Casts are veritable double-edged swords in equine practice: While they play an important role in stabilizing fractures and treating wounds and tendon lacerations, they can cause a variety of complications. Some horses don’t tolerate casts well, casts can cause pressure sores, and many veterinarians prefer to hospitalize horses with casts--an overwhelmingly expensive endeavor for many horse owners.
At the 2011 American Association of Equine Practitioners convention, held Nov. 18–22 in San Antonio, Texas, Ashlee Watts, DVM, Dipl. ACVS, of the Department of Clinical Sciences at Cornell University’s College of Veterinary Medicine, described an improved technique for applying and reapplying a standing bandage cast to horses with severe lower limb injuries.
“When a wound or injury is anticipated to require repeated care from the veterinarian on a near-daily basis but needs the stability of a cast, a ‘bivalved’ bandage cast is indicated,” advised Watts. A bivalved bandage cast is one that can be removed by two equal cuts on the inside and outside of the limb.
During her presentation Watts noted some key points regarding bivalved bandage casts:
- Standard casts, without an underlying bandage, are challenging to apply in the standing patient; can lead to rapid rub sore development; and cannot be removed and reapplied without making a new cast;
- A bandage cast can be applied to a standing patient, causes rub sores to develop more slowly,, and can be better managed outside of a hospital setting than traditional casts;
- A veterinarian can a bandage cast, remove the underlying bandage for wound care, and reapply the cast shell over a new bandage; and
- The bandage cast can accommodate changes in limb swelling while maintaining some rigidity.
“Stall confinement is absolutely necessary, and the horse and cast should be carefully assessed at least twice daily,” said Watts. “The most common complication is cast rub sores. Signs of a problem with the cast include increased heart rate, temperature, and lameness, loosening of the bandage cast, and moisture seeping through the cast.”
Owners and veterinarians should consider using this cast to treat horses with open joint lacerations, luxations (dislocations), injuries in high motion areas such as the front of the fetlock, and tendon and ligament injuries.
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.