Simple paddock injury develops into something more serious

Discussion in 'Horse Health' started by StraightandTrue, Mar 25, 2018.

  1. StraightandTrue

    StraightandTrue Senior Member

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    I thought I'd share this article as it very closely mirrors my recent experience with a simple paddock injury that developed into a sequstrum (aka bone fragment) which required surgical removal. Sequestrums are something every horse owner should be aware of when dealing with a horse that's suffered an injury.

    Equine leg puncture wound

    Important information on sequestrums:
    • Any injury that involves a puncture or impact may result in a sequestrum. This includes injuries from brushing/interference of the legs during training.
    • Sequestrums form when blood & oxygen supply to a section of bone is lost. This can happen when a fragment of bone breaks off during impact, or the periostuem (membrane that supplies blood & oxygen to the bone) is damaged. The bone 'dies' and infection develops as the body rejects the bone as foreign matter.
    • Sequestrums usually take 10-14 days to develop. Prior to this, the horse may appear completely sound.
    • If the injury has been healing well but suddenly flares up 2 weeks later (e.g. sudden increase in heat, swelling, soreness, lameness) you might have a sequestrum on your hands.
    • You will need x-rays to confirm the presence of a sequestrum. Ultrasounds can be helpful, but they aren't definitive. Sequestrums won't show up on x-rays until 10-14 days later so don't rely on x-rays taken earlier than this as proof that there isn't a sequestrum.
    • Some sequestrums can be reabsorbed by the body on their own, but some may require surgical removal. Your vet will help you determine the correct course of action.
    I hope this information has been helpful! There are cases of sequestrums that have gone undiagnosed for 17 years so it's good to be aware what the symptoms are.
    • Surgery can be done with the horse standing (sedation & nerve block), but in certain cases surgery will need to be done under general anaesthetic.
    • Post surgery, the horse will require a minimum of 2 weeks box rest followed by 2-4 weeks of rest in a paddock.
    • The recovery rates for sequestrums are good and generally the horse can return to normal work provided there are no other complications.
     
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  2. StraightandTrue

    StraightandTrue Senior Member

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    And here are the x-rays from the surgical removal of the sequestrum in the lateral splint bone of my horse's left hind leg. Amazingly the horse was 100% sound the day after surgery, not even a tiny bit sore or lame. It's been a week since the operation and so far so good - although I'm keeping fingers toes and everything crossed that there aren't any complications. Horse is well and truly over box rest and thinks she is invincible so obviously hasn't learned a darn thing.

    Sequestrum.jpg Marked out sequestrum.jpg Post surgery.jpg
     
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  3. Rhythm 'n Blues

    Rhythm 'n Blues Senior Member

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    My friend has a mare who they thought popped a splint. Had the vet out just to be sure - yup vet thought it was this exact thing & the horse would need surgery. Vet sent the radiographs off to the university......nope not this thing......they have no clue what it is! Hahahaha

    Before that I had never heard of this....and now twice within a month!
     
  4. StraightandTrue

    StraightandTrue Senior Member

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    I'm glad it's not just me! I've owned horses for over 20 years and never heard of this until now. Luckily my dressage coach had first hand experience with sequestrums and was able to reassure me that they do make a full recovery. She bought a dressage horse with a sequestrum in it's stifle that was detected during the pre-purchase examination. She knocked a good chunk off the sale price, then sent the horse off for surgery. A month later the horse was back in work, and it barely showed up on the radiographs when she sold the horse a few years later. So that's encouraging!
     
  5. slc

    slc Senior Member

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    That is large.

     
  6. Mcdreamer

    Mcdreamer Senior Member

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    Thank you for sharing this. Last summer i had a mare come in with what looked like a simple cut on her face. Turned out it was a puncture wound that literally punctured her face. She had to have surgery at the barn (she was a saint) to remove the fragment and it was a looooooonnggg process.
     
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  7. Circle C

    Circle C Senior Member

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    This is why I always opt to have splints xrayed no matter if the horse is sore or not. It worries me.
     
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  8. mkoktavy

    mkoktavy Senior Member

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    I know allll about sequestrums... we thought Flash got kicked in the canon bone last summer, after the cut wouldn’t totally heal, got it xrayed and it was actually a puncture. He had to have surgery as well and get it debrided. Healed well and now is left with a bump that just looks like a splint.
     
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  9. StraightandTrue

    StraightandTrue Senior Member

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    Did he have the surgery standing or under general anaesthetic? What program did you use to bring him back into work?
     
  10. mkoktavy

    mkoktavy Senior Member

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    He was only 1 when it happened so he technically wasn't in work. (I thought it was last summer, must have been the one before.. . My time line is messed up!)
    He went to the equine hospital and was put out. Stayed at the hospital for 3 days, then 3 weeks stall rest with hand walking and then turn out if he was quiet - which he was so worked well.
    I had tried laser therapy to help with healing but it just irritated it so I let it be. Finally almost a year later I bought a portable therapeutic ultrasound and treated the lump with really good results.
    He is coming into work now as a 3 year old and no problems. Was never lame to begin with.
     

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