August Case of the Month
Soldier is a 10 year old Pinto cross
gelding. His owner found him with a traumatic face wound that went down
to the bone when she was feeding that the morning. He also had several
small lacerations/abrasions on his legs. The owner reported that the
gate to the turnout he was in was a heavy, solid steel pipe gate, and it
was obviously bent from him running into it. She thinks dogs may have
chased him overnight, causing the accident. She called us immediately
and brought him to
the clinic. Upon our initial examination, he had a large upside-down
"V" laceration across the bridge of his nose with a large area of bone
exposed and an obvious fracture. There were also some small bone
fragments to the right side of the fracture. Soldier was heavily
sedated and the wound was lavaged (flushed) with sterile saline and
further examined. Radiographs were taken of his skull to check for any
additional fractures and none were found. The owner
was advised that we would need to put him on the surgery table under
general anesthesia in order to properly treat the wound. The owner gave
her consent, and Soldier was prepped for surgery. An IV catheter was
placed in his jugular vein, and he was induced with anesthetic
medication and placed on the surgery table and maintained on inhalant
anesthesia. Once Soldier was placed under general anesthesia, the wound
was lavaged and prepped for surgery. The wounds on his hind
legs were prepped as well. Some tissue was debrided in
order to expose the entire fracture on the nasal bone. The fracture
towards his nose needed to be slightly elevated by the surgeon in order
for it to be completely stable. After this was done, a bone rasp was
used to roughen the area to stimulate blood supply, preventing the bone
from dying. A Penrose drain was placed in the end of the wound to
ensure adequate drainage during healing; this would be removed in 2-4
days. Once the drain was placed, the wound was sutured closed. The
wound on the right hind limb was sutured and bandaged. The left hind
wound was not deep enough to warrant any sutures, so only a bandage was
placed on it. Soldier recovered well from anesthesia, and once he was
back in his stall, an aluminum bandage spray was administered to his
sutures and SWAT was placed around the drain to prevent flies from
gathering. Two days later, the drain was removed and the area was
gently cleaned and more SWAT was applied. The sutures were all intact
and most of the swelling had receded. His limb bandages were taken off
and the wounds were healing well. Another bandage was placed on the
right hind limb. The left hind was left open to continue to heal and
SWAT was applied around it. Soldier was hospitalized for a total of 5
days. Once sent home, the owner was advised to keep him in a stall and
monitor his head wound for any increased drainage and swelling. Soldier
was sent home on a regimen of anti-inflammatory medication. At his
suture
removal appointment, the wound was dirty and some of the sutures had
been rubbed out. After sutures were removed, the wound was thoroughly
cleaned. Part of the bone was visible, but it would granulate in and
should heal with no issues. The right hind limb sutures were removed
and the wound was cleaned. The owner was advised to bandage the limb
for another week and it should be re-evaluated after that. Soldier will
receive several more check ups, but is expected to make a full recovery
after adequate time off to heal.
CAUTION: THESE PHOTOS MAY CONTAIN GRAPHIC MATERIAL AND MAY NOT BE SUITABLE FOR YOUNGER AUDIENCES
CAUTION: THESE PHOTOS MAY CONTAIN GRAPHIC MATERIAL AND MAY NOT BE SUITABLE FOR YOUNGER AUDIENCES
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