Hind Leg Trauma

Are horses safer in stables than turned out? Not in my experience they aren't and we had a really horrific injury to deal with as a result of a big young horse becoming cast overnight in a large stable that measures fully 16 feet x 12 feet. Pam Harrison shares a personal experience of…… hind leg trauma.

It was 7am on a beautiful Saturday morning in early July and walking into our barn, the first horse I saw as always, was Solstice - 16.3hh, very dark bay, black really, a stallion and at just six, still full of mischief after a night in the stable.

Wondering what he'd been up to as he was standing with his head in a back corner, I first noticed the water bucket was missing - hooligan I thought - but then realised the heavy duty water bucket bracket held on with two large coachbolts was also off the wall completely and at the same time, I saw the first of the blood on the stable wall.

Going into the stable, his bed had a lot of blood in it, it was all over both hind legs and he was standing with his weight off his left hind leg. The water bucket bracket was at the opposite side of the box, quite badly bent (it was going to take a 14lb hammer and a lot of 'welly' to straighten it out later, so he had obviously been cast, kicking and kicking and kicking.....).

He didn't move whilst I put his headcollar on and was very lame when I led him out of his box and tied him up for a better look. Several cuts were visible and I decided not to mess about and just call the vet, as I thought he may have a cut that penetrated a joint - fetlock or hock.

20 minutes later and the vet started cleaning him up. The good news was that he hadn't done any damage to either of his fetlocks and his right hind had only superficial cuts. However the left hind had fared worst, with three cuts below the hock on the outside of the leg. Each was more than an inch long and they were fairly deep, but close together and clean cuts, so they were stapled, anti-inflammatories and antibiotics prescribed and an optimistic prognosis of  - 10 days and staples out, should heal fine - was delivered.

Solstice was an absolute gentleman throughout, but what no-one could see at the time was just how extensive the bruising was and how that would turn what looked like a fairly straightforward injury into an altogether different scenario.

He was turned out all day every day to try and keep the swelling down as he wasn't too lame thanks to the anti-inflammatories, but within 3-4 days, the wounds had all broken down. The staples were removed and we had several days of increasing swelling and never-ending quantities of serous fluid draining out of the wound, which was bandaged twice or three times daily and kept dry as far as was possible. Several vet visits, including one evening for a developing cellulitis, together with growing quantities of anti-inflammatories and antibiotics, didn't seem to be improving things. The weather continued to be very hot and the degree of swelling was becoming worrying, so the vet recommended a different management protocol.

We started walking him in hand around the arena and fields, five or six times a day for up to half an hour each time and he was still being turned out to graze and wander the rest of the day. The whole leg was cold-hosed through ice cubes in a double layer of tubular elastic bandage several times a day, but the wound continued to break down as the severely bruised tissues died, becoming larger and deeper. After each ice/hosing session, we cleaned the wound, were careful not to touch it and re-bandaged using activated carbon dressings and layers of veterinary gamgee, held in place with a cohesive bandage. It was endless, time-consuming and every day was roasting hot, which didn't help at all. Walking in hand in the arena was like being on a tropical beach!

Then we turned a corner. 

Day 12

The first of the photographs was taken on Day 12 when we had just taken delivery of a pair of Horseware's Ice-Vibe massage boots (the extra full size) and they replaced the ice and hosing so the leg could be kept dry. With really helpful advice from Horseware, we started by using only the gel ice packs, which after freezing, wrap around the entire leg from the hock downwards and are held in place by touch and close fastenings with the Ice Vibe boot fitted over the top, rather like a very big brushing boot. They were a revelation and are without doubt the best way I have ever found to cool a horse's leg. We didn't even have to remove the bandage and together with the walking, they made a big difference to the swelling. The wound was definitely not a pretty sight, but at least it was no longer getting bigger and deeper!

 

Day 23

Then - Eureeeeekaaaaa - on Day 14 we borrowed an ArcEquine from a friend and following the detailed instructions, started using that on the opposite hind leg every day for a three hour 'treatment', as it isn't necessary to use it on the injured leg. The dressing was changed twice daily due to the copious fluid still draining out of the wound, but we kept it totally clean, there was no smell and is was obvious that healing had started in earnest.

The second photograph was taken on Day 23 and what a difference! The swelling had reduced significantly, the wound had all filled in and dried up and somewhat unbelievably there was new skin growth, with black hair, clearly visible all round the edges of the wound.

The bandage was now only being changed daily and we started using 'non-stick' dressings and Manuka 20+ honey and finally 'padded' the wound with a layer of veterinary gamgee held in place with a cohesive bandage. We were still using the Ice-Vibe boot and the ArcEquine daily and still walking in hand. Solstice continued to be an absolute gentleman and he was obviously enjoying our walks around the fields. He was by this time sound again.

Day 40

Day 53

 By Day 40 and then Day 53 (third and fourth photographs) the healing rate actually seemed to have increased and his leg was looking more normal, although was still 'filling' overnight in the stable. The new skin and hair could clearly be seen and he was much less sore. We started a little work on the lunge and walking under saddle. The dressing was still being changed daily at this stage.

Day 74

The fifth photograph was taken on Day 74 and this was the day all dressings came off - yippee! There were suddenly a lot more hours in my day…… We were still using the ArcEquine and were so impressed with the results in terms of both the rate and quality of the healing and also they way in which Solstice had coped with everything (the ArcEquine calms horses in addition to repairing tissue) that we bought one - and have since found quite a few other uses for it.

Gradually, the remaining filling in the leg disappeared, all the hair grew back and at just over four months since the injury, we were left with only a degree of 'thickening' in the area of the leg around the wound, where the worst of the bruising must have been.

Now just over a year later, with continued use of Arc Equine for maintenance, that has almost gone and there is just a very small raised area of skin that is missing very little hair and to all intents and purposes, Solstice has made a complete recovery without even a cosmetic 'legacy'.