Here are some examples of wounds that need to be seen on emergency:
- Any wound that is over or near a joint, tendon, and/or ligament
- These structures are vital and your veterinarian will need to determine their degree of involvement
- Wounds on the face and especially on or near the eyes
- Wounds that are large (over 1 inch long) and/or deep (deeper than 1 inch deep)
- A wound that has excessive swelling, bleeding, and/or discharge in the injured area
- The average clotting time in a horse is approximately 15 minutes, therefore, bleeding wounds usually look much worse than they are
- Severe lameness associated with the wound and/or injury
What to do Before the Veterinarian Arrives:
- Take a deep breath! Try to keep both yourself and the horse calm.
- If there is profuse bleeding or bleeding that has a rhythmic “pulse”, it should be bandaged immediately to apply direct pressure. If the blood soaks through that bandage, apply another bandage over the initial one until the veterinarian arrives. DO NOT remove your first bandage.
- If it is safe to do so, get your horse to a location where the veterinarian will be able to safely bandage it.
- If possible, determine when your horse was last vaccinated for tetanus.
Once the Veterinarian Arrives:
- They will generally start by taking a thorough history of how, when, and where the wound occurred. Next they will evaluate the horse overall (listening to the heart and lungs, checking their temperature, and checking their overall perfusion and hydration).
- Following the general examination, your veterinarian will evaluate the wound more thoroughly. This may require chemical restraint (sedation) or imaging (digital radiology or ultrasonography). If the wound is over a joint, your veterinarian may discuss tapping the joint to determine its integrity.
There are several options for wound management (discussed below). Following a thorough evaluation of the wound, you and your veterinarian together will determine the best course of treatment.
Wound Management:
- Primary Closure:
- This involves suturing the wound within 6-8 hours of occurrence
- This approach provides the most cosmetic and functional result
- Cannot be performed on a heavily contaminated wounds or those with significant tissue loss
- Delayed Primary Closure:
- Involves suturing the wound >12-24 hours after occurence
- Affords the second most cosmetic and functional result
- Performed when there is too much contamination for primary closure but that which can be effectively cleared over a short period of time.
- Open Wound Management (“Second Intention Healing”)
- Performed when there is too much contamination or tissue loss for primary or delayed primary closure.
- Can either be performed completely open with monitoring and cleaning or with bandaging and/or dressings
At Home Care:
Occasionally, a wound will be severe enough to require advanced care and monitoring (surgery, hospitalization, etc.). This is determined on a case by case basis. The majority of wounds can be treated effectively in the field with close monitoring for problems including: increased swelling, heat, redness, discharge, increased lameness, etc. Depending on the wound, your veterinarian may recommend the administration of anti-inflammatory medications (bute or banamine) as well as a course of antibiotics for your horse.