Case of the Month

Foreign Body Removal

 

Kiwi is an 11 year old Thoroughbred mare who presented with a scrape surrounded by swelling on her neck. The mare has access to turnout on a daily basis, and has a history of sensitive skin and allergies.

The owner applied cool compresses to the swelling and scheduled for mare to be examined the following day. Upon presentation, Kiwi was alert and comfortable with a large grapefruit-sized swelling on the upper right neck.

 

The edema was body temperature, firm and mildly painful when pressed on. There was a one inch long vertical scrape that did not appear to cut through the entire skin at the top of the swelling. Her temperature was normal, and other wise appeared to be in good health. The mare was treated with and injection of Naquasone (steroid and antihistamine) to reduce swelling, and antibiotics.

Two days later Kiwi was examined and treated for hives that covered her face, neck, and torso. The swelling on her neck was slightly reduced.

At a recheck exam several days later the hives resolved, but the area on her neck was still swollen. There was a linear firmness palpable running vertically along plaque of edema. Ultrasound exam revealed an area that was whiter than surrounding area that was long (roughly 2 inches) and thin. At this time we suspected a foreign body(splinter), but it could be inflammation causing the skin to be thicker in this area. We decided on a plan: observe and recheck 2 days. If there was a foreign body under the skin, it would cause the scrape to open up and drain as the body tried to ‘push it out’ (the immune system will wall off foreign material to protect the body.)

Two day recheck revealed the swelling had decreased and the linear swelling was much more appreciable. While palpating the scrape, the scab came off and serum oozed out. The area was clipped, prepped (surgical scrub), a local anesthetic was applied, and a small incision (1/4th an inch) was made at the top of the palpable firmness.

 

A 3 inch long thin strip of wood was pulled from the incision! The wound was flushed with sterile saline, an incision was made at the bottom of the swelling so any residual fluid could drain, and the upper incision was closed with two staples.  Kiwi is currently back to normal with no further complications from her surgery.

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