Any one care to share their proud flesh tips?

Animax/Panalog are great, plus steroidal so help inflammation. I have never used, am not recommending, but have heard good things about meat tenderizer. Use at your own risk

Wonder Dust/any caustic powder is great, just be sure to apply ointment to the healthy tissue first. Animax/Panalog don’t have that requirement

[sp2813]

I’ve had two others swear by meat tenderizer as well. I haven’t read anything about animax or panalog, I’ll look into it!

[No1]

Meat tenderizer works great. You only put it on for like one or two days and then stop for several days. That said, I wouldn’t change a thing that you are doing to that leg. I certainly would not let the vet come out and debride it at this point. It looks great.

If it were my horse, I would be cold hosing it for 15-20 minutes at bandage changes, doing the passive range of motion exercises, and spraying wrap last on the bandage to keep her from chewing it. Also, if you can trim up the hair around the edges of the wound easily, that can sometimes help keep from disrupting the new epithelium. I would expect some stiffness and reluctance to bend properly.

[sp2813]

Thank you so much for this and your advice, makes me feel better as I haven’t dealt with a wound like this before!

[lenapesadie]

@sp2813 How is your horse doing?

[sp2813]

She is doing well, starting to gain full movement back but still swelling over the knee with slight warmth. My vet did come out and pull fluid from the knee yesterday to check what we were working with, it was blood and not any other fluid which is good. Did an ultrasound as well and could see the tendon the that runs down to front of the knee had some impact but nothing major we could see and she believes just patience and time for it to heal, which is also why she suspects the swelling still in the knee. Proud flesh had formed since the last updated photo so it was removed and the wounds themselves are looking great. Just trying to be patient and going to start doing some PT with her leg more. Super slow process and she is still on stall rest for at least another week. I’ll check in with my vet mid next week and may consider doing an xray to see if there’s anything we could be missing, we’ll see. It’s been a long three and a half weeks!

[lenapesadie]

Sounds very intense, but with a good prognosis!

I bet when she’s cleared for turnout that will help with her mobility!

[walktrot]

I’ve been using Equaide for proud flesh. There is another thread on it. A lot of proud flesh products are caustic, such as copper sulfate. They destroy the flesh in the wound but they also can destroy healthy flesh around the margins as well as healing tissue inside. I’m amazed at what Equaide does including speeding up the healing process. It does what the manufacturer says it will. It is easy to use, just paint it on with the tiny brush it comes with. I clean the wound daily, but don’t scrub it to get everything off. I leave the Equaide intact unless it is coming of with the scabs. I’m using on it some old proud flesh on a pastern. Also trying it on a few small hock sores - saw a suggestion about that on a product reviews.

[SuzieQNutter]

Debrisol works on proud flesh and promotes normal healing. I have never bandaged it and sprayed true blue over it for years.
.at the moment I am following the vet’s advice of confine and use roadside honey.

[sp2813]

Thanks to everyone who posted in response. Just wanted to post an update on my mares knee now that its been about two weeks. The wound is healing very well and she is walking normal and doesn’t appear lame at the trot, just stiff from the lack of being able to bend her knee up and forward. Her knee is retaining a lot of fluid, I had the vet out a week and a half ago to ultrasound and to pull fluid to see what we’re working with and its blood, not synovial fluid or anything else. The leg is also not warm/hot. The ultrasound showed that an extender tendon appeared aggravated but with no major damage done. We decided to let her continue to heal on stall rest while I walk her briefly 3x a day to see if the swelling would go down but its appearing to stay the same, so she will be coming to xray her leg later this week. Any further thoughts on her leg would be greatly appreciated. Its been just over five weeks since the initial injury happened, along with walking her throughout the day I’ve been working on bending her knee, she has improved slightly when I bring the leg forward but not much improvement when I bring the leg up, as if to pick her hoof. Thoughts, suggestions, or anything else appreciated.