Axillary wounds in horses and the development of subcutaneous emphysema, pneumomediastinum and pneumothorax

Equine axillary wounds are common in horses. Severe and potentially life-threatening complications that can result from axillary wounds include subcutaneous emphysema, pneumomediastinum and pneumothorax. This report describes the occurrence of these complications and appropriate treatment. Case records of 7 horses after sustaining an axillary wound are reviewed. Of these cases, all 7 developed subcutaneous emphysema, 5 developed a pneumomediastinum and 4 developed a pneumothorax. The time between the wound occurrence and the development of subcutaneous emphysema was able to be determined in 5 of the 7 cases. The mean +/- s.d. time for the development of subcutaneous emphysema following initial injury was 3.2 +/- 0.84 days (range 24 days). Resolution of subcutaneous emphysema was not achieved until the treatment included packing the wound to stop it from acting as a one-way valve. Horses with a pneumothorax in respiratory distress were managed with thoracocentesis or placement of thoracic drains. Horses with a pneumothorax but without respiratory distress were treated with conservative management. All horses survived to discharge.