Puncture wounds
Why you should never dismiss a small cut
The condition
Puncture wounds occur when a sharp object penetrates the full thickness of your horse’s skin, potentially damaging the structures beneath. Foreign bodies and bacteria can also enter his body, meaning there’s a high risk of infection. Puncture wounds can be caused by anything from a splinter to a kick from another horse with clips on his shoes. The most important thing to consider is the injury’s location. A wound on your horse’s body is much less likely to be serious than one over a joint. If bacteria is given direct access to a joint following a puncture wound, infection can quickly establish itself (usually within 24 hours), and if left untreated can lead to the horse being euthanised.
Symptoms
With puncture wounds, size doesn’t matter – it’s important to remember that even the smallest of wounds can have serious consequences. To check for a puncture, gently move the skin around the wound – the tissue beneath won’t move with the skin, indicating that the wound has penetrated the skin layer. With puncture wounds on your horse’s body, you may notice swelling and discharge around the wound. Depending on where the puncture is (for example on his hindquarters), the swelling could potentially travel down into his legs and you could see cellulitis-type inflammation. You may also see swelling with puncture wounds over your horse’s joints, and these injuries cause severe lameness. Look out for discharge – synovial fluid (the syrupy fluid inside the joint) is straw-yellow and sticky. If you see this, the wound has gone through to the joint.
Diagnosis
Call your vet immediately if you suspect a puncture wound over your horse’s joint. When assessing a wound, your vet may put a sterile needle into the joint on the other side (i.e. not the side of the wound) and flush a sterile saline solution. If the solution comes out through the puncture, the wound has gone through to the joint and your horse will require emergency surgery. Your vet may also take a sample of synovial fluid and analyse the protein level and number of white cells present. The job of white cells is to defend the horse’s body against infection. Bacteria in your horse’s joint will trigger an enormous immune system response, increasing his protein and white cell levels. Monitor puncture wounds on your horse’s body closely. If the swelling spreads or doesn’t seem to go down, call your vet who can scan or insert a probe to check how far and deep the wound extends. They can also X-ray to check for foreign bodies.
Treatment & management
Check that your horse is vaccinated for tetanus and keep these bi-annual boosters up to date. If necessary, your vet can administer a temporary tetanus anti-toxin that’ll protect him immediately and for several weeks after. Puncture wounds over your horse’s joints need to be flushed (via an operation) to prevent infection from setting in. This is typically done under general anaesthetic, but can be performed standing if he’s older or more at risk to the drug. The vet will flush saline solution at high pressure through the joint to clear bacteria and the horse will receive antibiotics intravenously and direct to his muscles to limit infection. After surgery he’ll be hospitalised and monitored before returning home to box rest. If your horse has a puncture wound on his body that needs veterinary treatment, he’ll probably need to be sedated and have the wound cleaned. Your vet might also make a second wound below the original to help with fluid drainage.