A hard-to-heal wound in a horse is defined as a wound that hasn’t healed despite several treatment attempts. Veterinarians say they’re always open to trying something new, especially when a lingering wound can mean euthanasia for a horse or months of ineffective or slow healing.
Updating wound treatment in horses
Although treating wounds in horses can be time-consuming and expensive, new therapies can stimulate healing and reduce recovery time by 25 to 50 percent.
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“If you take 10 people, you’ll get 10 opinions on how to treat wounds,” says David Levine, DVM, Dipl. ACVS, clinical associate at the University of Pennsylvania’s New Bolton Center in Kennett Square, Pa. “Just about any treatment has a 60 to 70 percent chance of working, but the best option is closing the skin, if possible.
According to David Jolly, DVM, of Step Ahead Farm and Training Center in Hot Springs, Arkansas, platelet-derived growth factors is a biological treatment some practitioners swear by.
“Some veterinarians think washing a wound 10 times a day, putting bandages on and giving antibiotics is the only way to treat a wound, but using platelet-rich plasma after wound decontamination helps the body heal itself faster.” Dr. Jolly has been treating his patients using PRP for 10 years.
“Ninety percent of wound education in veterinary school talks about how to sew up a wound,” Jolly says. “Many products that claim to help wound healing actually kill tissue they hope to heal. We need to start thinking more about how to treat equine patients biologically."
"I use PRP and bandage the wound, then change in three or four days. The sooner PRP is used, the more time that can be shaved off of healing. This product helps heal wounds open to bone level to skin level in 16 to 23 days.”
The platelets Jolly uses are derived from a disease-free herd. About 20 mLs of the PRP is applied to the wound and is reapplied as the wound healing evolves.
“Lack of blood supply is the big reason wounds don’t heal properly,” Jolly says. “By reintroducing growth factors to the damaged area, the body regenerates faster.”
Horse owners are bombarded by claims of many products that claim to successfully treat wounds in horses, but Brad Gordon, DVM, of the Equine Referral Clinic in Runnels, Iowa, says product claims that he investigates often are unverifiable, a concern when reliability and efficacy is essential to any practice.
According to Dr. Gordon, one products that has worked effectively is “... Vetericyn, a one-step cleanser and dressing, I tried it on a case that the wound wouldn’t heal,” Dr. Gordon says. “The client called and wanted more of the product after 10 days."
"This got my attention, and I have been using it for more than a year now. In addition to using the product on problematic wounds, I use it in surgeries. I also liked that the company was able to substantiate claims they made about the product’s efficacy.”
Bandaging a horse is a practical option if the wound is confined to a limb—and most often a lower limb, says Erika Wierman, DVM, of Rood and Riddle Equine Hospital in Lexington, Ky. Treating wounds can be time-consuming and expensive, but owners need to understand that the investment is essential to healing," Wierman says.
"Twice daily cleaning and treating, sterile bandage materials, systemic medications and topical preparations are all key to preventing a problematic wound."
“There are dozens of preparations on the market today,” Wierman says. “The key to medical management of wounds is to keep the surface clean and prevent infection from setting in. Therefore, antibiotics are commonly used in wound-care protocols, although the time at which antibiotic therapy is instituted varies widely among practitioners.
“Topically, everything from various antiseptic scrubs to topical antimicrobial preparations and products intended to encourage healing are being used,” he adds. “One of my favorites, QuickDerm, utilized a metal ion formulation to stimulate an immune response to aid healing. We’ve also used options such as plasma and amnion to supply healing factors to the wound. The choice of treatment depends highly on the veterinarian’s experience, the nature and age of the wound, and the stage of healing that it is currently in.”
Newer therapies for treating wounds in horses:
As in topical preparations, adjunctive therapies are ever-evolving.
“Hyperbaric therapy is receiving more and more attention these days,” Wierman says. “We are beginning to accumulate better information about how and why it might work to speed recovery. Shockwave and therapeutic ultrasound are other options for stimulating the body to heal itself.”
Laser therapy is another modality practitioners can utilize in treating hard-to-heal wounds. Kim Segal, owner of Laser Stim Inc. in Plano, Texas, says D3LT therapeutic system safely and painlessly achieves a depth of tissue penetration 10 times greater (up to 2.0 inches) than any other available.
“The laser can be used immediately after the injury presents to the practitioner and every other day afterward until it is healed,” Segal says. Each session lasts approximately 15 minutes. The laser stimulates healing and reduces recovery time by 25 to 50 percent.”
Learn more about treating Wounds