I was hacking this week when we had a little accident which I thought was worth sharing in case anyone has a similar incident so that you know how to respond.
The two of us were hacking along a byway track, which is used regularly by cars and horses, when suddenly my friend’s pony staggered and started hopping along. The little mare tried to put her left fore to the floor, but couldn’t weightbear. As soon as she’d stopped trying to walk (I’d already stopped) my friend jumped off.
I could see her trembling with what I could only assume was pain. I genuinely thought she’d broken her leg or popped a tendon. My friend cradled the left fore and looked at the foot.
She told me there was a stick caught, so I hopped off too and had a look. It wasn’t a stick, it was a large nail. Embedded in the poor mare’s frog.
We decided to try and remove the nail as we needed to get her home, which was only five minutes away, and being a smooth nail we were likely to remove the whole thing.
I held the horses while my friend wiggled the nail out. Thankfully her pony knew we were helping and stood like an angel. The nail had blood on, and had penetrated the frog by about half a centimetre. You can see the darkened area at the tip of the nail on the photo below, which is dried blood.
Immediately the pony seemed more comfortable and was sound so we started walking home and discussed treating the wound.
As it was a puncture wound we want to keep it as clean as possible and avoid any infection, which can be very tricky to treat so I suggested flushing out the wound, applying some form of antiseptic – iodine spray for example – and dry poulticing the foot to keep it clean. We talked about turn out versus box rest and decided that whilst it was warm and dry it was much of a muchness as to which was more beneficial. Given that the mare doesn’t like staying in my friend preferred the idea of turning her out in a poultice.
Given that the foreign object was an old nail, I checked that the pony’s vaccinations were up to date, and I did suggest it would be worth ringing the vet for advice and to see what they recommend with regard to tetanus boosters. I know that with serious injuries they often give a booster as part of the course.
When we got back to the yard there was a farrier there, so my friend took her pony over for him to have a look at. After all, the foot is their area of expertise!
The farrier said that she was lucky; the nail had gone in at an angle so whilst it was still a puncture wound it hadn’t gone up into the foot. The lack of blood was a good thing as only the frog was damaged. And the nail had pierced the frog closer to the toe than the heel, which is preferable.
I think we had a lucky escape in that the mare is fully up to date with vaccinations, and with the location of the injury so hopefully after a few days rest and keeping the wound clean she’ll be back to her normal bouncy self!
I did send a few messages to local yards to warn them to be vigilant along that track in case there was more debris on the track to cause another injury as it had the potential to be so much worse.
Horses like to give us something to puzzle over, and last week one of my clients had a mystery filled leg with her horse which has prompted me to compose a checklist for anyone in a similar position. After all, fat legs arise for a variety of reasons.
Sometimes you bring your horse out the stable, or in from the field, and they have a filled lower limb. It causes panic, and you think the worst. But calm yourself, and work through a process of elimination to decide whether the filled leg is purely an accumulation of lymph fluid or something more serious. Then you can decide on a course of action and potentially how to prevent it reoccurring.
If one leg is filled and the others not it suggests a knock or injury to that leg which causes a reactive inflammation, but if both hinds or both fores are filled it suggests an accumulation of lymph fluid for physiological reasons. Running through this check list on the lone filled leg will allow you to establish if there’s a more serious cause to the filling or if it’s just a curved ball that horse’s like to throw and get us worried.
With the physical examination done you should feel more confident the level of seriousness of the filled leg. If they’re weight bearing and sound, with general swelling and no heat, pain, or obvious wound or injury then it’s likely to just be a build up of lymph fluid or a mild response to a foreign body, so the best thing is to monitor it for a couple of days and if it doesn’t get any better then call the vet.
Next of course, you need to try and find the possible reason behind the swollen leg or legs, to see if it’s a management issue, or if there is a way to avoid the problem reoccurring.
My client’s horse was a little depressed last week and off his hay for a couple of days, but his bed was disturbed on the days that his leg was filled, suggesting he’d knocked himself, but it went down on turnout each day, and when his appetite picked up again his leg seemed to return to normal. Frustrating as it is because there was no obvious cause, but as it was mild swelling with no pain and it went down quickly we tried not to worry too much. I think the horse was off his hay so fidgeted more in his stable because of boredom and knocked his leg. Perhaps causing a contusion which filled overnight and then went down during the day.
Another horse I know came in from the field with a slightly filled hindlimb earlier this week. Again, not lame or in pain, but we couldn’t find a wound or injury. However, I found a bramble in her tail so I think she was investigating the brambles and got a thorn in that leg, triggering the swelling. The leg just needed monitoring over the following days to see if the swelling reduces and to ensure the thorn comes out, if it already hasn’t.
I had a nice head injury this week to first aid. Not mine – one of the horses.
I went to get him in and he mooched over as normal, but as I slipped his head collar on I noticed a wound on his forehead.
So I took him up to the yard and rang his owner to find out where her first aid kit was and then had a closer inspection.
Thankfully it was only a superficial wound; the hair had come off in a round patch, but the skin hadn’t broken. So I cleaned the graze and surrounding hair with hibiscrub and cotton wool to make sure there wasn’t any mud or grime to get into it, and also to make sure I hadn’t missed a deeper wound under the hair. All seemed well, so I put some purple spray on the area and left it for nature to take it’s course.
Everyone has different thoughts on first aid – do you dry out the wound, smear it in cream, leave it to breathe, or cover it up? I think at some point you’re told to do any one of those things, and it all depends on the type of wound. I prefer the letting it breathe and dry out if possible, but obviously if it’s going to get muddy or dirty then best to try to prevent an infection entering.
I think the cleaning stage is pretty much the same for everyone. Dilute hibiscrub in warm water is the most popular way. But did you know that hibiscrub actually destroys skin tissue so needs to be very dilute – so the water is barely tinged pink. Many people use too strong a mixture. For this reason too, I also don’t like over cleaning with hibiscrub. The other options are salt water or saline solution. What I like about salt water and hibiscrub solution is that you can make up as much or as little as you need, whereas saline solution often has to be used within a certain amount of time of opening.
Once a wound is cleaned there are a couple more options. Wound powder, which is an antibacterial fine powder is mostly known to help a wound dry out. Which I guess is best with wounds with a lot of fluid, perhaps where blood is involved. However, wound powder can be tricky to apply because it blows around in any wind and doesn’t always stick to a wound, especially if it’s on the side or facing the ground. The other problem I’ve seen is that the nozzle or container gets damp which I’d imagine would reduce the effectiveness of the powder, as well as making it difficult to apply. With this head wound, I didn’t feel wound powder would stick to the site of injury and I was also concerned about it blowing into his eyes as I applied it, and shaking a bottle around his head.
Sudocrem, or the equivalent equine versions, are often the go to ointment. Ointments get a bad name because whilst they seal the injury and prevent bacteria entering, they also don’t allow them to breathe which hinders the healing process. But then if an injury is likely to get dirty (during turn out perhaps) it is better to put some form of ointment plus bandage over it. If I needed to use ointment on a wound I’d ensure it was scrupulously cleaned, but also that it had some time to dry and air between cleaning and applying the cream, or between applications of the cream to ensure the healing process isn’t hindered. You can also get gels, such as Aloe Vera which have soothing properties. I find this really useful on bites or stings which horses will then scratch. I’ve actually just put some on Otis’s neck where he’s rubbed a fly bite.
Purple spray, or iodine spray, is the other main contestant for treating a wound. It’s an antibacterial solution and has the benefit that you can spray it upside down (for any sarcoids around the sheath) and it doesn’t form a seal on the wound like ointment, so allows it to breathe. You just need to be aware that some horses don’t like the hiss of the spray. Personally, purple spray tends to be my go to for minor scrapes or grazes.
Do horse’s get concussion? That was one of my thoughts when I was treating this horse. It depends on how they get a head wound, whether it’s by banging their head on a hard object or not. I’m fairly sure this horse rubbed his forehead on something abrasive in the field, as opposed to a direct hit. Their skulls are harder than ours, which you’d know if you’ve ever banged heads with a horse – but that’s another story – which I’d have thought would mean they’d be less likely to get concussion. I remember hearing about a horse who was being difficult to load and reared and fell over backwards, hitting her head. She starting fitting like she was epileptic, but when the vet came to treat her various injuries her withers had gone down inside her barrel, which must’ve impacted the spinal cord, and the injury to her head showed if not the skull, done grey matter too. Which I guess goes to show that they can get some form of concussion or headache from an injury. So if your horse comes in with a wound on his head it’s worth giving him a few hours of quiet time to let them recover from any headache they may have. Unfortunately they can’t tell us if it hurts, so it comes down to knowing your horse and when he’s withdrawn in himself.
It never rains, but it pours. At least it did for me last week. Otis had his MRI, which I told you about last weekend – Which you can read here – but simultaneously Matt was having a big adventure of his own.
Mum went to catch him on Saturday afternoon to feed him and give him some TLC. He was grazing in the field quietly, away from the others. Mum put his headcollar on and asked him to walk on. He wouldn’t move. She got a bit angry as he is sometimes can be stubborn about coming in. But he still wouldn’t walk.
In the event, with one of the girls practically pushing Matt, they got him down the field and onto the yard. He was dragging his hind leg, which had a small wound on the stifle.
Mum cleaned it up and rang the vet. She duly turned up and examined the puncture wound, after sedating Matt of course as he didn’t like it very much! The vet was concerned about an infection as the wound was close to the joint, and the stifle is a very shallow joint, so the vet arranged for Matt to be admitted to the local equine hospital that evening.
Leaving a sedated Matt in the closest stable, loaded with painkillers, Mum drove home to collect non-horsey Dad and the trailer. By the time they got back the sedation had worn off and Matt was less than impressed at being in with no friends. You may remember from the winter that he doesn’t like being left in without company. He danced around and refused to load until Mum got the yard owner out in her pyjamas to say a couple of stern words to him.
So it was 8.30-9pm when they got to the, thankfully, local horse-pital. Matt was sedated again, and X-rayed. This was when they found the fracture.
I think it’s the top of the tibia that is fractured, it’s non-weight bearing and it isn’t the patella. I’ve asked to see the x-rays so will share once I do.
After the X-ray, the area was ultrasounded. This was looking for oxygen bubbles in the stifle joint, which are indicative of an infection. Thankfully he got the all clear in this area, so was put into his stable and hooked up to a drip and an intensive course of antibiotics started. This was to hopefully nip any infection in the bud and if there wasn’t yet an infection it was a preventive measure. He was dosed up on painkillers and left.
On Sunday, the vets were pleased to say that there didn’t look to be a joint infection, which meant Matt didn’t need to go to the nearest university hospital.
With Mum and Dad about to go on their annual holiday, it was all systems go to organise Matt’s care. Thankfully, Mum has some lovely friends who offered to look after Matt on his box rest while she was away.
Matt had to stay in hospital for five days: three days of intravenous antibiotics and two days of oral antibiotics. On Monday his painkillers were reduced as he was getting very agitated at being kept in and was box walking. I think they hoped that feeling a bit of pain would encourage him to stay still.
Last Thursday, Mum’s friend collected Matt and took him home. Mum had ordered a mixture of calming feeds and supplements contains chamomile, valerian, vervain and magnesium. All of which are known for their calming effect. Matt was still keen to eat, so had been having ad lib hay to try and occupy him, carrots hidden in haynets. He’s also had some cow parsley, hazel and willow branches to strip, and a likit toy is on it’s way.
The first couple of days Matt expected to go out, but since the weekend he seems happier in this new routine so hopefully the effect of the calmer, plenty of forage and toys will keep him occupied.
He’s to stay on box rest for eight weeks, with another X-ray in six weeks time. Then limited exercise will ensue, with the aim of full turn out in twelve weeks time. Mum asked about picking up his feet, and the vet said his feet could be hoof picked if he’d let you, but keep the foot close to the ground to minimise the movement of the fracture. He can’t see the farrier until after his next X-ray because the fracture will open up in the next couple of weeks before closing and healing.
Today, on a dreary December day (the forecast thinks it’s the worst day of the week weather wise) I was on an equine-specific first aid refresher course. It’s a requirement that I attend one of these every two years so that my insurance stays valid, and I can remain on the register of Pony Club and BHS instructors.
The courses seem to get better each time, and I hate to say it but I almost enjoyed today. Perhaps it is the fact the content is familiar now, or the fact that I no longer wish the ground would swallow me up as I lie on the floor pretending to be unconscious while others try to manoeuvre me into the recovery position. Not that I jump at the opportunity to be the demo casualty, far from it. We went through all the usual things, the emergency procedure, defibrillators, chest compressions and assisted breathing. Bandaging (something all equestrians are very good at!), recovery positions, log rolls, burns, fractures and perhaps most importantly in our industry, neck and back injuries.
Hearing everyone talk about their horror stories and accidents they’ve attended always makes me think how lucky I’ve been, both personally and with client injuries.
It’s fairly public knowledge, but I haven’t blogged about it, that in October I fell off one of my clients horses. We were on the gallops, only in a fast working canter when he bronced me off. I will add that later we found that his saddle was causing him a lot of back pain, so it is likely that the bigger strides hurt him so he told me to b*gger off.
Anyway, it hurt. I went head first over his head, landing on the right side of my head before crashing onto my left shoulder. After assessing myself I got up, called the yard to catch the runaway before starting to walk home. I don’t think I ever admitted to myself, or anyone else for that matter, how much it hurt. I knew I wasn’t concussed as I remembered everything and didn’t feel disorientated or pale. But I couldn’t turn my head or raise my left arm. So we went to the hospital that evening, and triage had a meltdown that I hadn’t been stretchered in in a brace, but the X-rays showed no broken bones so I was given the diagnosis of whiplash and told to continue with my day to day life. Basically, the ligaments and tendons in my neck had been sprained and time was the healer.
After the weekend of struggling to lie down, sit up, turn, move, anything really, I was back riding in a limited fashion. Although I knew no bones were broken I knew my back was misaligned, so I booked an appointment at the osteopath. After crunching my rotated thoracic vertebrae and releasing the compressed cervical vertebrae over two sessions I was told that I just needed to wait for the ligaments to heal. Eight weeks, Pilates, gentle stretching, riding and two sports massages later, I can safely say that I am recovered. The tense muscles that had been protecting my injury have been unknotted and I’m back to full movement. But I was lucky. Very lucky, and doing today’s course made me realise that I probably should have taken a different course of action, and almost certainly would have done if it had been a client. But that’s life, and you live and learn!
I also remembered my friends accident, when we were young and naïve. We definitely should have taken her to hospital there and then.
We were catching our horses, and I had just gone out of the gate onto the road. It was a nasty corner, so I was on traffic watch whilst she fastened the gate. Sun delay I hear a bang, and I turned around and she was sat on the floor while her horse grazed the verge. She got up, saying she felt fine and that she’d gone to pull his head up and they’d banged heads. So we made our way back to the yard and by the time we’d put the horses away she had a cracking black eye. I think we iced it before getting back to work and then she went home as normal. With hindsight, I should have suspected concussion or a neck injury.
Over the following days the black eye became more impressive and I avoided her anti-equine father because he was under the impression I had banged heads with his daughter. She went back to university, and about a fortnight later she text me to say she’d been to the hospital. Her neck had been sore so she had gone to the doctor, who had sent her for X-rays. She’d only fractured her eye socket, suffered nerve damage, and fractured two cervical vertebrae! I genuinely couldn’t believe she’d gotten up and walked away from that sort of head-on collision, and really that should have given me a life long lesson to always investigate injuries.
Remembering that incident, my fall, and today’s course, means that I promise to insist that anyone who has any accident in my vicinity gets themselves checked out properly!
Over the weekend I read and interesting article about an experiment on the prevention of Mud fever – See here.
There’s no scientific basis for the experiment, but I thought about it logically. Experts have said for years that continuously washing horses legs is a contributing factor to mud fever, and it is far better to let a horse stand in and then brush off the dry mud.
But what if the horse is standing in and their legs aren’t drying properly? Or if an owner has limited time to dry the legs properly – such as a heavily feathered horse, or they only coming in during the day. People advocate the use of towels, but I wonder how towels are dried and kept clean (numerous towels and a strict laundry cycle I guess). And also, does rubbing the legs to dry them rub dirt particles against sensitive, damp skin and cause minute wounds for the bacteria to enter?
This article repeats the importance of not over washing legs, but said if necessary then it should be done but the focus of care should be rewarming the legs. I can see the inverse correlation between warming the legs and the time taken for them to dry, but I thought the bacteria liked warm moist conditions?
Lots of questions have been thrown up, and it’s so hard to know what to do in muddy conditions. Usually I don’t worry about mud fever and Otis, but this winter is so wet that I’m beginning to wonder how much wet and mud his legs can handle. It would be interesting to see some more research done into the effects of keeping the legs warm, not just dry, perhaps using thermography. I have dug out the thermotex stable wraps I inherited a few years ago as the article did make me think that they would be helpful in drying his legs quickly, which will at least help me brush off mud and keep them cleaner so in that way the article has a valid point.
If anyone else has seen any more recent experiments with preventing mud fever, as I think prevention of the bacteria establishing themselves is the critical factor in beating mud fever.
When revising the syllabus of my stable management course I asked my students to name a type of worm and when it should be targeted in the worming calendar.
One response was “ringworm”.
Now you could be forgiven in assuming that it is a worm, but ringworm is actually a fungal infection.
I assume it was named that before science got into fungi and bacteria and viruses, and it’s name was describing the symptoms. That is, a circle of tufted hair which then falls out to reveal a scabby area of skin which can become itchy.
Ringworm in horses is transmitted to other animals, including humans. This is why it’s important to isolate a horse with ringworm and have good hygiene routines in place to stop the spread of the disease. Ringworm spreads through grooming and by living in wood in the environment or spreading via tack and grooming brushes. Once ringworm has been found it can be very difficult to rid a yard from it as it lives in the wood and reinfects the horses.
Often it is new horses which spread ringworm onto a yard, and as the fungi can live on the skin for three weeks before symptoms occur it is very easy for infection to spread. Younger animals are more often affected, but once horses have been infected they gain an immunity which is quite long lasting. If ringworm is suspected then the vet will take a scraping to confirm the presence of the fungus.
To treat ringworm you should wash the horse with a mild detergent and rub off any scabs, before washing the horse thoroughly with anti fungal shampoo. This usually needs to be repeated, and a different anti fungal shampoo used in order to eradicate the infection from the horse’s body. If no more lesions appear then treatment has been successful. You should also disinfect the horse’s environment, tack, grooming kit, mucking out equipment, and rider’s/handler’s clothes to ensure the disease does not spread. The horse should also be isolated for 3 weeks to make sure he does not contaminate others.
Today I went on a first aid refresher course, so that I can continue to teach for Pony Club, be insured on the Instructors register, and of course for everyone’s peace of mind.
It’s been three years since I last did a course, and I was pleased that nothing came as a big surprise, and the knowledge was somewhere in my head, albeit a bit rusty. Thinking back to previous courses I’ve done this one was the most interactive and hands-on – not one I would have enjoyed four years ago, but in my old age I’ve become more tolerant of making a fool out of myself as I tap a mannequin and ask it to respond …
The hands-on aspect reinforced the theory well, and I think it’s made me feel more confident afterwards than I have on previous courses.
I still don’t particularly want to put my knowledge to the test, but I’m sure my clients will be reassured by my certificate.
I won’t bore you all with the details, but one thing that stuck in my mind came from a conversation with other equestrians over lunch. Most of us put body protectors on and then zip our coat up over the top. Or pull out hoody over our bulk. So what happens when we fall off and, God forbid, need “basic life support”?
Our body protectors need removing. Clothing we can live with and do chest compressions over the top, but it is impossible to save someone’s life with a rigid body protector. So by burying out body protectors under our coat and jumpers means precious time is wasted hunting for scissors to cut clothing off so that the front of the body protector can be opened or removed, depending on the design. Plus there has to be a scissor hunt …
So potentially, wearing your body protector on the outside of your clothes could be the difference between life and death.
You always hear horrific stories at these sorts of courses, of people falling off and smashing bones – this reminded me of a pony clubber who fell off last summer into her arms and broke both wrists and one elbow. And another lady told of when she fell off during her Stage III exam and her chinstrap-less hat flew off, causing her to be hospitalised for three days.
And you never think of banging your head in the same way … It’s definitely concussion or compression, you’ll tell the ambulance.
We all had a laugh with bandaging because, as equestrians, our standards are a lot higher than a first aiders – however, as pointed out, the paramedics won’t pass or fail us on our bandaging technique, they’ll just be pleased the injury or wound is being treated.
Today a lot of focus was put onto the fact that first aid is common sense. Don’t move the casualty unless necessary; breathing takes priority over everything, including paralysis; ambulance control will talk you through every step and make any decisions for you; and defibrillators are amazing and everyone should have one. They even talk you through, in a robotic voice, basic life support – counting thirty compressions and two breaths.
Compared to my first first aid course the approach seems to have shifted away from iron clad rules to a give-it-your-best-shot approach. This means if you lose count of the chest compressions it’s not the end of the world, and it doesn’t really matter if you do the breaths before compressions – although not the most efficient it doesn’t do any harm.
I think this approach should encourage more people to undertake first aid courses, as its a positive line of thought, and wants people to work in the right direction to save a life, rather than running away. I did think it was a shame that first aid is only taught in Scouts or Guides, or any other club, and not on the school curriculum, because there is initial fear associated with first aid, and the introduction at an early age would reduce this.
Now I’m home, I’m assessing our first aid supply, only to find that we only have a handful of plasters and recycled bandages to hand. My next job is to buy a home first aid kit, and also one for my car. If I’m feeling really motivated, I may even check the first aid kit at the yard and make sure there’s a list of first aiders up on display.
In the meaning, here is a video we watched today …Here!
I saw a horse earlier this week with rain scald, so I thought it was a very topical subject for the time of year.
So what is rain scald?
Rain scald, or rain rot, is a very common skin ailment of horses which predominantly affects the back of the horse. Like mud fever, the bacteria which cause rain scald thrive in warm, moist conditions which means the disease is more prevalent in spring and autumn.
The actinomycete, dermatophilus congolensis, has properties of both fungi and bacteria and causes the disease rain scald. This organism lives on the horses skin, not in the ground as is often believed, but a horse who is carrying the organism will not necessarily suffer from rain scald.
What does rain scald look like?
The horse will suffer from numerous scabs along his top line, varying in size from a pea sized to a two pence size, and can be crusty. The scabs and embedded hair can be easily picked off, revealing pink skin and often pus underneath. The scabs usually heal rapidly, turning grey and drying up.
Rain scald can be transmitted between horses by sharing rugs, saddle cloths or grooming brushes, so infected horses need to be carefully managed and the horse isolated as best as possible.
Horses suffering from rain scald will usually have thick coats, such as those going into winter as they retain a high level of moisture close to their skin. A cut or scratch allows the organism to enter the horse`s epidermis and thus the scabs form.
Putting a warm rug on a sweaty or wet horse provides the ideal conditions for rain scald to occur, or over rugging a horse so that they sweat. Some people suggest that poor stable management, or damp walls, can be a contributing factor.
Rain rot may go away on it`s own accord, when the horse moults and loses their winter coat, but there is a high risk of secondary infection so it should be treated immediately as the secondary infection will be harder to treat and more resistant.
To treat rain scald the scabs need to be removed gently. Baby oil is a useful tool for softening the scabs and making them less painful to remove. As the organism grows best in an oxygen reduced environment opening the scabs and removing the thick hair around them will oxygenate the area and promote healing. Ointments aren`t recommended for use as they hold moisture close to the skin, but it is beneficial to wash the affected areas thoroughly with an anti-bacterial shampoo, and drying the area carefully afterwards, and keeping the horse in a dry, well ventilated environment. In severe cases a course of antibiotics may be required.