Horses are experts at getting into things that they shouldn’t. Commonly, horses arrive on an emergency basis for evaluation of a cut or laceration, often on one of their limbs. When horses cut themselves, it is important to evaluate which anatomical structures are involved or damaged. Some lacerations involve only the skin, but others can be deeper and damage tendons, ligaments, or communicate with a joint space. A skin laceration heals more easily than one that involves muscles, tendons, ligaments or joints.
After a thorough cleaning of the wound, the area can be assessed to see if anything needs to be stitched, whether surgery is needed, or if it will be able to heal well on its own. Then, if the wound does not appear to require surgery, a bandage can be placed to protect the wound from contamination. Often, if the wound is close to the hoof and a bandage needs to cover the hoof, duct tape will be used to created protection around the hoof from the ground and wetness. Bandages are then changed every day or every other day to monitor healing.
In addition to physical damage caused by the initial injury, secondary infections are very common. It is thus important that, in addition to assuring that patient pain is controlled, antibiotic therapy is also instituted to prevent infection. A common way to ensure local delivery to the tissues most closely affected by the damage is to perform a distal limb perfusion. For this procedure, a tourniquet is placed on the limb and antibiotics (commonly amikacin, as it has good bone and joint penetration) are administered into a vein on the leg. The tourniquet prevents the antibiotic from dispersing to all parts of the body and when left on for 10-15 minutes gives the drug a chance to reach high concentrations in the area of concern.
Horses will always find ways to get into trouble and hurt themselves, no matter how much we try to prevent it. Therefore, it’s up to us to be able to stitch them up, keep them comfortable, and keep them healthy when they get into mischief.