horse sutures Smith Wilson

Dr. Wendy Smith Wilson's horse Mikey isnt' telling what happened to his shoulder. But rest assured, after sutures and healing time, he's almost as good as new and looking for his next adventure. Photo by Dr. Wendy Smith Wilson

“I don’t get it, doc. There’s no blood anywhere. I don’t see how she did this to herself.” Meanwhile the owner stands next to a horse that looks like it got between Freddy Krueger and a pack of drunken co-eds.

Horses have many talents – extraordinary athleticism, the ability to discern human emotions, the power to leap tall fences in a single bound. However, there is one skill at which they excel above all else.

The ability to self-destruct.

A horse can lay itself open from head to tail in a clean, well-maintained paddock in less than five minutes of unsupervised time.

I’ve had patients tear open their shoulders on the latch of the same gate through which they pass every day.

One horse found literally the one remaining strand of barbed wire in his five-acre pasture and sliced the entire side of his cheek open. “I just re-fenced the whole thing with vinyl so he wouldn’t do that,” the poor owner sighed. “He found that one piece of wire hanging from the post and got to it before I could."

A particularly special mare decided to itch her nether regions on a tree in her pasture, and in doing so, impaled roughly two feet of branch into her butt muscle.

If you own a horse, it’s best to prepare for WHEN your horse injures himself: not if, when.

Step 1: Horse-proof the environment. 
As noted above, this won’t work, but do your best anyway. If nothing else, you won’t have to face the “I told you so” from your spouse or teenage offspring when Trigger comes to dinner dragging a snail-trail of blood behind. Periodically scan walls, fences, feeders, and waterers for sharp edges. In horse terms, a “sharp edge” can range from a legitimately dangerous slice of sheet metal down to the millimeter of screw tip poking through the wall. This will need to be repeated. In addition to self-destruction, equine hobbies also include rearranging the environment to facilitate the aforementioned accident-proneness.

Try to eliminate potentially impaling objects. T-posts and dead-ish tree branches are the most common horse-harpooning items, but decorating stalls with spears, swords, and javelins should also be avoided. Likewise, horses and machinery (dead jeeps, tractors, etc.) aren’t a good mix. Basically if you can imagine the item killing off the secondary character in a surprise action scene, you don’t want your horse anywhere near it.

Step 2: Assemble a first-aid kit. 
The first item in this kit should be your veterinarian’s phone number. Horses are not only talented at damaging themselves, they have a knack for healing wounds in…interesting ways. Other helpful first-aid items include:

• A mild soap for washing the wound initially. (Put away the peroxide and strong iodine, step away from the scarlet oil. A lot of disinfectants also are incredibly damaging to the tissues. You can clean off the worst of the debris with a hose and mild soap.)
• Gauze and/or towels for pressure wraps over bleeding wounds. The good news is that it really takes a lot of blood loss to fell a horse; the bad news is they are big enough to make everything look dramatic.
• An antibiotic ointment. Plain old triple antibiotic ointment works fine. If your veterinarian is going to be out shortly, ask before putting ANYTHING on the wound, but if it’ll be more than an hour or so, it’s not a bad idea to put up a barrier against bacterial invaders.
• Wrap supplies. Leg wounds like to bleed and they like to heal poorly. Ask your veterinarian to demonstrate proper wrapping technique for when (yes, I said when) your horse decides the best place for his leg is on the other side of the fence from the rest of his body.

Step 3: In the immortal words of Douglas Addams, “DON’T PANIC” 
No matter how terrible it looks, chances are this wound will not be the thing that kills your horse (or you.) Nature has given the horse remarkable healing powers, and (at least from the knee up) even the most horrific looking injuries – I’m talking entire chunks of animal missing – somehow manage to heal. The lower leg is a different story; even small cuts down there tend to go sideways if not properly tended, so while you still shouldn’t panic, if your horse has cut his lower leg, at least muster up enough worry to call your vet.
While you’re waiting for your veterinarian, the following steps will help the eventual outcome.

• Put a halter on your horse. If he’s anxious, you don’t want to wait until the strange person in the coveralls gets there to have him properly restrained.
• If possible, bring him to some place with light, water, clean footing, and few obstacles. It’s remarkably challenging to do a good suture job in the lowest, darkest corner of the pasture against the horse-eating fence and by the light of one’s headlights.
• If he will let you, (DO NOT ATTEMPT THIS STEP IF THE HORSE IS BREATHING FIRE OR TRYING TO VAULT OVER SMALL CITIES), clean off the worst of the debris with mild soap and water. Getting the dirt and grass off the wound as soon as possible goes a long way toward preventing infection.
• If you think it may need stitches (if the skin edges are apart, or muscle is exposed, assume it will), do NOT apply whatever ointment, potion, powder, tincture, or poultice you have lurking in the cobwebs of that cupboard above the feed bins. Just don’t. I know you have those jars and bottles, the ones with the label most of the way worn off, the stuff the kid at the feed store, who now has grandchildren, recommended for your brother’s pony way back when. Put those away. Don’t even go near that cupboard. No. Don’t make me tell you the story about the wound powder and ointment that combined to create cement that I had to debride away from exposed tendon.

Step 4: Bubble wrap suit
Okay, not really, but isn’t it a nice idea?