PICTURES Mare with infected wound in withers. Still looks nasty.

MDB

MDB

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Hello again friends,

Looking for thoughts and advice re my mare's wound in her withers. Suspected bite from my other horse.

She is on IV gentamycin and butasyl, and IM penicillin. Everything once daily.

The first pic is how it was first thing this morning and the second after cleaning. I think it looks quite good in he second pic, except when I push around the wound specifically where my finger is, a fair amount of pus oozes out of the wound. :/

I have been cleaning with chlorhexadine and betadine and applying honey. He vet said to leave it open rather than covering or packing it. I have sent pics to my vet of the wouns today and am awaiting her response.

The pus concerns me. I just don't know if this is healing. It looks like it is healong superficially but there is obviously still deeper infection.

Thoughts, ideas and advice anyone?

sorry for typos.. fat fingers today!

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It was very deep and badly infected, I think you need to be patient as it is in a place where draining is not going to be easy, everything has to go up to come out rather than down, if that makes sense, if the vet is certain there are no foreign bodies or fracture involved then keep packing in the honey and let the antibiotics do the job of clearing the infection, the only other possibility is that you need to get a swab done so you can change the antibiotics if the infection does not respond this time.
I think I would probably use a hot compress for a few minutes each day to encourage it to draw a bit more, poulticing is obviously out but some warmth may help each time you dress it. The honey can also make it look worse, try putting some vaseline or baby oil below the wound area to stop the pus and honey sticking, one horse I was treating lost the hair below his wound as it was constantly sticky.
 
I would think about using an anti biotic spray on and around the wound. As she's already on AB injections, I'd discuss it with the vet first.
The sprays here have a blue dye in them and the vet sells it.
 
be positive said:
It was very deep and badly infected, I think you need to be patient as it is in a place where draining is not going to be easy, everything has to go up to come out rather than down, if that makes sense, if the vet is certain there are no foreign bodies or fracture involved then keep packing in the honey and let the antibiotics do the job of clearing the infection, the only other possibility is that you need to get a swab done so you can change the antibiotics if the infection does not respond this time.
I think I would probably use a hot compress for a few minutes each day to encourage it to draw a bit more, poulticing is obviously out but some warmth may help each time you dress it. The honey can also make it look worse, try putting some vaseline or baby oil below the wound area to stop the pus and honey sticking, one horse I was treating lost the hair below his wound as it was constantly sticky.
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Hot compress is a great idea. I clean it out with warm water but I never thought of hot compress. I think maybe I am being too impatient, but I don't like how it looks when it starts to scab over but then still has pus oozing. vaseline below the wound is also very good idea because she is loosing hair when I clean it.. and it's gross, blood amd pus all hardened into the hair.

thanks for that!
 
When we had a mare with an open wound on a leg, the vet told us to keep washing it out and to not let a scab form, we washed it out with warm water with an irrigation syringe. This was so it healed from the inside. It worked well and there was no scarring.
 
YorksG said:
When we had a mare with an open wound on a leg, the vet told us to keep washing it out and to not let a scab form, we washed it out with warm water with an irrigation syringe. This was so it healed from the inside. It worked well and there was no scarring.
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Ah ok. Maybe I should pul more scab off, or clean it more frequently so as not to let it scab over. Thanks for that!
 
The scab forms to protect the wound and encourage healing. The more you disturb the wound the more you disturb any healing. Open wounds are susceptible to infection, debris, dirt and whatever else there is in the environment. Wounds require a warm, moist environment to heal from the bottom up. Packing ie with intrasite gel or similar, would help deal with any topical infection, such as you describe, while the IM injections deal with any systemic infection.
 
I would honestly try medical grade Manuka honey it did absolute wonders on my colts leg when he degloved it - it's not even scarred now and it was seriously bad. Just do an allergy spot test first .
 
N
sula said:
The scab forms to protect the wound and encourage healing. The more you disturb the wound the more you disturb any healing. Open wounds are susceptible to infection, debris, dirt and whatever else there is in the environment. Wounds require a warm, moist environment to heal from the bottom up. Packing ie with intrasite gel or similar, would help deal with any topical infection, such as you describe, while the IM injections deal with any systemic infection.
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I will see if I can get intrusive gel here in Spain.. Is there another name for this stuff?

What you said makes sense re wound healing etc, but then the vet also said that if it heals over and scabs totally then the pus has nowhere to drain out of and the infection can go deeper. This also makes sense... So it's a tad confusing, leave open to drain, or allow to scab over to protect it from debris??

She has been on IV antibiotics for four days now.... Am I being too impatient?
 
A wound as big and infected as that needs to be kept open to some extent to allow draining, it cannot drain easily because of where it is, it should not get too much debris in for the same reason, you are being impatient a wound as ddep as this will take weeks, if not months to fully heal, once the infection has been resolved.
 
I wouldn't use intrasite gel until the puss cleared up.
I used lavender essential oil on a difficult and deep wound. It worked a treat but it's a bit eccentric if you're not that way inclined.
Washed it out with saline solution, waited for it to dry, lashings of lavender oil. But the wound had no puss. It did however keep the puss at bay, and the wound was a dead cert to become infected.
 
teabiscuit said:
Please ask auslander about manuka honey, it has to be medical grade for some reason which escapes me right now.
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Thanks Teabiscuit. Yes I am ordering medical grade Manuka honey online. In the mean time I am using normal human grade stuff which I managed to find.
 
MDB said:
N

I will see if I can get intrusive gel here in Spain.. Is there another name for this stuff?

What you said makes sense re wound healing etc, but then the vet also said that if it heals over and scabs totally then the pus has nowhere to drain out of and the infection can go deeper. This also makes sense... So it's a tad confusing, leave open to drain, or allow to scab over to protect it from debris??

She has been on IV antibiotics for four days now.... Am I being too impatient?
Click to expand...

The wound needs to heal from the bottom up. Disturbing the wound on a daily basis disturbs any granulation that may be forming therefore reducing or preventing healing. Packing it with a product such as intrasite gel, or similar, or possibly manuka honey, and covering the wound to keep the product in situ and the wound sealed allows for healing to take place by producing the conditions required for healing - moisture and warmth. With the gel in situ and a dressing such as hydrocolloid and wadding on top for any exudate (someone suggested a nappy) no scab will form. As the depth of the wound lessens (due to healing) there will be less need for gel/dressings. Once it becomes very shallow and superficial, it can be left open at which point a scab will form but the wound will essentially be healed so no pockets of infection should be left. The dressings can be left in situ for up to a week (if the surrounding tissue looks well and there isn`t any smell or excessive exudate/oozing) thus giving the wound the time it needs to granulate and heal.

Four days is still quite a short time for the antibiotics to work though you should be seeing some effects from them. That said, it may well be that the infection is confined to the wound only rather than in the blood stream therefore IV/IM antibiotics may not be as effective as topical preparations which are applied directly to the wound.

Not sure if this link will work but it will give you some info on intrasite gel (still the best I`ve used)

http://www.southwesthealthline.ca/healthlibrary_docs/H.4.CL336CA.pdf
 
So vet just been in touch. Says not to worry too much about the pus. I have to clean it more frequently to prevent it from stabbing over at the pus needs to drain out. I am to continue giving all injections and sending her photos daily and unless there is a deterioration she will come out in a few days to check it.

I must be too impatient.... And a worrier! Hate it when the animals are poorly :/
 
sula said:
The wound needs to heal from the bottom up. Disturbing the wound on a daily basis disturbs any granulation that may be forming therefore reducing or preventing healing. Packing it with a product such as intrasite gel, or similar, or possibly manuka honey, and covering the wound to keep the product in situ and the wound sealed allows for healing to take place by producing the conditions required for healing - moisture and warmth. With the gel in situ and a dressing such as hydrocolloid and wadding on top for any exudate (someone suggested a nappy) no scab will form. As the depth of the wound lessens (due to healing) there will be less need for gel/dressings. Once it becomes very shallow and superficial, it can be left open at which point a scab will form but the wound will essentially be healed so no pockets of infection should be left. The dressings can be left in situ for up to a week (if the surrounding tissue looks well and there isn`t any smell or excessive exudate/oozing) thus giving the wound the time it needs to granulate and heal.

Four days is still quite a short time for the antibiotics to work though you should be seeing some effects from them. That said, it may well be that the infection is confined to the wound only rather than in the blood stream therefore IV/IM antibiotics may not be as effective as topical preparations which are applied directly to the wound.

Not sure if this link will work but it will give you some info on intrasite gel (still the best I`ve used)

http://www.southwesthealthline.ca/healthlibrary_docs/H.4.CL336CA.pdf
Click to expand...

Thanks sula. I will check out the link. I understand what you are saying about disturbing the wound. And I take on board all the advice you give. I have however just had contradictory advice from my vet... Who says to keep it open. Without meaning to cause any offence and purely to understand things better.. Do you mind me asking if you are a vet? You seem fairly knowledgable. :)
 
Sula may I ask if puss is forming and the wound is plugged with intrasite gel, is the puss not trapped?
Would that be harmful?
I do agree that disturbing wounds should be avoided if possible, and intrasite gel is fab, but I've never used it when puss was present for fear of trapping it.
Am I wrong?
 
teabiscuit said:
Sula may I ask if puss is forming and the wound is plugged with intrasite gel, is the puss not trapped?
Would that be harmful?
I do agree that disturbing wounds should be avoided if possible, and intrasite gel is fab, but I've never used it when puss was present for fear of trapping it.
Am I wrong?
Click to expand...

Top tip from my Vet Wound Library friend. "Use the same colour on the wound as is coming out of the wound" ie; if the exudate is clear, use intrasite, and if it's yellow, use honey.
 
Don't do anything unless vet has instructed you to do so. I've had a few v nasty wounds to deal with, and one healed externally but not internally, leaving a tract under the skin (which had to be opened up) It needs to grow together from the outside, with the overall size of the wound reducing gradually. Don't be too keen for it to heal over of this will seal in any infection. The pus is an irritant so it is good to smear the area below with Vaseline to protect the skin (don't get Vaseline on the wound, just put it on the healthy skin below where the pus is running to). Be patient and liase regularly with vet and it will heal - just don't rush it or fiddle with it too much
 
I swear by this Botanica Cream:

http://www.botanica.ie/products/botanica-natural-herbal-creams/

My mare tripped on the road and took a massive chunk out of her knee (no photos unfortunately). Initially washed with hibiscrub but thereafter cleaned and flushed out twice a day with saline and then packed with the botanica cream to keep it moist so it wouldn't scab until it became level with the rest of her skin. It took about a month before the skin layers had built up again but it healed with no scarring and full hair growth so you can't even see where it happened.
 
A relative of mine had a horrendous leg wound that was treated at the hospital with manuka honey. With the honey dressing changed twice a week it was amazing how well it kept the wound clean and allowed the flesh to slowly grow back. I was so impressed with it and if it was my horse would be asking the vet about using it.
 
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