🐎 Vet’s 2025 Guide to Proud Flesh in Horses

By Dr Duncan Houston BVSc

1. What is Proud Flesh?

Proud flesh, or exuberant granulation tissue, is the **overgrowth of healing tissue** that forms during wound repair—most common on a horse’s lower limbs. This tissue is red, bumpy, and cobblestone in appearance, and though vascularized, it lacks nerves :contentReference[oaicite:3]{index=3}.

2. Why It Develops on the Lower Limb

• Limited soft tissue and low blood flow beneath the knee/hock.
• Frequent movement and skin tension impair normal healing :contentReference[oaicite:4]{index=4}.
• Contamination with dirt, infection, moisture—all disrupt healing.

3. Early Signs to Watch For

• Red, granular, cauliflower-like tissue emerging above wound edges.
• Persistent inflammation, rough texture, bleeding on touch :contentReference[oaicite:5]{index=5}.
• Any stoppage of healing by day 10–14 should raise concerns :contentReference[oaicite:6]{index=6}.

4. Diagnosis & Urgency

Diagnosis is clinical—based on appearance and wound history. Veterinarians rule out sarcoids, infections, or tumors via biopsy when uncertain :contentReference[oaicite:7]{index=7}. Early detection is crucial to prevent delays and complications.

5. Cleaning & Infection Control

• Flush wounds immediately using balanced saline to remove debris :contentReference[oaicite:8]{index=8}.
• Keep clean and dry—preventing moisture build-up is essential :contentReference[oaicite:9]{index=9}.
• Use mild topical antibiotics or medical-grade honey to reduce infection risk without damaging tissue :contentReference[oaicite:10]{index=10}.

6. Treatment of Proud Flesh

6.1 Mild Cases

• Apply topical steroids (e.g., hydrocortisone) weekly to downregulate excessive healing :contentReference[oaicite:11]{index=11}.
• Use firm bandages or casts briefly to control motion—but avoid prolonged moisture entrapment :contentReference[oaicite:12]{index=12}.

6.2 Moderate to Severe Cases

• Veterinary surgical trimming (debridement) with a sterile blade, removing tissue down to skin level—this tissue bleeds but is pain-free :contentReference[oaicite:13]{index=13}.
• Apply pressure bandage for ~24 hours to control bleeding then leave wound open to encourage skin migration :contentReference[oaicite:14]{index=14}.
• Skin grafts may be indicated with large wounds to speed epithelialization and reduce scarring :contentReference[oaicite:15]{index=15}.
• Repeat trimming may be needed every 1–2 weeks until healthy granulation is restored :contentReference[oaicite:16]{index=16}.

7. Ongoing Wound Management & Rehab

• Stall rest with short, hand‑walk sessions to maintain gut motility and reduce boredom :contentReference[oaicite:17]{index=17}.
• Monitor closely for infection—use antibiotics guided by culture if needed :contentReference[oaicite:18]{index=18}.
• Use silicone gel dressings to promote moist healing environment while preventing new proud flesh :contentReference[oaicite:19]{index=19}.
• Gradually re‑introduce turnout once healthy epithelialization is underway.

8. Prevention Strategies

• Suture clean wounds promptly—within 8 hours when possible—to avoid open limb wounds :contentReference[oaicite:20]{index=20}.
• Keep early bandaging controlled—reduce motion yet avoid moisture accumulation :contentReference[oaicite:21]{index=21}.
• Clean and debride any debris within 24 hours :contentReference[oaicite:22]{index=22}.
• Recognize individual risk—horses are more prone than ponies :contentReference[oaicite:23]{index=23}.

9. Ask A Vet Integration 🩺

Use Ask A Vet to:

• Share photos/videos of emerging proud flesh for expert early diagnosis.
• Receive customized bandaging, topical medication, and trimming guidance.
• Coordinate with your vet for surgical debridement and follow‑up care.
• Track progress and adjust rehab exercises and turnout plans.

Download the Ask A Vet app for timely, condition‑specific wound support as part of your horse’s holistic care in 2025! ❤️

10. Final Thoughts

Proud flesh is a common yet treatable challenge in equine wound care. With vigilant monitoring, prompt cleaning, controlled debridement, and smart use of bandages or grafts, most horses heal well. Integrating expert telehealth support through Ask A Vet ensures healing is guided, efficient, and welfare‑focused—making 2025 a year of confident, proud-less recovery! 🐴