Tuesday, February 19, 2013

Not too proud for flesh...

There's a saying I've been taking to heart over the last few years:
 "Untalented, difficult, aggressive horses have robust health and long lives; talented tractable horses are accident prone."
Of course, I'm referring to my accident prone gelding. That nasty cut/bruise I've been nursing took a bit of a turn last week. When I finally coaxed off the upsettingly-huge scab, I discovered (unsurprisingly) a small amount of proud flesh beginning to grow. A call to the vet, and I'm working on getting that taken care of before anything more upsetting comes from this wound.

This development, of course, made me think about the ways we treat our horses first-aid needs. With my disaster-prone horse, I've amassed quite a collection of first-aid materials. I have sifted through lots of suggestions and have a system that is proven to work, for me. I'd like to share my approach, as it's come to my attention that others don't have much experience or knowledge of first-aid and some of the best ways to treat wounds. Thus:

 I give you (with a small drumroll!): Austen's Tidbits of First-Aid Awesome

 Tidbit #1: TAKE A BREATH and TAKE A LOOK. I've seen lots of owners freak out at the smallest of cuts, and I've also seen owners do the absolute opposite and NOT react with an appropriate amount of concern to an injury that was clearly in need of attention. Unless you can see bone or something is severed, just take a deep breath and assess the situation calmly. If you do see bone, or something is obviously damaged (besides just muscle tissue, and this WILL be obvious), call the vet immediately. If the cut is small, and doesn't look like it needs stitches, take another breath and investigate further. What needs stitches? Here's a good explanation.

Tidbit #2: Punctures suck, and you should treat them like the delicate infection-prone disasters that they are. I'm speaking from lots of experience here. If your exploration of your horse's wound reveals a puncture (especially to the face or lower leg), proceed carefully. You may need to call a vet if you don't feel comfortable keeping the wound clean and disinfected. The following steps are how I treat punctures, and a good rule of thumb for all cut-type injuries:
Puncture Step 1  - Determine how deep the wound is (yep, stick yer finger on in it ... gross, I know).
Puncture Step 2 - Thoroughly clean out the wound. This is going to be painful, for you and your horse. You need to scrub off any scabbing that might be happening, you also need to thoroughly scrub as far into the wound as you can, and then you'll need to flush the wound thoroughly. I recommend doing all of this cleaning with a mixture of hot (but tolerable!) water and betadine. (BONUS TIP: Betadine stains like you can't believe. Make sure to avoid getting it on your clothing! It will rinse out with HOT water, if you get to it before the stain sets)
Puncture Step 3 - Here's where the controversy starts up. I don't believe in stitching deep punctures. I think it allows bacteria to fester, and makes them harder to clean out. Instead, I will spray a wound with Scarlet Oil (Scarlex). This stuff is an antiseptic, but it is pretty gentle. I love the spray, as it makes application much easier when your horse has had just about enough of your poking and prodding at his ouchy wound. I will often finish my dressing with a splash of wound powder (Wonder Dust). Some recent studies have suggested that wound powder doesn't promote healing. That's probably correct. However, I feel that the nastiness of the horse's environment and the difficulty of bandaging most wound sites makes wound powder an incredibly useful wound sealant.
Puncture Step 4 - Allow the puncture to heal, watching for signs of infection. This is the hardest part. The wound is going to get nasty. Wound powder makes stuff look gross. This isn't going to be a cut like you might have. It's not going to be clean and pink while it heals. You want a scab. At some point, your horse is going to lay down and get shavings and hay stuck to the thing. You are going to be embarrassed. Don't. As long as you don't see signs of infection (sudden swelling, increased tenderness to the area, yellow or white "ooze"), you are probably okay. Obviously, anything that seems out of the ordinary or is a step backwards needs a vet call, ASAP. As wounds heal, I like to put a thin layer of Corona Ointment (OINTMENT, kids. Not beer...) over the scab. This softens the scab, and provides a slightly antiseptic layer as the wound heals. I find wounds treated with Corona tend to grow hair back faster, and heal without scarring.

Tidbit #3: Lameness can be caused by lots of things, make sure to check all your options. When Guinness comes in lame (when, not if), I have a checklist I mentally go through to find the source of the pain.

  • Any cuts? If so, are they in a location that would cause bruising or pulling with movement? An example would be Guinness' cuts directly over the cannon bone, or a laceration over a muscle group that would pull open with movement. Examine these cuts carefully to make sure they are only superficial and don't damage any of the structures beneath. Additionally, watch any bone bruises for signs of sudden infection, as this can cause HUGE issues. 
  • No cuts? How about heat? Run your hands down your horse's legs (Note: you should be doing this every day, anyway. It's just good practice) and check for any abnormal heat or swelling. This could indicate a kicked area, or a tendon strain. Think about where the heat is. A kick or superficial type of wound would be up in the muscle. You might find a tight lump under the heat. This could indicate a bump/kick or a muscle strain. Give the horse some time off, and watch. If the bump or lameness is severe, think about calling your vet and giving a gram of bute to help with the swelling. Any heat or swelling in the lower leg is suspicious. This could easily be something severe. I suggest learning how to palpate tendons and ligaments for injuries and sensitivity. If any is found, call your vet immediately. Heat in the joint capsule typically indicates arthritis issues, but if your horse is young this could be an infection starting or a bone chip/acute injury. Anything that isn't normal here should be immediately checked on by your vet. These things can turn nasty FAST. 
  • No cuts AND no heat? How are the feet? The next thing I check is feet, if there is sudden heat in the foot and tenderness in a specific area, I assume an abscess or nasty bruise. These things will heal with time, but careful watching needs to be done. An abscess can turn gross and nasty if they don't burst on their own and aren't helped out. Some will heal without bursting, but usually not the ones that cause severe lameness. A bruise can easily turn into a abscess. I find Magic Cushion to be a good treatment for these types of injuries, or just sore feet. 
  • Still nothing and the horse is still lame? Call your vet. Some injuries aren't apparent, but can still be serious. Just "seeing if it gets better" can cause longterm damage and limit your horse's career. I don't recommend that. 
Tidbit #4: Your vet is your best buddy. Call him/her whenever you feel like you don't know what to handle. Just do them a favor. Don't hyperventilate into the phone, stay calm while discussing things with them. Having a good working knowledge of bone/soft tissue structure of the horse will help you discuss with your vet where exactly you are having issues. It will also help you stay calm, since you'll have a better idea of what is serious and what isn't. Another good tip to keep your vet happy? Make sure your horse is ready and waiting when the vet gets there. That means catch your pony and clean the mud off of it. If you are short on time, at least clean off the area with the problem. No one enjoys trying to dig through inches of wet clay to try to investigate a possible tendon pull. No one.

Tidbit #5: Keep your general first-aid materials handy, whether at home or traveling. I usually keep some sponges, Sore-No-More, betadine, Scarlex, Wonder Dust and Corona in my grooming bag at all times. Also close are gauze bandages, wads of absorbent cotton, rags, vet wrap and old polos. I find everyone has a different idea of what goes into their first-aid kit, so it's a good idea to figure out what works best for you.

So with all of this experience/information, what went wrong with Guinness' leg? Well, horse's are very prone to proud flesh, especially in the lower leg where soft tissue is at a minimum. This means cuts and scrapes need to be carefully cleaned and treated from the outset, and watched carefully to avoid strange healing. I went wrong by letting someone else handle the initial treatment. While the person treating him meant well, she used ointments that promote too vigorous of growth. In addition, I didn't keep a close enough eye on the healing process. This could have been cleaned up faster if I'd been more careful in ensuring the healing was happening from the inside out. (Tidbit #6? Wounds should heal from the inside out ... not rapidly and past the level of the skin!). Moral of my story? Keep a careful eye, make sure wounds are clean, and don't allow for vigorous healing. The long slow way is always better.

What do you think? Anyone had to deal with these issues before? How do you treat your horse's bumps and brusies and scrapes? I love new ideas on first-aid!

2 comments:

  1. I know how you feel. With 5 horses we have had our rash of injuries and we learn along the way. It is never easy. One item we keep on hand is honey. It is a natural antiseptic and prevents proud flesh, which we learned after our horse developed it from a bad down to the bone injury. We also keep Calendula cream on hand for abrasions and bruising. We lean towards holistic remedies so we always keep oral nasaids on hand too, like Arnica and Ledum, but we have much of what you listed too.
    Punctures are nasty and we came too close to losing a horse to one two years ago. Our Vet was awesome and he came through, but required long term care.
    Great post and important to anyone who owns horses.

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    1. I knew about honey's antibacterial properties, but never thought about using it in the barn. What a great idea!

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