Proud Flesh in Horses: What is it and how to prevent it?
Horses lead active lives – they run around, pull heavy objects, and they train with consistency and focus. Sometimes, they get injured, especially in the hoof and leg areas, and they rely on us to make sure that they recover properly. Proud flesh is a common issue when it comes to wounded horses.
It’s mildly serious – it’s not usually life-threatening, but it can hinder a horse’s ability to heal and recover. In this article, I plan to explain exactly what proud flesh is and how to prevent it so that you’ll know what to expect if your horse ever develops it. Starting off at the top, let’s find out exactly what this condition represents and how it can affect our horses.
What is proud flesh?
In scientific terms, proud flesh in horses is described as exuberant granulation tissue. It almost exclusively occurs in wounds of the lower leg, and it basically represents an overgrowth of granulation tissue over the skin that surrounds the wound.
While this disorder occurs in other animal species, it is most often encountered in horses. Proud flesh can hinder the normal healing process of wounded skin. It can delay the healing process by weeks, months, and even years in extreme cases.
What causes it?
The general consensus is that prolonged inflammation of the injury is likely to be the main cause of proud flesh development. When skin becomes inflamed around a fresh wound, it encourages healing by limiting environmental contamination while removing damaged tissue. It’s a defense mechanism that is present in humans as well.
In horses, however, this inflammatory response is not as strong. The weaker it is, the more likely it is to overstay its welcome, causing more harm than good. Prolonged inflammation encourages the growth of granulation tissue, which in turn produces proud flesh.
There’s another reason why this condition afflicts horses more than other animals. Have you ever seen a horse twitch its skin to shake off a fly? When they do that, they use a muscle named panniculus carnosus. This muscle is present in multiple areas of the horse’s body, but not in the lower leg. Its absence weakens the contractile force of the skin, which makes healing more difficult.
The nasty part about proud flesh is that it’s quite unpredictable. It can occur even in horses that are exceptionally well treated. It can cost quite a bit of time and money to deal with, and it can cause frustration in both owner and horse. Fortunately, there are some steps that we can take to prevent proud flesh. Treating it is a bit more difficult and should be left in the hands of veterinarians, but we’ll cover the basics nonetheless.
How to identify proud flesh?
Not all wounds that heal slowly develop proud flesh. However, if you notice that the wound on your horse’s leg looks unhealthy, you should investigate it closely and look for telltale signs. These include dark red patches, cracks in the skin, discharge, and uneven surfaces.
If you do notice any of these symptoms, you should definitely call your veterinarian without delay. If the condition has already occurred, chances are only a trained vet can make things better for your horse. What YOU can do as an owner is to try to prevent proud flesh from appearing in the first place.
What can we do to prevent proud flesh?
The best thing you can do is to identify new wounds early and to take steps towards cleaning them as best you can. That’s why it’s so important to check up on our horses regularly. An ignored leg wound has a much higher chance of developing this nasty condition than one that you spotted just minutes or hours after the event.
Get proactive in the first phases of the healing process and hose the wound down with clean, lukewarm water. Remove any dirt and debris around the wound as you hose it down. This will prevent contamination and will encourage healing. You can also clean the skin around the wound with an antiseptic solution, but make sure to clean only the surrounding parts and not the wound itself.
If there’s hair around the damaged area that could interfere with the healing process, smear some water-soluble hydrogel on that area before clipping. This will prevent any clipped hairs from falling into the wound. Furthermore, stay away from any petroleum-based ointments, as these can actually hinder the recovery process.
Topical medications can also work, but there is a concern of antimicrobial resistance, which is a serious issue now in both animals and humans. A good alternative comes in the form of medical-grade honey, which has natural antimicrobial properties and offers a suite of other advantages such as keeping the area hydrated. Don’t use edible honey, though, as that contains too much bacteria to do any good.
If you do notice a strong inflammatory response, make sure to let it run its course. The stronger it is, the less likely it will lead to proud flesh. Don’t administer any anti-inflammatory medication until your vet says it is absolutely necessary.
Treating the condition.
Vets usually choose to clean the wound as best as possible using a technique called debridement. They will trim away any contaminated skin and dead tissue, which promotes rapid and successful healing. Suturing the wound doesn’t always work, as only around 25% of stitched wounds will stay closed on horses before they fully heal. That sounds worse than it actually is, though. Even if a wound remains only partially sutured, it will still help.
The best way to treat proud flesh involves cutting away the excess tissue with a scalpel. The procedure is difficult to watch, as it usually produces quite a bit of blood. Since granulate tissue is infused with blood vessels, the blood loss is completely normal and should subside within 30 minutes. There are no nerve endings in this granulated tissue, so the procedure is not painful for horses.
Most horses should still be able to stand up while the vet performs the procedure. However, some of them might need a sedative, and some might have developed sensitivity in that area. To promote healing, the vet might opt to apply a skin graft.
Should you bandage proud flesh?
Your initial thought might be that bandaging a wound can only encourage healing and prevent contamination. While this is true for the most part, bandaging a horse’s wound is a rather controversial subject. Here’s why:
If the wound is relatively low on the leg, close to the ground, bandaging it will definitely help prevent contamination. However, there’s still the issue of wound discharge, which could accumulate under the bandage and irritate the new-forming tissue. If the bandage is particularly non-absorbent, it could definitely make things worse.
A good alternative comes in the form of foam and alginate wound dressings, which are much better at drawing discharge away from the wound. An unbandaged wound will soon develop a scab that keeps bacteria away while holding moisture in. A bandaged wound will not develop a scab, as the bandage itself serves this purpose.
Even if the wound has healed completely, the new scar tissue will be softer and much more susceptible to new wounds, which could lead to proud flesh. That’s why I always advise using a leg wrap for a while after the wound has closed.
Ponies are less likely to develop proud flesh.
Studies seem to suggest that ponies are much less vulnerable to this condition when compared to other horses. While nobody knows exactly why it has been theorized that their smaller size allows for better blood flow to their extremities. Moreover, ponies might have a better acute inflammatory response to wounding.
Apart from their resistance to proud flesh, ponies also have a higher success rate when their wounds are stitched. We already know that ponies live longer and are generally healthier when compared to regular-sized horses. Now, some scientists believe that they actually have a genetic predisposition for improved wound healing.
Here are some of the most important takeovers from this article. They will help you identify proud flesh, prevent it, and help it heal if it does occur.
- Look for early signs of dark skin, skin cracks, and discharge.
- Keep the wound clean, trim away any excess hair, and call your vet if you notice proud flesh forming.
- Have the vet suture the wound as soon as possible if suturing is actually possible and advisable in your horse’s case.
- Don’t interfere with the inflammation process.
- Allow your horse to rest in its stall while the wound heals.
- Use absorbent bandages that wick discharge away from the wound.
- Proud flesh might require more than one trimming session. Keep at it until it goes away completely. With proactive measures, patience, and care, your horse will rise over this challenge and its wound will heal nicely.
- Ponies are less susceptible to proud flesh, but they can still develop it.