💨 Vet Alert 2025: Managing Dangerous Axillary Wounds in Horses 🐴🩺

Author: Dr Duncan Houston, BVSc

The axillary region—the area where the horse’s front leg meets the chest—is a surprisingly common site for injury. And when a wound occurs here, it can lead to a rare and serious condition known as subcutaneous emphysema, and in worst cases, pneumothorax. In this 2025 guide, Dr Duncan Houston explains how to identify, treat, and manage axillary wounds before they become life-threatening. 🐎💡

📍 What Is the Axillary Area?

The axillary region is the “armpit” of the horse—between the foreleg and the chest wall. It’s highly vulnerable due to:

• 📏 Thin, mobile skin
• 🧱 Easily separated tissue planes
• 🔪 Susceptibility to lacerations from fence posts, tack, or falls

A wound in this area may appear small on the surface but can extend deeply—up to 8 to 12 inches upward under the skin. 🩸

💨 Risk of Air Under the Skin: Subcutaneous Emphysema

Because of the anatomy, a deep axillary wound can act as a one-way valve—air enters through the wound during movement but cannot escape. This leads to:

• 🫧 Accumulation of air under the skin
• 📈 Puffiness or swelling all over the body
• 🧼 Crackling sound (crepitus) when touched

This is known as subcutaneous emphysema. It may look alarming but is usually not immediately dangerous and will resorb over 2–3 weeks. 📉

⚠️ When It Becomes Dangerous: Pneumothorax

In rare cases, air can enter the chest cavity, leading to a pneumothorax—air compressing the lungs, preventing them from expanding. This is an emergency. 🚨

Signs of Pneumothorax:

• 😮 Rapid, shallow breathing
• 🫁 Labored or abnormal chest movement
• 🔊 Decreased lung sounds on auscultation

Immediate veterinary care is required. A large-bore needle may be needed to remove air from the chest and restore lung function. 💉

🛠️ Veterinary Treatment Protocol in 2025

1️⃣ Wound Exploration and Cleaning

• 🧼 Clean the wound thoroughly
• 🔬 Examine depth and check for tissue separation

2️⃣ Packing and Suturing

• 🩹 Pack the wound with sterile gauze or sponges
• 🧵 Partially suture the wound to allow healing and minimize air intake
• 📭 Leave a small gap for gauze changes and drainage

Even if sutures don’t hold long-term, they help stabilize the wound and reduce contamination. 🧬

3️⃣ Protective Dressing

• 🩺 Apply a sutured bandage over open wounds if suturing is not an option
• 🧽 Keep area clean and dry

4️⃣ Antibiotics and Activity Restriction

• 💊 Start systemic antibiotics to prevent infection
• 🚷 Stall rest to limit movement and further air entry

🧠 Vet Tip from Dr Duncan Houston

"Even small wounds in the axillary region can have big consequences. Always assume these are deep and act quickly to prevent air-related complications." 🐴💨

🧼 Prevention Tips

• 🧱 Remove sharp objects or nails from stalls and fencing
• 🧼 Keep tack well-fitted to prevent rubs or snags
• 🩺 Perform post-exercise checks on high-risk horses

🔚 Final Thoughts: Don’t Underestimate Axillary Wounds

Axillary injuries may not bleed much, but they can be deceptive. The danger lies not in the cut itself, but in how it traps air and potentially threatens your horse’s lungs. Call your vet immediately, follow proper wound care, and monitor closely for respiratory signs. 🐎🩹

Need emergency wound advice? Visit AskAVet.com or download the Ask A Vet app for fast veterinary guidance. 📱💡