What are Puncture Wounds?
The chance of infection from a puncture wound in a horse is high because many times, the injury is not noticed until a reaction to the bacteria involved in the infection has begun. A puncture wound almost always has bacteria from the beginning because the item responsible for the puncture, such as a nail, sharp rock, or piece of glass or metal is often dirty or dusty and has been exposed to the elements. The case of bacterial involvement is especially true with puncture wounds on the feet. If any puncture wound affects a muscle or tendon, infection can spread to a bone or joint, leading to a serious and life threatening condition that is usually hard to treat.
A puncture wound in your horse can be extremely dangerous if not treated properly, especially if it is in the sole of the foot, which the majority of puncture wounds are. In fact, in some cases, a puncture wound may be fatal. In many types of wounds, you can just clean and dry the area and then pack it with gauze soaked in antiseptic to stop the bleeding. The veterinarian may want to keep your horse in the hospital if the injury is severe enough. Some of the signs of a puncture wound are sudden lameness, aggravation, and holding the non-injured leg slack to put less weight on it. If you remove the object from the foot (or wherever the wound is), you should keep the object so the veterinarian can see the shape and length of the object to judge the size and severity of the wound. However, if you are able to, you should not remove it and place blocks around the object to protect it from damaging the tissues any further. This way, your veterinarian can get radiographs (x-rays) and ultrasound to determine the route to treating the wound.
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Symptoms of Puncture Wounds in Horses
The symptoms of a puncture wound depend on the location of the wound, how severe it is, and how deep it goes. While the majority of puncture wounds are in the sole of the foot, there are other areas prone to puncture such as legs, side, abdomen, head, and chest. Signs of puncture wounds that have been reported most often are:
- Sudden lameness
- Limping or walking abnormally
- Foreign object sticking out of the foot or other area
- Hole in the skin
- Scar or lesion on the skin
- Tear or rip in the skin
- Swollen area
- Bruising or gravelly skin
- Tetanus (muscle spasms, protruding third eyelid, labored breathing, unable to drink or eat well)
- Death (rare)
There are different kinds of puncture wounds, which are:
- Torn or ripped wounds have uneven or jagged edges and are usually not very deep
- Incised wounds such as a stab wound have sharp or clean edges and will bleed a great deal if blood vessels are involved
- Simple puncture wounds are usually in the sole of the foot, caused by a nail or other sharp object, can be very bloody, and get infected easily
Causes of Puncture Wounds in Horses
There are many situations that can cause a puncture wound anywhere on your horse. Bacteria may then infiltrate the tissue, causing the wound to become inflamed, red, and sore.
- Sharp rock or piece of glass or metal on the ground
- Barbed wire fences
- Dangerous areas in the stable or barn where your horse may get injured
Diagnosis of Puncture Wounds in Horses
To get a definitive diagnosis of a puncture wound on your horse, you will have to see an equine veterinary professional either at your home or their place of business. Even if you think the puncture is not deep or there is not a lot of blood, the injury needs to be seen. Some of the complications of not seeing a veterinarian are infection, lameness, sepsis (blood infection), and tetanus. Also, if the puncture wound is near a bone or joint, damage done can leave devastating injury complications such as an unrepaired broken bone or crushed joint. This can leave your horse lame, in extreme pain, and can even be fatal.
The veterinarian will first do a complete thorough physical examination including vital signs (respiration, pulse, and temperature), lameness examination and hoof test, weight, height, capillary refill time, reflexes, blood pressure, and breath sounds. Also important, radiographs (x-rays), ultrasound, CT scans, and MRI can show the damage done to tissues, bones, tendons, and muscles. Blood work will be done to check for infection, tetanus, and sepsis. This includes a complete blood count (CBC), biochemistry analysis, packed cell volume (PCV), bacterial, and fungal cultures.
Treatment of Puncture Wounds in Horses
Treatment for most puncture wounds involves cleaning, irrigation, sterilizing, medication, and bandaging. However, there are some cases when the veterinarian will need to perform surgery to remove necrotic (dead) or infected tissue and other debris.
The foot is a complex area for a puncture wound. Intense scrutiny will be required to make sure the entire puncture wound is clean and sterilized before bandaging. Sometimes this requires opening up the area to be sure what damage has been done, especially in the feet.
The area should be irrigated with warm sterile solution and any abscesses should be drained and cleaned with alcohol or iodine solution.
This step requires topical antibiotics such as Neosporin or nolvasan, oral antibiotics, a tetanus shot, and possibly some pain medication.
The veterinarian will be sure there is a way for the wound to drain, if needed, and then it will be wrapped in several layers of sterile gauze bandages, a roll of quilted cotton, and a support bandage such as vetrap or elasticon.
Recovery of Puncture Wounds in Horses
The prognosis depends on the severity of the wound, where the wound is, and how fast you were able to get treatment. If the injury involves the foot, you will need to put your horse on stable rest for a few days to a few weeks, depending on the wound. Always keep your horse’s tetanus vaccinations up to date. Survey the stall, stable, and paddock areas for potential dangers.