Wednesday, October 17, 2012

First Aid for Lacerations in Horses

I have been a horse owner since I was five years old.  I have been kicked, bit, stepped on, bucked off and have had a broken arm and collar bone from being thrown.  Yet, to this day, I am still in love with these animals.  Over the years I have come to learn that if there is anything within 5 miles of a horse, they can find it and a way to hurt themselves on it.  Barbed wire and metal from barns are some of the worst.    
  
l
This week I saw this horse for multiple lacerations to her neck, chest and front legs resulting from barbed wire.  I thought this would be a good time to talk about what to do if your horse get cut by wire. 

First of all, educate yourself about some basic horse first aid before your horse has any accidents.  Being prepared will make dealing with emergencies less stressful for you and your horse.  I also recommend having a good horse first aid kit handy.  I have one in my horse trailer and one in my barn.  Nothing more frustrating that being on the rode and discovering that my needed first aid kit was left in the tack room at home.  Ask your veterinarian what you should have in a good first aid kit.


The purpose of first aid is to minimize the damage done by injury and prevent infection, so that healing can proceed as rapidly as possible. First aid can remarkably affect the outcome. Once principles are understood, common sense must be applied. Remember, if you are in a panic, you will not be able to help anyone, so step back from the situation and gather your wits before you tackle the problem. You may not be the only animal who is excited. The injured horse will also be confused and excited which makes him dangerous. If you cannot safely approach him: do not.  RULE ONE: Keep calm.  RULE TWO: Do not let the horse hurt anyone.  RULE THREE: Get the horse to a quiet familiar location to work on him. Actively assess: "can this horse be worked on safely?".   What can I do to make it safer for the horse and me.

Lacerations can be very bloody, especially to the head and legs.  People tend to overestimate the severity of bleeding. Remember that a 1000 lb. horse has over 7 gallons of blood in his system and he can loose one gallon without serious effects. Of course, if a laceration has profuse bleeding, steps should be taken to slow it down.  Bleeding can be markedly slowed by applying pressure over the source of the blood. This should be done with a clean cloth, if available. Fold the cloth several times on itself to create a thick pad and apply a stretchy tape, Vet Wrap like material is excellent, firmly over the bleeding wound. This type dressing must be dry to adhere to itself so you must keep pressure on the bleeder as you apply the first few layers of the wrap. You can slow down the bleeding considerably using this method.

Too much padding or too loose will prevent you from getting adequate pressure. For instance towels wrapped around the bleeder are not going to help, though I see this done frequently. If the tape is very tight around the leg, change it every 10 minutes to allow circulation to the rest of the leg. If the location of the bleeding is such that you can not tape it, hold the bandage firmly in place until the bleeding stops.  If you cannot stop or control the bleeding within 15-30 minutes, then it's time to call your veterinarian.

Next:  Does your horse need stitches?  Deep cuts do not require stitches and antibiotics, full thickness lacerations do.  The pictures of the mare above are full thickness lacerations. How can you tell the difference?  The deeper layers of the skin can be white to pink resembling the tissue under the skin. One of the easiest ways to tell is that cuts which do not penetrate the skin all the way cannot have the edges of the wound separated. You cannot pull the edges of the wound apart because at the bottom the skin is still connected. How deep can a partial thickness wound be? In some areas where the skin is thick it may be 1/4 to 3/8's of an inch deep on the other hand in some areas the skin is as thin as 1/8 inch.

Lacerations that are not full thickness heal well with good cleaning practices.  I tend to use clean water from a garden hose over the wounds twice a day. Keeping the wound clean will deter flies as well.  Personally, I do not like putting any topical wound dressings on these wounds.  Studies have shown that many of these topicals actually slow down healing time.  If you absolutely feel that it needs a topical, Vetericyn VF Spray works well.  Spraying the area around the wound with fly spray can help deter flies.  If the area will be subjected to dirt like the lower legs a clean bandage kept dry is good.

Wether full skin thickness wounds should be sutured or not depends on many factors: age of the wound, location, contamination, blunt trauma, and even the first aid care all factor into the equation. Many people misunderstand the dynamics of serious infection thinking suturing insures this will not happen, when the opposite is true. Contaminated or badly traumatized wounds are safer left open and cared for properly than when sutured. The reason is drainage. Proper drainage helps insure the prevention of ascending infection. Obviously a sutured wound cannot drain. Before a wound is sutured it is imperative that it be clean, free of contamination, and badly traumatized tissue.

Open wounds that will not receive medical attention for several hours or more should be flushed out with clean water and bandaged, using an antibacterial ointment such as Neosporin. A garden hose with the nozzle set on a firm spray is ideal for flushing.  If a wound is to be stitched, flushing and bandaging will help minimize infection until the wound can be sutured. Avoid applying medications to the wound, as they may interfere with healing. If medical help is more than two hours away ask the opinion of the vet as to what you might dress the wound with. I like petroleum based triple antibiotic ointments, Furacin ointment or Nolvasan creme. A spray with diluted (somewhere between the appearance of strong tea or coffee) Betadine is good also.  If the wound is badly contaminated with dirt, it should be gently cleaned with a antibacterial soap, thoroughly flushed, then bandaged with ointment. Seek professional help with contaminated wounds, as these may have life threatening complications like tetanus or gangrene.

Avoid peroxide or blue wound sprays, as they will kill healthy tissue. The one exception would be a contaminated sole wounds. Peroxide can be used to clean these out initially.

What if structures deeper than the skin are injured?  With all wounds and particularly with full skin thickness lacerations you must consider what other structures are traumatized. With lower limb injuries penetration into a joint capsule or tendon sheath can turn a routine laceration into a lifetime performance compromising injury. Deep injuries to these areas should always be examined by a veterinarian.

Puncture wounds, such as from nails or fence posts can really be tricky.  They frequently look like minor wounds, but depending on the depth and contamination they can rapidly become infected. The first signs of problems are usually pain and swelling 24 to 72 hours after the accident. The puncture seals up rapidly, so the infection has no place to go and will spread to surrounding tissues. When in doubt about how deep the puncture is or you doubt that it is draining well have it examined by a vet. Punctures need to be open and explored for foreign bodies, thoroughly cleaned and may be left open or sutured.

I hope this information will help you be prepared for wound emergencies.  Above all else, stay calm and when in doubt, call your veterinarian.