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**update** On Infected Laceration On Horses Head Won't Heal....help!

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Okay, I will try to keep this brief. End of August, came home to find my nine year old gelding with his forehead sliced open, head covered in blood and his left eye almost swollen shut. Took a trip to the vet. He cleaned him up, stitched him up and he stayed there for a week, as an infection set in. We brought him home for about a week, with daily antibiotics, and then back to the vet as he had a large squishy area just about his eye. The vet opened it up, said he had a bone chip in there, flushed it and sent him home 3 days later. I have been flushing daily, at first with saline and then plain water. The incision that had to be stitched healed up, no problem, not even a scar. The problem area is the hole over his eye, right in the indented area about the eyeball. Two weeks later to a second vet, who flushed it and pulled two small pieces of wood (tree) out. Continued daily flushing. Three weeks later back to original vet who opened him up and flushed him out again, found nothing. Three weeks later back to second vet who again flushed him and said if not better in 10 days, take him somewhere for an xray, he is not set up for it. Two weeks later back to original vet, who opened him back up and removed a two inch long, one inch in diameter chunk of wood, that he said was lodged back behind his eye. Sent him home after 3 days with more antibiotics and daily flushing. After 7 days of antibiotics were gone, it looked better, but still not completely healed. Called vet again, he said come in for another round of antibiotics. Did that for 5 more days and 1-2 times a day flushing with water. It looked like it was improving. Now, it has been draining nasty yellow puss this entire time. Last week it had started to lessen, looked to be healing up, but this week it started draining more again. I am so frustrated and not sure where to turn. Second vet referred me to Texas A & M, but they have not contacted me yet to discuss price. I have been dealing with this for three and a half months and have spent close to $1000.00 on six trips to two different vets and have been flushing the area with water one to three times per day. I called the original vet yesterday. He said bring him back in, he would take a culture to see if it was a resistant strain of bacterial infection that is just not clearing up or if there is still wood/splinters in there. I am at my wits end wit this already, and of course worried the infection will cause him to lose sight in his eye. Does anyone have any suggestions?? Any experience with this type of situation?? My pateince and bank account is running low!!

Edited by palogirl

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Unfortunately, if there is a wood foreign body involved, you may be looking at a very long process. If the wood slivers off, you end up with multiple small foreign bodies that are near impossible to detect. I've seen wounds like this that have literally festered on and off for years!!

If its been since August and its STILL draining, you have some nidus for infection that is remaining, whether it is a bone sequestrum or wood that ultimately will need debriding. At this point, you may ultimately be looking at CT/MRI to identify the problem.....

Has the wound been cultured, rather than just giving antibiotics? Sometimes combination therapy will make a difference where a single drug will not.

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At this point if it were me I'd definately be taking him to A&M. They have more equipment, better experience etc overall. When there has been this long of a problem and a 2 inch chunk of wood lodged behind he eye through the course of a couple vets it took to find it you need more extensive equipment (MRI/CAT) to see if you can spot more wood (x-ray won't pick this up). As you've been able to tell rinsing and antibiotics isn't curing the problem and that's probably all that the origanal vets will be able to do.

I also second a culture because then you can pinpoint the infection more than just your broad spectrum antibiotics.

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Oh yeah, he needs the University to get to the bottom of it. He has to have something left in there for it to still be festering.

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Had the culture done on Monday. Vet said it will take several days to get the results.....not sure why so long?? Vet seems to think the site looked better than when he saw it last....don't know if I agree with that. He did flush it again with some type of antibiotic liquid. We are on wait mode until results of culture are in. I continue to wash daily with water. I'll update once results come in and we have a plan of action. Thanks all for the comments.

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Got the results of the culture yesterday, FINALLY!! Vet says he has a resistant Strep infection. We are trying 25cc Pennicillin daily for 10 days and hoping that will knock it out. I have pictures of original injury back in August, will try to attach them. Is there anything I need to be watching for as far as risks of using the Pen??

post-18445-1261589293.jpg

post-18445-1261589303.jpg

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I wonder why penicillin would be used on a resistant strep infection. A lot of things that are "resistant" are penicillin-resistant.

Ditto on the make sure you don't hit a vein when you inject the penicillin. When you insert the needle pull back a little and make sure no blood is in the hub before you depress the plunger. Make sure you finish the ENTIRE round of antibiotics, even if the horse seems to get better before the round is done. This will ensure that you kill as many bacteria as possible and don't leave any of the most resistant ones behind to multiply and increase resistance.

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Don't know why the vet said Penicillin. He looked at another oral antibiotic, but said it would be way too costly, said we needed to go injectable and that the Procaine/PenG, according to the culture, is what I should use. Thanks for the advice on giving the injections. My husband usually does this, but he will be leaving town this weekend, which leaves me having to do it!! I'm hoping this will take care of the infection. Next week will be 4 months I have been battling this!!

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Got the results of the culture yesterday, FINALLY!! Vet says he has a resistant Strep infection. We are trying 25cc Pennicillin daily for 10 days and hoping that will knock it out. I have pictures of original injury back in August, will try to attach them. Is there anything I need to be watching for as far as risks of using the Pen??

Sure he didn't say Staph infection? If so I'm surprised he prescribed Pen for it. We've got a horse at our barn that has an ongoing recurrent staph on his legs. Looks similar to what you posted.

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The vet said resistant strep infection. But when I researched it, it appears that strep and staph are very similar, or at least can be treated the same way. The pics I posted were taken on the day of the initial accident in August. His wound now is a small hole above his left eye, a little larger than a pencil eraser and is draning yellow pus. The infection is deep down inside. He has been receiving pen injections since Tuesday, and it appears a little better, not as much drainage. I have my fingers crossed!!

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I have now given my horse 8 of the 10 pen injections, and while I have noticed a slight improvement,.....it is only slight. After 8 injections, should I not have a more noticeable improvement? I called my vet this afternoon to check in with him, and did not receive a call back. I have ordered some Vetericyn to start using on the site. Any suggestions?

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As suggested before I really feel you need to goto A&M to get an ultrasound done on the site. You've already had vets miss a LARGE chunk of wood in there, how many other small pieces are still in there? With flushing you honestly can't know (and can miss easily) unless an ultrasound is done. With the infection and wound going on so long it points to more wood stuck in the wound.

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DM-- Actually one of the vets made a referral to A&M for me, but no one ever contacted me...of course it is during the holidays, and I know they are operating on a skeleton crew now. The culture that was done, according to the vet was supposed to determine if there was still a foreign object present or a resistant infection. The result was the presence of a resistant infection. It does seem a lot better today, very little drainage and it does not seem to bother him at all. He lets me clean all around the wound site, including the outer edge with no resistance. Another question I have is, can I continue the pen injections for 2 more days w/o harming the horse? Tomorrow will be the last of his 10 injections, and I feel 2-3 more days may be enough to completely knock it out. I also started using Vetericyn on it today. I called my vet yesterday and today, but am yet to get a call back. I am really put out with him!!

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iF it were my horse, I'd contact A&M myself and follow up on that apointment.

There HAS to be more foreign material in there.

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iF it were my horse, I'd contact A&M myself and follow up on that apointment.

There HAS to be more foreign material in there.

Not necessarily. The horse at our barn that has this chronic staph outbreak just "breaks" out with it. I imagine it's something similar in this case. the horse I'm talking about was actually donated to UC Fresno since the original owner couldn't get it under control. After who knows how long of treatment they thought they finally had it licked and sold the horse to the current owner. I honestly dont think his issue will ever be completely resolved.

edited to add:

to the original poster I really really like Vetericyn. I'd put it on stream and really clean the wound out and see if you can stimulate some healing.

Edited by RixKatToy

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Rix, what makes me and I think a lot of others on here think foriegn object is this,

The vet opened it up, said he had a bone chip in there, flushed it and sent him home 3 days later. I have been flushing daily, at first with saline and then plain water. The incision that had to be stitched healed up, no problem, not even a scar. The problem area is the hole over his eye, right in the indented area about the eyeball. Two weeks later to a second vet, who flushed it and pulled two small pieces of wood (tree) out. Continued daily flushing. Three weeks later back to original vet who opened him up and flushed him out again, found nothing. Three weeks later back to second vet who again flushed him and said if not better in 10 days, take him somewhere for an xray, he is not set up for it. Two weeks later back to original vet, who opened him back up and removed a two inch long, one inch in diameter chunk of wood, that he said was lodged back behind his eye.

^^^^^

This horse had had multiple vet visits with NO ultrasound and multiple pieces of wood taken out. This wound has been given time to heal, then reopened, then healed, then reopened. Who knows if there is scar tissue grown over another piece of wood in there??? It's not just a case of the staph it's much more.

Palo I really agree with Manes on this one, follow up with A&M. Ultrasound wil not only determine if there is more wood in there or not, but will give you the piece of mind that it's not up there either and this won't keep reoccuring (especially that huge piece 2in by 1 in missed for so long, wow!). With so much foriegn material missed then taken out just makes me think there is still more up there if the wound still won't heal.

Have you got a call back from your vet on the pen injections?

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I pushed for an ultrasound in November....the vet said an ultrasound of the head would not work due to ultrasound bouncing off facial ones. He said an MRI would need to be done, and few vets are set up to do that. I did finally get to talk to the vet yesterday and he said I could continue the pen injections for 3-4 more days. Said I could go longer, but the problem will be that the horse is getting sore at injection sites, and will not be happy. I am injecting in the neck, alternating sides, but still after 10+ days.....he is getting sore. I know there are a few other places you can give injections.....what are the safest you guys have found?? The vet also agreed the Vetericyn should be a big help. Thanks for everyone's suggestions and comments.

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MRI, yes, sorry. The "Look in the head and see what pieces of wood are still stuck" machine, lol.

I have given some shots some time back in the back of the butt cheeks. I was young and don't remember what it was, I do know it was an antibiotic of some kind and where to give it. I know that doesn't help too much, but it was the back of the buut cheeks right next to the tail where it comes down over them. I know the most suggested and safest place is the V in the neck.

I'd continue the pen injections for the extended period of time and if it all starts up again or still isn't cured start calling A&M and schedual that MRI.

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