Domino's story is horrific but we are delighted that it now has a happy ending. Savagely attacked by someone as he stood in his field in 2017 he was left with deep lacerations to his belly and shoulder along with facial wounds thought to be caused by a knife and a hammer. The wounds to his body were extensive, but his facial wounds most serious damaging his cheek bone which had to be removed.  All of his wounds healed in time, except an area on his cheek that left a hole through to his sinus. 

Domino's long term prognosis was poor on account of the risk of contamination and infection. His head had to be covered at all times to avoid dirt and debris getting into the sensitive area within his nose which could cause serious infection. The wound needed daily cleaning and protection. In addition, Domino was susceptible to intermittent infections, often requiring treatment with antibiotics which could affect his health in the longer term. Despite Domino's owner having raised thousands of pounds to get him healed to this point, there was little hope to fix this wound without specialist surgery. ​ 

It was at this stage that Georgie Hollis, founder of the Vet Wound Library was contacted and made aware of Domino's situation through Domino's Diary on Facebook. Georgie contacted her friend and specialist equine surgeon Dr. Dylan Gorvy BVSc PhD Dipl. ECVS. Dylan is a european specialist in equine surgery and although trained in the UK, is now part owner and head of surgery at Mälaren horse clinic near Stockholm, Sweden. He came up with the plan for surgery for Domino and provided his expertise on a minimal cost basis for the VWL HOPE fund. 

Dylan considered the options to help Domino researching the latest ideas to resolve this challenge. After hosting several teleconferences and discussions with Domino's vets and owner, Tracey, it looked like surgery was an option. Dylan flew over from Sweden on the 1st of November 2018 and he put his plans into place the next day supported by Domino's vets at  Towcester Equine Veterinary practice. 

The surgery lasted around 3 hours with layers of tissue carefully transposed to cover the deficit. Over the next 4 weeks we held our breath while the healing progressed so we could be sure that it was a success. Now, 6 weeks later we are delighted to share the overwhelmingly positive results. Domino's hole is now gone and he just has a small area left to heal naturally. 

Tracey, Domino's owner had already committed thousands to Domino and all involved felt that it was in Domino's best interests to try the surgery. By funding this case through the Hope Fund we wanted to offer Domino an option for surgery that may not have been affordable or accessible. The techniques required being extremely specialist. We know that many other cases like this exist and have taken extensive recordings of the technique used which we can now use for education and training for others.

Domino has been a fantastic patient throughout and we could not be happier with the outcome. We are delighted to have been able to help him and that at last the ordeal for Domino and Tracey can be put in the past. If you would like to help us do more for cases like this, then please consider supporting our Hope Fund. ​

A fund inspired by HOPE. Pictured: Mono and his owner Sam Hope accompanied by Georgie Hollis and Professor Derek Knottenbelt who kindly taught Sam's Vets how to graft Mono's wounds.   

About Mono: 
Mono is a beautiful, kind horse that after a career in the Polo field had a gentler life with Sam Hope. Sam is a qualified veterinary nurse and lives on a farm so is no stranger to the benefits of insurance. However, at 17 years young and with an athletic history, Mono was effectively uninsurable. Sadly, Mono managed to injure himself one day catching his hind legs on fencing in his field. What initially looked like superficial abrasions soon deteriorated as the tissue sloughed away leaving Mono with a massive tissue deficit in an area that is notoriously difficult to heal.  
Sam raised every penny she had to pay for Mono's recovery working tirelessly with Vet Kathryn Tuckett and the team at   Wendover Heights Veterinary Centre to try to heal Mono's wounds. As members of the Vet Wound Library Kathryn contacted us to get advice on the best options for management and to see if there were any new techniques available that could speed up the healing process and reduce the long term costs to Sam and to get Mono back in action.

All the cases helped by the Vet Wound Library are done so on the basis that we help clinicians to achieve the 3 aims of wound management:
1. A functional, cosmetic repair. Where the proper function of the skin and scar tissue is a priority. 
2. Relief of pain and distress to avoid unnecessary suffering.  
3. To achieve a rapid return to normal use by helping to find the most effective route to wound closure.   

In Mono's case Georgie Hollis (founder of the Vet Wound Library) proposed that Mono may need skin grafts to achieve the best outcome based on the 3 aims of wound management. But the funds available at this stage were extremely limited and would not cover the costs of the procedure. Furthermore it is a procedure that relies upon technical expertise and confidence to prepare the wound, place the grafts and ensure optimal take through careful aftercare.
Having seen similar scenarios in practice Georgie suggested that with the support of Professor Derek Knottenbelt that Mono be used to train the practice to master the art of skin grafting. By using Mono as an educational opportunity for the practice and with Sam's consent the procedure was performed at cost while the practice covered the cost of training.  Ongoing support was provided by the Veterinary Wound Library. Not only did the practice gain new expertise that would be of benefit to future patients but Mono and Sam got the surgery that was needed. 

The need for a HOPE fund
We (The Vet Wound Library) see cases like this frequently. That is where insurance monies are not enough to cover either referral, technologies, or reconstruction methods that will get the patient back to health most quickly. Grafting and basic reconstruction are techniques that we believe can transform the healing process from one that can take years to just weeks. Sadly when funds are limited we find it is the surgical option that is often  ruled out despite leaving wounds to heal naturally over an extensive period of time at the expense of the welfare of the patient. By supporting cases like this we hope to teach more practices how to better manage these wounds, while providing support for those cases that will benefit from specialist help. 

Our First Candidate: We have our first candidate for the fund, it is Mono himself. An area remains that would benefit from a further round of grafts and we would like to cover the costs as a thank you to Sam for being an inspiration. It is 1 year since the original grafts were placed at the lower part of the wound. At the time, the tissue higher up was not suitable for grafting. This area is now ready and rather than taking what may be years to heal naturally we could help reduce this time significantly. We would like to cover these costs for Sam and get her and Mono back on their feet as a thank you for their inspiration and for showing us what can be achieved given some support from the right people. 

Your Support: Any support for our fund will be spent purely on helping cases like this. Funds will be used to pay for specialists to travel to practice, for specialist equipment that may be required, or to contribute to the costs of care where a benefit in doing so is clearly made. 

All the cases we support are overseen and managed as part of the Veterinary Wound Library specialist support service. Practice membership is required and case progress may be filmed or documented for educational purposes. 

Our fundraising page is available here!