Unfortunately, most horse owners will find themselves dealing with wounds on their horses at some point. When assessing and managing these wounds, it is crucial for you to know when to call a vet and also to have a basic understanding of general wound care.
Location and type of wound
When evaluating a wound, first, you need to identify its location. It is important to recognize if it is near a joint or other critical synovial structure, such as the digital tendon sheath behind the pastern. Remember that some joints, such as the elbow, are very large. An injury that seems some distance away from the part of the joint that bends or flexes may still communicate with that joint. In addition, even if the wound doesn’t initially involve the joint completely, infection can spread from the wound towards the joint. Wounds near synovial structures, including joints, should be evaluated by a veterinarian.
Figure 1. Example of wound flap
In all cases, a vet should be called to assess a puncture wound, or a suspected puncture wound, as it is often more serious that it initially appears. In addition, the sooner it receives expert attention, the more likely the horse will be able to make a rapid and complete recovery.
Adequate blood supply is an important component to healing. Wounds involving the head region have a good blood supply and are thus less susceptible to infection than lower limb injuries. However, wounds that go down to the level of the bone (wherever they are on the body) are at high risk for infection and potential complications. Additionally, wound flaps that lack a good blood supply (tissue may feel cold or look dark red/purple) will likely slough off and may also have a higher chance of becoming infected. For all injuries that are lying over a joint region, are associated with bone damage, or are a puncture wound, we would strongly advise calling a vet out.
The cause of the injury should also be considered, with the degree of soft tissue trauma greatly affecting the ability of the wound to become infected due to a greater change in blood supply. Wounds from an impact injury are 100 times more susceptible to infection compared to wounds by a shearing force.
Figure 2. Full limb bandage provides wound protection and stability
Six to eight hours after the horse has sustained a wound is the golden period for healing. The longer the wound is left untreated, the more time it has to become contaminated and infected. Highest success rates occur when a wound is assessed, cleaned, and sutured in this time period. Infection delays healing due to increased inflammation, mechanical separation with discharge, and inhibition of healing factors. Wounds that are more than three to four days old will not generally benefit from stitches, as the healing granulation tissue will have already started to form and fill in the wound, and therefore the skin edges won’t come together nicely. It is vital however that these are thoroughly cleaned and are bandaged regularly.
Although bleeding can be scary, it is extremely unusual that a horse would bleed to death unless a major vessel is damaged, such as the jugular vein or uterine artery. Most lacerations occur on the lower legs. Even though horses look like they are bleeding a lot from cuts there, the vessels are fairly small, and the likelihood of losing too much blood is slim if a bandage is used to apply pressure. A horse’s blood volume is approximately 8% of its bodyweight, and blood loss is only life threatening when it’s lost 30-40% of its blood volume. An average 500kg horse has about 40L of blood so can bleed up to 12L until it becomes fatal. Clinical signs of blood loss can certainly be seen with losses significantly less than that; however, these numbers provide a good reference for blood volume. If your horse is bleeding, wrap the leg using a non-stick bandage directly over the wound and then additional bandage materials such as rolled gauze, Gamgee, and a cohesive bandage to make it secure.
If the wound does not fall into any of the categories that require a vet, you can clean the wound with dilute chlorhexidine and then rinse with clean water. Apply a dressing and then bandage with Gamgee or full thickness cotton wool. After that, apply a layer of cohesive bandage, making sure it does not lie directly on the skin. If applied too tightly or directly over the skin, it can cause very serious sores and may even cut through the skin. If you are unsure about bandaging techniques, is better to seek veterinary advice before applying. An incorrectly applied bandage can actually cause more harm than good.
The more immobile a wound is the quicker the healing process, so keeping a horse stabled is beneficial. In addition, bandages can be used to immobilise a limb and facilitate healing.
If your horse has sustained a wound and you are at all concerned, please call the clinic to speak with one of our vets.