Wound not healing, frustrated with vet, any layman suggestions?

[Draftmare]

My mare was injured on high tensile fence May 19th, cut left hind cannon bone to the bone. Was stitched up two hours after injury. Stitches removed on June 1st, she did pop out two of the stitches sometime between May 28th and May 29th (leg was wrapped for two days, so not sure exactly when). Vet said I could leave injury unwrapped starting last Thursday, June 9th, however injury worsened and we are back to wrapping.

Pictures: https://goo.gl/photos/CWcQjMwdNBNcfh8Y6

So, the first picture is June 3rd, the second picture is June 8th, the day before I contacted the vet and was advised that I didn’t need to wrap her leg any longer. Third picture was taken June 11th two days after attempting to leave her unwrapped. She was unwrapped from the night of June 9th to the morning of June 10th during which time she bled quite a bit and was extremely painful the morning of June 10th. Last picture was taken yesterday, June 14th after 3 days of being wrapped with icthammol to help with the swelling and some infection that popped up.

My local vet seems unconcerned and says that it looks like it is healing normally and no further medication should be needed.

I am feeling a bit frustrated with the progress (and some of the information that I am getting from the vet). The vet that came to stitch the wound (and then left the practice two days later) made it sound like it should have been much more healed by now than it is. I know that we aren’t vets on here, but I am wondering if anybody has any tips and tricks on how to help this wound to start progressing a bit better. This is my first time having to deal with any serious injury like this.

[beowulf]

The last picture, it actually does not look that bad. What else are you putting on it?

Just my opinion, and you can take it for what it’s worth, but I’ve had several adverse reactions to icthamol with my crew so I leave it exclusively for hoof salve/abscess drawing agent and don’t use it for wounds anymore. That being said it does look like it did its job with your horse. Maybe she just isn’t ready for it to be completely naked yet, did she rub/scratch it?

If it were my horse, I’d continue wrapping it for a week, maybe with some Corona ointment on/off followed by a week of Vetricyn (uncovered).

[SuzieQNutter]

The next problem is that as it heals it will get itchy and some horses will then bit it and reopen it. A grass muzzle with stop this happening…hopefully.

[goodhors]

I leave them wrapped until I get hair growing back in. This can take a LONG time, but there usually is no scarring this way. Was fence hot, how long was she in it?

We had one who rolled and stuck his legs thru the wire. He didn’t fight, not really cut, though he did split open after Vet advised cold hosing which made skin fragile. I could NOT get the split to heal, despite a variety of efforts. Husband and I were looking at it, both said “maybe it is a burn from the fencer. Not a cut, needs different treatment.” Great minds think alike! Ha ha. Fence had been going, not sure how long he was in it, would have been easy to get electric burned. We used Silverdene cream on leg and did get it finally closed, leaving a thin line scar. It took over six weeks to get healed.

I find Vets want wrapping off way too fast. Wounds easily reopen, get granulated for proud flesh, scarring, infected. Even if wound has closed, new tissue is 50% water. Dries fast to split open when not covered by wrapping. Usually splits within 2 hours uncovered. Keeping wrapped seems to prevent itchng, so horse leaves it alone.

I use people antibiotic ointment on regular wounds, wrapped or unwrapped. Brand x is fine. You want ointment, not creams that don’t last as long on the wound. Good luck with this.

[Obsidian_Fire]

I had a similar issue last summer. My boy was bandaged with every other day changes for a month. We used (per vet) triple antibiotic ointment on the wound, plus he got oral antibiotics.

Once it got where I could quit bandaging quite so heavily, I used Wonder Dust.

There were a couple times he just couldn’t stand himself and tore it open (the wound was on his knee, so a high motion area and very difficult to keep closed; he did pull a few stitches).

He did heal up well enough there is no visible scar.

Based on how your last picture looks, it’s healing but how deep is it still in the center? That would be my concern and why I would still be bandaging. You could try using Iodine ointment or if you feel no more meds should be used directly on the wound, use a non-stick sterile pad and bandage it up. I would clean it with either a betadine/water solution or chlorhexadine/water every time I changed the dressing.

I would bandage until I was positive the wound was superficial, then I would use the wonder dust to minimize proud flesh.

[eclipse]

If it went down all the way to the bone make sure there is not a bone sequestron, although if there was I’d be surprised as the wound has filled in quite a bit! I too would also keep it wrapped. When my guy severed a tendon we had it wrapped 24/7, and used no creams, just a wound pas to keep it moist and then the bandage and wrap. You do not want the wound to dry out… It should heal from the inside out with as little proud flesh as possible … Wrapping will keep it compressed!

[NancyM]

That has filled in well, it’s looking good. You will be surprised by how much all that sucks down and reduces in size as healing completes.

By this point, I would not be bandaging any more. The injury walls off from the rest of the body, and it just takes time to heal. There is no more risk of infection with this now. The proud flesh is needed to fill in the gap that the injury has created, and when you have a nice button of proud flesh there, then a proud flesh inhibitor will sculpt the fill, tighten it down, and complete the process. You may get a small scar, but it should be sound and fine.

I have one at the moment that I inspect daily, removed part of the hoof, coronary band, and heel. Wire cut. Was not able to be stitched, the piece was removed entirely by the injury, as well as cutting the artery there. It is taking longer than yours is, and it will be fine eventually too I think. It is no longer bandaged either now. Patience is a virtue with horses.

[Ghazzu]

I’d keep it wrapped, maybe going several days between bandage changes, if the wrap stayed in place.

Problem is that you’re dealing with a relatively high motion area with significant skin tension and those are a bugger to close.

[Draftmare]

The fence was hot. They have been having some issue with the charge jumping right at the gate, and while they were leading her in apparently something made her jump (which I suspect was the charge jumping) and then fly backwards into the fence right by the gate. She was removed from the fence as quickly as they could (they had to cut the fence to remove her), and didn’t struggle at all.

Even just dabbing the wound to get the old medicine off and to put new on makes it bleed right now. I have been trying to minimize using water and soap to get it clean, which is why her leg looks so grungy. I only wash it about once a week right now. We did have an issue with the wound staying too moist, which is what we suspect is the culprit of her popping the two stitches. Those stitches were right where it has opened up so much.

I have been using a generic antibacterial ointment on it until last Thursday. I then switched to icthammol because it started to look infected. The icthammol pulled out a lot of really nasty, gross, fluid. The last two bandage changes have been rank! So, it appears to have done what it was meant to do. Now though, I am not sure if I should go back to antibacterial ointment, or try something else. I meant to add that question to the OP. My vet tech friend suggested Vetericyn, my instructor suggested Schreiner’s, but I have heard that it stings, and considering where the injury is I would really like to not get kicked. Thank goodness my mare is a saint because I have been putting myself in some precarious positions to clean and inspect her wound.

I do believe I will keep it covered from here on out until it gets more closed. It is a tough balance though between it getting too moist, and keeping it protected. I was doing a maxi pad on top of the wound and then a quilted wrap and track bandage, but she kept pulling that off. Caught her in the act a few times, the stinker. Now I am using rolled cotton covered by vet wrap and it stays much better. I changed it every day over the weekend, now I am trying to make it last at least two days between changes.

[Draftmare]

Oh, and I also meant to say that she has PSSM, so I have to keep her moving some what. We had worked our way up to 20 minutes of walking and two minutes of trotting on the lunge with the vet’s blessing. Now I am back to just hand walking a few minutes around the arena. I don’t want to make things worse, but the more she stands the less healthy for her overall well being. She is on individual turn out right now.

[beowulf]

Vetricyn does not sting and I 100% recommend it, especially if the wound needs to stay somewhat dry.

It has made incredible differences in tissue granulation all the times I’ve used it… last November my guy had a similar situation, huge laceration caused by flipping over a gate (:eek:) - we wrapped/covered the wound for 2 weeks and sprayed Vetricyn every 6 hours on the wound. He is not one to recover quickly from cuts (he seems to take forever) and the wound was nearly entirely resolved by the middle of December… and it was a BIG wound.

[Draftmare]

Do I just spray the wound and then wrap it up like I normally would? Will I have to reapply it every day?

[RedHorses]

I can’t see your pictures, so I’m going purely on your description. If you are getting gross gunk out of the wound I would be hot compressing daily until Iwas getting nothing out for a couple of days in a row. It is a great way to draw crap out of wounds.

The other thing I do for deep wounds is pack with sugar (plain white sugar from the grocery store) cover with a telfa (non-stick) pad and wrap. Sugar also has a great drawing action and it creates an environment bacteria don’t like. Though it can be a bit messy and sticky. :lol: I’ve had some gory wounds heal up beautifully with the sugar treatment.

[beowulf]

I know it might be hard since you saw what the wound looks like originally, but that last picture really isn’t bad and to my eye it does look like it is healing really well all things considering.

I’d keep it wrapped since it is probably very itchy… With Vetricyn, I would spray the wound first thing and while it “settles”, groom her or whatever you do to spend time with her, then put a non-stick over and wrap to cover.

It works best if it’s applied every 6-12 hours, but you can only spray once a day. It won’t make as quick progress if you do it that way but obviously time constraints do make going to the barn every 6 hours quite unrealistic.

[csaper58]

If it bleeds that easily, you probably have a little proud flesh on it. Proud flesh has no nerve endings and does not feel pain, but it bleeds easily and copiously.

I would

1. clip the hair off 1 inch around the wound

2. wash with antiseptec skin clenser. Hibiclens is excellent and available at most drug stores (store brand is ok). Then hose with gentle pressure for up to 20 minutes. Do this AM and PM if possible or once a day if it is not.

3. Apply this cream liberally after hosing. This product will get rid of the proud flesh with out burning/stinging and speed healing. The 1 oz tubes are for small pets, the 14 oz for large animals. Get which ever size you want, the same product is in both. If you get the jar, use a plastic spoon or something similar to scoop out medicine. Never stick dirty fingers into the jar. You can bandage over it or not.

www.zoetisus.com/products/cats/derma-clens-cream.aspx

www.vetdepot.com/derma-clens-dermatologic-cream-14-oz.html The jar is back ordered but the small tubes are in stock. Get 3 or 4.

4. I would wrap the leg, to protect it, while you exercise the horse. I would leave the wound uncovered IF flies are not present. If you have flies, keep it covered.

With this kind of wound you really need to use a non-stick dressing that absorbs exudate. They can be expensive. Many horsewomen have found that Maxi pads, or Depends, will do the job. Just get the size that will cover the wound, and absorb the goo. Hold it in place with cling gauze. Cover that with a standing wrap. Be careful bandage is not tight, but not loose either. It must not shift, or impede circulation. If you are new to bandaging wounds get help with this.

If you are unsure you can properly bandage the leg, leave it bare. It will take longer to heal, but it will heal.

[Equibrit]

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Did you HEAR…EQUAIDE !! Follow the directions and it’s amazing.

[aliceo]

i’ll just tell you what my truly excellent vet always tells me: never cold hose a wound–it will keep it from healing. don’t wash or scrub it with anything–it will keep it from healing. spray on vetricyn once a day and leave it alone.

if it is infected, you should have the horse on oral antibiotics.

[Draftmare]

[QUOTE=RedHorses;8705515]
I can’t see your pictures, so I’m going purely on your description. If you are getting gross gunk out of the wound I would be hot compressing daily until Iwas getting nothing out for a couple of days in a row. It is a great way to draw crap out of wounds.

The other thing I do for deep wounds is pack with sugar (plain white sugar from the grocery store) cover with a telfa (non-stick) pad and wrap. Sugar also has a great drawing action and it creates an environment bacteria don’t like. Though it can be a bit messy and sticky. :lol: I’ve had some gory wounds heal up beautifully with the sugar treatment.[/QUOTE]

I think you have to have a Google account in order to see the pictures. I don’t know how else to get them all in one spot. I have heard of using “sugardine” concoctions before on hooves, but never on wounds. Do you use dry sugar, or mix it with something to help it stay on the wound while bandaging? I have also heard of people using honey to heal wounds, but that made me a little nervous.

[QUOTE=beowulf;8705539]I know it might be hard since you saw what the wound looks like originally, but that last picture really isn’t bad and to my eye it does look like it is healing really well all things considering.

I’d keep it wrapped since it is probably very itchy… With Vetricyn, I would spray the wound first thing and while it “settles”, groom her or whatever you do to spend time with her, then put a non-stick over and wrap to cover.

It works best if it’s applied every 6-12 hours, but you can only spray once a day. It won’t make as quick progress if you do it that way but obviously time constraints do make going to the barn every 6 hours quite unrealistic.[/QUOTE]

I work second shift, so as a courtesy to the barn owner’s I try not to go out again after work unless I have to.

[Draftmare]

[QUOTE=aliceo;8705602]
i’ll just tell you what my truly excellent vet always tells me: never cold hose a wound–it will keep it from healing. don’t wash or scrub it with anything–it will keep it from healing. spray on vetricyn once a day and leave it alone.

if it is infected, you should have the horse on oral antibiotics.[/QUOTE]

And see my vet didn’t seem to think that I needed to put her back on antibiotics. Either way the icthammol seems to have pulled all the infection out. My vet did agree that cold hosing is not a good idea, and I am trying to not wash it either, though I think I will give it a wash after I switch from the ichtammol to get the nasty residue off.

[Draftmare]

[QUOTE=aliceo;8705602]
i’ll just tell you what my truly excellent vet always tells me: never cold hose a wound–it will keep it from healing. don’t wash or scrub it with anything–it will keep it from healing. spray on vetricyn once a day and leave it alone.

if it is infected, you should have the horse on oral antibiotics.[/QUOTE]

And see my vet didn’t seem to think that I needed to put her back on antibiotics. Either way the icthammol seems to have pulled all the infection out. My vet did agree that cold hosing is not a good idea, and I am trying to not wash it either, though I think I will give it a wash after I switch from the ichtammol to get the nasty residue off. She also said to not use Wonder Dust.