First Things First
Assess the situation quickly to get a general idea of the wound's severity and your horse's reaction. Your own safety is a paramount: If the horse is panicking or thrashing, keep yourself at a safe distance until he settles down or professional help arrives.
Extricate your horse from any entanglement, if possible, so he doesn't try to struggle to break free, further exacerbating his injury. Again, take care not to endanger yourself in the process.
Control heavy bleeding by covering the wound with a pressure bandage or pressing directly on a wound that can't be bandaged. Only gushing or spurting blood poses a major danger to your horse's well-being--he has nine gallons of blood and would have to lose nearly four to be in real peril. Sterile gauze pads are ideal, but clean leg wraps, towels, a handkerchief or even your hand will do. Hold it in place until veterinary help arrives.
Determine whether the wound is a Red Alert--a potentially life-threatening injury that requires an emergency call to your veterinarian. In addition to heavy bleeding, signs of a Red Alert include:
- clear, yellowish fluid--sometimes mixed with blood--oozing from a deep cut or puncture near a joint or tendon
- an injury more than skin deep in the eye or jaw
- severe lameness or deformation/distortion of the affected or nearby area
- an embedded foreign object
Also, look for signs of shock even with a seemingly minor wound. These include irregular breathing, shallow pulse, an unfocused look in his eyes, and cold ears and feet. Do not attempt to move or treat the wounds of a horse who seems to be in shock. Cover him with light blanket(s) and call your veterinarian immediately.
What You Can Do
If there is no sign of a Red Alert you may be able to administer first aid yourself. Here's how to proceed.
Remove foreign material. Splinters, gravel, nails or other objects embedded in a wound introduce bacteria then facilitate their proliferation.
Retain any object you remove, particularly from a puncture wound. If complications arise, your veterinarian might find it useful to examine the item. Additional pieces may remain in the wound. Do not attempt to remove any object that has penetrated the horse's eye or torso.
Wash the wound with tap water or, better yet, physiologic saline solution. It stings less than plain water because it matches the chemical composition of body fluid. You can make your own saline solution by dissolving two tablespoons of table salt in a gallon of distilled water. Whether you deliver the cleansing liquid by garden hose, spray bottle or syringe, use the minimum amount of pressure to fully rinse the wound surface. Excessive force can aggravate the injury. A pressure of 10 to 15 pounds per square inch--about the amount of pressure you would use to wash your hands--effectively removes approximately 80 percent of the contaminating material.
Scrub the wound gently but determinedly with gauze squares, especially if it is heavily contaminated. To prevent the wash solution from becoming sullied, pour water or saline onto the square rather than dip it into a bucket. Discard each square as it becomes soiled with dirt and blood. Continue scrubbing until the gauze remains clean of visible dirt and only stained by a little fresh blood. A thorough, gentle scrub session may take as long as 15 to 20 minutes.
Medicate an obviously superficial wound with an over-the-counter antibiotic paste or other ointment such as icthammol. Not only will this help prevent infection, but the greasy coating will help keep insects and dirt off the actual surface of the healing tissues. Reapply the medication daily or more frequently until the horse has formed a protective scab over the area. Deep or contaminated wounds may require a systemic antibiotic to fight infection from within. Your veterinarian can administer that as well as a tetanus booster if your vaccination records indicate he is in need of one.
Bandage, if necessary. Most cuts and abrasions do not require bandages, but there are certain situations when a properly applied dressing can help protect the quick-growing and fragile replacement skin. In considering whether to bandage a wound, location and depth are key considerations:
- Wounds above the elbow and stifle are likely to scab and heal well on their own, thanks to the relative immobility of the horse's torso combined with good circulation near the heart. Leg wounds, however, can have healing hampered by contamination from dirt and motion, both of which can be minimized by bandaging.
- Superficial scrapes, those that remove only a partial thickness of skin form strong scabs almost immediately and can be left uncovered. A full-thickness wound, however--one that penetrates all skin layers so that the edges separate or can be pulled apart and moved to reveal underlying structures--will not form a strong scab and can invite infection if left unbandaged.
If you decide to bandage a wound, approach the task layer-by layer, with this simple and commonly used procedure:
1. Position a nonstick dressing that allows excess fluid to pass out through the wound and medication.
2. Over this layer, wrap conforming gauze wrap to hold the dressing in place,
3. Then add layers of sheet or roll cotton or a shipping quilts to protect the wound, absorb fluids and prevent swelling.
4. Secure the entire dressing with an elastic veterinary bandage.
Monitor the wound's progress. Inspect the wound daily for the first few days looking for signs of trouble, such as gray or greenish appearance of the tissues, a foul odor or excessive fluid drainage. After a couple of weeks, you'll also want to be on the lookout for proud flesh, a pink, cauliflowerlike mass of granulation tissue bulging from the wound that delays or halts healing. When tending to a wound, reapply any recommended ointment or bandaging, but avoid any needless meddling, which will only lengthen the healing process.