My Experience with Proud Flesh

Before I start I would like to point out that I am not a qualified veterinarian, nor do I guarantee that this will work with another horse, I am purely posting it to document my experiences and if they can help anyone in any way will be very happy. All the pictures and content of this article are the sole property of myself Lori Schmidt, and may not be copied or reproduced in any way for any reason without my written consent.

Always consult with your vet first.

A blogging buddy of mine, Rising Rainbow, has had a colt who has injured his coronary band (where the hoof and flesh meet and the hair starts. Unfortunately with leg injuries, what is called proud flesh is inevitable. I had the occasion a few Decembers ago to have to deal with this myself and through misunderstanding did not dress it the way it should have been and the proud flesh flourished. Once I had the correct instructions from my vet it was a much quicker healing process but the padding and tension of the bandages are all important. You can't over tighten the dressing but if you undertighten it the proud flesh will grow. It looks dreadful, I have posted pictues of the progression to try to show you what it looked like.

The day before Xmas we had about 8 inches of snow on the ground and I had gone into town to get a heating tape for one of the faucets that had frozen. When I came back I still had Dosie my stud in the roundpen and Blue in the area outside the rounden, I never dreamt he would get his legs over the top of this 5ft 6in railing. They used to face box but I wasnt worried.
I unpacked the tape and went outside to install it only to see Blue laying on his back against the panels of the roundpen. At first I thought he had got himself "cast" (cast is when they lay down to roll in their stable or some place and get themselves into such a position where they cant get the movement and leverage to get themselves back up so they are stuck cramped in a corner on their backs which is not good.

As I got closer I realised his right front hoof was wedged between the panels of the roudpen and he was hanging from his front leg. Thank heavens he was quiet and not panicking, he has always been very laid back and easy to deal with. I ran inside to tell Larry to get some help and went back out to him to keep him calm which he was doing quite well, I was hysterical (go figure). Because it was frozen I could not get the pins out of the panels on either side to release them so that we could drop the panels he was stuck between to release the leg. Fortunately Larry's nephew was nearby ploughing roads from the snow and he came straight over and two of the neighbors behind us arrived at about the same time to come and work on the house they were building. They all managed to get the other 3 pins out and we were able to drop the panels (they weigh about 120lbs each) and his leg just slipped out and he lay there for a bit and then got up. I had totally forgotten about Dosie who was still wandering around but stayed out of the way thank heavens. The pin holding the panels together had done horrible damage to the joint and I got him into a stable as quickly as possible and covered. I think the fact that there was so much snow and it was cold (it was -6F that night and -8F on Xmas night) which stopped excessive bleeding and he hadnt struggled which would have surely snapped his leg like a twig.

So the long healing struggle started.

(this was taken 5 days after the accident and is the first picture I have of the wound)
(Click on pictures to enlarge)

The 2 pictures below show the proud flesh and was taken after 5 weeks of incorrect treatment.

His cut went from the middle of the fetlock joint right round to the middle of the back of the pastern angling down at a 45 degree angle which started on the fetlock . On the other side of his leg he had a few cuts which pretty much made the whole foot a mess.

My vet wanted to put him down but I couldnt do it he was only 18 months old, and it was my now four year old stallion Blue who I love dearly, a lot of our bond was formed during this time when he had to ensure the soakings of his foot every day and bandage changing and he was a star, never even tried to chew the bandage until right near the end of the 4 month battle to heal it.
This is the other side of the hoof
I used a method that worked for me but needs to be taken care with so you dont over tighten the dressing and bow a tendon or cut off circulation where the bandage comes to the end of the padding. I had to do this daily despite the cold temps and he was a star. First I soaked his leg in a bucket with warm water and epsom salts, then I rinsed it in another bucket of clean water. I had a pad to put his foot down on to keep the shavings and dirt out of it. I patted it dry and then started dressing it. I started out by tying him up by his feeder and doing this while he was eating breakfast or dinner which kept him occupied and he eventually got so used to it he just stood like a star.

I used a black salve called Ichthammol 20% (drawing salve). First I made a long piece of gauze bandage folded the length of the cut and in five or six layers. Then I smeared the salve onto this length of dressing from one end to the other quite liberally. I then wrapped it around his leg on the wound and the salve held it in place. Then as padding you can use sheets of cotton wool but I used those leg wrap quilts (cheaper option again for long term dressings), they are about 12 inches wide and 24 inches long and I had one cut in half which I doubled over to go around the thinner part of the pastern for padding. I then took a whole one and wrapped that around and around the entire leg so it extended from the hoof nearly on the ground and extending upwards on the leg. I purchased Ace bandages (elastic reuseable bandages) because to use vetwrap was just going to be too expensive. They were 6 inches wide and can't remember how long.

Have a few pieces of duct tape available so that as you put each layer on you can secure it while you get the next layer sorted with a little piece of tape. I then started with the ace bandage pretty much halfway up and wrapped the quilting with at least the top 2 inches of the quilting sticking out and the bottom 2 inches as well but I wrapped it as tightly as I could. Here you have to be a bit careful because you dont want to damage a tendon. This pressure stops the proud flesh forming and having the padding sticking out top and bottom stops the tight bandage from cutting off circulation. Then as a precaution I put a piece of duct tape loosely around the top and bottom padding that was sticking up, to avoid him being tempted to chew at the flappy bits LOL and helps to stop it from slipping down on the leg. I also put a leg pad (the ones that wrap around and secure with velcro) over the top of all of this to keep the bandage protected from teeth and dirt and also wrapped a few pieces of duct tape loosely around that to hold it in place.
The shot below was taken 10 days after correcting the dressing procedure.
One warning when you come to re-dress this and take all of that stuff off, the proud flesh produces a lot of pussy muck and it has a smell all of its own!!!! The proud flesh bleeds pretty easily so you have to be careful to not rub it or bump it gainst something when washing it or it bleeds profusely.
The two shots below were taken 6 months after the accident.

The photo below of the dressing is similar to the one I used on Blue except this was a back leg and the wound was higher on the leg here, and the tightness issue was even more crucial, too much pressure and you will bow a tendon or cut off circulation and the leg will start to swell, not enough and you will get proud flesh.

So that was the daily routine the pictures show the progression of the wound over the 4 months, it started slow and got bad because I didn't dress it with the pressure it needed for the first 5 weeks or so but after I got that right it just got better and better.

As it was a long time for stall rest, over 4 months, I made all sorts of toys for him to play with and I am sure that helped keep him from chewing the bandage and becoming a cribber as a result.

If you have any questions please do not hesitate to ask away, I will try to help in any way I can, but always remember, consult your vet first.

Lori

Taxes - Wound Progress - Part 1

On 27th July in the morning my three and a half month old stud colt "Taxes" decided that he was going to go through the electric fence to visit with the 2 mares and gelding on the other side. I found him and turned the fence off, unhooked a section of wire and herded him under it onto the right side before we had a wreck. He was fine up until then. As I was reattaching all of the wire so that I could turn the fence on again he promptly went behind my back and suddenly was on the other side again!!! Again he was fine, don't know how he did it so easily but there he was. He and the two mares and gelding then decided to start racing up and down the field. As they came back up the hill he veered off towards his and his momma's pasture and hit the fence, tried to jump it and caught his left back leg in the top wire. He managed to shake it loose but not before he had cut himself really badly. There was a 5 inch flap of skin that had been ripped open. It didnt bleed so it was just the skin but I have had to deal with leg wounds and proud flesh before, that is another story which I will go into later.

I got the vet over immediately but he had already run back into their barn and had got into the sawdust so the vet knew he couldnt stitch it. My first problem was that I was leaving that night to photograph a welsh pony show 89 odd miles away and was due to spend two nights away. The vet told me that I needed to hose the leg for at least half an hour and then wrap it the way he had taught me the last time I had a leg injury. There lay the second problem, I have 20 horses and have not had the time to devote to this little guy and hadnt even got him halter broke so that was out of the question. He said to bandage it the best I could and deal with it when I got back home.

(Taken 27 July 2007 - Immediately after accident)

(Taken 27 July 2007 - Immediately after accident)

After spending an extremely hot weekend at the horse and pony show and worrying about my baby horse I got back home and managed to take the bandage off and see the damage(see below). The flap of skin had shrunk which I knew would happen and it didnt look as bad as I had feared so I started the long haul to healing this wound.

(Taken 30 July 2007)

(Taken 30 July 2007)

Padding and pressure is the key to dealing with leg wounds which always develop proud flesh in horses. If anyone would like to know how I go about it let me know and I will also go into it in more detail when I post about my other experience as I have pictures of it which I took before I knew what I was dealing with.

This is how it looked a few days ago, the black is the salve that I use on the wound but you can clearly see the new pink skin growth. It just remains a matter of time and patience and will probably leave a nasty scar but it could have been a whole lot worse.

Needless to say I will never leave a baby un halter broke again. It would have made life a lot easier but he learned fast and is a star. One good thing on both the occasions of dealing with this is that neither colts have chewed the bandage. That can give you a whole lot more headaches.

(Taken 15 August 2007)


(Taken 15 August 2007)
I will post the progress as I take the photos.

Lori