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Ask the Vet – Cellulitis in horses

September 16, 2019


DAN: “Cellulitis, and how
to bring more circulation to the legs?” DR LYDIA GRAY: Oh, that’s it? DAN: Ashley is to the point. DR LYDIA GRAY: OK. DAN: She knows what she wants. DR LYDIA GRAY: I have a lot
to say about cellulitis. So we should probably
define it first. DAN: OK. DR LYDIA GRAY: And not to
be confused with cellulite. DAN: Yes. Yes. DR LYDIA GRAY: So cellulitis. I mean, the itis gives it
away – it’s inflammation. DAN: Yeah. DR LYDIA GRAY: Right. And specifically, it’s
under the skin, and sort of between the skin
and the next layer, which is fatty tissue
and connective tissue. And it’s sort of a
deep seated infection. And usually in horses it’s legs. It’s hind legs. And it’s one hind leg. And only in about half the
cases do we know what caused it. DAN: Of course. Horses. DR LYDIA GRAY:
Hey, half is good. When we do know, it’s
from a wound, an injury, a break in the skin. Could be there was a
surgery, and it just allowed bacteria to go in. But it is a bacterial infection. And the thing about cellulitis
is, one day your horse is totally fine. And the next day he’s
three-legged lame. The leg is blown up. DAN: I was going
to say, usually. DR LYDIA GRAY: We call it
a stovepipe leg, because from the hoof to could be the
hock or knee, could be higher, it is like one thing. It’s excruciatingly
painful to the touch, but also to stand and move on. So it would be an
emergency, because you don’t know that it’s cellulitis. And even your vet looking
at it is not going to know. So they might do some imaging. They might do some
blood work to see if there is an
infection going on, to see if it’s a
local infection, or to see if it’s a
body wide infection. Because this all tells
them how to treat it. If everything points
to cellulitis, then we do try to find out
what the cause is, because you have to get rid of that. But aggressive antibiotics. DAN: I was going to say. Yeah. DR LYDIA GRAY: And then
painkillers, pain relief. And anti-inflammatory. So non-steroidals, like
your butes and banamines and firocoxib, which is Equioxx. And it comes down pretty quick. Now, the things that the
owner is going to have to do is cold hosing or icing. DAN: I was just going
to say, it sounds like you’re going to do
some time cold hosing. DR LYDIA GRAY: Oh, yeah. And you would like
to use something like a game ready
or an ice horse that has the cold and compression. But it’s so painful,
you’re not going to be able to do
that right away. DAN: Well, that’s what
I was just going to ask. As far as poulticing or things
of that nature to help… DR LYDIA GRAY: No. Cause it’s open. DAN: But you don’t
want to touch anything. DR LYDIA GRAY: It might be open. And the other thing is,
when the body swells, skin has only so
much room to expand. DAN: Elasticity. DR LYDIA GRAY: Yeah. Whew. That’s a big word. DAN: I tried. DR LYDIA GRAY:
And when it swells more than it has
elasticity for, there can be microscopic
breaks in the skin. And then you’ll
see a yellowish– the serum of the
blood is oozing out. And it even gets crusty. So you don’t want to
put a poultice on it. You don’t want to
put a liniment. You don’t want to
put anything on it. You let the antibiotics
do the work, let the non steroidals, the cold
hosing or icing. You will eventually
be able to bandage it. Bandaging and application of
cold are tremendous for it. There are things you may have to
do well beyond the medication. And even because when a horse
has cellulitis in the leg, that leg is more susceptible
to it in the future. DAN: Oh, really? DR LYDIA GRAY: Yeah. DAN: Even if you get
rid of the infection? DR LYDIA GRAY: Yeah. Because you have
stretched all the tissues, maybe created scar tissue. Now, I say “you.” It’s not your fault. The
circulation is impaired. The lymph drainage doesn’t
work properly anymore. And so you have to be in the
future, to prevent it, I mean, there’s things you can do. You closely monitor the legs. So you have to everyday be
looking for cuts, breaks, scabs, abrasions. You can’t let your let
your horse get scratches. DAN: OK. DR LYDIA GRAY: And
turnout is great, because when they’re in
a stall, they swell up. DAN: So you want
a little movement. DR LYDIA GRAY: But you
don’t want to turn them out early in the
morning when there’s wet grass, because you want
to avoid that leg getting wet. Can’t put it in. You can’t turn it out
when it’s muddy or sloppy. DAN: The fun parts
of horse ownership. DR LYDIA GRAY: Oh, my goodness. So I don’t mean to
be discouraging. But there is quite a bit
of care in the moment, and then afterwards. DAN: So that’s good
to know, though. Cause a lot of times when
horse owners do go down, they see that the horse’s
leg is swelled up. A lot of times, even if
it’s just the hock and it doesn’t seem super dramatic. They do want to
wrap, or do something like that to kind of get
the compression down. DR LYDIA GRAY: Yeah. But the horse will tell you. It’s so painful. DAN: So at this point it’s
like, get the vet out. Make sure. It’s important. DR LYDIA GRAY: Because
the horse probably isn’t going to be bearing weight. And so you won’t know
that it’s a cellulitis, unless you’ve been through
this with this horse. You don’t know. I mean, this looks
as bad as a fracture. DAN: Oh, so it’s– DR LYDIA GRAY: Oh, yeah. It’s three-legged lame. It could be an abscess. There’s a couple things that
make horses– joint infection. When your joints get
infected, the horse is three legged,
non weight bearing. So this is an
emergency, not only to make sure it’s not
one of those things. But you’ve got to get
therapy started right away. DAN: And get ahead
of the infection. DR LYDIA GRAY: Yeah. DAN: So then with the
follow up question of how to bring more
circulation to the legs? Turn out’s OK. Hand walking I’m assuming. DR LYDIA GRAY: Yeah. Exercise is really good to
keep things moving as little– like I don’t keep
my horse in a stall. Not for this reason,
but for others. So if you can find a situation
where the horse is not in a stall at night, like
it’s a run in, run out, that would be ideal. Because when they’re
stabled and standing still, that leg is just
going to stock up. Trailoring even will
cause them to stock up. And you also want
to protect the leg. So when you trailer,
you’ll want to for sure, if you didn’t before, use
shipping boots, or wraps, however you want to do it. This may be a horse that you
now wrap when you exercise, because they can’t have a
bump or booboo, because then that’s going to get
the cycle going again. DAN: Oh. DR LYDIA GRAY: I know. DAN: But it sounds like,
though, if you get ahead of it, there is at least hope for you. You have some treatment
and management. DR LYDIA GRAY: Yeah. Yeah. DAN: OK. We don’t want to
scare people too much. DR LYDIA GRAY: Well,
I want to add that it can be life threatening. But that’s why you call
your vet right away. And you get on top of it. DAN: Instantly. OK. DR LYDIA GRAY: And
there are treatments. Yeah. DAN: Well, that is
definitely great to know. And keep us posted with how
your horse is doing for sure. DR LYDIA GRAY: Sorry.

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