Front leg injury

Question
QUESTION: Hello, I do understand you are not a vet but, I am looking for some advice on things I have not tried yet.  I have a 4 yr old quarter horse gelding that on Monday was in a fight with another horse in another pasture which had barb wire fencing.  My gelding reared up and struck out at the other horse and when he came back down he caught the right front leg on that wire.  He brought it back down with him and it imbedded in his leg just past the fetlock.  It isn't in the indentation of the fetlock but just below that but above the hoof and the bulb area of the hoof.  The cut goes from side to side and is approx a inch to inch and a half deep.  I can't see any bone and I did get the bleeding to stop once I was able to catch him.  He ran after breaking loose and with adrenaline and shock he didn't limp until coming to a stop.  The vets in my area want a minimum of 500 bucks to even come and see him, I do not have this money.  I did go to the local grange and got a tetanus shot and materials.  I flushed it with water and peroxide about 4 times and put on this antibacterial ointment that is bright yellow in color and put gauge to that and then wrapped it.  I have done this everyday.  He is very sore and hobbles around a little bit but for the most part he is walking on his toe just to get around.  I am afraid of infection and if I am doing something wrong I need to know that.  Any help at all would be greatly appreciated as I feel bad enough I can't afford a vet to come out. Thank you for your time.

Samantha
Medford, Oregon

ANSWER: Hi Samantha -
I am so sorry that you are having to deal with this accident!  I completely understand the vet situation and wish it was possible for you to have someone trailer your horse into a clinic to have this looked at ... I imagine the cost would go down greatly if he came to the vet versus the vet coming to him.  Even so, $500 sounds excessive to me but let's deal with what we can control instead of what we can't.  I really wish I could see this injury ... can you take some pictures of it to post here?

It sounds like you have great instincts ... you've done a great job so far!  I imagine that your horse is walking on his toe because of the pain in the back of his foot.  If you had access to some bute from your local grange, you could help with the pain by giving your horse 1 - 2 grams per day.  This injury is complicated because it is in an area that moves every time the horse walks so the healing time will be extended due to that fact. Plus there are tendons in this area so without the help from a veterinarian examination, we have to pray that no tendons were damaged and when your horse begins to use his whole foot again, we can breath a sigh of relief!

Let me say that I tend to avoid ointments and place my priorities on keeping the wound really clean.  Part of the job of salves and ointments is to encourage tissue growth or what's know as granulation.  The issue arises with the fact that the ointment doesn't know when the wound has granulated in sufficiently and it doesn't have a "stop granulating" feature so we get proud flesh. Once you notice the wound begin to heal and new tissue growth appearing, I would discontinue the use of the ointment and let the horse's natural healing take care of the rest.  

With that said, I can't emphasis the whole keeping this thing clean enough times.  I'm glad you're wrapping it ... are you able to keep your horse in a stall or small pen in a dry place?  That's important too.

The only changes I would make in the wound care you have given already is that first, I would add hydro-therapy.  When you remove the bandage, hose the wound really well for a good 15 minutes and then let it dry if you have a place to stand your horse out of the dirt - preferably on a mat or concrete floor. The fresh air will do it good :)

I would also cover the wound with a sterile telfa pad when your re-wrap it.  Hold it in place with a roll of gauze wrapped around snuggly enough to keep it in place and then put a layer of cotton over this.  The cotton layer will even out the distribution of pressure from the bandage so you can avoid tight spots when you apply the vet wrap which could damage other areas of the leg.  Then to seal out dirt and debris, I finish off my bandages with a layer of elasticon at the top and bottom.  If you've never used elasticon, let me warn you that it is very aggressive stuff and it has no "give" to it at ALL so it's very important that you apply it, you simply **place** it where you want it (half on the bandage and half on the horse's bare leg) and then press it firmly.  It's really easy to get elasitcon on too tight so please be careful.  Also, it's pretty expensive but there isn't anything else out there that works as good to keep a bandage on place and keep the dirt out of it.  

The last thing I'd do different is that if you do have a dry place for your horse to stay while this thing heals, I would leave this bandage on for two to three days between changes.  I would love to hear updates from you on how your horse is doing and if you can take pictures of it when you do your bandage changes, that would be awesome!  Please let me know if I need to clarify anything I've said here of if you have any new questions okay?  



---------- FOLLOW-UP ----------


Diamond's Wound   QUESTION: Thanks for all your advice! I have done alot of the things you suggested before I read what you wrote.  I have stopped the ointment and went and bought some stuff called shriners in a spray bottle.  This gelding isn't broke to ride, I rescued all 4 of them from starving to death and have given them all a year off to recoop from that ordeal.  He does let me do alot to him however a water hose is still out of the question with him, he isn't too sure about it yet.  He will let me use a large syringe to flush it though, his patience seems to give out on me after awhile of me messing with him so my time to deal with him is limited.  This is getting better each day though.  I can't ask for a better tempered horse that isn't even broke yet.  I hear you on the tendons that could have been damaged however I just hope to get him out of pain at this point, I will keep him forever even if this has a last effect on him.  I have attached a picture the day that this happened which was Monday Oct 11th and I can send you more as we progress if you like.  I also have been using large maxi pads instead of gauze pads because they seem to wrap completely around before I apply the vet tape. thank you again so much, I will follow up after I take more pictures tomorrow.

Answer
Samantha - thank you for the great picture and I'm excited to hear that things are going well.  It sounds like you are a great mom and so patient ... this guy is really lucky!!!  Great idea about using the maxi pad ... I had not heard of this before but have heard of people using diapers for the same reason.  You're a genius!  How is his pain level?  Does it appear to be getting less painful each day?

Thanks again for the update and I really look forward to following this great progress :)