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Expert
Posts: 2685
   
| I have a 2yo filly that has a t-post puncture wound that does not appear to have punctured the abdominal cavity and I have it sterilely wrapped and medicated. I have spoke with the vet and sent pics- ect. Her concern is the amount of fluid on the Ab pad when I removed it this morning was a little high. Worried it might be per-blahblah fluid from her abdominal cavity. BUT I cold hosed the wound before wrapping it last night and did not dry the area so its **probably** water. I did a "fancy" sterile flush and bandage today the way we do them at work for colic surgeries- ect so it is good and clean and dry today bandaged up. I am supposed to change bandage tomorrow to check the amount of fluid since I know its dry this time. My vet is extremely concerned about it puncturing the abdominal cavity.
Any experience?
PS- she is on some kick a$$ antibiotics.
thanks |
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Expert
Posts: 3514
| Since the chance of infection is high, I would put her an immune builder too. |
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  Making the post season
Posts: 7288
Location: your guess is as good as mine | Yup...not sure how my mare did it although I suspected a t-post. Found her one morning when I went out to feed, hauled her to the vet - luckily hers didn't puncture the abdominal cavity either, but it was deep...cleaning it out my vet's hand disappeared into the wound. Couldn't wrap hers, just kept it clean as possible - don't have running water at the pasture I lease so I used a big irrigation syringe to hydro out the cavity, then coated the inside of it good with a mixture my vet makes up (he calls it Hue...I think it might be DMSO and nitrofurazone and something else maybe - it's fluorescent yellow so I'm pretty sure about the furazone lol). Then sprayed the whole area & inside with Alushield to keep the flies from blowing it wide open...and of course heavy antibiotics for a week. First pic is obviously when I found her lol...second pic was I'm guessing about 3 weeks later maybe? It healed without so much as a scar...
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 Keep Your Eye on the Prize
Posts: 1080
Location: Vicksburg MS | Lestat impaled himself on a tpost when he was trying to escape a pasture bully. It went in about 2-3 inches inside his flank area and "fanned" for lack of a better term all the along the abdominal wall from the end of his ribs to his hip point.
I can't help you with immediate after care as he spent 7 days at the vet clinic with pressure wraps, on IV antibiotics and heavy duty pain meds. So I have NO clue what his banadage changes looks like, fluid wise. When he was released into my care (and 5 weeks stall rest) the wound was open. I kept it flushed twice daily with a Bedadine/water tea that I mixed up in a gallon sprayer.
I just fed the wand up in the wound and pumped up the sprayer to rinse all the nastiness out. He was suprisingly good about that and the 15cc of Pen he got twice a day.
It wasn't any time at all before the wound closed completely. He was released off stall rest at 4 weeks and promptly jumped a 5 ft fence from a standstill, thus earning himself another week in jail.
When all was said and done, the scar was smaller than the diameter of a pencil eraser, tho he had a funky fat deposit right above it from carving all the subcutaneous tissue as he hung on the tpost. I got a call when it happened, drove like a bat out of hell to my friend's and then we spent 2.5 hours calling every vet in a 75 mile radius to come help us before he ended up getting himself off the damn post.
This was the day I got him home from the vet's. Still had a lot of edema.
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Expert
Posts: 2685
| Thank you everyone :)
I am pretty confident in bandage changes and I have her on Uniprim. Might go to Baytril since I have it. I just worried due to how worried my vet is about the abdominal cavity thing. If there is a hole into the abdominal cavity, it's tiny. I poked around in it good this morning and couldn't get through the muscle. Problem is where the puncture is on her belly is on her midline where there is no "muscle" it's just where the muscle meets. That's why abdominal surgeries do their insicions on the midline :/
We shall see tomorrow folks! Prayers please that it is NOT in the abdominal cavity and there is no excess fluid! |
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 You get what you give
Posts: 13030
Location: Texas | I would be careful about baytril… isn't that the one that can cause colitis really bad?
are you monitoring rectal temp twice a day? If not, I would start. |
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The Advice Guru
Posts: 6419
| RoaniePonie11 - 2014-09-14 6:59 PM
Thank you everyone :)
I am pretty confident in bandage changes and I have her on Uniprim. Might go to Baytril since I have it. I just worried due to how worried my vet is about the abdominal cavity thing. If there is a hole into the abdominal cavity, it's tiny. I poked around in it good this morning and couldn't get through the muscle. Problem is where the puncture is on her belly is on her midline where there is no "muscle" it's just where the muscle meets. That's why abdominal surgeries do their insicions on the midline :/
We shall see tomorrow folks! Prayers please that it is NOT in the abdominal cavity and there is no excess fluid!
I wouldn't go around sticking my fingers in open wounds as you can introduce bacteria in and cause a nasty infection.
Unprim is a broad spectrum antibiotic, please don't change antibiotics for atleast seven days without doing a culture as you will contributing to antibiotic resistant organisms.
A puncture of the peritoneal abdominal cavity can be very severe if it gets infected, as the horse could come down with many complications.
I would be checking temperature daily as well as HR and respirations, keep them documented and you can use this a a reference point as these will be the first visible symptoms of an infection. |
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Expert
Posts: 2685
| Thanks guys.
I give baytril PO because if you try to give it IV you have to give it so slow that it's just easier to give PO (orally). You do not give it IM. I don't have a whole lot of the injectable form but I can get the oral form (Enro) at work.
I did not just go poking my fingers in a wound. I had an incredibly sterile situation (given that I was in a horse-environment and not a surgery room). I work for a vet and have access to the tools and information needed to sterilely investigate, clean and wrap a wound. It is literally my job to know how to do that.
I will finish the round of Uniprim and keep in contact with the vet (the one I work with) and we will decide what is best.
We will find out tomorrow if the wound goes into the abdominal cavity. Crossing out fingers and toes that it's not.
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 Elite Veteran
Posts: 974
Location: USA | Dude can I just say, kudos to you for being so upbeat. I swear every week something happens to your horses! And I'm not saying this to be snarky or beetchy. Like, I feel for ya. Seriously. I just want to send you a $hit ton of bubble wrap so you can wrap them all up   |
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 BHW Resident Surgeon
Posts: 25352
Location: Bastrop, Texas | readytorodeo - 2014-09-14 4:08 PM
Since the chance of infection is high, I would put her an immune builder too.
Which immune builder do you suggest? |
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Expert
Posts: 2685
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Haha! Thank you!
Yeah when it all started I wanted to throw my toys in the dirt so bad but being a big baby was only making it worse and honestly I know this sound silly but the only thing I have left sound enough to ride is 3yo and is coming along so nicely that it's kinda worth it. After trotting the barrels twice she could confidently lope it and we have loped it about 10X total and now I can kick her leaving the barrels (tshoes) and she puts some umph behind her launch. She is just being sooo easy. Let's me know why I do this. |
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Expert
Posts: 2685
| HotbearLVR - 2014-09-14 11:00 PM
readytorodeo - 2014-09-14 4:08 PM
Since the chance of infection is high, I would put her an immune builder too.
Which immune builder do you suggest?
I agree. What do you recommend? I always thought that stuff took weeks to start helping though? |
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Elite Veteran
Posts: 974
Location: USA | Doesn't echinacea help? What about antioxidants (vitamin C, vitamin E)? It does need to build up in the body, but it doesn't take weeks. If her peritoneal cavity is punctured, you'd need more than an immune builder for that though. The immune builder is good to help prevent sickness from the stress of traveling and such because that lowers your immune system. In this situation, the immune builder wouldn't hurt, but it's not going to prevent infection. Diligent wound care and prophylactic ABX are your best friends right now. Any word on how deep the puncture wound is?? |
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BHW Resident Surgeon
Posts: 25352
Location: Bastrop, Texas | If the horse has peritonitis, it depends on the source. If it is simply from a penetrating injury through the abdominal wall, but no blowel penetration, then antibiotics have a good chance of working. If the horse is draining peritoneal fluid that doesn't appear to be bowel contents or bile, then that might be what's going on, and that horse stands a good chance of survival, with the right treatment. "Immune builders" alone won't help very much at all. If the bowel has been perforated as well, then chances are you would know it by now, because the horse would be much more sick or dead by now, without surgery. Also, keep in mind that if there is a penetrating injury there is a good chance that the horse will later on develop a hernia that won't go away on its own.
In either case, you really should have a vet see the horse.
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