Recently I received a call out to a horse that had been on a hack through a forested area. While crossing a river, he had sustained a deep laceration to the back of the pastern on a front leg which presumably had been caused by a sharp stone. The horse pulled up lame immediately and the wound was bleeding.

The owner was luckily not far from home and was able to walk the horse back to the stable in hand. She cleaned the wound as well as she could with hose water and disinfectant and applied a pressure bandage as there was still a lot of bleeding. She then called me for help.

When I arrived, the horse was in obvious pain. He was weight-bearing on the injured leg but was agitated and was lifting the leg constantly. I removed the pressure bandage to find that the bleeding had stopped. I cleaned the area with saline and hibiscrub.

The wound was approximately two centimetres in width and was a typical laceration injury which appeared like a stab wound. As it was difficult to pull the two surfaces of the wound apart, it was difficult to assess the level of damage that had occurred to the structures beneath the skin. Even though the injury had occurred less than two hours previously, there was considerable swelling from the back of the fetlock to the knee in the area of the tendons. I administered painkillers, antibiotics and boosted the tetanus cover.

I explained to the owner that, in cases like this, it is difficult for the veterinary surgeon to tell, based on a clinical examination, if the deeper structures have been damaged. In many cases, these types of lacerations can involve the digital synovial tendon sheath or the deep digital flexor tendon or, in extreme cases, the pastern joint itself.

This creates a dilemma. Does the veterinary surgeon try to treat the case for a few days at home and assess the progress or refer the case to an equine hospital immediately? As previously stated, it is impossible to see if the deep structures have been involved and as lameness and swelling in the area are not a reliable way of establishing if the synovial structures have been involved, it is safest to refer these cases to an equine hospital for full investigation immediately. There is of course a cost factor involved. However, if the synovial spaces have been involved and are not treated correctly and on time, the potential outcome for the horse may be serious.

GOOD PROGNOSIS

At the hospital it is possible to check if the synovial spaces have been damaged and to take samples of the synovial fluids to establish if there is infection present. If there is infection or damage - or both - they can operate to resolve these problems.

In this case, the owner decided to go for the option to refer the horse to an equine hospital. Luckily for her, the veterinary surgeons at the hospital were able to report that there was no serious damage or infection involved. The horse returned home after two days with instructions for bandage changes and medication. The wound healed well after two weeks and this horse should make a full recovery.

In cases like this, it is essential to apply first aid principles when the injury occurs and seek veterinary assistance as soon as possible so that decisions on the most appropriate form of treatment can be made.

Denis Doyle MVB MRCVS is a veterinary surgeon in Wicklow town and is a member of the Equine Group of Veterinary Ireland

Email: hq@vetireland.ie

Telephone: 01-4577976