my horse has a bad injury

Question
yes.  i took him to the vet, cause i know you'll ask lol.  

he cut is leg, in the front, right above the back hoof.  the vet gave him an injection of antibiotics (not sure which), put silver sulfediazine (sp) on it and wrapped it real good.  he said there was no point in stitches, because of the location.  said he should be ride-able in 2 weeks.  this was about a month ago.  it looks like it might be healing, but bleeds what seems like a lot each time we re-wrap it.  every 2 days, we have been changing the wrap, cleansing in betadine and putting neosporin on it, then re-wrapping.  he still holds it up, whenever he has to move and limps still.  it still looks swollen and open.  we tried to call the vet back, but he didn't return the call. still waiting and will try again on Monday.

is there anything we can do for it, besides what were already doing?  what about any pain meds we could give him (i have a whole pharmacy of pain meds!)

should i be worried?  also, he seems to be losing his hair in spots and his mane, its coming out in bunches.  don't know if that has anything to do with his injury, but thought id add...

Answer
Pam:

Im sorry of I have a reputation for telling people to get a vet to look at their problem, but it amazes me that people contact me without ever even getting a vet to look at their horse and expect me to tell them how to fix their horse over the internet- without ever even seeing the horse. My service is not a replacement for veterinary care nor is it meant to help people keep from calling a vet for appropriate evaluation and care.

Once again, you are asking me to evaluate a cut that I have never seen and is difficult to visualize. First though, I will say that a cut in that area or any other never keeps me from trying to stitch it because even if only a part of it takes, you are ahead of the game when it comes to healing. Its too late now to try to stitch anything and maybe it was impossible to stitch. Healing by second intention is what you are now left with and that does require long term bandaging. I would not expect a cut of any size to heal in just 2 weeks. I think that suggestion could have been misleading in this instance. The bleeding tissue you have every time you rewrap it is probably granulation tissue that is very highly vascular. It tends to bleed quite a bit with rebandaging and even when it is just bumped. Your wound care must continue and it is a very long process depending on the size of the wound. Also, if that pink granulation tissue ever gets to where its edges are higher than the edges of the skin, the skin will stop contracting to close the wound and the exuberant tissue over the wound edges must be cut off and managed well to keep it from getting over the edges again. this means using a substance designed to keep granulation tissue down. Once the excess granulation tissue (proud flesh) is cut off- and it will bleed alot- the bandaging must be kept up until the wound is completely healed. Its alot of work and takes a long time. At this point there is no way around it for you now in order to get this to heal completely. If you quit bandaging, that pink vascular tissue will become very enlarged and will keep the wound from healing until it is removed- it will also bleed profusely too. Im going to say it again, you need a vet, maybe another one, to look at this wound and guide your managment of its healing in order for the wound to heal completely. good luck to you. Im here if you need me again.