Swelling/fluid behind an old wound

[iJump]

About a year ago my young guy got caught in the fence where he was boarded and ended up with a nasty gash on the front of one of his hind legs just slightly lower than the hock.

Vet was out, used antibiotic ointment and wrapped it but it was in an almost impossible place for the wrap to stay on.

Unfortunately I have to travel a lot and the place that this guy was boarded at, the girl just didn’t do an amazing job wrapping it but when I was home I got it all under control and it was looking really great.I used a silver topical and wrapped it.

I moved him to another farm, again, the guy just didn’t take care of it.

It’s been healed over for a while now, and he’s finally under my care full time but now I am dealing with a swelling about half the size of my fist. I managed to shrink it considerably but it’s plateaued and I’m at a loss with what I should do. It’s too high to wrap, wrapping it only moves the swelling up.

Vet will be out this week and I was thinking about having it drained if possible. Has anyone ever had a year old injury drained? Experiences?

[4LeafCloverFarm]

The “swelling” could be several things (infection, scar tissue, abscess, damaged tissue that’s not healing and probably a few things I’m not thinking of right now). A picture would be helpful. Is he sound or lame on that leg?

And if it was a nasty gash, why just antibiotic ointment? Did your vet not think it warranted debridement and stitches?

[iJump]

@4LeafCloverFarm

The “swelling” could be several things (infection, scar tissue, abscess, damaged tissue that’s not healing and probably a few things I’m not thinking of right now). A picture would be helpful. Is he sound or lame on that leg?

And if it was a nasty gash, why just antibiotic ointment? Did your vet not think it warranted debridement and stitches?

Vet said it was in an impossible spot to stitch, which it kind of is.

I’ll take pictures tomorrow and post. He’s not unsound, but you can tell it bothers him a bit sometimes. I was thinking infection behind it because it seems to be a pocket and it just doesn’t move down.

He had his teeth done a few weeks ago and I asked the vet (different one) about it and they said it might be something that is just always like that. Not very helpful!

[4LeafCloverFarm]

Well, vet #2 might be right, but if it is something like cellulitis (which is the term I just couldn’t remember in my earlier post) it needs to be taken care of sooner rather than later.

Is the lump warm when you touch it? Like, if you cup your hand over it, does it feel warmer than lower or higher on his leg?

[Groom_amp_Taxi]

Have you tried anything like a hot compress? Wonder if there may be a bit of debris from the wound that is trying to work it’s way out.

[4LeafCloverFarm]

@Groom&Taxi

Have you tried anything like a hot compress? Wonder if there may be a bit of debris from the wound that is trying to work it’s way out.

Especially if it was a wood fence that caused the injury - might be a splinter or piece of wood in there.

[iJump]

It is warm. Hmm… didn’t think about debris. Honestly I’m unsure if it was from electric wire or the wooden fence.

[4LeafCloverFarm]

Well something could have gotten into the wound at any point before it closed up completely. But if the injury was caused by a wood fence, a splinter is a possibility.

Since it’s warm, that would lead me to think some type of infection/abscess. Scar tissue wouldn’t typically be warm to the touch. Definitely have your vet assess - though I think I’d try to get them out sooner if they aren’t planning to come until Fri or Sat. If it is an infection, the longer it goes, the more damage it might cause to surrounding tissue.

It may be that the vet might have to open it back up to determine if there is something stuck in there, so be prepared to be nurse maid to your horse again (and I am only speculating, they may just drain it with a tiny hole or may have to do nothing at all). But if they do open it back up, remember that cleanliness for an open wound that can’t be stitched is the best thing you can do for it to encourage healing, secondary is the ointment you put on it. So cleaning it carefully with warm water or saline and following with a bit of bedadine solution on a cotton ball or sponge will help keep it clean, making sure to remove any drainage below the wound as well.

There are ways to wrap hocks to keep the bandage from sliding all the way down their legs (even though this injury is below the hock, wrapping up towards and over the hock would help keep the bandage in place). I’ve never quite mastered it myself, only managing about 24 hours before the bandage ended up around the pastern. It is an awkward place to wrap. But you might find some helpful info on the pony club website or try YouTube. The other option is a standing wrap, which is easier, but works best with standing wrap bandages (if the injury is far enough down the front of the leg to be covered by a standing wrap).

Let us know what your vet finds. And wishing your horse a speedy recovery.

[Groom_amp_Taxi]

I had a horse that had an enormous abscess at the withers after flipping over backwards. The result was a fist sized hole where her withers had been that took more than six months to close up completely. Part of the reason it took so long to close was a stray bone chip from one of her spinous processes that had to work it’s way out.

Not quite a year later, the mare had a fluid filled swelling appear on top of the depression where her withers had been - it opened and drained after some hot compresses, and though I never found anything, the assumption by the vet was that another small chip or some debris had been expelled.

[Simkie]

Just under the hock seems like a fine place to wrap. Buy the widest standing wraps you can. I’ve been wrapping a lot of hind legs and the 18" ones cover from the coronary band to the bend in the hock.

Ultrasounding the lump would be a great way to take a look see at what’s going on inside there.

[eqsiu]

Farm House Tack sells 20" wilker’s combo quilts. That is plenty tall to cover the lower hock and not slide down. I do recommend getting 16’ bandages to use with them though. Jack’s and Equine Textiles make them in that length.

If you don’t want to do a standing bandage on the whole leg, elastikon tape is your friend. You can do it as a figure 8 wrap to make it extra secure.

[AKB]

I would ask the vet about doing an x Ray, ultrasound and maybe even an MRI if there is any chance of a piece of bone or wood in there.

[4LeafCloverFarm]

Any update @iJump ? What did the vet say?

[merrygoround]

I would suspect a foreign body. left over from the original wound.

[iJump]

I am so bad with updates, and I have no idea how to share pictures…

So, I had the wound xrayed and ultra sounded… there are no foreign bodies in or around it.

It seems to ‘stock up’ just in the wound area if he stands around too much. Poultice will pull all the swelling out.

It will also start to heal, no hair really… but will randomly break open and bleed like something is working its way out.

I’m not sure what I should be doing with it, The vet really had no suggestions and just said to ‘watch it’.

Anyone else ever have a wound like this? What did you do with it? It’s been going on 1 yr 3 months since it happened…

[4LeafCloverFarm]

At this point, if your vet is shrugging, I’d consult another vet. It is certainly not typical for a wound to re-open and bleed more than a year later… with maybe the exception that the skin is so fragile over the original wound area that swelling/movement is causing it to split open. Infection is another worry. Regardless, this will continue to be an issue unless a cause is found and something is done to make it stop. What that is, only a vet can advise.

I wish you luck!

[iJump]

I should add that the horse was on antibiotics for 15 days back in November. And that I never see ‘puss’ coming from this wound.

I’ve done round of bandaging this with a silver dressing but it opens and gets ‘wet’ when its bandaged and just never heels.

I’m going to have to try another vet. I’ve had 3 look at it so far but no one has answers…

[CanteringCarrot]

I’d have another vet look, or I’d bring the horse to a clinic if possible.

My horse had an injury just below his hock and the cut seemed small, but it was quite deep and a week or so later he had swelling and slight lameness. I brought him to the clinic and they cleaned up the wound, debrided, put some medicated little beads of sort in the wound, wrapped the entire leg from hoof to above the hock, and prescribed antibiotics. The wound has since healed up nicely. He did have x-rays and there were no debris and the joint was not involved.

The farm vet that originally l had look at it, who showed me how deep it was (by sticking a metal instrument well into his leg) said I could chance it and heal it at home and maybe things would go just fine, or I could go to the clinic and x-ray, treat, and leave him there for a few days of observation. I chose the latter. While more expensive, I thought it was a better plan that would set us up for success.

Clinics will have better quality diagnostic tools, and you can also leave the horse there for observation and diagnostics until something or nothing is found. You may also have access to a team there so more brains can be involved.

[iJump]

@CanteringCarrot

I’d have another vet look, or I’d bring the horse to a clinic if possible.

He’s been to one clinic overnight, to have rads and ultra sound done. They wrapped it and gave antibiotics for 15 days.

Upon check up at the farm, suggested to ‘watch it’ and that it may be something the horse just ‘always has’.

It’s been suggested to me to use castor oil for draw out swelling, but I’m not sure I would be comfortable using it on an open(ish) wound.