At the end of November 2017 I was asked to manage a wound on a mares leg after a major injury, the leg had obtained a major trauma and the mare had come home the next day with a very large leg wound to the lateral side of the hind leg, 3 to 4 inches of bone were visible, the second part of the injury was to the point of the hock which had a large flap of skin missing, and when the leg was flexed the muscle and tissue would bulge out of the hole in a large bubble.
The mare was slightly lame in the walk and an 8 out of 10 in the trot, she was bandaged from above the hock to the hoof and the hock was very swollen. Bandages were changed daily and she was on IV and IM meds for 7 days no bute from day three. Her prognosis was not good and we were told that she may need to be put down in the next few days. The mare was in foal and with foal at foot so management was important to ensure they both remained unaffected.
She was stabled with a review of this to be at a month or when the wound had closed borders and was more stable.
As you can see the injury was quite necrotic and a lot of dead tissue was sleuthing off, the wounds were lasered daily directly and by addressing not only the wound itself but also general acupuncture points and master points, after which it was washed with saline and redressed with flamazine. Our main focus was to get tissue over the bone as the vets were concerned that this was dangerous as the infection could reach the bone, but also to reduce the amount of proud flesh and bubbling of the wound, there was concern that the muscle that was bulging out of the point of hock would not close without surgical intervention.
As you can see the wound is much healthier and starting to fill in. Antibiotics were stopped.
There was a lot less dead, smelly tissue coming away. The mare was moved out to a foaling paddock (small size) as she was much sounder and the foal was getting stir crazy.
At three weeks lasering was put back to every two days.
I should mention that the vets were very happy with the health of the wound and surprised how well it looked and the lack of proud flesh. Lasering twice a week, and bandage changes was all she received.
So at eight weeks the wound looked amazing the vets were really happy, then she went lame. Of course the initial worry was an infection on the bone, it was decided to take her to Camden Uni for a full work up and to decide if there was more going on.
It was discovered that the splint bone had a sequestrum and another small sequestrum was seen in the hock joint, there was also a tiny fracture. It was decided to remove the splint sequestrum by scraping the bone, to leave the joint as it was too risky to touch, and leave the fracture to heal, she was put back on IV meds for one week and back in a box. After the week the bone scrape was done, they commented on how well the wound looked and how, had the sequestrum not been there they felt it wouldn’t have flared up.
She came home one week later, and remained on oral meds, low dose for two weeks and was put into a paddock. We continued to treat the wound and although the Camden vets had requested the proud flesh be removed after a week and regularly there after, it was never needed.
The mare and her foal are currently out with the herd with no bandages or meds and 90% sound.
All concerned are pretty amazed at the outcome and she has been re scaned and is still in foal.
Love my Laser
The wound today