I have an equine arterial bleeding emergency of the ...

Hello,

Thank you for sending your question to Just Answer!

Sounds like you have quite a lot of vet experience and I too after having 42 horses in my barn, and did minor emergencies myself.

I would recommend dissolving sutures for the vein and/or muscle if you are able to keep the horse somewhat quiet during the healing process. Of course, for the skin I would definitely close the wound with staples or regular sutures for a good hold until the interior vein is healed.

Of course, your main goal is to proceed in a way that will stop the bleeding. If you are not successful in stopping the bleeding or you accidently punctured another area, or sign of any distress, temperature, abcess, I would definitely call your vet right away.

If you need additonal information, please feel free to contact me.

****If this answer has helped, please click ACCEPT. Thank you, Tammy****

Edited by JustAskTammy on July 31 2006 at 8:57am

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Thank you Tammy...We have her in a double stall (12x24) as we didn't want her to get "stuck" in a 12x12 should she fall - which she has done. (That's how she got the vein squirting). I've seen alot of wounds and it looks to me like she got into a scrap metal pile (all 4 legs are injured, but this one is the worst).We've had her in our layup care for 5 days now, and she is trying to be very nice and quiet. There is nothing to stitch in the area, everything is ripped wide open, big gaping hole. No skin flap or surrounding tissue to pull over the area. We jammed a chunk of cotton against the end of the vein to plug it off, as she'd suprised us one morning with pools of blood in her stall. Then added a few layers of telfa pads, and wrapped it with vet wrap and duck taped it to her leg so it wouldn;t slide down. It is the part of the saphenous vein that is right between her hocks on the inside of the bone. I think all I can do for her is tie off the vein and keep it wrapped for protection? The vet has looked at it after we took care of it, said she didn't like our wrapping, and since it had stopped bleeding opted to do nothing about it, and charged the owner $230-, then she wrapped it with an army pad (like a huge diaper). Well when I got back home from work that night I knew I had the other 3 legs to care for, and went to the barn to find her "diaper" hanging on her leg full of blood and puddles of blood on the floor again. (needless to say I was very displeased with the vet and her decision, not to mention diss'ing our work - that's how the bleeding got stopped!). We took off her blood filled diaper wraps, and plugged the vein end again with cotton wad (the vein is sucked back in her leg - you can just barely see the end of it when it's not squirting), and pressure wrapped it again. We've gotten the bleeding under control, but not stopped copmpletely. The owner has given us full permission to do whatever we think we can for the mare, as the Vet obviously didn't handle it. So, I just wanted to get my facts in order first to take care of it...I don't think it will heal on it's own - do you? Can it be tied and covered with ointment and wraps? Will the ointment cause the suture string to dissolve too quickly? Thanks!

Kandy,

You need to find a way to completely wrap this area. Do you know how to do a "HOCK WRAP"? It's one way to make sure the wound is covered. I would not put ointment on the dissolving sutures you plan to use on the vein. However you can put a 4x4 (or several) over the wound to keep it clean. As the skin begins to heal over the wound, then I would add a topical oitment.

Also, I would start the mare on "bute" 2 tabs (soak in water and put in feed) a day for 3 days and then taper to 1 per day.

She needs to be on an antibiotic as well. Do you have SMZs or Genamiacin (only intravenious) or pennicilliam? Use 15 tabs SMZ twice a day for 7-10 days and if you notice the drainage from the wound become greenish, she needs to be on a more stronger antibiotic such as the Genamiacin.

Also, believe it or not, pantyhoses can be cut in a fashion that can be part of your bandage, then absolutely secured by Co-Flex. You need to use the Hock wrap so that when the horse walks around it moves with her. It is like a figure 8 wrap, going around the hock and does not cover the point of the hock directly to enable movement so the bandage does not come off. This is a really hard area to wrap, but this should do the trick.

I would also suggest that you wrap the other three legs first by applying a antibacterial ointment to a 4x4 pad for the area of the wounds, and a brace (Ice tight) to help circulation and "stocking up" in the other three legs. Be sure to change the bandages everyday. Use standing wraps (not too tight, but secure enough to stay on) and secure with tape.

Otherwise, it sounds like you have everything under control.

***If this was enough to answer your question, please go ahead and click ACCEPT. Thank you, Tammy****

Edited by JustAskTammy on July 31 2006 at 11:38am

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Hi Tammy~

Sorry for the wait - had to go and do our morning vetting on the mare.

We have had the complete area wrapped from above the hock to her foot as the entire leg is mangled. Our wraps are staying in place - the ones the vet did, did not work. (she is fresh graduate). I've kept the 4x4 telfa pads on every wound (so we're going thru them fast!)

I am giving the mare 2 grams of bute daily along with Ranitidine (for her stomach to counteract the bute, and reduce incidence of ulcer from stress & bute). She has also been given a mix of Probios/B complex bloodbuilder) to help rebuild her supply and oxygen in the blood. She is also getting an oral antibiotic (Tucoprim) twice daily. We had originally started with an injectable, but that was hard on her (and us).

Thanks for your help and hints - she smells of rotten flesh today (a break from the blood-bath smell I guess!) I am cleaning her wounds really nicely, and keeping them clean while new flesh tries to grow.

When I took the pressure wrap off this morning, she was not squirting, and the head of that vein was not visible, she had grown some new flesh over it! I do have a blood supply coming around the area of that vein, but it is trickling, not gushing. I put a cotton wad around this area and several 4x4's over everything else, and pressure wrapped again.

I haven't tried a brace on the other legs - good idea!
Part of her falling over is that she will be shedding that front hoof and possibly one other one as well.

Her spirits are good, and she keeps trying. Her appetite is good, so we'll keep at it.

I would like to continue keeping in touch with you, as you're ideas are helpful, and keep me positive. We thought we'd go out and try cotorizing (spelling??) it with 2 sticks of silver nitrate, but didn't have to, and the area had filled in...We'll be ready to get that done should she decide to bleed profusely again.

Kandy~

Kandy,

Sounds like you are doing a great job. Tupercin is another good antibiotic, as as you said it is easy to use. It's a little more expensive, but worth it since you know the mare will eat it in the grain.

The question will remain open for about 6 more hours, I believe.

I will watch for your reply during that time. After that, you need to click Accept and request "Just Ask Tammy1" to keep in touch. We can also go to chat if need be.

Thank you, Tammy