Proper treatment of wounds in horses greatly reduces the chances of complications.
It is important that horse owners are prepared and are systematic in dealing with an injury. Not all wounds will be serious, of course, but all require horse owners to follow through a process that ensures a good outcome.
That process is pretty much the same for all open wounds. Any serious blood loss needs to be arrested, the wound needs to be cleaned thoroughly, assessed, treated, and left in a state that will encourage rapid – and uneventful – healing.
Let’s look at the different kinds of wounds. The course of treatment varies slightly with each.
- Incised wounds: These are made by a sharp object such as a knife or a piece of broken glass. They will have clean-looking edges and may bleed heavily if blood vessels are cut.
- Tears: More jagged edges. These kinds of wounds are often caused by barbed wire. They are very unlikely to bleed as badly as an incised wound because the wound is usually created by a pulling or pushing action against an object. Blood vessels, being elastic, are often able to stretch or slide with the foreign object and then spring back into position.
- Puncture wounds: Caused by the likes of a stake or nail. Will usually not bleed heavily because of the elasticity mentioned for tears, but if the object does manage to puncture a major blood vessel then the outcome for the unlucky horse may be fatal.
- Abrasions: Caused by friction. A rope burn is a typical abrasion. Most abrasions normally involve only the skin and hair, but sometimes they can go deeper. Abrasions will often seep blood or body fluids and can look very messy.
- Contusions: Essentially, an internal wound. The tissues have been damaged and are bleeding, but the skin is not broken. Usually, there will be swelling at the site and the horse will show discomfort.
Most wounds can be treated by the horse owner unless they involve the eye, or deeper tissues such as tendons, muscles joints, and, of course, bones. In these cases, the risk is that the horse may not fully recover unless proper treatment is given, so it is recommended the vet be called.
Aside from major blood loss, the greatest threat your horse will face is that from tetanus. This is a serious disease caused by a bacteria living naturally in the soil. Ideally, horses should receive long-term immunisation against tetanus, but even so, a vet will probably recommend a booster or protective dose in the case of injury. Many horse owners will naturally not want to pay the cost of a vet visit for every wound or scratch. However, they need to recognise there is a risk, which can be minimised with immunisation. The risk is also considerably greater in wounds that receive large exposure to soil, such as fall that cuts the knees, or if it is a puncture wound. These can provide the airless conditions in which tetanus spores thrive best. A tetanus booster in these circumstances is strongly recommended.
The first issue in the treatment of any wound is to control the bleeding. If the blood is spurting from the wound, an artery has been damaged and a vet must be called. Usually, however, pressure applied directly to the wound site will be enough to stem the bleeding within a few minutes. If this fails to stop the bleeding, a vet should be called.
Remember that some bleeding can be a good thing, as it helps flush the wound and remove any foreign matter.
If the blood flow is life-threatening and cannot be kept in check, you may have no choice but to apply a tourniquet above the wound. The tourniquet will stop the bleeding, but it will also starve the area below the tourniquet of blood and oxygen, and you run the risk of killing tissue. A tourniquet MUST be released every few minutes to allow some blood flow, and, if it needs to be put back, should be moved a little higher or lower on the limb. A vet must be summoned immediately.
Once bleeding is under control, the next step is to ensure that the wound is free of dirt and other foreign objects. Never use disinfectant and the use of an antiseptic is probably not necessary. The best way to cleanse a wound is to use a moderate flow of clean water or saline. If you remain concerned, you could use a mild soap and water, but use clean water to thoroughly remove any residue afterwards.
A clean wound provides you with the best opportunity to assess the damage and decide whether veterinary intervention is necessary. Is there muscle or tendon damage? If the wound is over a joint, is the joint capsule intact?
Generally, dry powders should not be applied to fresh wounds, as this can interfere with granulation, which is the first step in the wound closing over and healing.
You must now decide whether a bandage is appropriate. There are several benefits: it prevents dirt entering the wound area and keeps flies at bay. They can also restrict movement, which may speed the healing process. A bandage can also bring the edges of the wound closer together.
Generally, bandages are only an option for the lower body parts. Dressings should be changed regularly to keep them fresh, and it provides an opportunity to check on the healing process. They’ll need to be firm to stay in place, but never apply them so tightly that they restrict blood flow. Bandages also discourage the formation of proud flesh (see below).
If wounds are left open, they can be given a gentle flush each day with about 600ml of sterile water with a teaspoon of salt to keep the wound clear of any debris or fluids oozing from the wound.
Generally, dry wounds will heal faster.
Stitching is always an option for bigger wounds, particularly incisions, but the location of the injury will very much determine whether this is sensible. In some areas, particularly around the legs, the stretching of the skin is such that it is unlikely the stitching will ultimately hold. Your vet will recommend the best course of action.
Contusions – bleeding beneath the skin – can be painful for a horse. They are usually caused by a kick, a fall, or a bad knock. Applications of cold-packs immediately after the injury will help with the discomfort and minimise the amount of bleeding into the issue. Once you’re satisfied the bleeding has stopped, warm-packs will encourage healing.
Lacerations, with their ragged nature, probably carry a higher risk of infection and need to be very thoroughly cleaned.
Hydrogen peroxide at the right concentration (read the label) is good for cleaning puncture wounds, as it allows oxygen into the injury. The big risk here, as mentioned above, is tetanus, so call the vet and arrange for a booster. Some vets may even open up a puncture wound to get air to the base of the injury and to ensure the cut heals from the inside out.
Bigger wounds run the risk of developing proud flesh, which is excessive granulation. This needs to be dealt with when it appears, to prevent bigger problems later. The wound will need to be dressed daily with a mildly caustic solution that your vet can provide. This needs to be used until the wound surface is back level with the surrounding skin.
Keep a record of such injuries and the paddocks in which they occur. Do your best to identify the cause and, where possible, remove it. Invest some time in checking your fences regularly for any nails, bolts, or wires that can cause injury. Replacing a top strand of barbed wire is not expensive and will not only save you vet bills, but also the cost of repairing and replacing horse covers.
A first-class equine first-aid kit
Stabling a sick horse
Proper wound treatment reduces complications
Wound First Aid in Horses
Immunisation gives long-term tetanus protection
Tetanus on the increase
The Accident: To Treat and Spell or to Spell and Treat?
First published on Horsetalk.co.nz in March, 2006.