Q: What about lacertations?

A: Lacerations are one of the more common emergency calls an equine veterinarian receives. As horse owners, we try and rid our pastures and barns of potential hazards; however, horses are notorious for finding ways to hurt themselves. We say our prayers, and knock on wood, but if you own horses long enough you are bound to have a cut that requires a call to the vet.          

     Many of these wounds may be cleaned, sutured, and heal in a couple weeks; but if an injury involves a joint or tendon sheath it can be life threatening. There is minimal protection for a horse’s joints on the lower part of the limb. If a cut or puncture penetrates deep enough to go through the skin, the next structure is a thick tissue called the joint capsule. This capsule surrounds and protects the joint and contains synovial fluid. This fluid helps lubricate the joint and is rich in nutrients; which, unfortunately, provides an excellent environment for bacteria to flourish. The joint capsule is the last shield of protection to avoid a severe infection.

     When the body sustains a cut, white blood cells are called in like firefighters to the rescue. These cells arrive to the area to help clean up bacteria and debris that prevent healing. This is all part of the inflammation process along with heat, swelling, and redness following an injury. While the body is trying to protect itself, the inflammatory process is actually damaging the joint. The longer this inflammation is affecting the joint; the more damage is being done to the cartilage and supportive structures of the joint.

     The first 24 hours following an injury involving a joint are crucial in determining if your horse will return to athletic use or even survive. In order to properly treat, we must first determine the extent of the wound. Before your vet arrives, you may attempt to clean the wound with low pressure tap water. Make sure you keep yourself safe while dealing with a fractious or excited horse following an injury. The purpose of the initial cleaning is simply to remove large amounts of mud or manure. Then you may apply a clean, padded bandage to protect the area from further damage and to control bleeding.

     In order for your veterinarian to properly assess the wound, sedation will likely be needed. A tetanus booster will be given, and the wound should be clipped, thoroughly cleaned, and explored. At this point, the joint should be aseptically prepped and a needle inserted into the joint, away from the wound bed. A sample of the joint fluid is collected for microscopic evaluation. Then, a sterile solution is instilled into the joint to see if any fluid leaks out of the wound. If this happens, the joint is considered infected and should be treated aggressively. Proper treatment from that point may include surgical debridement, thorough lavage (flushing), and the wound may be closed with sutures or left open depending on the case. One of the most important parts of the treatment is long-term, systemic antibiotics and intra-articular antibiotics. Anti-inflammatories, hyaluronic acid, and chondroprotective medications will help protect the joint from the damage caused by the infection and inflammatory reaction.

     There are never good lacerations, and while some are less serious than others – the full extent of a cut or puncture needs to be discovered quickly. Try to avoid denial, don’t assume an injury is “not that bad”, and call your veterinarian for guidance. Our horses work hard for our enjoyment and we should reward them with quality care. 

Did you know?  Ever since humans and horses have been together there have been people advising how to treat them. There are early writings from Cato, a Roman agricultural writer, in 200 B.C. on treating wounds with olive oil dregs, lupine extract and wine.

(Reprinted with permission from Dr. Kerby Weaver, DVM)

Previous Ask a Vets articles

• February 2009