If you own a horse, chances are at some point in time you will contend with scrapes, cuts, and lacerations. Even if you were to bubble wrap these guys, these types of injuries are very common and can happen outdoors or even when they are confined to a stall. For many owners, their occurrence is so common that they have their own way of dealing with them, while for others, these injuries can create a state of panic. When do you call the vet for a laceration in your horse and when can you possibly manage them on your own?
The skin is designed to be a means of protection for the body, helping to keep invaders outside of the body. The skin is also very thin and thus, susceptible to injuries including lacerations, cuts, scrapes and other types of wounds. These injuries can be very minor, but in some cases, they can be severe even if they were originally deemed as being ‘innocent’ in nature.
In order to determine the severity of the injury, you need to keep in mind:
- How deep does the wound go?
- Is the wound an open or closed wound?
- How long is the wound?
- Are other structures involved?
- Where the wound is located on the body?
How Deep Does the Cut or Laceration in Your Horse Go?
The skin has 3 main layers to it, including the epidermis, dermis, and subcutaneous tissue. The epidermis is the outer most layer with the subcutaneous being the innermost and often includes fatty tissue. A wound that is minor might just include a nick or scratch that has only penetrated the epidermal layer, maybe reaching into the dermis. These types of wounds often opened up partially, with separation of the wound margins, but are easily closed with finger pressure. There is often mild to moderate bleeding, due to blood vessels in the skin layers, but you cannot readily see any other tissue or structures such as major blood vessels, fat, bone, or muscle.
These superficial type of lacerations can be managed in some cases simply, while others do require sutures. However, before you make that determination, there are other factors to assess.
Is the Cut or Laceration Open or Closed in Your Horse?
A cut or laceration to the skin in the horse can happen for a variety of reasons. In many, the horse simply rubbed up against something like a nail or other sharp object, creating that laceration. However, in other cases, it was blunt trauma, due to a kick, that created the obvious cut. There is a difference between these two sources of trauma.
The source of the trauma can dictate the extent of underlying tissue damage. A nail or a kick can just graze the surface of the skin, creating a small wound, but it can also create more extensive damage that does not meet the eye. In some of these cases, you may think it is a superficial abrasion or laceration, but indeed, there is a puncture leading down to deeper layers. In other cases, due to the force of the trauma, there may not be a puncture wound, but instead deeper tissues are damaged due to the blunt force nature.
The only way to determine if there is a puncture wound or deeper involvement is by exploration and careful evaluation of the wound. In some cases, the wound may seem superficial, but there is a steady drainage of fluid from deeper layers. In other cases, you may see a small area where fat or other deeper tissues are being revealed or pushed out. Still, on others, there is no evidence of deeper trauma, only to have the wound closed with stitches and discover the deeper damage at a later date.
When there is evidence of a deeper puncture wound or that deeper layers of tissue are involved, your veterinarian needs to be called and get involved to determine the best course of action. Puncture wounds can be very serious, depending on other structures involved.
How Long is the Cut or Laceration in your Horse?
Taking into consideration the first two items on our list, the next thing to determine is the length of the wound. A minor laceration or cut that is only an inch long, superficial and not involving other structures might be able to be managed topically. While a laceration that is 4 or more inches long generally requires stitches or sutures. The main reason being is that the longer the wound is, the more exposed and susceptible the tissue is, and the higher risk of infection. It is generally easier to stitch the wound closed, which helps to speed the healing process and lower risks of secondary complications.
Does the Cut or Laceration Involve Other Structures?
This is the million dollar question and was addressed briefly above regarding blunt trauma type of wounds. When there is a cut or laceration on the horse, you need to determine the extent of the wound and it’s location. A cut or laceration can be minor or it can be disastrous if the location is just right.
There are many areas of the body that are protected when it comes to cuts or lacerations, but others are at high risk of damage. The main areas of concern are those that occur over vital structures, which may include the neck, chest, abdomen or the limbs. A cut can look minor, but could have gone deeper and now involving other vital organs, a joint, or a tendon or ligament. In other cases, such as the neck or jaw region, (image to the right), the cut can open up and expose vital structures including arteries, veins, nerves, and even the trachea or windpipe. The head is one area that is high exposed and at risk, due to low fat levels and cushion underneath the skin. Lacerations around the eye are also of high concern, and can directly involve the eye or globe, creating significant concerns for future health and soundness.
Signs that the wound has gone deeper include a large amount of continual bleeding, deeper tissue exposure, drainage of a clear-amber colored fluid, or acute lameness of favoring of the limb involved.
Where is the Cut or Laceration Located in the Horse?
This question helps to determine the risk of further involvement of deeper structures within the body and also ease of wound closure by your veterinarian.
Areas at high risk of deeper injury include:
- Head and neck region
All 4 of these areas contain vital structures that can be potentially damaged by a kick or laceration by a sharp object. Dependent on the area involved, it can also determine the ease of closure of the wound by your veterinarian. Wounds localized to the limbs, especially lower down, can be very difficult to close with sutures, due to lack of excess skin to the region. Wounds localized to the head, neck, chest, and abdominal regions tend to have more skin to allow for primary closure.
Evaluating and Managing the Laceration or Cut in Your Horse
Cuts and lacerations will happen in almost every horse. The main thing to do is first not to panic. Second, after you take a deep breathe, evaluate the 5 points above.
- Where is the cut on the body?
- How deep is the cut?
- How long is the cut?
- Is the cut open or closed?
- Are other structures involved?
After you get a better feel for the answers to these questions, you can then determine whether or not there is a need to call your veterinarian. It is always a safe bet to contact your veterinarian, advise him or her as to the nature of the wound, and gained their insight. Many wounds can be handled superficially, while others require sutures.
We will discuss wound closure, healing, and therapy options in another article.
Author: Tom Schell, D.V.M., CVCH, CHN