I’ve got a horse with chronic lymphangitis/cellulitis who experiences flare-ups fairly regularly. Over the past three years we’ve experimented with many different meds (as he’s become immune to the garden-variety SMZs) and have landed on a combo of enrofloxacin and metronidazole as the antibiotic regimen that consistently kills off the infection.

I just received this month’s vet bill and the price of a single 500mL bottle of Enro has increased by $100 to $269!!! :grimacing: Given that a single course of antibiotics takes 3/4 of a bottle and I have to start a course every couple of months on average, this is not sustainable for me, combined with all the other medical costs this horse incurs.

So, two questions:

  1. Any Canadians have sources for less expensive meds? I assume the vet office is passing on their own cost increases, is it worth shopping around to other vets or is the cost likely to be the same everywhere?
  2. Tell me of your antibiotic regimens that you’ve had success with for chronic lymph/cellulitis - we’ve tried a lot of different options but one never knows!

thanks in advance!

When I’ve used enro, it comes as a compounded paste. Is that an option?

It’s generally my last choice antibiotic due to the potential dire effects of fluoroquinolones, though. We use Exceed or Naxcel for the cellulitis cases that don’t respond to SMZs.

Like you, I was dealing with cases really frequently, and it was really frustrating. I finally figured out that if I heavily supplement copper and zinc, my cellulitis horses stopped developing cellulitis. The two that were problem children just take more than the others, but with a full scoop each of poly copper & poly zinc very rarely pop with anything.

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What Simkie said about looking for a compounded paste. Rood and Riddle compounds Enro, but I don’t know if that would be available to you in Canada.

You could also ask your vet if they would send in a prescription for you to one of the mail order type places. Like Farmvet, 1800PetMeds, etc.

I had good luck with Equisul if you can get that. Originally we used penicillin IM and gentamycin IV which covered all the bases and was not as expensive (but not fun to administer), until my horse reacted to the penicillin.

Adding copper, zinc, vitamin e and a high-quality probiotic to the diet (which was “balanced” to begin with) did help clear up skin funk and stretched out the time between cellulitis flare ups.

Also, do you board or keep the horse at home? I think horses can become sensitized to the organisms in the environment/soil of a particular location. Moving my older horse to a different farm for retirement seems to have reduced the scratches infections he gets (which often led to cellulitis)

Thanks for these comments! I’ll inquire about the compounded enro paste - though @Simkie, now I’m worried about the side effects you mention - my vet had never mentioned this.

We’ve done Equisul (worked for a while, not any more) and Excede for a couple of really acute episodes where the swelling/vitals are particularly alarming - will chat with the vet about Naxcel also.

I learned about the Cu/Zn/Vit E supplementation here on COTH and have been at it for a few months - I can’t say I’ve noticed a ton of improvement so far unfortunately :frowning:

@theresak We’re dealing with very stubborn scratches right now at the boarding farm which, to your point, I think are a factor of whatever micro-environment is brewing in his pasture. The move to a retirement facility is on my mind so would be interesting to see whether that makes a difference. I’m having a lot of angst about that decision as well given how much care and attention my guy needs to prevent or quickly get a handle on his flare ups. Such a frustrating condition to manage!

Try adding probiotics that haven’t been heat treated (so powder, nothing pelleted). My vet theorized that we killed all of the good bacteria in the gut and on the skin with all the antibiotics he was getting over the years for cellulitis. We needed to try and encourage a good microbiome to grow so it would hopefully counteract the bacteria causing the cellulitis.

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Mine also didn’t really respond until I upped the dose. What’s commonly discussed here is a half scoop each of poly copper & poly zinc. My problem horses get a full scoop of each. When they’re building coat (like right now) I up it even further to a scoop & a half for maybe six weeks.

I have no idea why they require so much. I didn’t have a single cellulitis before moving to New England, and spent a few years here dealing with it constantly before figuring out the cu/zn dosing. Scratches, too. I’ve tested the hay & water and run everything through FeedXL, and there’s no reason why. I assume it’s something we don’t understand yet. Perhaps they have a microbiome that consumes more copper and zinc than “normal” horses :woman_shrugging::woman_shrugging:

Fluoroquinolones are certainly very effective broad spectrums. But they’re black boxed in people and prohibited from food animals for a reason. The last time I used enro was because there was real risk the horse was going to die, and she did blow a suspensory while on it. Related? I dunno. But we use other antibiotics first, unless facing an immediate life risking infections.

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Thanks both! Maybe I need to up the Cu/Zn again. I’ve just added a powder probiotic a couple of weeks ago so fingers crossed we start seeing results soon!