Wound Healing and Surgery in horses

What can slow healing after trauma?

  • Severe, prolonged inflammation results in less effective repair
  • Increased scar tissue (compacted collagen) deposited results in weaker and less flexible tissue
  • Infection leads to increased swelling, slowed healing and degeneration of tissue
  • Lowered circulation, oxygen supply and tissue drainage results in poor wound healing
  • Existing conditions that already exhibit poor healing such as diabetes, hypothyroidism and Cushing’s syndrome

Trauma, whether it results from surgery, training or injury, is damage to tissue that leads to inflammation, bruising and breakdown of tissue. Damaged tissue cells release compounds that have the potential to damage neighboring cells.

The more cells that are affected by this inflammatory cascade – “domino-effect” – the larger the area of trauma will be. The larger the “zone of trauma” is, the more intensive the inflammatory reaction will be, resulting in more pain and tissue damage.

Scar tissue is deposited as a compromise in areas that are too extensively damaged. Scar tissue has lowered circulation, enervation and drainage – results in a tissue that is resistant to being broken down by enzymes like collagenase; however, is far less flexible and has decreased function.

  • Rest or immobilization of the affected area is helpful for recovery; a splint or a removable brace may provide adequate stabilization during recovery period.
  • Recovery®EQ halts tissue breakdown, inflammation and resultant pain and improves repair
  • Acetaminophen helps to control pain – NEVER use this with cats
  • Administer plenty of water to avoid dehydration
  • If infection arises, antibiotic therapy may be necessary
  • Heat/Cold therapy helps to reduce pain
  • Your active involvement in developing the prescribed treatment plan is essential

Nutricol® (Recovery®EQ)

PROS

Vets may recommend Recovery®EQ, which is proposed to stabilize tissue structures (cartilage, bone, tendons, bursae, synovium, ligaments, skin and blood vessels) and decrease tissue breakdown, inflammation and pain (anti-catabolic/anti-inflammatory). Recovery®EQ is also proposed to increase joint cell receptivity to hormones such as insulin required to speed repair of tissue (anabolic repair). Recovery®EQ can be combined safely with other drugs used to treat pain and inflammation or it can be used alone. Recovery®EQ relieves pain, inflammation and may decrease tissue breakdown. Recovery®EQ can be purchased from your vet without a prescription.

CONS

If initial doses of Recovery®EQ are too high, may result in loose stool or nausea. Reducing dose and beginning more slowly decreases adverse effects that may occur during the first three to four weeks of therapy.

 

Acetaminophen

PROS

For mild to moderate pain vets may recommend acetaminophen (Tylenol®, Panadol®, Exdol®, etc.) to relieve pain. Acetaminophen is only a pain reliever and has no anti-inflammatory properties (Consult your vet). Acetaminophen can be purchased without a prescription and does not affect normal blood clotting.

CONS

Acetaminophen does not decrease the tissue damage. There are dosage limits of acetaminophen so caution should be exercised, particularly if other medications that contain acetaminophen are being used. An overdose of acetaminophen can cause liver damage. Acetaminophen cannot be used in cats.

Non-steroidal anti-inflammatory drugs (NSAIDs)

PROS

Not applicable, see CONS to the right

CONS

NSAIDS, such as ASA and ibuprofen, affect normal blood-clotting and therefore cannot be used directly after surgery as they may result in excessive bleeding and slowed repair. NSAIDs do not prevent tissue damage and when used chronically may accelerate tissue breakdown.

Never use Ibuprofen with dogs as it is toxic to a dog’s kidneys.

Visco-supplementation

PROS

Visco-supplementation is a gel-like substance that is injected into the joint; this substance lubricates the cartilage (much like oil lubricates a car engine), reducing pain and improving knee flexibility. Visco-supplementation decreases friction within the joint, thus reducing pain and allowing greater mobility. Visco-supplementation requires ongoing injections as benefits are only temporary.

Examples include hyaluronic acid (HA) such as Legend®, Hylartin®, Synacid® and poly-sulfated glycosaminoglycans (PSGAGS) such as Adequan®.

CONS

Visco-supplementation is costly, requires injection and has only temporary effects.

 

 

Heat/Cold
  • Applying heat helps relax aching muscles and reduces pain
  • Applying cold helps to lessen pain and swelling. For example, put an ice pack on the area that is lame

Heat or cold application can provide temporary relief of pain. Heat helps to reduce pain and stiffness by relaxing aching muscles and increasing circulation to the area; however, there is some concern that heat may worsen symptoms in an already inflamed joint. Cold helps numb the area by constricting the blood vessels and blocking nerve impulses in the joint. Applying ice or cold packs appears to decrease inflammation.

How can Recovery®EQ improve healing?

  • Decreased area of trauma = decreased amount of tissue damage
  • Decreased scar tissue (second intention) and increased ideal (first intention) healing
  • Faster and improved recovery
  • Increased tissue circulation and drainage
  • Refer to Tips for a Healthier Horse

Surgical trauma generally is accompanied by inflammation and deposition of scar tissue. Scar tissue has decreased circulation, enervation and drainage resulting in tissue that has an increased susceptibility to further trauma.

Optimal healing depends on proper clotting, adequate oxygen and nutrient supply, sufficient drainage, regulated blood pressure, partial immobilization, decreased breakdown of tissue (catabolism) and increased repair of tissue (anabolism).

Recovery®EQ is developed to decrease damage and tissue breakdown (anti-catabolic), decrease inflammation (anti-inflammatory) and increase the rate of recovery (anabolism).

Technical Description

Surgical trauma generally is accompanied by inflammation and deposition of granulomatous (scarrous) tissue due to second intention healing (fibroblast involvement). Granulomatous tissue presents tissue of decreased microcirculation, enervation and drainage, thereby, exhibiting an increased susceptibility to further trauma. Optimal healing depends on proper clotting, adequate oxygen and nutrient supply, sufficient drainage, regulated blood pressure, partial immobilization and cell membrane stability and growth factor receptivity (necessary to healthy anabolic repair and decreased catabolism).

How can you reduce risk of re-injury?

Your veterinarian will inform you of the period of time you will need to immobilize the areas affected by the surgery. After this period there are many things you can do to lessen the risk of injury. Many of the things you can do have to do with strengthening the area by proper stretching and exercises in addition to ways to reduce strain on muscles and connective tissue.

  • Relaxing the muscles around an area affected by trauma reduces pain
  • Recovery®EQRecovery®EQ with Nutricol®, is an elite proprietary performance and wellness supplement for horses that enhances quality of life.Recovery®EQ improves healing by increasing circulation of nutrients to affected cells and extracellular structures, halting tissue damage and decreasing inflammation. It may be used on its own or in combination with prescribed medications. Ask your veterinarian how Recovery®EQ can help your horse.Review in the prestigious Horse Journal in October and December 2003Recovery®EQrated as “Best Performer Overall” as a pain-relieving supplement for joint pain, back pain and tendonitis – comparison of natural joint care supplements.Review in the prestigious Horse Journal inJune 2006:”You get what you pay for” – Horse Journal quote about Recovery®EQ used as a performance enhancing supplement – comparison of natural performance enhancing supplements
  • Avoid chronic administration of drugs that may accelerate tissue breakdown
  • Make sure you incorporate more healthful food into the diet
  • Refer to Tips for a Healthier Horse

Exercise

  • Exercise helps rebuild bone, strengthens muscles, increases circulation and lymphatic tissue drainage “detox”
  • Exercise helps reduce pain and inhibits further bone breakdown and can help your horse maintain a healthy weight
  • Disuse of a sore area will cause the muscles around it to weaken, resulting in pain
  • Swimming or other exercises done in the water may be best if the level of pain is too intense or the horse has osteoporosis.
  • Your veterinarian can help you find the exercise that best meets your horse’s needs.

Muscle, bone and other many other tissues respond to exercise by becoming stronger. The best exercise for your horse’s body is weight-bearing exercise, which forces you to work against gravity, such as walking. Bones respond to exercise by increasing in strength and mass.

In addition to preventing bone loss or rebuilding bone, exercise can also strengthen muscles. Having strong muscles will help your horse maintain better balance and become more flexible; this can help prevent falls that could cause bone fractures.

Your choice of exercise might be more limited if your horse has severe pain. However, it is still important that your horse exercises. Swimming or other exercises done in the water can reduce impact on your horse’s body and may be less painful.

While exercise is good for horses with osteoporosis, it should not put any sudden or excessive strain on your horse’s bones. As extra insurance against fractures, your veterinarian can recommend specific exercises to strengthen and support your horse’s body.

Always consult your veterinarian before beginning an exercise program. He or she may also be able to refer a physical therapist who can advise you of the forms of exercise that are likely to be helpful and those that could be harmful.

Prevent Falling

Fall prevention is a special concern for horses with osteoporosis as falls can increase the likelihood of fracturing bones. In addition to the environmental factors listed below, falls can also result from impaired vision and/or balance, chronic diseases that impair mental or physical functioning and certain medications such as sedatives. It is important that horses with osteoporosis be observed more carefully so that physical changes they may be experiencing that affect their balance or gait are noticed early and mentioned to your veterinarian. Some tips to help eliminate the environmental factors that lead to falls include:

Outdoors

  • Be careful on highly polished floors that become slick and dangerous when wet
  • Remove debris that your horse may stumble over

Indoors

  • Keep stalls free of clutter, especially on floors
  • Keep floor surfaces smooth but not slippery
  • Be sure mats have skid-proof backing or are tacked to the floor

Avoid Excessive Stress on Bones and Joints

  • Prevent your horse from keeping the same position for a long period of time.
  • Maintain a healthy weight in your horse to avoid putting extra stress on its bones.
  • Use supportive devices when necessary