First Aid for horses - Dealing with cuts and wounds

All horse owners will have to deal an injured horse sooner or later, and those of you who have experience of this will know that it can be quite a drama.  There may be blood everywhere (and a little blood can go a long way!).  The horse may be panicking.  There may be distressed onlookers, and of course too often there are bystanders telling you what to do and giving different opinions about it!

If you have to deal with a sudden and significant injury, you have to act immediately, and what you do can make a huge difference to the outcome.  It might even be the difference between life and death. 

Cuts and wounds

You can treat small wounds and shallow cuts yourself.  These are minor injuries in which there is slight bleeding that stops within about 15 minutes and no significant underlying structures like joints or tendons are damaged.

If the wound is bleeding heavily, call the vet and then try to stop the bleeding by applying firm pressure over the bleeding area as outlined in 3 below.

The basic steps to follow are:

• Pacify and restrain the horse
• Assess the injury and call a vet if necessary
• Stop the bleeding
• Clean and disinfect the wound
• Dress the wound
• Arrange for an anti-tetanus injection if necessary

Pacify and restrain the horse

Injured horses do not behave predictably so be careful when dealing with them.  Do whatever common sense tells you will reduce the horse’s anxiety.  This might include providing plenty of re-assurance, or bringing in a quiet paddock mate.

You will need all your horsemanship skills to keep the horse quiet and steady while it is being assessed and treated.  Try holding up a front leg if it protests during treatment before applying a twitch or resorting to other handling methods to control it.

Assess the injury and call a vet if necessary

You must quickly assess whether the injury is minor and one that you could treat yourself, or significant enough to require a vet.  For any significant injury, first aid is just a stop-gap measure until a vet can be consulted. 

You should consult a vet if the horse shows signs of any of the following:

• severe pain
• difficulty breathing
• weakness
• a deep or extensive wound
• a wound with gaping edges (these injuries heal more quickly and leave less scarring if stitched) 
• heavy or prolonged blood loss
• possible broken bones
• an injury to the eye or joint or tendon
• contamination of the wound by dirt or embedded debris or splinters (these wounds should be cleaned by a vet using anaesthesia)
• a puncture wound (these deep and narrow wounds may require antibiotic treatment and tetanus antitoxin)

Stop the bleeding

Make an assessment of the extent of blood loss e.g. slight from small vessels, medium from intermediate vessels or heavy fro arteries and veins.

If the wound is bleeding heavily you must try to stem the flow of blood, leaving cleaning of the wound to a vet. 

• Apply direct pressure to the wound to stop the flow of blood, trying to keep the edges of the wound close together. 
• Do not wipe the wound as this may introduce infection and disturb early blood clot formation.
• Place sterile or clean gauze onto the wound, then a pad of cotton wool or sterile or clean cloth and hold it in place.  This stops the immediate flow of blood and acts as something for clots to stick to. 
• Apply a bandage to secure the pad in position and secure it firmly.
• The pad over body wounds may have to be held in place by hand until a vet arrives. 
• If bleeding continues, reinforce the dressing, but try not to undo the first dressing as this may disturb any clots that are forming and make the bleeding worse.
• When the bleeding has stopped, remove the pad very gently and replace it with a clean dressing.

It’s an ominous sign if bright red blood is pumping from the wound.  This means an artery has been severed, and you must urgently try to stem the blood loss using a direct pressure pad as described, or a tourniquet above the injured area.  A tourniquet is a last resort and it shouldn’t be left on for more than 10 minutes. 

Clean and disinfect the wound

Wounds that are not bleeding heavily can be cleaned if necessary by squirting gently with water or saline (5 gm salt per litre boiled water) or very dilute antiseptic, such as tincture of iodine, using an old syringe barrel.  Many antiseptic solutions are too strong for open wounds so read the instructions carefully for the correct dilution.  Dried scabs and crusts can be gently removed with a solution of 10% sodium bicarbonate (10 g bicarbonate soda in100 ml boiled water)

Dress the wound

Small wounds can be left uncovered, or they can be covered with a smear of topical antiseptic ointment such as Bioderm or Vetex, or sprayed with antibacterial spray (e.g. dilute tamed iodine) or.

Large wounds are best covered to keep out dirt and flies and to help prevent ‘proud flesh’ developing.  You can bandage as follows:

• Apply antiseptic ointment such as Bioderm or Vetex
• Cover with either a non-stick swab, or a smear of Vaseline then a piece of gauze
• Apply a layer of gamgee or cotton padding then firmly tape this pad in place.
• Secure the padding with an elastic bandage.
• Add a final layer of Elastoplast to secure the dressing.
• It’s important that the bandage is not too tight (the leg will swell beneath it) or too loose (it will not stay in place).
• Smear on ‘Stop Crib’ if necessary to discourage the horse pulling off the bandage.
• Note that some very useful medications such as Copaderm, Lotagen and Socatyl are no longer available. 

Arrange for an anti-tetanus injection if necessary

Deep cuts can trigger the fatal disease tetanus. 

If your horse has been fully vaccinated against tetanus in the last few years, i.e. if it has had the two-injection vaccination course, it won’t need an anti-tetanus injection. 
If your horse has not been fully vaccinated, it is at risk of tetanus, but your vet can provide short-term protection by giving it an injection of tetanus anti-toxoid.