Cellulitis - need advice

[Weluvhaha]

My 15 yo gelding with TONS of arthritis-related problems (amongst them, a fusing right hock) had to be relocated due to a property sale. Two or three days after the move, I noticed that his right hock (the inside) was larger, firm, warm to touch. There was also a lot of scraped up skin. The vet came out and said he has cellulitis and a skin infection. It’s not clear if he scraped himself up scratching at it (I had put Surpass on the day before. Maybe with an underlying skin infection the Surpass burned him and he scraped it up. We just don’t know.) Vet gave him Dex and left me with antibiotic powder and suggested I cold hose him and spray an anti-microbial CK Shield on it.

Next day he was worse, hot and more sore. This morning he was better than the evening before but not better overall. He is avoiding putting normal weight on it… Vet appt. tomorrow.

I’m concerned that we aren’t doing enough. Vet didn’t tell me to wrap it. When I left my horse this evening, he had just rolled in his paddock and the affected area was covered with dirt. I could have re-washed but I can’t stay there all night to stop him from rolling on the ground after I leave. I don’t have a lot of control over his environment at this new place (we just moved from a frickin’ palace; worst timing.) He’s in a paddock with loose dirt and shavings. I don’t have any way of locking him in a clean stall anymore like I could have just a week ago.

What more should I be doing? I’m asking because my vet has a history of under-treating, taking things too casually. I need to push a little and be proactive. And I’ve never dealt with this in a horse before. Should I ask him to culture it? I read there is grave danger in draining it (from, I imagine, creating a deep puncture, however small.) Should I ask him about a compression wrap? How can I possibly keep the affected area clean?

[SAcres]

IME once the infection has started, cleaning the area more often will do very little to help anything. I would clean the area twice a day and apply something like alushield to help create a barrier, but other than that, let it go. Movement is the best thing for cellulitis, again IME, as once the horse stops moving it gives more opportunity for the leg to blow up and lameness to set in. Wrapping the hock area is difficult and will cause more harm than good if turned out (rubs, wrap shifting, etc) so I would leave it be.

I usually treat with heavy antibiotics and bute, but my horse has chronic lymphangitis, which is a bit different than an isolated cellulitis case. It’s better to try to let the horse deal with it on its own before interfering with a lot of big antibiotics and other medication. Keep following the vets advice, but if you notice it getting worse instead of better, or no swelling reduction, it may be time for more aggressive treatment. It will however take time for the swelling to go down, usually a few weeks to fully go away.

[Laurierace]

What is his temp? If it is elevated you might want to think about taking him to the clinic. My filly spent almost two weeks at New Bolton as a two year old with cellulitis that I caused by covering up a tiny nick with baby powder at a show. Her temp was over 102. She was on IV antibiotics and steroids and had two or three regional limb perfusions.

[Angela_Freda]

I like to cold hose with pressure, and for Yo I wrapped with a compression wrap.
Both horses went out as much as possible to encourage movement.
As for washing, I use an antimicrobial/antifungal soap, but like others, only if/when the leg is weeping… or later on, after leg is better, as a preventative.

Hope your horse is much improved today

[silverdog]

I had a horse with chronic lymphangitis. The owner before dealt with the acute cellulitis. With me he had one very severe flare up and the swelling and lameness took several months to resolve. I agree with temp monitoring and would add some basic lab work to check white count. When my horse had his huge flare up it was critical to know if he was infected or not. His leg over the stifle was huge and hot and he was non-weight bearing lame. His white count was normal so we treated with steroids and diuretics. We did not use antibiotics.
If it is infected, IV abx may be the way to go so he may need to be hospitalized.
The lymphangitis when under control did not limit him very much at all. I just had to pay attention.

[cloudyandcallie]

Look at the old threads about cellulitis. Lots of advice there.
Hattie had it after snakebite a few summers ago.
I followed the vet’s advice and she was fine.

[Groom_amp_Taxi]

I am mostly concerned right now about the horse not being on a systemic antibiotic. The heat in the problem area suggests infection. Are you monitoring temp?

[Weluvhaha]

I have read the threads. Helpful. Little confusing: wrap vs. not wrap.

What are SMZs???

He is on powdered antibiotic (not uniprim but similar; I forget the name.) I think that is systemic.

Glad to know movement is helpful because I was thinking to lock him in a stall just to keep him clean.

Meeting vet today again.

[Groom_amp_Taxi]

Aha, I misinterpreted your first post - I thought the powdered antibiotic you referred to was topical (something to apply directly to his wound and skin) rather than systemic (something that would be fed or injected). SMZs are a systemic antibiotic as well, sulfa based and available in tablets and powdered form.

I personally tend to fall on the side of not wrapping unless it definitely seems to be indicated or recommended by the vet.

[gumtree]

[QUOTE=Weluvhaha;8738496]
I have read the threads. Helpful. Little confusing: wrap vs. not wrap.

What are SMZs???

He is on powdered antibiotic (not uniprim but similar; I forget the name.) I think that is systemic.

Glad to know movement is helpful because I was thinking to lock him in a stall just to keep him clean.

Meeting vet today again.[/QUOTE]

SMZs is short for;

Sulfamethoxazole and trimethoprim is an antibiotic used to treat a wide range of infections in horses, dogs, cats and other species of animals. SMZ/TMP Tablets may be used to treat bacterial and protozoal infections.

A reasonably inexpensive “universal” antibiotic. Bit of a PITA to give because it only comes in tablets for some reason. The usual dose for a full grown horse is 10-15 tablets depending on weight twice a day.

Some people have said they’ve had a horse that will eat them like candy. None of the many I have treated did. Nor would they eat the feed mixed with them.

I have a dedicated meds coffee grinder for them and other pills and a proper size pistol grip dosing syringe to give. They do melt pretty quickly in warm water.

IMO every horse owner/caretaker’s meds cabinet should have the 5 basic meds on hand, SMZs Butte, Banamine, Ace and AluShield. And perhaps a bottle of medicinal alcohol or wine of choice.

I would only wrap on a vets advice.

[gumtree]

[QUOTE=Groom&Taxi;8738635]
Aha, I misinterpreted your first post - I thought the powdered antibiotic you referred to was topical (something to apply directly to his wound and skin) rather than systemic (something that would be fed or injected). SMZs are a systemic antibiotic as well, sulfa based and available in tablets and powdered form.

I personally tend to fall on the side of not wrapping unless it definitely seems to be indicated or recommended by the vet.[/QUOTE]

I have yet to find nor have I been told that SMZ is available in powder. Maybe from a compounding lab? I prefer to use the real McCoy

[Groom_amp_Taxi]

I’m pretty sure I’ve used the Tucoprim powder in the past although I have tabs in my FA supply at the moment.

http://equimed.com/drugs-and-medications/reference/sulfadiazine-trimethoprim

[SouthernYankee]

Antibiotics, movement, and time is best.

I deal with chronic lymphangitis in my old mare. Tucoprim didn’t work as quickly as I liked. She responds well to Naxcel but it’s got a short shelf life, the daily shots make her sore, and it’s expensive. Now I keep Excede on hand for emergencies and it seems to be working. She is on daily isoxuprine and it has helped keep her from having flair ups. I haven’t ever wrapped her, but she is on 24/7 turnout and that seems to help the most.

[Zu_Zu]

Jingles & ((hugs)) ~ AO

[BrookdaleBay]

A horse at my barn had a cellulitis flareup just this past Monday. He was swollen from his hoof to just below his gaskin, non-weightbaring, and a temp of 101.8. Vet treated with IV antibiotics, Banamine, and bute, and he’s been on SMZ tabs, Dex, and Banamine since Monday. He was so swollen that first day that he could barely bend his hock to walk, so he shuffled around his stall for the day until the drugs kicked in. The treatment has been cold hosing, and frequent hand walking along with his regular turnout. For a couple days the vet had us put a thick layer of poltice over the swollen area to draw out the heat. We never wrapped, the skin was way too sensitive.

[Weluvhaha]

What is Excede? My horse is on isoxsuprine as well for navicular.

The antibiotic is tucoprim.

Would laser therapy help?

[Highflyer]

Tucoprim is compounded sulfatrim/ SMZ. It’s a broad spectrum, relatively inexpensive antibiotic and most horses tolerate it well, which is why it’s the starting point. If it isn’t working within 48 hours (as in it should not still be painful-- swelling may take a while to go down) the vet should culture the infection and switch to something targeted for it. He should probably be getting bute for the pain as well, and as Laurierace said, monitor his temperature.

Lasering probably won’t hurt, but only the right antibiotic will actually fix this. You’re probably not going to be able to wrap the hock itself if he’s turned out-- and hocks are not super easy to wrap even in a stall. Keeping him moving once he’s comfortable is preferable to in and wrapped anyway.

Excede is a type of injectible antibiotic.

[theresak]

I asked my vet about Exceede last year with our second bout of cellulitis. If you can treat with something else, he doesn’t recommend using it for cellulitis - the reason being if it’s the wrong antibiotic, you have to wait for it to clear the system before switching. We injected penicillin and gentamicin for 3-5 days then transitioned to oral.

[tstefanidis]

Hi, my mare battled cellulitis for years until I put her on a daily dose of bovine colostrum 5 years ago. You can purchase colostrum from Getty Nutrition or from Biostarus.com. I know how frustrating it can be when it flares up.