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Jump-starting the Healing with Manuka Honey

A tragic misstep could have endeda Kansas ranch horse's career, until honey sweetened the story’s end.

By Lou Anne Epperley, DVM
For Veterinary Practice News

Posted: Nov. 28, 2012, 2:00 p.m. EST

Who could have predicted that a pair of bickering bunnies would set off a chain of events that would heal a Kansas ranch horse’s mangled leg and save his career?

Certainly not his owner, a registered veterinary technician who was working miles away at The Ohio State University College of Veterinary Medicine. Chances are, not even his veterinarian, Andrea Arbuckle, DVM, a mixed practitioner in Grenola, Kan.

Horse's lacerated hind leg
Day 1.  Ranch horse Gunner kicked through a guard rail and lacerated his hind leg down to the cannon bone.
But today, they both believe that manuka honey worked a miracle in healing the horse’s horrific wound.

“We think the horse kicked through a guard rail,” Dr. Arbuckle recalled. “In the process, he ripped a laceration right down to the cannon bone on the right hind leg. It was so severe; there was a small fracture, significant periosteal stripping and minor tendon damage.”

Tradition First
For more than two weeks, Arbuckle treated the leg with traditional mainstream products including Nitrofurazone Ointment, povidone-iodine (Betadine), Corona Ointment and tetracycline topical powder.

“At that point, the horse’s wound had 11/2  to 2 inches of bone exposed, and proud flesh was becoming exuberant around the edges,” she said. “A small-animal colleague had told me about using honey, right out of the cupboard, on fight wounds on a rabbit, and it had worked really well. So I began researching the use of honey in wound healing.”

Arbuckle floated the idea to Sue Huck, RVT and owner of Freckles “Gunner” Buckshot, the injured horse.

Horse's lacerated hind leg
Day 4. Dr. Andres Arbuckle trimmed away the extra skin beacuse it wasn't viable. The wound was then kept wrapped.
“I was pretty skeptical about the efficacy of this type of treatment, but thought that it wouldn’t hurt to give it a try,” Huck said.

Her position as a veterinary technician at a major teaching hospital provided access to samples of medical-grade manuka honey wound care products manufactured by Links Medical Products Inc. in Irvine, Calif.

Armed with a manuka honey arsenal and an open mind, Huck set out for Grenola to check on Gunner and join forces with Arbuckle.

“We began applying the honey to the center of the wound, over the bone, and using Proudsoff Proud Flesh Ointment around the edges,” Arbuckle said.

Four days and two bandage changes later, Huck said the improvement was “drastic...the proud flesh had greatly decreased, and the color of the tissue was less yellow-brown and much more pink.”

“Within five days, the bone was completely covered and could only be felt with deep palpation,” Arbuckle said. “I couldn’t believe how quick it started filling in when we started the honey. Within two to three weeks, it went from complete bone exposure to the tissue being level with the skin surface.”

The Power of Honey
Medical-grade manuka honey is gaining favor among some equine practitioners as a way to jump-start the healing process by neutralizing the bacteria that lead to infection and inflammation, said Chad Muhr, marketing director for Links Medical Products Inc.

Horse's lacerated hind leg
Day 9.
Honey made from nectar collected from the manuka bush, a native New Zealand plant, possesses a high level of non-peroxide antibacterial components comparable in strength to that of phenol, or carbolic acid, Muhr explained. This was borne out in tests by the biological sciences department of New Zealand’s University of Waikato.

“The honey has such a low pH that bacteria can’t survive,” Muhr said. Manuka honey’s pH is in the range of 3.2 to 4.5, whereas bacteria thrive and multiply in the 6.0 to 7.8 range, he said.

Moreover, the honey’s high sugar levels exert osmotic pressure on compromised tissue, which helps promote autolytic debridement of necrotic tissue and cuts down the odor, he said.

Medical-grade manuka honey wound care dressings are recommended for trauma wounds, surgical wounds, ulcerated wounds, first- and second-degree burns, lacerations and abrasions, Muhr said.

Huck said that within two weeks, “The proud flesh was completely gone and the wound was filling in nicely. After 28 days, there was smooth epithelial tissue. At that time, we switched from the filler (ointment dispensed from a tube) to a honey-impregnated pad that kept the wound moist and healthy,” she said. “Within three weeks, the margins of the wound were visibly less, and the heavy compression bandages were changed to a light bandage with a non-adhering gauze pad impregnated with the honey.

“Now, 14 weeks after the initial injury, there is a scar, but the horse is sound and back to work,” Huck added.

Horse leg wound
Day 16. The wound looked similar to this two days later when the honey was first applied.  The bone is visible in the center.

Horse's wound healing
By Day 23, Dr. Arbuckle had to palpate deeply to feel the bone. All photos courtesy of Dr. Andrea Arbuckle.


Arbuckle believes the treatments halted bacterial growth and prevented bone sequestrum formation.

“Three factors must be present for sequestrum formation: bone separation (fracture), loss of blood supply (damaged periosteum), and infection,” she said. “With the fracture and periosteal compromise, we felt sequestrum formation was likely if infection wasn’t properly controlled.”

Gunner was treated for 10 days with injectable ceftiofur (Excede), “But most of the work needed to be done in the wound,” Arbuckle said. “There was still ample drainage from the wound when we began the manuka honey, and we felt certain surgery would be necessary in the future to remove bone sequestrum.”

Gunner’s dramatic recovery gave Arbuckle and Huck a new-found respect for manuka honey in wound healing.

“I can’t say it wouldn’t have healed without the honey, but it was a night-and-day difference once we started using it,” Arbuckle said.

“I was kind of amazed. It was fantastic!” said Huck. 

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