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Case 253
Forearm Injury
We received a call from Cinda in Idaho, indicating to us that the injury to her horse was exactly the same
on the upper forearm as
Case 170. In order to fully appreciate the owner undertaking the healing of this
wound with the help of her local veterinarian, you should look at
Case 170, and see how closely matched
the trauma, the healing time, and the final results of these two horses wounds duplicate each other.
We are encouraged when cases that we have treated encourage horse owners to believe that they can
achieve these results at a time interval and a cost level that they can afford.
We would like to point out that based on our experience with
Case 170, we gave her a four month recovery
time instead of a full year. This prognosis was a part of her decision to take on this project.
The dialog, which is included in this case, are the correspondences that took place during the
consultations.
It appears the most helpful information that we were able to tell her were the events that would be coming
up during the healing process, with pictures of a similar injury (
Case 170) and methods of bandaging.
As is always the case in wounds of the upper forearm and chest area,
bandaging was a critical part of the
process.
Cinda's initial contact with us was on
December 12, 2011. We learned that the
injury happened on 12/2/2011. After an
informative phone consultation with
Cinda, she sent us pictures of her horse's
injury. These are the initial injury
photos.
Her local vet applied the buttons in an
attempt to help hold the wound closed.

Many of our communications were by
phone, below are the e-mails.
Click on the photos to enlarge the view.
12/2/2011
12/12/2011 - The buttons and sutures did not hold.
After viewing the above pictures, we started communicating by e-mail as well:
12/12/2011
Hi Cinda,
The forearm will grow back by fibrous union. There will be a dimple, but the horse will have full strength and
motion of the leg. I encouraged the people that brought case 170 (the barrel horse) that their horse could come back
and be competitive, which he did. I think you're looking at about 3 months of committed work on your horse. I don't
recommend cutting off any tissue that is live. It will contract down and be cosmetic at the end.
Dr. Jolly

Cinda called Debbie (Dr. Jolly's assistant) and ordered our
Bandaging DVD, Case 170's DVD, a Bandaging Kit,
Lacerum Wound Wash, Lacerum Ointment & Lacerum PRP Regen Gel.

Dr Jolly and Debbie,
Thank you both for everything I am feeling much more positive about Bookers injury.  Thank you for spending so
much time on the phone with me today.  It is greatly appreciated. I'm so happy I found you to support the process
and give us positive messages about the miracle of the horse’s ability to heal.
I got diapers and panty hose tonight and I can’t wait to get your DVD.  Maybe you should send Case 170 also without
seeing the pictures Debbie thought the blind mare (Case 232, on website soon)was more helpful. Whatever you
think thank you again.  I'll tell my vet no honey for now.
Sincerely
Cinda

Cinda,
I have an idea about the honey. Ask your vet if she will pull a liter of blood from one of your other horses, collect the
serum in 30 cc syringes and freeze it until it can be used on the wound. Use 30 cc every third day. We call this
platelet poor plasma. It is shy on growth factors but does have healing agents and will provide moisture. If your
horse chews on the bandage use a bib or cradle.
Cheers Dr.J.

12/13/2011

Dr Jolly,
Which horse would we draw blood from?  2 yr old gelding not full grown.  6yr old gelding  or 28 yr old mare?  At
what point is this used on the wound? Later or sooner? And what is your honey idea???  Are we mixing the blood
with the honey or is it unrelated??
Thank you I was too busy at the post office today to call you.  We are walking him slowly for 5 min twice a day...  We
think that will help his mind and legs...is this okay with you??
Did you get a delivery confirmation or insurance number for the package you sent so I can see when it arrives at my
P.O.??
My vet has changed the cream I am putting on the wound on the gauze to PVP Iodine Ointment she says that will
help with the granulation...I meant to call you and ask about that today.
We are still changing the dressing daily. Not sure when you want me to leave the bandages on for 3 days.  I think
after the bone gel stuff comes. (Powder to mix with saline)
Thank you very much!!!
Cinda

Cinda,
This is a serious wound and over the next 3 mo. you may be confronted with situations that will require on hands
vet assistance. It is important to keep your vet in the loop. Some of her ideas don’t mix with PRP TECH, but we will
try to give her better options. Wound healing is all about blood supply and live tissue once you get a wound
decontaminated. The iodine creams are cytotoxic [kill tissue]. Take the serum from the 6yr gelding if you have a
negative coggins test on him. My idea is if we start your vet doing the REGENERATIVE HEALING THINGS then we are
all on the same page. If she will pull the blood today then put 30 cc on the wound and use it until your package
arrives[Christmas mail]. When the desiccated powder arrives start 3 and then 4 day bandaging after using the
wound wash which is non cytotoxic. Send me her phone number and I will talk to her about applying the powder.
Start back using the serum after the powder application.
Cheers Dr.

(shipping track information and phone numbers removed for privacy)

Dr. Jolly,
Yes okay she is open for new ideas and willing to here but may not agree with everything she told Alex my husband
I thought Iodine would be bad myself....Thank you I hope your package arrives today or tomorrow. I have a negative
coggins on him last April when he went to the polo fields in Spokane for the summer  is that okay or does he need
another test???
I do have another vet down the street and another I haven’t met yet so I’m not too worried if she says no to some of
your ideas and stops seeing him but I don’t anticipate that happening.
Off to work now I may phone you later.
Cinda
12/17/2011
Dr. Jolly,
Here are a couple pics from yesterday it is looking better. I will send a couple more photos soon.  
We did 1/3 of the powder and 2/3 plasma but she took it from the injured horse instead of Cosmo. We only took
2 syringes from Booker and I do not know if freezing it is okay. It seems to be very gelled, how do I apply it from
the jell state? Is there something I should be adding to it before I freeze it? My vet separated the blood in a few
minutes in a centrifuge.  
My vet did not cut away any of the dying tissue on the front edge, even though she thought it would best. Will it
slough off if we keep it wrapped for three days at a time?
Thank you for your help.
Cinda

Dr Jolly,
Sent you an email yesterday about the blood coming from the injured horse, with some current photos from
Saturday. AFTER we separated the serum from it jelled...how do I use it the jelled state...Tuesday is the 3rd day
again to change the bandage.  Please advise how to un-gel it or what you do? I have some serum frozen now.   
Please advise....I’m trying not to bug you on the telephone.
Cinda

Cinda,
Did the serum gel before being frozen? CALL ME AND I WILL TALK YOU THRU YOUR PROBLEMS.
CHEERS DR. J.

Dr. Jolly,
Yes while it separated I went to work for 2 hours and was jelled upon return....I will call you soon thanks.

Dr Jolly ,
I trimmed the ragged edge just a tiny bit and the white off the muscle. There is pink tissue right under it.  My
concern now is the skin is folding down to his leg right there and what’s going to become of that big blob of
muscle???
This was yesterday...at noon  tonight at 11pm wed the plastic I had trapping in the fluid was dripping and very
wet...so I just took that off and left all the bandaging above which I could peek in and looked good, sprayed
more wound wash and put gauze without plastic over that mass of muscle.. Seems the tissue between the
muscles is white and slimy like its dying...trimmed a bit of that slim away and wiped with wound wash .Will
look for another picture from side angle.  Will call you Thursday and talk again.
Thank you,
Cinda
12/20/2011
Dr. Jolly,
Thanks for the email, I will get another desiccated powder soon I still have 1/2 a vial that I am using sparingly mixed
with saline solution and mixing it with the serum from the blood.  Doing this every 3 days and using wound wash
in-between around edges to keep moist with gauze.
I feel like eventually a vet would want to cut the big knotty muscle back?? ? Bad idea?? You say it will shrink down.
Or will it grow up? The wound is dripping like crazy I think mostly from that front ledge area.
It is hard to lift up that lip , gravity is definitely pulling it down...Will try to use a support hose there that I have or
tall sock  good idea!!
Cinda

Cinda,
There is no perfect course when you sail thru uncharted waters; take heart in the fact that we are above water,
moving forward, and evidence of land and solid footing ahead. Solve the problems as they. We are sending you case
170 as for your Christmas present.
Cheers.
Dr. J.
12/22/2011
Dr. Jolly,
Thank you I need some other supplies when you send the video thank you thank you thank you ! Send 2
desiccated powder. 1 gal wound wash and 5 yards of red netting bandage.  Thanks again and  Happy holidays
and Cheers to you.  I’m glad you and Debbie are there to assist Booker Alex and me...
Sincerely,
Cinda :)
12/24/2011
Cinda,
My what a Christmas present ! Even the knobby spot looks better !
Cheers Dr. J.
12/28/2011
Dr. Jolly,
Wound before cleaning 12/28/11.  Could not take pics after cleaning.  The bone is covered  Yahooo!! Is it time to
start the finishing cream on the edges yet? Still quite a flap in the front and really no way to hold it up with socks
or anything.  I’m putting a roll of gauze under it and vet wrapping it.  Do you think it will eventually need to be
trimmed off??
Thank you Dr Jolly and Debbie for all you assistance.
Sincerely
Cinda

Cinda,
Remember the uncharted course we are on. Make sure you look at your own pictures; the tissue looks great. All of
the white connective tissue can be cut off now. The muscle tissue is still contracting and is best dealt with later.
How long has it been since we started? Are you still using serum?
Cheers Dr. J.
12/26/2011
Cinda,
Remember the uncharted course we are on. Make sure you look at your own pictures; the tissue looks great. All
of the white connective tissue can be cut off now. The muscle tissue is still contracting and is best dealt with
later. How long has it been since we started? Are you still using serum?
Cheers Dr. J.
Hi Cinda,
It does look good! Yes, start the finishing cream just on the very edge. The part I circled in the attached pictures
is the connective tissue Doc referred to in his email to trim off. This is also partly the top of a tendon, and needs
to be trimmed back to just below the surface of the wound (about 1/4 inch below). Trimming it back will do two
primary things; prevent it from adhering in the granulation bed and tearing loose some of your hard work, and
help prevent there being a "lump" at the bottom of the wound as it progresses further in its healing, making it
easier for the epithelial border to grow new skin over the wound site.
Debbie
Hi Doc and Debbie,
I took that pic before I cleaned it and the white goop on the top right was white jelly not connective tissue.  I
forgot to take a pic after cleaning.  That was 3 days ago.  It looked even better today.
My vet thinks it looks super and attributes it to Bookers good ability to heal and our wound care abilities.  I hope
she starts believing in the desiccated powder; serum and wound wash by the end of this journey.   She didn’t even
recommend trimming from the muscle or hanging over skin.
She s right on the same page as you Doc that it is still contracting and should be left alone.  
Booker got a New Years present we untied him and gave him a big stall to move around in. He hasn’t been trying
to roll; I’ve been currying him a lot.  Now that he s moving around a lot more he is much happier.  He was getting
mad about his situation.  
So anyway all is going great. My package didn’t come today, Friday, hopefully it will come Sat.  Anxious to see the
video and get some new red webbing.
Your knowledge and help is greatly appreciated. You are both amazingly kind to share your knowledge with us to
help these wonderful creatures.
My vet thinks he possible won’t be ridable this year, maybe in the fall.  I think the healing is going to go much
faster that she imagines since we are so dedicated and have good healing products to help us along.   
My Farrier came yesterday and stood him up a bit and trimmed his toes.  He was ready for a trim and did well
with the injured leg. No wedge shoes needed, he is putting lots of weight on the injured leg.
His wife’s barrel horse just got a nasty wound on her rear leg and our vet sewed it up 10 days ago and of course it
didn’t hold.... It is below the knee and now I can help Christine with her horse’s injury.
They made the mistake of hosing it off the first couple days with water.  I gave him a small container of wound
wash to use and told them not to use the iodine cream that another vet had recommended.  I’m hoping she will
email a picture of it to me. It supposedly just scraped a tendon back there.
So the journey continues.  Will get my daughter to get my pics in order with dates to document this case for your
use.
Cheers and HAPPY NEW YEAR TO YOU BOTH....
Cinda, Alex and Booker

Dr Jolly,
Looked at a bunch more injuries on you web site last night and realize that you charge for phone consultations
and help...so  I need to know how much I owe you for what has transpired so far so I can get you paid.  
I will send photos less often if it costs for to look at them, or I will send them every 3 days if you are not charging
me to look at the progress.
I am pretty broke right now and happy Booker will be right again. ALSO grateful that I found you and Debbie to
assist us with this major injury.
Please advise an amount to send and I will include it with the check for the wound wash parcel .Please advise if
you want to see pics weekly at no charge.
Sincerely
Cinda
Happy New Year!!!!!!

Hi Cinda,
I added in the consultation fees in the last shipment.
Our consultations run $35 for about 4 communications; we gave you a discount :-)
We LOVE getting the pictures (no charge). Keep going with that!
Glad to hear that the spot was not exposed connective tissue, that will speed the healing even more!
It's a wonderful thing when we get other vets on board with our treatment system, the more we get the word out,
and the more horses can be healed!
I know Booker is happy to be able to move around freely now, but do keep an eye out for chewing/scratching at
the wound site. It's getting close to the "itchy" stage, and you may need to use a neck cradle or muzzle to prevent
him from chewing at the wound.
The ability to ride may surprise you, just have to wait and see!
On the farrier's horse, big concern is to be sure the tendon sleeve wasn't penetrated.
Looking forward to new pictures!
Happy New Year!
Dr. J & Debbie

1/1/2012
Cinda; It is hard for me to project when we can ride if I don’t see any pictures I’m still interested in the knot of
muscle on the front. If it helps you any I have people send me pictures of horses they have treated for a year spent
$5, 000 dollars and are still bobbing around on the uncharted course.
Cheers,
Dr.J.

Cinda ,
It's your lucky day; I was looking at case 68 on the web site and discovered that I have sailed the uncharted waters
before a little lower down on the leg and handled the muscle knot a different way. We are still good.
Cheers,
Dr. J.
12/31/2011
Cinda,
I must bow my head in the sand. Debbie did not send your package; I missed the mail today (12/31/11) USPS, ups &
fed-ex are closed so we can’t ship your package until next year. And we did so well the first time.
Sorry !
Dr. J.

Dr. Jolly,
That’s OK I’ve got enough of everything in there to get by no worries...Thank you  
We needed it immediately last time and it got here for that...Booker lay down last night and got up so that s a
first... I didn’t see him do it... Now that he s loose in the stall his bandage slipped down so now the challenge begins
on keeping it covered 24/7. It was pretty darn easy when he was tied.
And really no big deal about the shipment. You do not need to put your head in the sand...Ur great!!
Happy New Year and Cheers... I prefer USPS not ups...They are my employer :)
Cinda
1/9/2011
Dr. Jolly and Debbie,
Last we talked was 12/31 our happy New Year email. When booker got his stall area and got untied. I had a
birthday and slacked off on pictures for a week.
My next two bandage changes on 1/3 and 1/6 I had no camera.  No change in treatment.
Your box came Thurs the 5th so I had more yellow netting to help with keeping gauze in place to keep moist.  
Enjoyed the video very much.  Reminded me to use more wound care for moisture.
I re-bandage it every 3 days without missing a beat.....
I have been painting on with a paint brush and small amount of desiccated powder mixed with a bit of saline
solution. And then painting on the blood serum mixed with a bit of saline solution and then putting the extra
on the gauze concentrating on the bone covered area and the front muscle stumpy part.  After the paintbrush I
put the gauze... And then saturate bunches of gauze with wound wash and cover with sock and netting.
So, without two treatments with pics you will see lots of improvement.  The next few e-mails are the pics from
Jan 9th am 2012. So we went from day 27 to day 38. Next pics will be Thurs. day 41.    Sorry I don’t know how to
attach the pics from my email but I do not. So there will be 4 separate shots.  There is still a bit of a flap on the
front which is getting smaller.  We stopped wrapping his legs last weekend and he is doing great when we lead
him around.  He looks at it when we take the blanket off but he is not attempting to bite at it yet. His blanket
is long and I have a towel hanging down to deter any thought of biting at it.
I am ordering one on those under the mouth shields and hoping not to need the wooden thing for his neck
since it is winter and have a heavy blanket.   

I’m not worried about riding Booker I just think he will be usable sooner than my vet thinks.  I really don't
think she's on board with what we are doing but it is working for Booker for sure.  I'm a believer.  She just
thinks he's a good healer and Alex and I are diligent with our wound care.
When do you think I should stop Uniprim in your opinion?  If your opinion is free.  It's been 5 1/2 weeks...And I
will take a better pic of the front hanging over part on Thursday and send it on to you both.  I will go online
and look for case 68 also.....
Will send you a check this week. Will probably not call for awhile to save money.  
It is getting easier to care for finally, just gotta be sure he doesn't start messing with it to continue progress
Thank you again and again.
Cinda and Alex and Booker

Hi Cinda,

The wound looks spectacular! Your granulation bed has grown well, and a big achievement is that it is now
covering the entire exposed muscle & bone. The muscle hanging in front should continue to contract down, he
will most likely have a "dimple" like case 170, but it looks to be healing very well. If there are no holes or cracks
in the granulation surface, you should be able to stop the Uniprim.
Dr. Jolly

THANKS Dr. Jolly!!
I looked at case# 68 this morning before going to work and looks like in 2003 you trimmed the muscle flap off
at about 30 days.  Will take more pics tonight from the side.   Also the notes were that the horse in case 68
seemed to stop wanting to chew the wound after the flap was gone.
Maybe the flap feels weird to them if there is feeling with the nerve being cut??
Also has your treatment planned changed since 2003? As far as it will retract more and to wait for trimming??
Hi to Debbie...
Cinda and Alex :)

P.S. There's still a small hole where we cut the connective tissue away a couple weeks ago.  Will see if it’s all
filled in tonight/ and will continue Uniprim until it s gone
Thanks
Cinda
1/16/2012
Hi All,
Here are the latest photos.  Cold and snowy here the weather is changing. We have been lucky during the worst
part of his injury...
First Email pictures are last week 1/11/2012
Still using Blood serum, not wrapping legs anymore. Booker goes out in the  3/4 acre corral with the other
horses for 4 or so hours a day...
The next email is 1/16/2012.
The muscle is contracting still and the flap getting smaller....
More next week
Cinda :)

Enjoy these great healing pics...  Changing every 3 days and keeping moist with wound wash...

Cinda,
Make sure you go back and review your pictures from one month ago to stimulate your efforts. I see a big
difference in the 2 groups of pictures you sent me. I agree that we haven’t found the perfect BRA for this type of
wound but what we did was functional and cost and time efficient. The muscle issue appears to be resolved.
This muscle will continue to contract in size for the next year; it lacks a good blood supply. So the side
cosmetics will get better. Serum is good. We hope to use your pictures with some sales people on Feb. 1 so send
us what you have around the 25th and we will send you a DVD of your work .
Cheers,
Dr. J.
Photos from
1/11/2012
Photos from
1/16/2012
1/25/2012
Hi Dr Jolly

Pictures from tonight 1/25/12 It's been 8 weeks on Friday.  I can really see the white line in these photos. Wider
on the inside of the leg. I need to remember to put cream on margins daily  have only done it about 5 times so
far.  
Still using serum each time.  I rub both his legs, shoulders, and scratch him alot.  Cleaned the hair really well
near the margins after I took the pictures.  
You can see the ridge (groove) where the flap of skin was folded down. Amazing how much its retracting!!
All is going well. Let me know if you see anything odd.
Thank You
Cinda  

1/27/2012
Hi Cinda,
It is looking truly nice ! Be sure to apply the Lacerum Cream on the border every day, this will help stimulate the
new skin growth to cover the wound. Start walking him about 10-20 minutes, and flex his leg. (Pull it outward
and upward, and bend at the knee). This will help to prevent any adhesions from forming in the granulation
tissue, and help him keep good flexibility at the wound site.
Debbie & Dr. J
1/30/2012
Dr. Jolly and Debbie,
We had some super cold blizzard weather so I think some of the granulated tissue in the middle looks like it got
frosted and had a bit of odor.  So I scrubbed it pretty hard to stimulate that part it looked kinda purple and
different texture.  Hopefully it will come back okay without any setback.  I am changing the bandage every 2 days
now and still painting on Blood serum and then applying it to gauze and adding wound wash.  
I do not have an indoor barn so I feel fortunate that the weather has been so mild or I may have had issues
sooner.   I have one stall that he would not be happy in away from his herd friends.
He is doing great!  Out of his overhang stall in the day and in at night and rolling in the snow very well.  On 1/19
he got all excited and was bucking and running and ran thru the woods and jumped a stump and was having a
grand ole time.....sure made me nervous but all is well!!
Did not take a pic today when I re-did it from 2 days ago, I forgot to take it with me but it looked a bit pinker
where it was purple 2 days ago..So no cold cold weather in the forecast for the next week. Yeah...
Excited about you making a cd of Bookers leg.  What are you selling to whomever your meeting with?? Just
curious.
Have a great week I will Take a few more pics Tues night after work when I redo it again.
Cinda

Hi Cinda,
We are giving a presentation on the Lacerum Products, and the on-line consultations using these products. As
yours is a current case, with an extensive injury, it was one of the cases we chose to present.
Be sure to keep the edges clean and free of scabs. Clean this gently, as you don't want to damage the new
epithelial border (new skin).
Cheers, Dr. J
2/9/2012
Hi Dr Jolly or Debbie:
I will send another couple pictures soon. WE are progressing fine. Stretching leg out and up daily.  
I was reading more cases on your site and see case 234  and there is talk and picture of stage 3 bandaging.  I don't
see that on any of the videos I purchased.  Will I be needing to do this soon?  Also case 144 is of interest to me as
far as not covering the edge of the wound after applying cream; I'm afraid the cream is just wiping off on the
gauze I cover it with and am running low on cream soon.
I may order more Lacerum ointment next week.  So please advise if I need anything more that I dont have from
you guys.
Thank you.  Hope the video worked okay of my horses wound that you were making.
Thanks again
Cinda

2/13/2012
Hi Debbie & Dr. Jolly:
Okay I took no pics for about a week.  These are from February 5th seems when it gets colder the granulation bed
gets a little dark and different texture. I'm putting Lacerum Creme on the border almost daily hard to do when it's
goopy and only changing bandage every 2 days. Should I be changing it daily now?? I still put blood serum on the
wound every other day after cleaning .  I have only missed 3 times of applying that.  
Does the wound wash have a shelf life after adding the distilled water?? I'm ready to start my second gallon and
am wondering if I should only dilute 1/2 of the gallon at a time?? What is your opinion on this???
The other eclipse cream you sell is 22oz. is it as good?? Is there more for the money or the same??
Okay, these 4 pics are from Feb 5th   then next 3 individual e-mails are from my husbands cell and are from  Feb
11.  Send me a video when you can, maybe you can include it with the cream I decide to buy after you advise
which on will be best......
Thank You
Cinda

Cinda,
The 22 oz Eclipse is the Wound Wash, not the ointment.
Debbie

(Cinda spoke with Dr. Jolly on the phone the next day...
Photos from
2/5/2012
Photos from
2/11/2012
Photos from
2/18/2012
Photos from
2/20/2012
Photos from
2/27/2012
Phone & text conversations
during these two weeks, Dr. Jolly
asked about the swelling in the
2/27 photos.
Yes Sir....
That was when it blew up last week and he was lame... It's much better now..  Just the knee is larger than I'd like
and we are doing all the stretching etc now and massage and such....He is out and always roaming around so no
more standing in a stall....
Thanks.
I keep leaving the bill at home for the cream I will get a check in the mail tomorrow!!!
Thank You,
Cinda

Cinda,
It is lovely, Keep putting the cream around the border and the epithelium will grow much faster. Not impressed
with the leg stocking up, more exercise.
Cheers,
Dr. J
4/26/2012
This is the latest picture we have of Booker's injury. The wound continues to contract, and we expect very
little scarring and a "dimple"  where the wound was located. We also expect Booker to return to full use,
he and Cinda are now in the longest part of healing; growing new skin, contraction of the wound site and
rehabilitation. Compare this view to the ones at the top taken on 12/12/2011 !

We will continue to post new pictures and information on Booker's progress as we receive them !
3/25/2012
It continues to contract and heal, Booker is into stage three, the longest period of healing. Cinda's work
now is to keep the scab off and promote the epithelial border, using Lacerum Finish Ointment.
4/8/2012
Still contracting, looking very nice !
Photos from 7/31/2012
Compare them to the original injury (shown below), amazing healing !