Non Healing wound after 4 months

[Lexie01]

My pony injured herself in the field towards the end of August. Normal cut to right hind canon bone area. Vet was called immediately and she had the normal treatment - antibiotics, cold hosing for swelling etc. anyway to cut a protracted story short the cut refused to heal. After 2 scans, swabs and further antibiotics by local vets she was referred to an equine hospital in early October. Here radiographs showed no evidence of bone involvement but ultrasound revealed the presence of foreign material. Under GA the wound was de brided and infected tissue removed. The wound was stitched and all went well. However within 48 hrs of stitches being removed the leg swelled up and cellulitis was diagnosed with further treatment. The wound opened back up!

More swabs, more antibiotics and more scans. By end of Nov the scan showed that the bone was no longer 'smooth' and off she went back to the equine hospital. This time a sequestrum was found in the infected area. This was removed under standing sedation and the wound was flushed out again. This time they didn't stitch the incision - to enable it to heal from within. This was 3 weeks ago and my pony is still on box rest. The wound is still not healing despite antibiotics and clean dressing changes (by the vet) every 3 days. The discharge from the wound has now started to smell and she has been referred back to the equine hospital.

I am literally at my wits end. I'm nearing 10k vet fees and can't see an end to this. She also had kissing spine surgery 12 months so really shouldn't be on box rest for this length. of time.

Has anyone experienced anything like this before? If so what caused it and what fixed it? TIA xx

 

[AmyMay]

Are they putting anything on the wound?

 

[shortstuff99]

How old is she? Any possibility of cushings or other metabolic disorder as that can impact healing.

The only other suggestion would be to culture the bacteria to see what antibiotics it is sensitive to but I'm sure vets have thought of all this.

 

[Lexie01]

Are they putting anything on the wound?

oh yes sorry I should have said. At the moment Manuka honey into the wound area plus flamazine on the surrounding skin

 

[Lexie01]

How old is she? Any possibility of cushings or other metabolic disorder as that can impact healing.

The only other suggestion would be to culture the bacteria to see what antibiotics it is sensitive to but I'm sure vets have thought of all this.

HI, yes she has had 3 swabs to date. The last one done a few days ago. Each time the bacteria causing the infection has been different and antibiotics designed to treat that infection given.
She is only 9 and shows no signs of Cushings although no blood test has been done.

 

[nagblagger]

The dressings aren't working - I would change the type of dressing. (Flamazine shouldn't really be used long term..in humans I think about 2 weeks.)

 

[AmyMay]

Have they suggested intravenous antibiotics?

 

[Lexie01]

The dressings aren't working - I would change the type of dressing. (Flamazine shouldn't really be used long term..in humans I think about 2 weeks.)

she hasn't been on flamazine that long. She was on it for about 3 days after the final op 3 weeks ago and has been put back on it the last couple of days. I should say a scan by my local vet last week (post op 2 week scan) showed that the bone was still not smooth and that there was still a pocket of infection. Not sure what changing the dressing would do?

 

[Lexie01]

Have they suggested intravenous antibiotics?

Just before the last op I injected her for a week myself with some v strong antibiotics. These did absolutely nothing. This followed a culture swab of the infected area so were the correct antibiotics to give. Is this what you mean? Thanks x

 

[nagblagger]

In conjunction with appropriate antibiotics. Did you give the injection into the vein..that is what @Amymay in a manger meant, not into the muscle.

 

[shortstuff99]

I think bone infections can be quite difficult as getting antibiotics to it is hard?

 

[Lexie01]

In conjunction with appropriate antibiotics. Did you give the injection into the vein..that is what @Amymay in a manger meant, not into the muscle.

ah no then. She had them whilst in the equine hospital (both times) but not since she has been home x

 

[AmyMay]

What are you feeding (info online cites nutrition as being important to a successful outcome, alongside the medical treatment.

 

[Glitterandrainbows]

My daughter got a infection in her bone from falling over at school she was on iv antibiotics for weeks and oral for some time after plus a operation to remove the infection they are stubborn infections to go the antibiotics did work eventually just a slow process don’t give up hope fingers crossed for you (I know it’s not the same I just thought worth pointing out it feels like it will never go but it does)

 

[Lexie01]

Just her normal - Safe & Sound plus TopSpec balancer. She is now also on a gut supplement to counterbalance the effects of the drugs.

 

[Lexie01]

My daughter got a infection in her bone from falling over at school she was on iv antibiotics for weeks and oral for some time after plus a operation to remove the infection they are stubborn infections to go the antibiotics did work eventually just a slow process don’t give up hope fingers crossed for you (I know it’s not the same I just thought worth pointing out it feels like it will never go but it does)

Thank you

 

[AmyMay]

Just her normal - Safe & Sound plus TopSpec balancer. She is now also on a gut supplement to counterbalance the effects of the drugs.

It may be worth speaking to an independent nutritionist to see how you can support her through her food as well.

 

[Landcruiser]

No suggestions really but sending my very best wishes. I empathise with your distress and frustration, it's so bloody tough sometimes.

 

[Lexie01]

No suggestions really but sending my very best wishes. I empathise with your distress and frustration, it's so bloody tough sometimes.

Thank you so much - and you are so right xx

 

[Ricedance]

Post colic surgery (burst stiches 3 days post op, back on the table) and further wound breakdown 2 weeks later, we did Manuka mixed with pectin powder and a drop of water. Healed well, small scar.

 

[Ricedance]

Post colic surgery (burst stiches 3 days post op, back on the table) and further wound breakdown 2 weeks later, we did Manuka mixed with pectin powder and a drop of water. Healed well, small scar.

A new, easy-to-make pectin-honey hydrogel enhances wound healing in rats

Honey, alone or in combination, has been used for wound healing since ancient times and has reemerged as a topic of interest in the last decade. Pectin has recently been investigated for its use in various biomedical applications such as drug delivery, ...

www.ncbi.nlm.nih.gov

This is the link to the study for it, but from my first hand experience it worked well.

 

[Bobthecob15]

Oh goodness I feel for you, how frustrating! No real advice I’m afraid other than could you ask for another opinion? I don’t think the damp weather helps… is she on box rest still? Is the wound covered or open to the air?

In humans often if wounds don’t heal it’s something underlying like diabetes…I suppose EMS would be an equine equivalent. Might be worth asking the vet’s opinion? Nutrition is also important so the independent nutrition advice is a good one, top spec is fine but I suspect you could
Be feeding better to help healing x