What is Proud Flesh in Horses and How to Prevent It?

Last Updated on December 1, 2021 by Urska

All horse-owners know that horses are all too injury prone.  We wish we could wrap them up in bubble wrap every time they go outside or step foot in a trailer.  But, regardless of the many precautions we take, horses will always wind up hurting themselves. An unfortunate by-product of these injuries, specifically cuts, is proud flesh

Thus, this article seeks to answer the question, what is proud flesh in horses and how we can prevent it? If we, as horse owners, understand what proud flesh is, why it occurs in horses, and how to avoid it, so we can better understand how to keep our four-legged friends happy and healthy.

Proud Flesh Definition 

Proud flesh is the overgrowth of granulation tissue on a wound.  It occurs after a horse sustains a soft-tissue injury. In horses, these are most commonly a cut, rub, bite, or kick, but are anything that breaks the skin and tissue through the soft tissue, but not further.

To understand the healing process and why proud flesh occurs, think of what happens when you get a cut. Typically you bleed, and your body begins reproducing cells in order to replace lost blood and grow new skin over the area that has been cut.

Proud flesh occurs in horses when the growth of this new tissue, granulation tissue, is disrupted.  The result is too much tissue and a wound that cannot close, due to the excess tissue. Proud flesh most commonly occurs below the horse’s knee. The photograph below shows what this looks like in horses; puffy, irritated, and reddish or pinkish in color.

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Proud Flesh Causes 

Often, when you have a cut, you put some kind of a bandage over it in order to protect it from the everyday wear-and-tear of life.  With horses, this isn’t as easy because horses move more than people do, and horses are less conscientious of their injuries than people are.  

Especially with soft tissue injuries, horses aren’t going to slow down their movement or activity because they are injured. Depending on the injury, sometimes they won’t even know that they have been injured.

While they say ignorance is bliss, this ignorance does not help with the healing process.  When a horse’s wound is healing, it grows granulation tissue, which serves to close the wound.  As discussed, this is normal and is what occurs in your body when it is closing a cut. But, the growing of granulation tissue is a delicate process, and nearly anything, especially a horse’s frequent motion, can disrupt that process.

Proud Flesh Causes 

Proud Flesh Triggers

Movement may be the most common, but there are other reasons a horse’s wound may contract proud flesh.  One of these is an unclean wound. If a horse has any kind of hay, straw, bedding, dirt, dust, etc. inside of it, the wound can become infected.  This infection can lead to proud flesh, as it disrupts the growth of granulation tissue.

Another cause of proud flesh is incorrect treatment or bandaging. Different studies have yielded different results, and it is still unclear as to whether or not correct bandaging is beneficial in getting rid of proud flesh or not. But, incorrect bandaging is absolutely detrimental.  Any type of incorrect treatment or medications applied to a cut can also be a reason for proud flesh to occur. Be sure to consult with your vet before using any type of product on your horse’s wound, especially if you believe your horse may have proud flesh.

Preventatives

The best way to prevent proud flesh is to do your best to reduce the likelihood of it occurring.  This means that you should take proper care of your horse’s wound from the day it starts until the day the wound is closed and healed.  Proud flesh can still occur even if the wound is cared for correctly, but the chances of it happening will be significantly lower.

When you notice your horse has a cut, the first step is to immediately hose it down under room-temperature/lukewarm water, to ensure no debris (straw, dirt, grass, etc.) stays in the wound.  From there, antiseptics and clippers can be used to clean the hair around the wound, but shouldn’t touch the wound itself.

From this point forward, preventatives are purely situational.  If the wound appears to be deep, or anything outside of your expertise to handle, consult a vet for further instructions.  If the wound doesn’t appear to be healing in a timely manner, consult a vet.

In cases where the flesh is not infected, vets are sometimes able to use steroids to help reduce the amount of excess granulation tissue on the wound.  And if the tissue is shrunk down significantly enough, the skin can grow over it without any additional treatment.

Conclusion

Unfortunately, if your horse does have a large amount of infected proud flesh, there is a high likelihood that it will need to be surgically removed.  But, fortunately, this procedure is mostly painless for your horse, because there are no nerves in the excess granulation tissue. Similarly to preventing proud flesh to begin with, proper care, dressing, and cleanliness is crucial to your horse having a successful recovery from surgery.  In some cases, the area of flesh removed might be so large that vets will have to use a skin graft to help the skin in growing back over the affected area.

Understanding why proud flesh occurs and how to prevent it is the best we can do to protect our horses from suffering from it.  Our horses will always get hurt, no matter how many steps we take to keep them safe, and being informed and prepared is the best way to protect them.  I hope you found this article helpful in understanding what proud flesh is in horses and how to prevent it. If you did, please comment and share it with your friends!

FAQs

What is proud flesh composed of?

Proud flesh is a type of fibrous tumour that horses can develop as a result of a wound, such as a deep cut, puncture wound, or abrasion. It is composed of collagen, elastin, proteoglycans, and hyaluronic acid. These components are what make proud flesh so tough and resilient. Proud flesh is also a very vascularized tissue, meaning it has a rich blood supply. This is why it can grow as large as it does and be as tough as it is.
Proud flesh is a very acidic tissue, with a pH of around 4.5. This acidity helps to retard the growth of bacteria and prevent infection. However, proud flesh can sometimes harbour bacteria. This is why it must be treated with great care and caution, as bacteria from proud flesh may invade the body and lead to a systemic infection.

Is proud flesh contagious?

Proud flesh is not contagious and cannot be transmitted from horse to horse. However, it can be a breeding ground for bacteria. If proud flesh is not treated properly and bacteria invade the body, the infection can be transmitted to other horses. Therefore, it is important to take great care when treating proud flesh and to make sure all exposed tissue is clean and sterile.
If proud flesh continues to grow and wraps around important structures such as tendons and bones, it can cause lameness, but proud flesh itself does not spread through the body. In fact, proud flesh can actually be beneficial to healing by keeping contaminants away from the body's vital structures.

Can proud flesh form in humans?

Yes, proud flesh can form in humans. It is not as common as it is in horses, but it can happen. Human proud flesh has the same composition as in horses but it doesn't have the same acidity as horse's proud flesh. This means that human proud flesh may be more prone to infection.
Human proud flesh can form for a variety of reasons, including cuts, scratches, surgical incisions, and burns. It is usually treated with antibiotics and, if necessary, surgery.

Is proud flesh cancerous?

As proud flesh is a type of fibrous tumor, there has been speculation that it may be cancerous but it has not been scientifically linked to any form of cancer.
In order for proud flesh to become cancerous, it would have to form from a cancer cell and replace normal tissue with the cancerous cells. It has not been found to form in this way. Proud flesh is most often caused by a wound or injury, so if it eventually develops into a tumor, it is more likely to be benign than malignant (cancerous).

When do you have to trim proud flesh?

Proud flesh must be trimmed if it is interfering with the movement of the horse or causing him pain. It may also need to be trimmed if it is growing excessively or becoming infected.
If proud flesh is not trimmed and is instead allowed to grow, it can eventually lead to damage of the tendons, bones, and joints and even lameness.
Proud flesh is a common problem in horses, but it can be treated effectively if it is caught early. If you are worried that your horse may have proud flesh, please consult with your veterinarian. He or she will be able to advise you on the best course of treatment for your horse.

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