What happens when we honor our horse’s body wisdom and our own intuition alongside, or even above, our vet’s instruction? Let’s go on a pictorial journey of one such incidence. Warning: blood and flesh will be shown…
The place where I am boarding has a wooden board fence with a line of high tensile steel wire in between the boards. Well, my Belgian/Fjord colt put his left leg through this fence and when he pulled it back, realized he was stuck, so yanked harder and the steel wire nearly sliced off the back of his heel. I say nearly, because the chunk of flesh was left hanging there.
I did not even notice anything was wrong until that evening when he began to limp a tiny bit – keep in mind, most of the pasture is covered in 18-24 inches of mud this time of year, so nothing much can be seen on the horses legs, other than mud. By the time I noticed his injury, the light was fading, so I asked him what he wanted to do about it. He said, “I can heal it. Just give me an energy healing.” So I did and then went home.
The next day, his limp had worsened, but his energy was good, he was positive and happy. I attempted to wash off the wound, but he refused, saying, “What’s the point of doing that? Look around you, it will be filthy again in no time.” I had to agree and phoned my tractor guy instead to see when we could get the rest of the gravel in for the paddock I was creating. We had already fenced off the area, and laid down chunks of 3″ rock for the base, but were waiting for the rain to stop, so we could get the gravel and crusher dust in. Realizing that Montaro needed a clean, dry area to heal put an added urgency on the project!
I said to him, “Well, we could trailer you to the vet, have them take care of the wound and you can stay in a stall there until the paddock is in.”
Not surprisingly, he sent me pictures of all the trauma caused by his transportation and castration surgery at the vet clinic 6 months earlier (and he’d had his brother with him) and how he would feel going through all that again and being alone. I agreed that things weren’t critical, so we would do our best at home and try to work around the rain to get the paddock set up asap. He again said that he only wanted energy healing.
I gave him an energy healing, but I also told him that he needed to find a way to tear off the flap of tissue hanging there, or he would not be able to heal the wound. Think of a hangnail, every time that piece of skin gets tugged, it hurts/irritates further and sets the stage for infection.
By the next day – 2 days after he first sliced his heel – he was limping badly and when I put him in the paddock area (which just had the very uncomfortable 3-inch road base rock on it) he refused to go back in with his herd again. I realized that he was very tired and having to be the herd boss was draining the energy he needed to heal. Although he likely couldn’t lie down on this surface, at least he wouldn’t be having to keep order in the herd and could eat in complete peace.
So. The flap of tissue was still hanging there, he was tired and limping badly and I said to him, “Okay, we’re done. You’ve had your chance. I did what you said for 2 days, you’re not any better, you haven’t ripped off that tissue and you are headed for infection.” So I poured 2 ounces of 50/50 diluted wild oregano oil (half olive oil, half commercial – not essential – wild oregano oil) over his wound to completely saturate it.
And the next morning, Monday, I called the vet clinic. They sent a vet out at 1:30 that afternoon and he used an injected sedative as we stood in the paddock area. Montaro leaned his head into my legs and I supported him and told him (out loud) exactly what was going on. Just the way I like my dentist to explain what he’s doing with each step.
Here’s what the wound looked like after the vet clipped the hair and cleaned it up a bit:
The vet agreed that the best thing to do was slice off the piece of flesh, so the wound could heal clean. He also had to scrub the entire area quite vigorously as it was so filthy from the deep mud in the pasture this time of year. Here’s what the wound looked like after the hanging piece of flesh was cut off (the blood spray is from 2 veins that were cut through):
Although vets generally don’t like being told what to do, I was able to advocate on Montaro’s behalf by being subtle: “It looks like he’s having trouble balancing…” rather than saying, “Could you put his foot down so he can rest for a bit?” And the vet released his leg for a few moments. And Montaro heaved a sigh of relief. I also noticed that the interning vet (a young woman) was far more open to requests – so I directed comments or questions to her whenever I could.
I also took down her name afterwards, so that when she is fully practicing I can call her when needed. I always look for practitioners who are at least willing to try working with my horses in a consensual manner.
An interesting thing: He was so sedated during the procedure that his head was hanging low and he was leaning quite a bit of his weight against my legs. But when the other 3 herd members started galloping past the gate, his head shot right up and his eyes became alert and focused. Just shows how incredibly strong that “run with the herd!” instinct is. It makes me even more amazed that any one of them will control it when I have them on the lead rope (not drugged!) and their herd thunders by, yet they stay with me. Okay, back to the surgery…
The vet then applied a non-stick pad, wrapped it with gauze, then wrapped it self-adhesive bandaging tape (VetRap), then with a half inch thick layer of polyester batting, then another, stronger adhesive bandage, then duct tape around the entire bottom and side of the hoof:
The vet completely wrapped up his lower leg and told me to leave this bandage in place for 1 week. Unless, the bandage got wet – either from water, mud, or blood seepage – in that case, take it off and re-bandage. He left me with a 10-day supply of oral antibiotic powder, to be given twice per day. Normally, I avoid antibiotics, but due to Montaro wading around in mud and manure for 2 full days with an open wound, and his aversion to having his feet touched, I felt the antibiotics were a good idea in this case.
The vet also said that this kind of wound is almost guaranteed to turn into “proud flesh” (hypergranulation of tissue), so if/when that happened, call him to come back out and cut/scrape the tissue back again. He told me to keep the wound bandaged until pink granulation tissue had formed and then I can leave it open to heal. I need to keep him dry and clean in the paddock for as long as possible, but at least until new skin has formed over the entire wound. If Montaro’s lameness gets worse, I need to call him as that may signify that infection has gone into the bone. He estimated the complete healing process would take 3 – 4 months.
Well, I’m pleased to say that Montaro’s healing process followed an entirely different course and I believe that is due to my background in natural healing combined with my willingness to be Montaro’s helper in his own healing journey – not his boss/dictator.
I believe very strongly in the ability of every earthling to tap into their own body wisdom and know what is best for their own, unique healing journey or process. So whilst I had the vet’s advice, my own experience, and access to herbs, antibiotics and probiotics, I was also seeking Montaro’s direction – based on his own body wisdom – to determine the best, quickest route to healing for him.
Perhaps Montaro’s experience will give you some ideas for healing tools to use or adapt when/if your horse has a tissue wound.
Montaro’s Holistic Wound Healing Process
Here’s what Montaro and I ended up doing differently from what the vet advised – when we collaborated on his healing. Like all healing, I believe it was the multi-pronged approach (holistic healing) that resulted in his wound healing so rapidly and without complications:
1. Increased air flow – I left Montaro’s leg bandaged the way the vet wrapped it for 2 days. However, my intuition was screaming at me that a wound cannot heal without oxygen! I do not apply even a band-aid to myself or my children’s wounds for more than an hour or two for this very reason. Instead, I apply comfrey salve – which is the best wound healer I have ever come across – which stops the bleeding within 5 minutes for even a severe wound, and I leave the wound open to the air. Now, obviously for a horse, it is not possible for me to apply comfrey salve every few hours, nor for the horse to keep that wound perfectly clean – especially when the wound is on the heel.
So for that reason, I left the bandage on initially and then used my healing experience and intuition to feel my way along. A friend of mine came out (who also has 4 children – so lots of experience treating wounds!) and she too agreed, that the wound needed to have some air circulation.
Now, keep in mind that Montaro was a semi-feral horse when I got him 7 months ago. He does not even allow me to pick out his hooves yet. Having undergone a painful surgery 2 days ago, do you think he’s going to let me get anywhere near his leg?
Well, I explained to him that I thought his wound needed to have access to oxygen. At which point my friend Lori intuited, “I think if you give him some feed, he will be able to allow you to touch his leg.” So she distracted Montaro with a feed dish of his vitamin/mineral supplement plus chopped carrots and apple, while I began cutting away at the top of the bandage, and then pulling at the adhesive gauze and VetRap underneath to loosen it, so air could get in from the top. When I got about 3 inches cut off from the top, Montaro refused to let me do anymore.
As my friend Lori and I watched him walk around, we both felt that, actually, the bandage now looked/felt perfect. Montaro was right and I should not cut away anymore. I left the bandage like that for the remainder of the week.
Over the next 5 days, I checked the bandage (clean and dry) and made sure the top of the bandage was loosened away from his skin/hair. Occasionally I would need to flick tiny stones out that had accumulated in the fluffy batting – but these did not seem to be bothering him. I also figured that if Montaro decided the bandage should come off, he could probably rip it off himself, which felt good to me. Each of us knows our own body better than any doctor, vet, or authority figure.
When we hit the one week mark – when the vet said the bandage should come off – I too was feeling it was time to remove it. Here’s what it looked like by then:
I knelt down next to Montaro with the scissors in my hand and asked him what he thought. I kid you not, he reached down and started biting at the front of the bandage! He was unhaltered, with no feed or anything to distract him, and he stood perfectly still while I cut away at the remaining layers of bandage. Here’s what the 7 day old wound looked like:
I emailed this photo to my vet and asked: Does this look like healthy granulation tissue, or the beginning of proud flesh?
WHAT is proud flesh, or hypergranulation of tissue?
Hypergranulation is where the body keeps producing collagen III instead of switching to collagen I, which is the normal healing procedure once granulation tissue has formed on a formerly open wound. The body is then supposed to switch to producing epithelial tissue and healing the wound from the edges inwards.
Why does this NOT happen in some cases? Common causes are thought to be bacterial infection, lack of oxygen, too much moisture, and continued inflammation due to friction or irritation of the wound.
Here’s what proud flesh can look like on a horse’s leg:
My vet said the wound looked good, but to keep an eye out for proud flesh as it would most likely develop. Then I was to call him to come out and abrade the tissue, and this was likely to happen several times before the wound finally healed.
2. Montaro abrades his wound every day or two – I waited to see what Montaro would do with his wound after the bandage was removed. And for the first hour or so, he did nothing. When I came back, about 5 hours later, he had abraded the wound with his muzzle until it was completely red and bloody. He barely tolerated me looking at it and did not want me to use a herbal healing spray or anything on it. He sent me a clear message to “leave it alone.” I said to him, “I hope you know what you’re doing,” and left him alone.
The next day, the wound looked like this:
I was still coming out twice a day to administer his antibiotics, so I had a good idea of his wound progression. I noticed that some days he didn’t touch the wound at all, and other days it would be completely red and there would be blood on his muzzle – so he was obviously using his muzzle to abrade the tissue. I wondered if he was doing this to prevent proud flesh, or simply because a healing wound can be itchy?
However, I will say that as a 2 year old colt, who was semi-feral 7 months ago, and who wrestles daily with his 2 year old brother; Montaro is often missing pieces of flesh up to 1 or 2 inches in diameter and he has never abraded those wounds. I spray his larger wounds with 7:1 diluted wild oregano oil (7 drops of olive oil to 1 drop of commercial – not essential – wild oregano oil) once or twice, and they have all healed without incident.
So WHY might Montaro be abrading the wound himself? Well, according to Dr. Widgerow – keep in mind, he is using his muzzle, not a sharp object:
“Surgical or sharp debridement of the area is extremely successful at removing the hypergranular tissue, but not successful at preventing recurrence and does require the clinician to have skill and competence in wound debridement.”
Perhaps Montaro’s debridement method – using his muzzle and his body wisdom as to how much, how often, is a key factor in his healing.
3. High dose probiotics following antibiotics – After the very first dose of antibiotics, I waited 2 hours, then gave him a double dose of Equiflora therapeutic-grade probiotic (probiotics must be given 2 hours away from antibiotics or you are throwing your money away). I did this to help counter the dose of Bute the vet administered at the end of the surgery (at some point I will do a blog post about why I do not use Bute). I did this again about half-way through his 10-day course of antibiotics, as his stool was getting really loose. I also added extra ground flax to his feed to help firm up his stool.
Then, when the course of antibiotics was finished, I gave him a triple dose of Equiflora probiotic, then a double dose of Equiflora each day for the next week. Then a daily dose for one month. His HorseTech High Point vitamin/mineral feed also contains soil-based organisms thought to improve gut flora. In horses, as with humans, you must follow antibiotic usage with probiotics, to re-populate the gut with good bacteria. Otherwise, you leave the body and the wound wide open to secondary, or opportunistic infection. Infection is thought to be one of the leading causes of proud flesh.
4. Oral Immune & wound-healing herbs – During the 10 days following the surgery, while I was giving Montaro antibiotics twice per day in his feed, I also gave him 1.5 cups of organic herbs specifically selected to bolster his immune system and assist in wound healing: comfrey, echinacea, goldenseal, nettle, marshmallow root, meadowsweet and a little bit of peppermint. As I mentioned above, I have tested comfrey usage with humans extensively over the years and it is a key ingredient in both my FissureHeal suppositories (used to heal anal or rectal fissures/tears) and my Healing Implant Enema (used to stop colonic bleeding).
Since I couldn’t apply comfrey topically, I gave it to Montaro internally. I have not seen ANY substance stop bleeding and heal wounds faster than comfrey. However, as comfrey taken internally can be hard on the liver to process, I only fed it for 2 weeks, and then switched to an herbal immune blend that did not contain comfrey. I ordered all my bulk organic herbs from Mountain Rose Herbs – which is much cheaper than any horse herbal product – and then mixed them together in an old tub.
5. Topical herbal treatment – by Day 6 after the bandage had been removed I felt it was time for some topical wild oregano oil.
I used Joy Of The Mountains wild oregano oil (which is essential oil of oregano already diluted 4:1 with olive oil). Here are the 4 reasons I selected wild oregano oil for topical application:
- Wild oregano is a broad-spectrum anti-pathogen. This means it kills bacteria, yeast, fungus, viruses and parasites. It is even effective against stubborn pathogens like Staph. A, E. coli and mycobacterium. So this would eliminate one of the top causes of proud flesh; infection.
- Wild oregano is anti-inflammatory and aids in wound healing – for this reason it is even used with burn patients.
- The carrier oil helps to keep the wound moist. In just about every wound healing guide, you will see they caution against letting the wound dry out. This is because epithelial cell growth needs a certain amount of moisture.
- Application would be easiest as I could either pour it on, or spray it on. I didn’t feel Montaro would be happy for me to touch his open wound (not even my kids like that!).
I originally thought I’d be applying wild oregano oil every day or two for a few weeks. But Montaro had other ideas. He let me apply it twice and then refused it from then on.
Although he lets me apply diluted wild oregano oil to his groin area during bug season (all insects hate the smell), after only 2 applications to his heel, he refused any more. I wonder if this is because his body wisdom knew that too much wild oregano oil would make his wound too moist – remember this was Spring in the Pacific Northwest; when the pasture is a swamp and it rains frequently.
Fix The Fence!
Oh yes, and the day after Montaro injured his leg on that high tensile steel wire, I had my fencing guy come out and completely cover that entire fence line with wire mesh. That should stop any other members of the herd from slicing up body parts!
The day after his surgery, my mare Zorra asked to join him in the paddock. Since she is the least dominant in the herd I felt that would be okay and she would be a comfort, rather than a stressor for Montaro. Montaro’s healing progressed slowly but surely, with no further help from me required. The vet was also not needed again. Montaro continued to abrade it to varying degrees (some days a lot, other days only a little) every day or two. As the wound followed the healthy healing pattern – healing from the edges first – the central wounded area got smaller and smaller.
As you can see, Montaro’s wound healed nicely and amazingly a lot of the hair has re-grown too. Nine months later, he let Kesia trim his two front hooves (completely at liberty, unhaltered) – thus showing the emotional trauma has also been healed.
Montaro’s healing is yet another example of how following our body wisdom and using our caregiver intuition can result in remarkable healing. I think Zorra asking to join him in his paddock confinement was a big support. They were often seen massaging and snuggling with each other (love and cuddles are super healing!). Even when I gave Zorra the opportunity to leave the paddock for a couple of hours a day (to graze and run free in the field), she went out the first few days, but then refused and just stayed with Montaro.
I also followed my intuition as to when Montaro was allowed out of the dry paddock to be with the herd – even though his wound was not completely healed. Again, the vet may give you instructions for stall rest, or paddock confinement – but they are not taking into account the power of positivity and joy in the healing process – not to mention the power of sunshine (Vitamin D3!) and fresh air.
Sports medicine discovered about 10 years ago that most injuries heal faster if the person gets moving and that most breaks heal better without a solid cast. I was listening to my own intuition, along with Montaro’s body wisdom and began letting him out of the paddock (into the muddy fields) for a few hours a day only 2 weeks after his surgery – even though the wound was not healed and more than half of it was still raw/pink flesh. Of course, I kept an eye on it daily, and if he’d shown any signs of infection or limp, I would have kept him in the dry paddock and applied topical wild oregano oil, and increased his probiotics. But all went well and by the third week he was permanently back in with the herd and the dry paddock was opened up for all of them to use.
Now, just in case you’re currently dealing with a case of proud flesh – or if you might have one in the future, I’m also going to pass on my conclusions from the hours of research I did on this topic…
Topical Treatment For Proud Flesh
Based on my experience and knowledge, if Montaro had developed proud flesh, I would have looked to address these 2 central issues:
- Re-establishing normal wound healing at the cellular level
So the most important component – and the trigger that can cause horses to keep attacking/scraping off their proud flesh (beyond the point where it’s beneficial) – is if there is underlying, or deeper infection present. All animals possess the instinctual knowledge that infection cannot be contained within the body (or it can lead to sepsis and death) and must be allowed to drain out of the body. So if the infection is underground, or in deeper tissues, the animal will tear open its flesh in an attempt to open up a pathway for the body to push/drain the infectious microbes out of the body.
In searching through various posts and forum discussions online, 2 products stand out as being worthwhile or effective as topical treatments for proud flesh. Unfortunately, neither of the products list their full ingredient list! I spent about an hour searching as to whether this was even legal, and yes, amazingly it is – pet product manufacturers are not legally required to provide a complete list of ingredients – only basics like weight, volume, etc.
- PF Wondersalve – however, this company does list 8 of their ingredients (comfrey!) along with a list of what is not in the product. So I would be inclined to try them first.
- Equaide – I wrote to the owner of this company, as their website refuses to disclose any ingredients, but I did not receive a response.
One other product worth talking about is slaked lime (also called slack lime) – it is the primary ingredient in Wonder Dust and sold in most tack stores. It seems that this product has gotten a bad rep in certain cases because the slake lime (calcium oxide “slaked” with water to form calcium hydroxide) dries out the wound, forms a scab and in some cases seems to dry it out too much. However, if you were in a rainy, humid climate, where wound healing was impaired because the wound was too wet (fungus loves moist environments!), I can see that slaked lime would work well. As Dr. Widgerow points out:
“Accordingly, it has been suggested that low oxygen levels and high moisture can stimulate granulation tissue formation…”
However, if you were to mix the slaked lime with a moistening agent, like manuka honey, or comfrey salve, or wild oregano oil – then you would get the best of both worlds. I mix zinc oxide (antibacterial yet very drying, just like calcium oxide) with wild oregano oil to form a paste and it cures even serious fungal infection. So if you’re in a dry climate, or during the summer, mixing slaked lime with a salve, wild oregano oil, or raw honey (preferably Manuka) may be just the ticket.
In either instance, because slaked lime is so powerful and can seriously damage tissue if used improperly, I would only apply it once per day maximum and I would never use it on mucosal tissue (lips, nose, eye area, udder or sheath area, or rectal/vaginal area). And make very sure you don’t get any of it in your eyes (or your horse’s eyes) or it can cause blindness.
Alternatively, if you didn’t want to apply a mixture and you needed or wanted to keep the wound bandaged, you could also use a semi-permeable dressing that would allow air to get through and also sop up any extra moisture (exudate) from the wound:
“The converse approach has therefore been used to treat hypergranulation – vapour permeable dressings (increased oxygen) with low moisture (absorbent dressing) to replace any occlusive dressing that may have been used.”
Lastly, here are some good references with useful ideas and helpful information. The chart is a nice round-up of clinical studies or published research on the various causes of proud flesh and you’ll see why it’s so important to prevent infection (wild oregano and probiotics) and either leave the wound open to the air to dry out, or use a drying substance (zinc oxide, slaked lime), or a permeable (not occlusive) bandage combined with an absorbent dressing to reduce moisture.
But remember not to make the wound TOO dry, or you will retard healing by preventing epithelial cell growth. Another great reason to use your intuition to feel for the balance between moist and dry that leads to optimum wound healing.
Hypergranulation tissue: evolution, control and potential elimination
Widgerow AD, Leak K, Department of Plastic Surgery, University of the Witwatersrand and Irvine CA, USA
Great overview in plain English: