How to manage blackthorn injuries [H&H VIP]

  • Catherine Austen’s hunter is hurried to surgery for a joint flush after a blackthorn injury, and makes a speedy recovery

    Tuesday, 18 November

    After a great day’s hunting with the Cottesmore, my horse, Molly, doesn’t look 100% sound. She was fine when she came off the lorry, but within an hour is lame. There is nothing to see in the leg or hoof, and the hoof doesn’t respond to hoof testers. But I did pull a long blackthorn out of her knee when I was washing her off, and there is a small amount of heat in the left side of that knee.

    I am in Leicestershire, 2½hr away from home in Gloucestershire. I’ve seen one blackthorn injury before — on this horse, four seasons earlier — and I just know it’s happened again. I ring my veterinary practice, Bourton Vale Equine Clinic. They say to bring her straight in. Rugged up and bandaged, Molly limps into the trailer in the dark, bless her. I worry all the way home and concentrate on giving her a smooth drive.

    I arrive at Bourton Vale at 8pm, and am met by vet Peter Clements and two interns, Maureen Whyte and Karolina Radwanska. I unload Molly and we take her into the examination room.

    Clipping is not her favourite thing, and we sedate her to clip her foreleg out and look for signs of penetration by a foreign body. The knee is scanned to make sure there are no thorns embedded in the skin.

    Peter takes a sample of synovial fluid from the radiocarpal joint, and the fluid is tested to check the white blood cell (pus) count and protein levels. A high level
    will indicate infection or contamination.Molly’s counts are far higher than is acceptable.

    Peter tells me that Jeremy Swan, the surgeon on call, will operate on Molly that night to flush the joint. The nurses reclip and scrub Molly’s leg, and the team anaesthetise her. She is lifted up with a winch and put on an airbed.

    Jeremy puts an arthroscope into the joint through a 4mm sleeve, and can see on a screen what is happening inside the joint. An egress cannula is put into the other side of the joint, and 10 litres of saline fluid is pumped through the joint. While that happens, the arthroscope is used to look for obvious signs of penetration and bits of blackthorn or grit.

    That takes 45min to an hour, and after that Molly is lifted off into the recovery area. Her head and tail are supported by ropes and pulleys so that she gets up with assistance.

    Peter phones me late that night to say that they are very happy with how the operation went.

    Wednesday, 19 November

    I visit Molly at Bourton Vale. She has a huge bandage on her foreleg, but looks pretty happy and is eating, which is great because she tends to stop eating whenever she’s unhappy. I ponder the subject of blackthorns. Hunters seem to have joint flushes all the time because of them now — Jeremy confirms this, yet any older member of the hunting field will tell you that they didn’t happen 25 years ago.

    “We treat them much more aggressively now than we did 20 years ago,” says Jeremy. “And we didn’t have arthroscopes then, which give a much more accurate diagnosis.”

    Thursday, 20 November

    Bourton Vale ring and say that Molly trotted up sound this morning. I can take her home on Saturday when she has finished her course of intravenous antibiotics. I’ve been lucky; a single flush has worked.

    “It’s common to have two or three flushes,” says Jeremy.

    “On the second or third day after flushing you know whether or not it has been successful. The clinical signs — whether it is hot, or painful — will tell you.”

    Saturday, 22 November

    I pick Molly up from Bourton Vale. She’s perfectly sound and leaps up onto the lorry. Her discharge notes say that the stitches can come out in 10-14 days, and that she is not to move much until then. The bandage should be removed in two days.

    Monday, 24 November

    I decide to rebandage the leg because I am worried about exposing the site of the operation to any dirt. I’m probably being over-cautious, and the incisions are tiny, but there we go.

    Monday, 1 December

    We take the stitches out — it has healed beautifully. Molly goes on the horse walker for 10min, which can be upped by 10min on each of the next few days. The farrier comes out to put her shoes back on.

    Friday, 5 December

    I ride Molly for the first time since her injury.

    Thursday, 11 December

    Molly goes hunting for the first time since the Cottesmore day. Accompanied by a friend on a young, green horse, we go for just 2hr. It’s perfect: we jump and gallop without ever really getting a long hunt, and she feels a million dollars. In fact, it’s like she’s been to a health farm or to Barbados for three weeks, rather than had an operation under general anaesthetic and box rest to recover. I’m lucky — she’s a tough old girl and has had a textbook recovery.

    This article was first published in Horse & Hound magazine (22 January 2015)