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Air that infiltrated a horse’s wound led to lung collapse – case report

A Hanoverian horse needed to be put on oxygen because of breathing difficulties after a wound to its front, above its right leg, developed potentially fatal complications.

The case report, described in the Veterinary Medicine and Science journal, highlights the potential risks associated with wounds in the axillary region – the space that lies between the inside of the upper limbs and the body wall.

Lacerations in this region occur frequently in horses, Linda Marie Schoen and her fellow researchers from Justus Liebig University Giessen in Germany noted. They can be caused by running into objects, being impaled by sharp objects, or kick injuries from other horses.

Depending on the size and depth of the wound, air can be trapped during movement of the limbs and migrate within the body, causing problems that can be life-threatening.

The yearling colt was referred to the university clinic for evaluation and management of a cut to the right axillary region, which appeared to be about 3cm deep. The exact age of the wound could not be determined. No therapeutic steps had been undertaken before referral.

The horse had a heart rate of 44, a respiratory rate of 12, and an elevated rectal temperature of 39.2°C. His mucous membranes were pink with a capillary refill time of under 2 seconds. Airway sounds in both lung fields were normal.

Beyond the 10cm by 4cm wound, a layer of air was beneath the skin, known as subcutaneous emphysema, was evident over the right and left thoracic walls.

An x-ray of the chest from the right side showed typical signs of pneumomediastinum – a condition in which air is present in the mediastinum (the space in the chest between the two lungs).

The wound edges were swollen, irregular, partly dried superficially, and had detached from the subcutaneous tissue. It was cleaned and treated, with packing and bandaging applied. Due to skin loss, a complete closure of the wound was not possible. The horse received a tetanus jab, the anti-inflammatory painkiller flunixin-meglumine, and a course of the antibiotic cefquinome.

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