Abscess, now swollen leg, advice please!

[skip99]

Thanks for the additional input

Swelling can linger as an abscess drains/heals. Unfortunately since we can’t see the swelling, from your description it’s not clear if it’s what I would consider stocking up from being heel sore and/or not moving much vs a stovepipe leg from bad cellulitis. In general if it was the latter you would have a temp or obvious lameness.

I’m not sure where you are either but here in the northeast it’s brutally hot and humid which can also contribute to stocking up in a leg that has (or had) something going on.

It sounds like he is sound at the walk - have you jogged him? If he’s sound I would incorporate some exercise beyond turnout such as handwalking or light lunging and see how the swelling responds (and try to cut out the bute if sound). If lame, then check in with your trainer/vet - it could still be the original abscess is bothering him or something else.

[hj.eq.xc]

I don’t think so, the swelling was at its worst off bute, on SMZs on full turnout, he wasn’t moving as much as normal but he was moving a decent amount. The bute I think helps him move maybe a bit more, he definitely does seem more comfortable/content on it, it could then mean the moving gets swelling down because bute makes him comfy to move more or the bute keeps the swelling down in general I honestly would say the difference on or off bute in how much he moves seems minimal. But, I will say he has only been off bute for two days this past week in all and those days the swelling was worst. Thank you though for mentioning this because that’s a really good point to keep in mind and I will try to think about it more to try to remember change

[hj.eq.xc]

I would say pretty confidently that he is not dealing with bad cellulitis, the swelling is not that intense nor is his behavior indicating fever or massive infection and at this stage it feels a lot more than it is to just look at it (even though it is visible too) what you have to say about swelling lingering is very interesting and I didn’t know any of that. My vet did get back to me today and was very responsive to my follow up questions and concerns (maybe they saw the thread lol ) I haven’t tried jogging him, but that sounds like a good idea, and it could give a baseline if nothing else or if he is sore at a faster pace with higher limb loading. I’m also located in the northeast, and the heat and humidity has been rough and the ground is hard. He also isn’t a horse that generally does great in the summer or in higher heat but the temps are supposed to dip soon so it may help that swelling go down if that’s contributing and improve possible healing.

Do you have any opinions on taping the leg to help with lymphatic drainage? I was talking with his masseuse/body worker and she mentioned it may help. I’ll mention some suggestions to my vet and hopefully get some good input/thoughts there too or if he wants me to wait until the end of the week before doing anything other than continuing the same treatment of bute and SMZs. I also did put a call into another practice just for a second opinion at this stage that may help to have other eyes or experience weigh in. Getting advice and thoughts have made me feel more hopeful that it isn’t totally catastrophic (thanks concerned horse owner brain). Thank you so much for taking the time to provide your input!

[trubandloki]

@hj.eq.xc

nor is his behavior indicating fever

Have you taken his temperature yet?

You can buy a thermometer almost anywhere. A cheap human digital thermometer works great.

[Montanas_Girl]

FYI: Cellulitis has to get very severe before the horse spikes a fever.

OP, can you post photos of the leg? I think that would help us give you better advice. It sounds like cellulitis to me, but it’s hard to be sure. If it is cellulitis, SMZs are the usual first treatment. My vets have only ever gone to stronger/more expensive drugs for extreme cases.

I would not allow taping, massage therapy, or anything like that until you know what you are dealing with and that it isn’t cellulitis. For mild cellulitis, I usually just do Bute and SMZs (discontinuing Bute when the swelling begins to subside), and the horse stays on its usual (24/7) turnout. For severe cases, wrapping (changing wraps every 12 hours) and twice daily cold hosing helps, and I will usually make the wrap a sweat wrap for 12 hours and a dry wrap for the other 12. I would not poultice a case of cellulitis - poultice doesn’t actually do anything, for one, and often there are microscopic skin injuries that you don’t want any of the poultice material getting into.

[Bristol_Bay]

If the swelling goes down with exercise, why aren’t you hand walking him? Swelling is an evil in and of itself because the tissues can stretch and then you’re dealing with a permanently fat leg, which may be just a blemish but may predispose the horse to cellulitis in that leg.

Walk, ice/cold hose, sweat wrap.

[hallie2]

does your vet do stable side testing for serum amyloid? it is a quick blood test which shows if there is infection, vs inflammation. You can follow the direction infection is going, ie. the results are higher or lower depending on which direction the infection is going. So, for instance, if a horse has cellulits and the numbers keep going up, antibiotic needs to be changed. It’s a really valuable tool. https://equimanagement.com/sponsored-content/understanding-the-typical-serum-amyloid-a-response-curve-the-key-to-interpreting-stablelab-results/.

[FitToBeTied]

A handy tool for determining the location of an abscess is an infrared thermometer that you can get at lowes or home depot. When we suspect an abscess I scan the hoof wall look for hot spots. It shows up pretty well.

Also, I have found covering the hoof with icthamol and covering with a gauze pad before wrapping works really well.

I’d be very concerned about he leg swelling.

[paw]

Wow - I hadn’t thought of using an infrared thermometer to check for heat! Duh. Off to Home Depot I go…

[hj.eq.xc]

Thank you so much for your input! As of now, I haven’t seen anything that indicates that the swelling is correlated directly to movement. Following the abscess drainage on increased turnout it greatly increased and then adding bute brought it back down still on full turnout with the same levels of movement. My vet has told me not to treat it with any cold therapy and as the temps have been 90+ with high humidity, a sweat wrap on the leg given that he is also on 24/7 turnout I think would end up doing more harm than good in this situation. This might change but right now that’s where we’re at. I am also concerned with the possibility of the leg retaining the swelling and being bigger but right now my main focus is checking that there is nothing retained in the hoof/leg and that there is no systemic infection that the SMZs or bute might currently be masking in anyway and then take it from there.

[hj.eq.xc]

Thanks so much! I have never heard of this and I will definitely ask!

[hj.eq.xc]

This is great! I love this idea, thank you so much!

[QM2]

If you have metronidazole (flagyl) you can desolve them in warm water to make a paste and pack the hole with it.
Soak in epsom salts and warm water to clean, then dry, pack with paste then cover with a wrap.
Metronidazole kills many of the bacteria found in poop.

You could also mix the paste with the cow mastitis treatment called Today.

I’d be do this until the closes up some more and then pack it with iodine soaked and squeezed out cotton to keep dirt out.

[hallie2]

at my barn lives a big mule. this is her second abscess today. each time she abscesses it is accompanied by swelling up to her knee. Abscess and swelling occur simultaneously. First time she was so dead lame, we thought it was a broken leg.

[hj.eq.xc]

Wanted to add a question on to this for answers and opinions. My horse still has swelling and heat in leg (although it is more mild, not raging), hoof is still being wrapped (I have heard I should not be doing the soaking and wet poultice wrap for more than 3-5 days after the abscess drained? Is this true ?) I texted the vet on Friday asking for directions on what to do going forward now off meds (I was instructed to continue treatment of meds and poulticing through Friday earlier in the week), how long the hoof should be wrapped with an updated pic of his leg and can he please come out ASAP but I haven’t heard anything. Is it normal for vets to not respond on the weekend? It’s just that at this point we are going into the third week struggling with this now, I know some abscesses take some time but I am concerned that the reason for the lack of healing is that there is something more serious going on (obviously). To clarify, any instruction has taken place via text, he has not been out to see the leg/hoof since Tuesday, the 9th when he drained it.

[Night_Flight]

@hj.eq.xc

Is it normal for vets to not respond on the weekend?

If the vet is trying to maintain a work-life balance and isn’t on call that weekend, I wouldn’t expect them to respond. They have a very stressful job and as long as they have arranged for someone to cover their emergencies, they’re entitled to disconnect from work occasionally.

[wanderlust]

I’d have wanted it re-looked at as soon as the leg swelled up beyond a little bit of puffiness in the fetlock. I’ve had plenty of abscesses over the years, including ones that blew out the heel, and have never seen the level of swelling you are describing and certainly not for this long. Not saying it doesn’t happen, as posters here have attested to, but I’d be concerned at this point.

If you think it’s an emergency and you need someone to talk to, call the emergency number. Then on Monday find yourself a new vet who doesn’t dunk fresh wounds or wraps in dirty water before applying, or think a leg swollen up over the knee is no big deal.

FWIW have seen two horses whose legs never went back to normal size after lymphangitis/cellulitis so I’m on top of that stuff crazy fast.

[Christa_P]

My TB has presented the last two springs lame with a swollen ankle, both times it was an abscess.

[skip99]

Can you post a picture of the leg here? How sound is your horse now and have you checked his temp?

My vet does respond on weekends, but I have a 12 year + relationship with the practice and I rarely message on weekend. The last weekend message I sent was last year: a response to a Friday evening text from my vet where I confirmed how I wanted to proceed with treatment for a low positive Lyme result - vet responded with dosage, I had one follow up question, vet responded, and then I ordered the Rx via Chewy. I can understand a vet not providing a ton of support for an access if the horse is not lame. Also is there any office you need to schedule through? I always schedule through the office but send the vet a message with more context if the situation warrants.

[SMF11]

If the abscess is draining, you don’t need to soak because the purpose of soaking (and using something like ichthymol) is to draw the infection. You keep wrapping to keep the drainage site clean.

Is your horse lame? If lame that would indicate the abscess hasn’t burst yet. And vice versa.

I’ve just skimmed this thread, but it is very hard for me to tell if this is a run of the mill abscess or something more. Is the horse still on antibiotics?

If this is a normal abscess and the swelling is going down then I’d say you were WAY out of bounds to bother the vet on a weekend for a routine matter. If this is something more than an abscess with a bit of swelling, then that’s a different matter.