Bad leg injury

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zsmm4

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my pony was found in the lane this morning having scrambled over a sheep wire fence and thick hedge. [another thug of a pony had him cornered and was kicking/bullying him] Hes skinned the front of his hind cannon from hock to about half way down. Vets been washed and stitched and bandaged and treated his other smaller superficial injuries. Vet coming again Mon morning to remove dressing and see how its doing. Pony has had tet injec and also anti -biotics. the concern is if the tendon sheath has become infected.
Has anyone experience of this type if injury?
 
It is a wait and see, if (fingers crossed) it isn't affecting the tendon sheath and doesn't get infected then it should slowly heal and swelling go down, but it may get infected even though on antibiotics, hopefully not though. You will just have to wait to see whether the swelling goes down and if lame that decreases....The only way of confirming no damage to tendons is with ultrasound but you would prob only do this if a bit later you start to suspect it. Just wait with your fingers crossed x
 
Erk! Poor ned zsmm4. Sounds dreadful. If it was me, I'd be terrified that the tendon sheath had been penetrated. Did you see any clear, pale yellow liquid oozing from the injury? JodieS, am I right in thinking that in such an instance there's about an 8 hour window and if the tendon sheath isn't flushed out by then it's a dodgy prognosis? There have been 3 cases on my yard: one was miraculously spotted within an hour of the injury - flushed out under GA and the horse was fine. One was almost missed by an inexperienced vet (long story - don't ask) and the horse had to have 2 flushes because she had been left so long. She was fine in the end. Third case, ponio's infected tendon sheath wasn't discovered for 2 or 3 days and no amount of flushes could help the poor lad.

Fingers crossed your ned is just very sore and will make a full recovery. Do let us know how he does xxx
 
Excellent advice from Jodie and I agree with BoF concerns. Your vet should have been able to feel the tendon sheath - did they raise concerns about it? If your horse becomes non weight bearing on that leg then you will need to horsepitalise for a flush and treatment.

Please do let us know how you get on.
 
I have never heard of the 8 hour window theory but obviously the less time left between the incident and flushing out will decrease the chances of infection. Any amount of flushing will not rewind any tendon damage it will only help to flush out any infection from the wound, and if the tendon sheath was punctiured then this will also help to flush any dirt/ bacteria out of the sheath.

I imagine with the worry of the tendon sheath being infected you are relating to the one at the level of the hock? How far up the leg was the injury?

The other day out with an experienced equine vet we had a case with a 16.3 WB which had a back kick to the front oh his knee directly over the tendons and tendon sheath. Again the worry was whether the tendons had been damaged and whether the sheath had been punctured.
After the knee was clipped and scrubbed with hibbiscrub and then in as sterile a fashion as can be achieved in a stable the vet inserted a sterile needle into the tendon sheath and sterile water was injected to see whether it would come out of the puncture wound, thankfully it didn't so it seemed the sheath hadn't been punctured. Unfortunately although covered with antibiotics (noradine granules in the feed twice a day) the knee continued to swell up and all the other little cuts started to ooze pus, poss due to lack of sensitivity to the chosen antibiotic (this antibiotic is just as good as any other just not specific to the infection in this case). This was since changed and the swelling has gone slowly down and the other cuts have started to heal.

Did your vet just wash the wound with hibbi scrub or flush it with sterile saline? Either way I am sure they did their best to get it as clean as possible which is what any vet would do unless there was clear evidence of the sheath being punctured.

How is your horse doing today? Swelling decreasing at all?
 
Morning everyone. Wound is large. Hind leg reaches from front of hock to about half way down cannon, completely skinned ,cannon visable,also reaching to inside of leg, ditto skinned. Skin hanging down . Wound flushed with lots of saline and stiched. We reckon horse treated no later than an hour and a half after injury happened, maybe sooner. Lots of nice clean red blood.Vet reckons all major blood vessels and joint structures are ok [ fortunately!]. As already stated the concern is if the tendon sheath is damaged and subject to infection.
We discussed this with vet and have decided if this happens pony will be PTS as we are not insured [ we have good reason for this , I am £9,500 loss after Ins company not paying out on a case of EGS some years ago -----long story which I'm not going to go into but we made a decision not to insure anymore and only have low value animals in future ( this particular companion pony cost £200)with a budget to stick too for vet treatment for each horse].
Also vet informed me that if pony had to go to hospital for general and flushing then theres only a 40% success rate anyway. In addition to the financial concerns I am also reluctant to put my horses through prolonged treatment involving ops and box rest. I'm not and never have been happy with that and have always taken the decidion to PTS eg tendon breakdown injury etc. I'm not one for keeping things going "because I love it". Prolonged treatment and box rest etc is not a kindness to my way of thinking. Just my opinion.
Update today is that the pony is eating his feeds with the antibiotics added [hurray] and last night was on 3 legs despite bute but this morning is weight bearing to the point of resting the other hind[ fantastic] hes bright and alert and eating and otherwise A-OK.
Vet calling monday to have a see how its healing and change dressing.
I'll keep you informed with updates.
Thankyou for the replies and advice, its much appreciated.
 
Jodies re swelling, hes much bandaged so cant tell! Obviously if he swelledup then I'd notice that. Looks ok though from what I can tell.
 
That's good news z - and Jodies, your advice and expert understanding is fabulous. Please don't ever leave this fourm!!!! I didn't know that a way to check for a possible tendon sheath penetration was to inject a sterile solution and watch for it squirting or oozing out. Stored in my memory banks!
 
issacalsoMerrylegbandaged011.jpg
 
My mare was 9/10ths lame with a big knee one morning. I called the vets and said "I am bringing her down now". (They tried to give me an appointment for a few days time)

When I arrived her knee was xrayed and the tendon was tapped (after her knee was clipped). The colour that came back was a clear indication of infection within the tendon sheath.

The vet said they'd need to operate as no amount of systemic antibiotics could tackle an infection in the tendon sheath, due to a poor blood supply (I guess that's why tendon injuries take so long to heal).

I remember saying "When will you do that?" because I didn't want to have to take her home...it had taken half an hour to help her up the trailer ramp to go the vets. His reply left me cold..."She'll be under the knife in 20 minutes, it's a life and death emergency".

I was told that had I not taken her to the vets that day, the infection would have eaten through the tendon causing extensive damage which would have resulted in her being PTS.

Thankfully 3 1/2 years later she is fully sound and back in full work. It was a long process of fitness as she was left with adhesion post op and quite lame whilst they were being broken down.

Surgery and a five day stay in horsepital wasn't that expensive....£1800
 
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Patches , your is one very lucky pony! apparently that is the problem, anti-b's dont get to the infection.

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That's it. No matter how strong a dose they give too..be it orally or systemically. The blood supply to the tendons is so poor it can't carry a "bug busting" dose to kill off infection.

She had hers flushed and "gentocin/gentomycin" (sp) beads stitched into the wound on her knee for five days. The idea of the beads was to help target anything left behind.

It was a complete success. She didn't require any more surgery and came back into work fine. It was only the adhesions from surgery sticking her tendon to the tendon sheath that caused the temporary hiccup. I had to ride her every day, on strong doses of bute, to break them down.

Now, even when she has a flexion test on the leg with the affected knee, she is 100% sound. She really was lucky.

I am so pleased I was so insistent on the phone because the receptionist was adamant I had to book an appointment for a few days time. I just had this instinctive fear that she needed to see the vet ASAP at the clinic where they had everything on site to help her.
 
UPDATE 24/08/09

Leg been looked at and rebandaged this morning by Vet. Only 1 lot of sedative needed this time! It is LOOKING GOOD but we are not out of the woods yet of course.
will be re -dressed on Wed by me and vet calling Fri to examine and do whatever necessary.
 
Sad Update. Yesterday wound had broken down and pony now very upset at vet and us. He needed a double dose of sedalin a bridle and a twitch and was still rearing. this just to sedate him enough with an injection to remove the dressing.
We decided that hed gone through enough as his behavoiur was getting worse re being treated and it would take months of more treatment yet. So, he had bute nd was given the afternoon in the field with fresh grass and 3 large buckets of varoius nuts and mixes to choose from. Huntsman called at around 7pm and shot him. Huntsman [Michael Rowson South Shropshire Hunt] very proffessional and good and if anyone reading this finds themselves in this unhappy situation i can thoroughly reccommend him to "do the job" well.
 
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