The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
Issue link: https://thehorse.epubxp.com/i/475867
TheHorse.com The horse April 2015 30 old-wives'-tale-based approaches, only a handful of these actually enhance wound- healing, and many impair the process. There is no magic cure to speed-heal a recalcitrant wound, but cooperation and communication between the veterinarian and owner and quick action can mini - mize complications. First, says Blikslager, you need to control any bleeding by applying direct pressure and bandaging. Once hemor - rhaging stops, clean the wound. Initially, he says, the goal is simply to remove dirt, hair, and debris. You can accomplish this with tools as simple as a gentle stream of hose water and a mild soap. The next step, say both Blikslager and Fortier, is to determine the extent of the wound and what structures could be damaged. "X-rays at the time of injury are highly underutilized," says Fortier, and can yield extensive information about the wound. She also recommends using ultrasound to look for gas pockets (which might indicate a puncture or open space) near joint or tendon sheaths. Fortier advises owners waiting for the veterinarian not to "put any goop on the wound." If not fresh out of their packag - ing, ointments and oils can be contami- nated from previous use; they can also make it more difficult for the veterinarian to clean and examine the injury. Caustic powders purported to minimize proud flesh (excessive granulation tissue) can damage tissues, say both Fortier and Blik - slager. Even preparations such as meat tenderizer (which some people claim pre - vents proud flesh formation), while likely harmless, says Fortier, don't substitute for proper care. "There are just two things I would want on a truck or in a barn (for treating wounds): an antibacterial ointment and a steroid cream," says Blikslager, explain - ing that he applies the antibacterial early on, particularly if the wound has been contaminated, and switches to the steroid cream as the wound begins to granulate. To prevent granulation tissue from pushing up past the skin margins and preventing the wound from closing, Blikslager suggests veterinarians trim the proud flesh back, even though it bleeds tremendously. He acknowledges that bandage chang - es can become expensive and suggests that owners and veterinarians discuss the practicalities and desirability of keeping a particular wound bandaged based on location, owner resources and expecta - tions, and the horse's environment. Blikslager calls regenerative therapies, such as platelet rich plasma or stem cell therapy, "experimental and expensive" at this time for wound-healing. He acknowl - edges, however, that the right cocktail of tissue growth factors could be useful in the future. There is some evidence that approaches such as hyperbaric oxygen therapy and shock wave therapy might also promote wound healing, but more research on their use in horses is needed. Take-Home Message For now, say both Blikslager and For- tier, the best treatment for poor-healing equine wounds is to minimize the cir - cumstances that lead to delayed healing in the first place: infection and motion. "Some of those basic steps get skipped," notes Blikslager. "We need to protect the wound until it can heal." Ultimately, says Fortier, it's important to listen to the patient: "If the horse is more lame than it should be for the wound, then something else is going on." h AbouT THe AuTHor Christy Corp-Minamiji, DVM, is a former equine practitioner who now works as a freelance writer in Northern California. She has three children and writes fiction and creative nonfiction and blogs in her spare time. Treating Tough-to-Heal Wounds E N V I R O N M E N T A L F A C T O R S THE HEALTHY SKIN CYCLE EquiShield CK Salve Chlorhexidine Gluconate 2%, Ketoconazole 1% Antibacterial and antifungal salve with a water-soluble base of Polyethylene Glycol. Available in 1 pound and 4 oz sizes. EquiShield CK Shampoo Chlorhexidine Gluconate 2%, Ketoconazole 1% Synergistic shampoo base with deep cleansing and deodorizing properties. Available in 16 f oz and gallon containers. EquiShield CK Rinse Chlorhexidine Gluconate 2%, Ketoconazole 1% Formulated to relieve fungal and bacterial infections associated with Ringworm, Rainrot, Bacterial Folliculitis, Scratches, Malassezia (yeast) and Pyoderma. Best used as a leave on rinse after bathing to prevent or treat fungal and bacterial conditions. Available in 32 f oz containers. EquiShield CK Spray Chlorhexidine Gluconate 2%, Ketoconazole 1% Antiseptic spray. Available in 16 f oz bottles. VETASAN Shampoo & Ointment Chlorhexidine Gluconate 4% Soothing formulation for use on Bacterial Folliculitis, Pyoderma and Minor Wounds. KINETIC VET RESPECTED FOR SCIENCE. LOVED FOR RESULTS. Our line of equine skin health products are clinical-strength and veterinarian-proven. From cleaning to treating to protecting, we've got the solutions for healthy skin. Healthy skin starts here. CALL 877.786.9882 TO ORDER OUR SPECIALLY PRICED EQUISHIELD RX PACK! SOLD EXCLUSIVELY TO VETERINARIANS. S Y S T E M I C ( A N T I M I C R O B I A L ) T O P I C A L T R E A T M E N T Wounds that penetrate joints can become infected and are challenging to heal. Dusty Perin