Fetlock wound - still not healed after 6 weeks

Pinkvboots said:
I hope the bloods come back with nothing serious.
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PS as you kindly asked about my retired mare….
1) her eye that had surgery on it a few years ago for an ulcer is grumbling again and the cornea looks slightly rough (though no ulcer) so she is getting eye drops to see if that clears it up , else back to the eye hospital we go
2) bloods showed up a slightly high kidney marker and a slightly low iron marker (possible inflammation somewhere - the eye?). Bloods are being rerun in case the kidney marker was dehydration after her episode.
3) her episodes appear to be due to sleep deprivation- I got cctv working again which shows she isn’t lying down. (At least in the recorded hours of midnight to 0630) Trying to establish whether it is due to insecurity or discomfort . Today we are cutting a large window in the wall between her stable and my other horse’s stable to see if that helps if it is insecurity . They both have their stable door open overnight onto their respective patios - I don’t know if an open door makes them feel insecure? It seems a shame to lock her / them in but it is something else to try.
 
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Reacher said:
Quick update in case anyone is interested -new regime for the past couple of weeks - the vet has come and debrided it a few times then put on a moist dressing and bandaged. I replace dressing every 2 days.
Also she took a swab at my request - am waiting for the results.

BTW From the dirt on the bandage I can now see that he does lie on it and perhaps was rubbing the wound so it’s good that the bandage also protects the wound


The debriding and moist dressing has helped kick start the healing I think, the wound looks healthier and appears to have contracted by a few millimetres.
View attachment 108729
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That now looks a lot healthier and actually clean! I think you are now on the correct protocol.
 
Looks a lot better after debridement. After my mules proud flesh was removed from a large lower leg wound it encouraged better healing with minimal scarring. I think you have turned the corner. (fingers crossed).
 
nagblagger said:
Looks a lot better after debridement. After my mules proud flesh was removed from a large lower leg wound it encouraged better healing with minimal scarring. I think you have turned the corner. (fingers crossed).
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Thanks that’s encouraging - fingers crossed!
 
Thanks 😊
SweetDreams said:
It looks beautiful on the picture uploaded good job!
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Thanks HMC , I’m resigning myself that the whole area will be hairless but if the area is smaller that would be nice!

Highmileagecob said:
Well done! Massive difference to your first picture. You may be left with a small area where the hair doesn't grow back, but all in all it's looking very healthy.
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Reacher said:
PS as you kindly asked about my retired mare….
1) her eye that had surgery on it a few years ago for an ulcer is grumbling again and the cornea looks slightly rough (though no ulcer) so she is getting eye drops to see if that clears it up , else back to the eye hospital we go
2) bloods showed up a slightly high kidney marker and a slightly low iron marker (possible inflammation somewhere - the eye?). Bloods are being rerun in case the kidney marker was dehydration after her episode.
3) her episodes appear to be due to sleep deprivation- I got cctv working again which shows she isn’t lying down. (At least in the recorded hours of midnight to 0630) Trying to establish whether it is due to insecurity or discomfort . Today we are cutting a large window in the wall between her stable and my other horse’s stable to see if that helps if it is insecurity . They both have their stable door open overnight onto their respective patios - I don’t know if an open door makes them feel insecure? It seems a shame to lock her / them in but it is something else to try.
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Thats quite a bit going on I hope you manage to sort the sleep issue then hopefully the other things will improve.

My mare I had years ago went through a stage of not lying down, I was on a block of just 2 stables and when that one left thats when it started, I moved her up to the main block with other horses and she was fine then.

You could do a bute trial it might show if it is a discomfort thing as it is quite common when they get older as they struggle to get up.
 
Another quick update (ETA turned into a long one actually!) for anyone interested -

in order to empty my bank account further 🤪and make sure there are no underlying issues, I had a swab of the wound taken - it found one type of bacteria , nothing very nasty apparently but associated with poo - I was advised to either use fuciderm or our old friend manuka honey - as I had 6 unopened tubes of activon honey I’m using those!

I also had an X-ray of the wound to rule out damage to the bone which could be stopping the healing - this was clear thankfully.

The epithelialisation is cracking on now - yesterday’s photo below.

In case anyone in the future has a similar wound to deal with, and finds this thread, my experience has been :

1) Under vet’s original protocol of cleaning, applying flamazine cream and leaving exposed to air, the healing had stalled, epithelialisation hadn’t got going and slight proud flesh developed (just a rough surface rather than obvious proud flesh).

Wound was then debrided a few times by the vet and suggested we try different protocol i.e. dressing and bandaging the wound to keep it moist:

2)bandaging protocol:
Allevyn dressing * with a generous squirt of hydrogel and I have also added manuka honey - taped in place with micropore tape (else it slips down despite all the layers on top)
A roll of Soffban on top
Cotton wool wadding on top
A roll of light mesh bandage on top to hold cotton wool in place, I’ve been washing and reusing this (ETA @Elf On A Shelf says this is called Knitfirm.)
Vet wrap on top.
This is changed every 2 days.
ETA Also keep edge of wound clipped as fur can inhibit epithelialisation.

* I’ve been told now to use a melolin dressing instead of the allevyn as there is no discharge from the wound and the allevyn can be drying.

This might be more layers that some people would use but this is what the vet did and it gives good protective padding.

The vet wrap needs to be firm enough that the dressing doesn’t rub the wound but not too tight to cause pressure sores.

Hindsight being a wonderful thing, I’d advise anyone with this type of wound to bandage from the start - I think it would have saved weeks off the healing time.
BB74AE4C-6221-4483-A9D7-8C19A16952CC.jpeg

I’ve kept him in his small turnout area (but not into paddock) as both vets I’ve seen (the second being a very experienced vet from the mini vet hospital) advised that field turnout would slow the healing process due to movement as well as risking reinjuring the wound or risk infecting it.

I know many people disagree with not turning out fully- I’m just noting this point so anyone who finds this thread can weigh up the risks. I’m fortunate that my horse has not been on complete box rest as I have a small yard turnout area about the size of 6 stables which he has 24/7 access to outside his stable

I am hoping in a week or so he will be able to go back out in paddock.
 
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It's looking fab and defos on the home straight now.

A roll of light mesh bandage on top to hold cotton wool in place (not sure what this bandage is called. I’ve been washing and reusing this bandage).

^^Knitfirm^^ it's a fab piece of kit.
 
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