When it comes to equine axillary wounds—those that damage the space between the inside of the upper limb and the body wall—the part you can see on your horse's skin might be the proverbial tip of the iceberg: Apparently minor wounds can cause some serious problems under the horse's skin. And veterinarians need to know what to look for and how to treat them to give the horse the best chance at a full recovery.

At the 2013 American Association of Equine Practitioners' Convention, held Dec. 7-11 in Nashville, Tenn., Amanda-Jo Joswig, DVM, MPH, a postdoctoral research associate at the Texas A&M College of Veterinary Medicine & Biomedical Sciences, reviewed with veterinarians how to manage such wounds.

Axillary wounds are common in horses, Joswig said. And while these insults can appear minor, they can have severe complications, including:

• Pneumothorax (air in the chest cavity);

• Subcutaneous emphysema (air pockets beneath the skin);

• Hemothorax (blood pooling in the chest cavity); and

• Pneumomediastinum (air in the mediastinum, or the space in the middle of the chest, between the lungs).

When a veterinarian first encounters an axillary wound, he or she should perform a clinical assessment, Joswig said. She recommended veterinarians evaluate the horse's vital signs before sedating the animal for a thorough examination of the wound itself. At this point, she said, the veterinarian should clean the wound; determine its depth and direction; and identify any elbow joint, mediastinum, or thorax (chest cavity) involvement