Severe chest injury

slowsnail

Hi guys,

Just wondering if anyone has experience of dealing with very severe chest injury. My horse impaled himself on an arena fence. Initially it looked like a small piece of wood stuck in his chest but it turned out to be a lot worse than initially though as there was approx 6"x1.5" inside his chest and into his muscle. Vet treated him etc, The wound was packed with sterile toweling to maintain pressure and stop the bleeding. No stitches were applied. After 12 hours the packing was removed - bleeding had stopped. The wound which now measures 4"long by 1.5" wide is being left open to facilitate drainage and flushing out with Saline solution. He's on bute now (under vet supervision) to ease pain and reduce swelling.

Does anyone else have experience of this sort of thing? Once the puss starts to develop and drain out how long will that go on for? How long does this sort of injury take to heal to a point were the skin will close up over the wound? Is he in a lot of pain - he does seem to be very precious in his movement so he's obviously feeling something (how much relief do they get from bute)? We've been told that because of where in his chest the injury is he may be left with a condition where he will throw his leg out ahead of him when walking - will this be painful on him longterm? There's supposed to be a cream that can be applied to scar tissue once formed that aids healing and reduces scaring - does anyone have any experience of using it and what is it called?

Sorry to be longwinded - just want to make sure he's going to be ok.....

Any advise would be appreciated...

Hiya, very sorry to hear about your horse.

However, please note that any advice given on the forum is just words posted by random people on the internet. It should not be taken as a substitute (or a compliment to) vetinary advice.

However, if anyone here has had a similar experience, I am happy to let them recount it but please, don't engage on a course of action without consulting your vet first.

slowsnail

understood -thank you.

The vet who is treating him is very good - sort of specialises in really bad injuries so I know he's getting the best care. I'm just very concerned about him and am trying to get a handle on timescale involved in recovery. I'd say the vet is sick of me asking questions at this stage though to be fair she has been very nice about it. He's at a yard at the moment. The staff are brilliant with him and they are the ones keeping the wound clean etc but they have other horses to look after too. His bed is reasonably clean but not the way I would have it at home. The vet wants him out in a field as quickly as possible and I suspect its because shes afraid of him getting something intothe wound from being stabled. I know I can't transport him home till the wound is no longer open so I'm sort of trying to gauge timescale from other peoples experiences. I won't be doing anything without sign off from the Vet though.

convert

slowsnail wrote: »

There's supposed to be a cream that can be applied to scar tissue once formed that aids healing and reduces scaring - does anyone have any experience of using it and what is it called?

We had a mare who put her leg through a gate and tore her leg badly, leaving a huge wound you could put your fist into. Luckily she didn't damage her tendon, but because of where the wound was it couldn't be stitched.

Our vet recommended a spray called MultiDerm to help heal the wound. It also comes in cream and powder form. We found it absolutely fantastic and because it encourages healing from the inside out, it also helped reduce the amount of proud flesh, so the horse's wound healed with minimal scaring. It also has antiseptic qualities, so lessens the chances of infection getting into the wound once the directions are followed carefully. You should be able to get it easily enough. I've seen it in tack shops and veterinary shops. And it's not hugely expensive, either.

Maybe just mention it to your vet before you start using it, just to find out if she'd recommend it and which form she thinks would be best for your horse.

Wicked

firstly, sorry to hear about your horse, it's really unfortunate when things like that happen.

manuka honey is very good for cuts and healing. we had a tb who fell on the road and cut her knee, couldn't be stitched either. vet gave us the honey to put on it, salt water is good to, but its in an awkward spot on his chest. she got injections etc aswell though to.

dollydishmop

Firstly, as has already been said...your vet must be your first port of call for specific wound advice.

I had a hunter with a similar injury one season, except that it was in his thigh.

Initially the original wound healed too quickly, and formed an almighty abcess.
We then had to use a mobile ultrasound machine on him daily, to try and bring the abcess quickly to a head, and when it burst....yuck, it came out at such pressure that the pus flew horizontally for approx 3ft before arcing back down into a bucket we used to collect it in. The vet warned me that it would, but I had to see it to believe it!

Once the abcess burst the vet opened up the original wound, and then he opened a second wound just below and had a good dig about to make sure both wound sites were connected under the skin. Sounds gross, but was for good reason. This meant that when I was flushing it with the saline I only had to pump the saline into the top wound and keep going until it ran clear out through the second wound below...to ensure that each flush was truly flushing it. This was done a minumum of 3 times a day.
Once the pus stopped forming we could then work on allowing the wound to heal....but to prevent another abcess forimg we had to physically make sure it healed slowly, and from the inside out. The initial abcess was formed because the outside healed over too quickly, whilst the internal part of the injury was still healing.
So, every day, until the wound started to heal in the centre, I had to break any crust or scabs that had formed on the outside, and gently clean it from the centre out, via both wound points.

It took weeks, and he was on buckets of bute, I was injecting him with pen&strep daily and various other antibiotics that I'd have to check my old yard diaries for if you wanted specifics. (A daily diary of treatment and observations can be invaluable for an injury like this, log the meds, and any observations, including how it smells etc!)
To add insult to injury, during treatment he contracted septicemia (blood poisoning) and we almost lost him. It came on *very* quickly! His entire hind leg blew up....from the thigh down it was the size of a tree-trunk, and his joints were totally lost to swelling. He was a very, very sick horse there for a while!
It was an awful injury, and one of the hardest I've ever had to deal with.

Happy to say, the wound did heel, and he was back to his cheeky self and once he came sound again he was back in full work with no further problems as a result of the original injury.

Bio-oil can reduce scarring..in humans anyway, should be available in any chemist. No idea if it works one horses, but don't see why not...however, do check the active ingredients out with your vet first, in case its topical use will clash with any of the other treatments he's already on..and obviously, dont start using it until the wound has healed over externally.
Old fashioned green oils is great at promoting hair growth too, once its all healed up!

best of luck with it all...and if I can give any advice at all, hopefully to back up your vet.....clean, clean, clean....keep the wound as clean as you possibly can, and you can never do too much sterlising of stuff!

Please keep us informed, I for one, would love to follow the progress of this!

slowsnail

Thanks for the info and advise folks.

To update you - he was out in field for most of day yesterday and today - it seems to have done him the world of good. The yard staff are flushing out the wound and injecting him daily. He's stabled at night. The wound is still open (not bleeding though) and the yard guys are making sure it stays like that until all signs of infection are gone. It does seem to have affected his muscle though. Instead of throwing his leg out as we had expected he's dragging it which is a bit worrying. He is able to stand on it though just doesn't seem to want to walk on it - if that makes any sense. Still its very early days and it could just be his way of dealing with the discomfort.

A small flap of skin has formed under his chest between his front legs when the packing was removed. We think its due to stretching with the amount of packing that had to be used. Its flapping about when he moves and does not seem to be filled up with anything. Still after you're experience with absesses I'll be keeping a close eye on that.

I'm a little bit worried about the cleanliness thing as you mentioned dolly. If he were at home I'd be taking all wet and soiled bedding out several times a day and putting fresh straw in. The yard seem to just remove the droppings every so often and then top dress every other day. He's been moved to a very large stable for ease of treatment and I know the the bedding underneath the top dressing was there from the previous occupant. Still he is out during the day so at least he's not locked up 24/7.

Anyway thats all for now - fingers still crossed that he'll be ok.