Head Scratcher Heat/Swelling/Intermittent Lameness Question

[luckycricket123]

I’ve got a horse who presented with what seemed to be cellulitis in the RH about 2 weeks ago.

Originally treated with SMZs and banamine. When I didn’t see enough improvement after 3 days, I contacted my vet. They agreed cellulitis. Sweated the leg, kept him on SMZs and the swelling seemed to clear up for 3-4 days. He wasn’t lame at all during this period.

I left the horse out overnight in a muddy paddock during a light rain and the next day I brought him in and the leg was blown up again and he was now lame. My first thought was that I missed a soft tissue injury and I had the vet out to ultrasound. Nothing was found, so we treated it like a particularly stubborn cellulitis. 3 days of IV gent, banamine and another sweat.

The swelling is now more or less under control, but he still looks to be a little off on the RH and there is some very localized heat and swelling on the medial side of the canon bone maybe 2 inches below the hock.

I’m staying in touch with my vet about this, but it’s really got me scratching my head. I can’t figure out what this might be - it certainly doesn’t seem like cellulitis anymore, but maybe it is? Any ideas?

[CindyCRNA]

The muddy paddock turn out clouds the picture. Possible he didn’t have cellulitis to begin with, it was an injury and he has reinsured it. I would ultrasound it.

[luckycricket123]

Since it’s been a few days since I originally posted, I did have my vet ultrasound it since. Twice actually.

Once for my own peace of mind, and then a second time when the stubborn swelling still hadn’t subsided after all the usual tactics and we were starting to think maybe something was missed in the original scan.

As best they can tell, this is just a really stubborn case of cellulitis still. It’s really an atypical presentation - both in the general sense and also compared to how this horse typically presents with cellulitis.

[CindyCRNA]

Well shoot. Better than an injury anyways! So IV longer term antibiotics?

[luckycricket123]

My thoughts as well! We were thinking proximal suspensory desmitis if it wasn’t cellulitis, which is a terrifying diagnosis for the hindlimb so I’ll take it. He’s spending the weekend at the horsepital getting IV antibiotics and hopefully will be discharged tomorrow.