PICTURES Wither wound.. will it ever get better??

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MDB

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Some days I think it is never going to improve. I guess the original wound is looking better. Less pus every day so maybe healing, which is the aim of the drainage cuts.. to allow the primary wound to heal but allow the infection to continue to drain. I clean it all up, it looks good, then a few hours later we are back to this. To top it all my lovely mare has had enough of injections and has started tossing her head around so I am unable to give her IV bute and gentamycin. I am giving the gentamycin and penicillin IM but she is having no pain relief / anti inflam.... so she is sore :( :(

Can anybody tell me how long it may take for the pus to stop?? At least she is eating normally and seems not too bad in herself.

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ooh looks nasty :( my boy had something similar last year and i ended up sewing animalintex inside a chest bib which drew a lot of cr*p out without me getting my head kicked in...took about 8 weeks to heal
 
Having followed your posts since this started, I'd say that looks loads better! I imagine seeing it day in day out you don't see the progress like someone dipping in and out of it like we are.

You're doing a great job. It was a big wound with a horrible infection, it will take time, but you're defintely on the right track. Well done.
 
Can't comment on the wound, but to make injections stress-free make sure you have treats - a chunk of carrot or something - and give them to her as she is injected.
All mine practically offer their necks to the vet because the goodies they get are worth it.
 
Looking good! Good bed of healthy tissue in the wound, lots of free flowing pus. I know, I know - it's like a sci-fi horror show with all that gunk, but....MUCH better out than in :-) Can you try giving bute in powder form in the feed?
 
s4sugar said:
Might be worth trying Cut'n'heal - I've used it on worse to good effect.
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Good grief you couldn't put that stuff on a wound that is still oozing like this is. All that gunk need to come out! Sealing it in with cut n heal would be one of the worst things you could do.

Personally I would have expected the pus to be slowing by now, could there still be something in the bottom of the wound somewhere still causing trouble?

OP - you're doing a sterling job with this, hang on in there it's got to start getting better soon.
 
Thanks LBM .. my husband holds her and dishes out food.. but with three injections everyday for two weeks now (I think) she has had enough. It probably hasn't helped by the fact that I have only just learned to give them so there is a lot of faffing around by me.. not as skilled and smooth as the vet :(
 
3OldPonies said:
Good grief you couldn't put that stuff on a wound that is still oozing like this is. All that gunk need to come out! Sealing it in with cut n heal would be one of the worst things you could do.

Personally I would have expected the pus to be slowing by now, could there still be something in the bottom of the wound somewhere still causing trouble?

OP - you're doing a sterling job with this, hang on in there it's got to start getting better soon.
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thanks everyone and 3OP.. it really makes me feel better mentally to have you all look at it and give me your thoughts.

The vet had a really good feel inside when she made the drainage incisions.. infact her hands were so far inside it madw me feel a tad queasy! Vet thinks there is nothing inside. I would also have expected the flow of pus to slow but vet says it looks ok at the minute. I am sending her daily photos and she is coming out again this week. She keeps telling me to have patience. I have no patience but plenty of paranoia.

I clean it all out, syringe the cavity with diluted chlorhexidine solution and squeeze all around the wound in the direction of the drainage cuts. At the end I am sure there is no pus inside. I put vaseline all around he bottom end of the wound and furacin ointment in the old wound. But within a few hours it is oozing again. Arrrgggh.
 
Cortez said:
Looking good! Good bed of healthy tissue in the wound, lots of free flowing pus. I know, I know - it's like a sci-fi horror show with all that gunk, but....MUCH better out than in :-) Can you try giving bute in powder form in the feed?
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I will ask re the bute in the food. Good qiestion, thanks Cortez!
 
Is the vet still seeing the pictures daily?
if yes what do they say?
If not I would send one and ask their opinion, I think the healing looks great but would have expected the infection/pus to have reduced by now-I wonder if there is a foreign body in there.

cross posted.
and I second the idea of a pain killer being give- bute is an anti inflammatory too though and may hinder the drainage of the wound
 
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It is 'going the right way', which is the best you can hope for. It will take time but be guided by your vet. Can you inject into the hindquarters to give the horse a break from injections into the neck? How about oral painkillers?
 
Looking much better to me too. I know it's frustrating but you are going about it the right way and, as annaagain said, can see progress better when you're not seeing it daily
 
Cut'n heal doesn't seal - it keeps wounds open.
I first used it on my vets recommendation when a haorse retuned from loan with a finger sized puncture wound.
Are you confusing it with one of the spray dressings?
 
I think it is going the right way :). If you saw some of the wounds that PFK in egypt seem to manage to get better with limited resources you might worry less ;).
This S4sugar? http://www.vetscriptions.co.uk/MULTIHEALLQ.html or the ointment?
I'm not sure why you would use it in this situation tbh, given the ingredients though cutheal have nothing on their website.
'Multicare cleans, seals, and aids natural healing. Multicare disinfects and provides a pliable barrier across the wound to help exclude fly bacteria and infection'
 
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It is looking loads better than the original pics, and shows some lovely progression since the debridement. Unfortunately deep wounds like these are going to take weeks to months to heal.
 
Thanks everyone... it's really great to get all your opinions. I am going to ask the vet if we can give injections into another muscle group or failing that oral medications. We will keep going and hoepfully things will progress... it is hard to see when you are dealing with it three times a day.
 
Can the vet not place an iv catheter so that your not giving new needle veryday? For one thing you're likely to end up with an infection of the jugular vein with such regular punctures. I realise the horse is field kept but a correctly fixed catheter should be no problem?
 
s4sugar said:
Cut'n heal doesn't seal - it keeps wounds open.
I first used it on my vets recommendation when a haorse retuned from loan with a finger sized puncture wound.
Are you confusing it with one of the spray dressings?
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The cut n heal at my tackshop says that it creates a breathable, waterproof seal over wounds, perhaps there are two versions?
 
SusieT said:
Can the vet not place an iv catheter so that your not giving new needle veryday? For one thing you're likely to end up with an infection of the jugular vein with such regular punctures. I realise the horse is field kept but a correctly fixed catheter should be no problem?
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I will certainly ask about this.. To be honest it isn't something I thought about. I am not able to give the IV injections at the minute anyway... Horse seems to have had enough and has started avoiding them, and I am not experienced enough to deal with this. So I am giving both injections IM at the moment. If a catheter was an option it would certainly make things easier, either that or oral meds... Both me and horsey have had enough of needles!
 
Have you thought about a second opinion? IT all sounds rather hands off and third world way to treat it or is there a reason the horse isn't going into the vets for treatment- cost/inability to transport etc? I would also wonder if the antibiotics are actually doing anything - have they swabbed or cultured it? there are oral antibiotics you can give so might be worth culturing to see what its actually sensitive to..
 
I wouldn't be massively over the moon to see pus like that still pouring out after 2 weeks antibiotics.

I'd be getting cultures done to check what ABs are best. If no improvement I'd be further investigating a foreign object in there
 
SusieT said:
Have you thought about a second opinion? IT all sounds rather hands off and third world way to treat it or is there a reason the horse isn't going into the vets for treatment- cost/inability to transport etc? I would also wonder if the antibiotics are actually doing anything - have they swabbed or cultured it? there are oral antibiotics you can give so might be worth culturing to see what its actually sensitive to..
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Hi SusieT,

Why do you think it is a third world way to treat it? The horse is under veterinary care and I am carrying out all the vets instructions...

The vet hasn't carried out swabbed and cultured it. She did mention it but said that the two antibiotics that she has prescribed will treat a broad spectrum of bacteria... The only doubt is if there are anaerobic bacteria present which she thinks is unlikely.
 
Wounds like this antibiotics only prevent systemic infection. They can't get into the cavity of the wound ... This is going to take months to heal - probably 6 or more. Anything that seals the outside will, in the long run, delay healing and increase infection risk... It's got to heal by secondary intent which is slow... And debridement for a second and third time is not out of the question. Your vet is so wise not to rush this.

(Human) Dr Blitz
 
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ihatework said:
I wouldn't be massively over the moon to see pus like that still pouring out after 2 weeks antibiotics.

I'd be getting cultures done to check what ABs are best. If no improvement I'd be further investigating a foreign object in there
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No, quite...me neither. To be fair we are only one week on gentamicin. But still. I will discuss getting a culture with my vet, she mentioned it before. She is certain there is no foreign body. The original wound was just superficial but the infection went deeper and created the cavity filled with pus, so the original wound was never that deep if that makes sense.
 
blitznbobs said:
Wounds like this antibiotics only prevent systemic infection. They can't get into the cavity of the wound ... This is going to take months to heal - probably 6 or more. Anything that seals the outside will, in the long run, delay healing and increase infection risk... It's got to heal by secondary intent which is slow... And deride net for a second and third time is not out of the question. Your vet is so wise not to rush this.

(Human) Dr Blitz
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Interesting thoughts Blitznbobs. I am rinsing the cavity out three times a day and cleaning the drainage sites and stopping them crusting over. At the moment the vet is aiming to get original wound healed whilst keeping the cavity open and allowing drainage. The original wound I think is slowly healing... Less pus oozing each day. I have no idea how long it will take for the other area to heal.. As you say, it is going to be a long haul I think. :(
 
A horse requiring IV antibiotics would normally be hospitilised- allowing catheters, monitoring, change in treatment as necessary. Treating in an open field seems an odd way to do it - rain/mud etc. won't be helping?
 
SusieT said:
A horse requiring IV antibiotics would normally be hospitilised- allowing catheters, monitoring, change in treatment as necessary. Treating in an open field seems an odd way to do it - rain/mud etc. won't be helping?
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Really? I had no idea. i guess things are different in different countries. The option of hospitalisation never came up in conversation, so probably the vet didn't think it necessary. I guess the treatment would be no different if the horse is in a field compared to being in a clinic...except maybe for a catheter, which I can see could be beneficial. I will speak to the vet about that.

I don't know how things are done in the UK, would a horse with a wound which may need antibiotics for weeks on end be in hospital all that time? Maybe someone can tell me.

Other than the catheter I cant see any advantage. Maybe that is my lack of experience showing. I do believe that the horse will be happier at home, she is monitored pretty much round the clock, she is moving around and keeping mobile, eating and drinking fine, I speak to the vet daily and send her pics and the horse is stabled in inclement weather. Fortunately she is not a big rolller so I have yet to find bits or dirt or debris in the wound.

At the end of the day all I want is for my mare to get better so I will be in touch with the vet again tomorrow with lots of questions :)
 
If it needed iv antibiotics it would be hospitilised certainly, unless in very exceptional circumstances and regular checks by the vet - will be interested to see how it gets on -hope its better soon
 
Any ideas how deep the wounds are? Just from experience, a 2 inch deep cavity took 4 months to heal and that was in a mobile area. Possibly these wounds may take less time. The one on the left is looking good. You've come a long way from the original injury. Whatever you're doing seems to be working, you just have to be patient. One day, you'll look and be amazed at it sealing up. Be patient, this will come right.
 
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