Horses are creatures who seem to always be in motion-- whether running through their pasture, going through jumping courses, or just taking a walk on the trail-- and we never want to seem them sustain an injury from doing what they love. However, sometimes accidents do happen, and our loyal companions can get injured, no matter how many safety precautions we take. Like any animal, there are stages a horse’s wound healing process which should be closely monitored by both owner and vet.

In this article, we’re going to specifically be examining the issue of proud flesh and how it can interfere with the healing process, including:

• What is proud flesh?
• How to treat proud flesh when it appears
• Ways to prevent proud flesh that will have your horse back to normal in no time

No matter where you and your horse go, it’s always a good idea to keep some fast acting healing spray with you. That way in an emergency, you’ll always be able to disinfect irritations or cuts to your horse’s skin.

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What is Proud Flesh?

A part of the healing process

Exuberant granulation tissue is typically referred to as proud flesh, and is a normal part of the wound healing process in horses. When your horse sustains a cut anywhere on their body, the wound will start to heal by first producing granulation tissue. This type of tissue is granular and composed of blood vessels and fibroblasts, but is not connected to any nerves. Granulation tissue is typical on wounds that are left open to heal, as opposed to those that are sutured closed. This type of tissue is actually quite beneficial to the healing process in a couple of ways:

• It helps the wound resist infection
• Granulation tissue provides a surface for the new, healing skin to begin to close the wound
• Aids in the faster contraction of the wound

Where does proud flesh affect horses?

The problem with granulation tissue is that sometimes there can simply be too much of it. Horses in particular are known for their ability to produce granulation tissue quite rapidly-- which unfortunately can lead to proud flesh. Proud flesh can occur anywhere a horse sustains an injury, but it is more likely to occur on wounds that are below your horse’s knees and hocks, as there is little soft tissue there. Proud flesh is most common around your horse’s joints, where there is constant movement that can obstruct or delay the healing process.

Proud flesh can be difficult to treat for those reasons, which is why it is extremely important to keep a close eye on your horse’s wound. The areas around the joints are always in motion, and wounds sustained in these areas need to be healed as soon as possible. 

What causes proud flesh to occur?

As mentioned above, proud flesh occurs when too much granulation tissue is produced over the wound while it is attempting to heal. When this occurs, the tissue will appear to take on a life of its own and begin to surge over the skin level-- preventing any further healing or new skin from forming. In severe cases, especially in wounds that are on the lower legs of the horse, granulation tissue can enlarge enough to appear to be a tumor on the side of the leg. 

Proud flesh is most common in these areas because of the lack of soft tissue and inability to use suturing to close these wounds. Lower limb wounds are also easily contaminated, and due to the constant motion of your horse, are very slow to heal. It is important to intervene when an injury in this area in particular occurs, and enlist the assistance and guidance of your vet.

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How to Treat Proud Flesh

If you notice that your horse’s wound appears to be generating too much granulation tissue, it might be progressing into a proud flesh problem. There are a couple of ways to treat your horse’s condition, depending upon the size and severity of the problem.

Medicate

If your horse’s proud flesh is small to moderate size, you may be able to treat it with a steroid ointment to prevent further growth of the tissue. This should not only slow the growth of the excessive tissue, but it may even shrink it as well.

Confirm with your vet before attempting to apply any type of over the counter ointment or other remedy. There are some products that claim to get rid of proud flesh but are composed of caustic agents which can cauterize the wound instead. This discourages the wound from healing and can cause more harm than good.

Trim

If your horse’s proud flesh is of a moderate to large size, ask your vet to trim back some of the tissue. Do not try to attempt to do this yourself, always allow a professional to do this. By trimming back some of the granulation tissue, hopefully it will encourage healthy, healing tissue to grow as well. This is typically done when the horse is standing up and with a scalpel, but not to worry, there are no nerves in the granulation tissue so your horse will not feel pain. These types of trims do bleed profusely though due to the blood vessels that comprise the tissue.

In severe cases of granulation overgrowth, your horse may have to undergo general anesthesia for the mass to be trimmed down. After this type of surgery, your horse may require a split or a cast as well to further prevent growth.

Wrap 

After applying a steroid ointment, your vet will recommend bandaging the area to prevent further proud flesh growth and to allow for healing. If your horse must undergo a surgical procedure, the vet will also wrap the wound as well and might also apply a splint or a cast. This will ensure that the proud flesh can no longer grow and encourage the skin to heal-- it will also help to immobilize the wound a little, allowing the wound to heal faster. In extreme cases, your vet might use a skin graft to cover larger wounds that are having difficulty healing. A skin graft will speed healing and reduce the chances of a scar forming. 

Persist

Don’t give up on your proud flesh treatments! It is important to monitor your horse’s movements and to continually be observant while the wound heals. Sometimes proud flesh takes a couple of trims before the wound fully begins to heal, and you and your vet can discuss how many treatments may be required in your particular case. In the meantime, make sure your horse is comfortable and goes about their regular routine as much as possible. Keeping your horse happy and healthy will go a long way in helping to speed along the healing process.

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Ways You Can Prevent Proud Flesh

Depending on the severity of the tissue enlargement, engaging one of the above treatment strategies is your best bet at eliminating your horse’s proud flesh problem. So now that you’re aware of how you can treat proud flesh, we’re going to discuss some ways to prevent it from happening to your horse’s wound in the future. 

Contact your vet

If your horse has sustained an injury, especially to their lower legs, it is important to first contact your vet. Although there is the possibility of proud flesh forming on any area of your horse, it is most likely to occur where there is little soft tissue and lots of movement. Your vet can decide whether or not it would be beneficial to leave the wound for an open healing, or to suture it shut instead. Suturing it is difficult on the lower leg region, so your vet might not recommend that strategy if your horse is wounded in that area.

Follow any course of advice your vet gives, and make sure you are keeping the wound cleaned and covered. Also, administer any antibiotics per their instructions as well. 

Minimize movement

Once you and your vet have decided on a course of treatment-- whether that is with a steroid ointment or with a trim of the proud flesh-- it is a good idea to minimize your horse’s movement for a time period. The wound needs time to heal, so excessive movement will want to be avoided. No matter how much your horse wants to go back to the pasture to graze and run, you’re doing the best thing for them by keeping them as rested as possible. 

If your horse has had a particularly bad time with their proud flesh condition, it might be best to even keep them in their stall for a time. However, if your horse’s wound is on their lower leg, keep an eye out for any signs of infection in the wound that can develop.

It’s bad enough your horse has sustained an injury, but when proud flesh starts to develop over the wound, it can entail a whole other set of worries for any owner. Make sure to always keep a close watch on any injuries, and always contact your vet for assistance. This way, you can be sure to catch proud flesh, or any infection, before the problem has gotten out of hand.