PATIENT OF THE MONTH

Dreamer is a six year-old Quarter Horse mare owned by Ryan Seger. Dreamer was seen by Dr. Leslie Schur on an emergency farm call the end of November 2011 for a sudden lameness that would not go away. The day before Thanksgiving, the barn manager found Dreamer favoring her right front limb. Ryan came out to take a look at her later that day and he couldn’t find any wounds on her leg. Ryan continued to watch Dreamer and noted that she got better the next day. Two days after Dreamer first started to show signs of lameness, she was unwilling to walk. Dreamer had otherwise been healthy and happy, but Ryan was concerned that her lameness had gotten worse.

When Dr. Schur examined Dreamer, she found that Dreamer was definitely lamer on the right front limb. She had a swelling over where her flexor tendons run on the back side of her cannon bone that were painful when touched. The hair was clipped so that the area could be better evaluated. A small wound no bigger than one-quarter of an inch was found and cleaned. After further examination, Dr. Schur suspected that Dreamer had an infected tendon sheath because the wound was over the flexor tendons with smelly pus was draining out. She recommended for Ryan to bring Dreamer to the hospital for further medical treatment.

Small wounds on horses can cause more harm than what meets the eye as they can be puncture wounds. A puncture wound occurs when a horse steps around or on a loose piece of wire, large wood splinters, or another object that can go into and under the horse’s skin. Puncture wounds tend to be round, small, and can tract further up underneath the skin into important structures such as joints and tendon sheaths. The foreign object is often dirty and once inside can cause an infection; sometimes the foreign object remains stuck inside and your veterinarian may need to remove it, although it is more common to find nothing. These types of wounds can warrant a medical emergency if the puncture wound is suspected to have contaminated a joint or tendon sheath. If these wounds are not evaluated by a veterinarian, they can cause life-threatening harm to the horse and compromise their ability to use the affected leg. Dr. Schur suspected that this happened to Dreamer and therefore recommended aggressive treatment to be done at the hospital.

Ryan brought Dreamer to DPEC soon after for further treatment. Dr. Schur recommended that the infected tendon sheath to be opened and flushed or “rinsed” with a large amount of sterile saline solution. Rinsing the tendon sheath with a sterile liquid helps to remove any pus, bacteria, and other foreign material out of the wound to help promote healing: “dilution is the solution to pollution”. In order to flush a tendon sheath or joint, two or more needles are placed through the skin and into the affected area: one to push the sterile fluid through and another for the fluid to exit. This often requires multiple flushes done over a few days to ensure that the wound is thoroughly flushed. After Dreamer’s tendon sheath was flushed, the area was wrapped with a bandage and she was given antibiotics and phenylbutazone (“Bute”) to help fight the infection and relieve the pain.

When one leg hurts a horse, they tend to bear more weight on the opposite leg. This goes true for horses with laminitis (“founder”), injury to the navicular bone or its surrounding structures, or when a joint or tendon sheath is infected. The extra weight put on the supporting limb can be overbearing and cause “support-limb laminitis” (rotation of the coffin bone). To help prevent this from happening, special horseshoes called “Ultimates” are put on. Ultimates are similar to a wedge shoe but offer temporary relief as these shoes are taped and bandaged onto the horse. In Dreamer’s case, these were applied to help prevent support-limb laminitis.

At Dreamer’s last re-check, the wound was healing beautifully! This was obviously due to Ryan’s hard work of ensuring Dreamer received her antibiotics, Bute, and that the wound remained bandaged and clean. However, she did develop laminitis in the same leg that the wound was on. Dreamer will continue to receive rechecks to ensure that the wound continues to heal and that her laminitis receives proper corrective shoeing treatment. Although her prognosis for racing barrels in the future is poor, the expected outcome for Dreamer to become a pleasure horse and broodmare remains favorable.

If you think your horse may have had a puncture wound or have any other medical concerns, we are here to help! Please do not hesitate to contact us at 702-645-2247 with any questions you may have.