06/20/2017: Piper’s injury

I’ve been chronicling Piper’s injury and progress on my Facebook page, but I haven’t posted photos of the injury site itself because of their graphic nature.  Continue to scroll to see the photos of her progress.

On May 7, Piper got her right hind leg wrapped in a fence line. I use elastic polymer fencing that doesn’t cut skin, but it does stretch. Because her leg is so tiny, she was somehow able to wrap it completely around her leg, piano-wire-around-the-neck style. It cut off circulation for an unknown amount of time before I found her and cut her free. The best estimate is six hours, based on the amount of poop there was in the area where she was caught; horses poop about every two hours, and there were three piles.

The fence didn’t cause any internal damage, but she was very sore, and the tendon was contracted. I trimmed around the area and didn’t see any broken skin.

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A few days later, the skin started to slough off. I expected this because of the length of time she had lost circulation.

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Over the next days, more skin came off in chunks.

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We also ran into a disgusting problem: maggots. Because I had left the leg open while the skin was coming off in the beginning to keep it from rotting under a bandage, flies had a chance to lay eggs in the tissue. It’s a common issue and easily fixed, but it’s disgusting.

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The rest of the skin came off quickly after.

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The challenge became allowing granulation tissue to fill in the gaps without letting the bandage stick. But it did fill in with the proper care.

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There are grass clippings in the wound in the above photo because I would let it go bare for a few hours each day while she grazed. Before being bandaged, I would clean the wound and clear out the debris.

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It was at this point that I became concerned about her hoof. The coronary band was turning black, and the hoof didn’t seem to be growing out as one consistent piece. The new growth was separate from the old. Nothing to be done, just monitoring.

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Keeping granulation tissue in check is difficult. The nature of the tissue means that it is fast-growing and can grow excessively out past where it is needed. This is what is called “proud flesh” colloquially in the horse industry. The use of the proper topical application (bandage and ointment) is pretty important in preventing proud flesh. Piper had not grown much proud flesh and was coming along nicely.

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On June 6, her leg was looking really good and was beginning to grow hair!

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However, when I picked up her foot to inspect the backside of her leg, I saw that her pedal bone capsule was starting to penetrate the sole.

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Not good. The foot was dying because of the extended loss of circulation, and the laminae that hold the inner structures were separating. This continued to get worse, despite our efforts.

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All the material on the bottom of her foot was sloughing away, exposing the inner structures. Her pedal bone was rotating downward, much in the same way that a laminitic horse’s does when it founders. It became very important to dry out the foot so the tissues wouldn’t deteriorate as quickly and to increase blood flow to the foot to try to save as much tissue as we could.

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Her hoof had become very soft and could be squeezed and manipulated much more than what should be possible. This was because of the separating tissues.

The foot did dry out a bit, but the pedal bone continued to rotate.

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The sole continued to bulge outward more and more as the inner capsule rotated.

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It was, however, drying out.

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We’re at a point now where we can treat it essentially like a foundered hoof that has solar penetration. The plan is to trim down the walls to even out the weight distribution on the foot and support the hoof as it tries to regenerate the sole. We will have to address the pedal bone rotation eventually, but right now, I just want to prevent any more laminar separation and get some sole beginning to regenerate.

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Update: June 21

Last night I trimmed away the excess wall so that her weight would be spread over the remaining sole, bars, and frog as well as the wall.

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The edges are a bit rough still because I didn’t want to torque the foot too much by rasping. I put a soft foam pad under her foot to help cushion it since I dramatically changed the way her foot bears the weight by trimming that wall. After a few days I think I can take that pad off.

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Update: July 11

Trimming the excess wall helped a lot. There is new growth underneath flaps in the sole that have developed from the old sole material coming off.

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I left them intact as long as they were willing to stay on there on their own. I also got her a little rehab boot so I didn’t have to continue going through rolls and rolls of vetrap.

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I continued to trim away excess wall as it grew out, and I’m keeping her booted with a shock absorbing pad to keep her walking on the foot and a cotton pad (changed every 12 hours) to absorb any moisture.

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Last night, I took a hoof knife to the foot and took off any material that was ready to come off on its own.

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The foot will likely grow out in an odd shape and/or grow at different rates, and it will need weekly trimming to keep it on the right track.

July 27:

After I trimmed off the excess dead material, the foot really started looking healthy and pink.

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The frog was also peeling up, exposing new frog growth underneath. I left it alone, letting it come off on its own.

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As the foot dried out and healed, the tissue changed color and got darker. It also got harder!

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Her hoof was growing at an incredible speed. The heel is growing faster than the toe, which is normal because of the trauma the toe sustained. You can see the capsule of the old hoof being pushed off by the new growth.

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At this point, she was ready for some controlled exercise. I started taking her on walks down my rural road, along with her “sister,” Scarlet and my dog, Abe. I ordered her another boot for this purpose. This one is more sturdy and allows more movement without rubbing like the rehab boot does.

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Her frog finally came off! Underneath was an underdeveloped, but developing, frog.

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Her sole is growing nicely, but it has a few splits in it that have grown out from the interior tissue.

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I’ll have to monitor these splits carefully. We’re not out of the woods by any means, but she’s looking promising!

 

 

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