Chatting with folks over the years and I’m hearing so many different treatments for cellulitis; the rain, the scratches, the fungus, the fat legs, it’s on my mind.
So… what’s your favorite treatment? or your vet’s favorite?
My old vet did:
a) Naxcel b) stall rest c) compression wrap of cotton, vet wrap, and elastikon
New vet:
a) SMZ b) turnout
Friend:
a) smz b) sweat with DMSO and furazone
SMZ, Dex, Panalog sweat wrap, stalled.
My guy has chronic lymphangitis, so a bit different than cellulitis, but essentially same treatment. I think it really depends on the horse what works best, so for my guy, I do the following.
As soon as a flare starts he gets a full dose of banamine and I get him moving. He is usually on 3 legs when I first find him, but after 15 mins of walking he is just “off”. For him, movement helps a lot! As soon as he can tolerate it I do a tight compression wrap with a pillow wrap and standing bandage. I wrap from heel bulb to the bottom of his hock. No cold hosing, his leg doesn’t swell with “hot” swelling that would make cold hosing beneficial. He gets put on a high dosage of bute (4 grams in the first 24 hours, 3 grams in the next 24 hours, then 2 a day for at least a week) and we hit him hard with antibiotics. We’ve used…gent/SMZ’s, gent/excede, and baytril, on different occasions of course.
He is turned out as usual during the flare, and re-wrapped several times a day.
He is now at the point where he needs to be wrapped 24/7. Annoying, but worth it for the health of the horse. Flare ups are scary because each time, the leg could go septic and I would have to put him down. Cellulitis/lymphangitis is not something to be treated lightly and I certainly would not be treating with only SMZ’s unless it is the first flare and very mild.
Depending on the severity sometimes an injectable such as Gentamicin sulfate for the first few days, and then onto Apo-sulfatrim along with cold hosing, hand walking, DMSO furacin sweat and sometimes bute and omeprazole.
Sometimes just Apo-sulfatrim, cold hosing, hand walking and wrapping will work.
Different situations call for different care.
Just went through this with one of mine.
Started day one with:
Banamine
Penicillin
Started 3 days of Gentamicin (shots)
Started 7 days of Uniprim
Cold hosed and walked as much as possible.
Did a sweat wrap (DMSO/Furacin) for 6 hours during the day for the first 3 days and compression wrap the rest of the time.
Did 2g bute once a day for a few days then 1g for 2 more days.
We added in 5mg Dex twice a day for 5 days and once a day for a couple more when the swelling came down more slowly than expected.
My filly spent a week and a half at New Bolton last fall with cellulitis. She was on SMZ’s and banamine and dex before she went to the hospital. They switched her to something injectible, I don’t remember what and also did two regional limb perfusions then pressure wrapped her almost up to her stifle. She was on doxy for a month when she came home and recovered with no ill effects.
SMZs, NSAID (banamine or bute - kind of depends on how early I catch it - if he will eat powder bute/feed, fine, if not IV banamine), cold hosing, turn out if he can move (typically he’s in a lot of pain the first 48 hours so usually no turn out since it is a downhill/uphill walk between stall/pasture). Sweat/wrap as high as I can (usually above the hock). Monitor carefully for 24-36 hours for signs of improvement, prepare to switch abx if not immediately responsive on SMZs (so far, so good). I used to add a little dex to the mix early on to help with inflammation, but he’s recently dx’d with PPID and on pergolide so messing around with dex unless critical isn’t high on my list.
Banamine for fever/pain, cold hosing as much as possible, movement as soon as possible (not stalled). Poultice at night, SMZ’s. Surpass used on the hock once the immediate swelling is down since that is where most of the inflammation is.
I’ve tried Dex but saw absolutely no difference in swelling and she goes off feed, so generally don’t bother.
The last episode was fairly mild, no hair loss or oozing serum. I’d call it lymphangitis and it’s a chronic problem for my mare.
If caught early, before the actual lameness sets in…
…wash with Chlorhexidine then cold hose, then polo wrap and walk until the vet arrives; then anti-inflammatories, antibiotics, and standing wraps if in/nothing if out.
If not…
…wash with Chlorhexidine then cold hose, anti-inflammatories then leave alone until vet arrives; then continue anti-inflammatories, add antibiotics, and keep in with standing wraps for the first night or two.
My horse just got over his first case a few weeks ago. I made the mistake of thinking he’d slightly tied up at first (looked similar since it was his left hind & he was so sore he wasn’t wanting to move off much, plus I’d ridden that morning & he’d been fine), so gave banamine and some ace and turned out (he’s tied up a couple of times in the past 6 years, but only slightly & never requiring anything more aggressive). The next morning, the leg was all huge, so called the vet. We used Excede, then gave it again in four days. He wore standing wraps when in during the day and I cold-hosed a couple of times a day.
My mare came in from the field last night stocked up mildly on all four legs. Back ones were worse than front. She is a chestnut TB and does get more welts from bugs than the others.
Is this cellulitis maybe? I have never dealt with it. Have been in touch with my vet, he wants her turned out, no wrapping, bute (given) and will get me some dex tomorrow I think if she is not better.
She is slightly better this afternoon, I have kept her inside, but hand walking and trotting her often through the day. We are such a mess of wet and mud here in Kentucky right now I feel her feet are better off dry.
Mine was 3 legged on day one:
Banamine, antibiotics- injected at least the first week or so, Lasix or something close to that, cold hose. hand walk.
By day three, turn out, hand walk later in the day.
By day six, walking under saddle, turn out, etc.
Cold hosed for a couple weeks, drugs for a couple weeks, we tried Furazone sweat, but really it did not seem to do anything for my horse.
My vet’s general theory was move, move, move…
He was back in full work w/in three weeks. Thankfully there has never been a recurrence, and its been 5 years.
[QUOTE=DLee;7075007]
My mare came in from the field last night stocked up mildly on all four legs. Back ones were worse than front. She is a chestnut TB and does get more welts from bugs than the others.
Is this cellulitis maybe?[/QUOTE]
I don’t have a lot of experience with cellulitis, and dealing with it last week was my first time through, so take what I say with that in mind.
With that being said, I think you would know if it was cellulitis, and in part because I think that it doesn’t usually involve all 4 legs. With my guy (it hit his RH only) I was very seriously convinced that he had a broken hind leg/pelvis. From what people are saying here, it sounds like the swelling can set in before the pain, which is the opposite of what happened to my guy who went absolutely 3-legged with zero swelling for the first couple of hours. But either way the high amount of pain seems to be a common thread. I had one heck of a time getting my horse the 100 or so feet from where he was in the pasture into the barn (though he was much more mobile by the end of that little walk than at the start). He was a bit shocky (grey gums, unwilling to even put weight on the leg, and a 102.5 temp) within an hour of me noticing that he was walking a little funny. It came on really fast and absolutely crippled him.
I am dredging this thread back up because it is very educational for me. After 15 years of being a horse person, I am dealing with cellulitis in my 15 year old OTTB.
Came in with a laceration on his gaskin day 1. Slight swelling, slight discomfort. I cleaned, cold hosed, left open to drain- thinking nothing major. Day 2, swelling and more discomfort, but I am at the barn at 8 PM so I put off calling the vet until the next day. Day 3 VERY uncomfortable and gaskin is hot/puffy. Vet called- came and administered gentimicin and excede with SAA test of 490. Not majorly concerned about the level of infection. Have been cold hosing and bute 2x a day. I’ve decided to leave him turned out 24/7 as long as the dry weather holds as walking definitely seems to help. We are at day 6 and greatly improved, although not 100%. If not 100% by tomorrow, vet will come administer more abx.
I hope to be through this soon, and not see it come back. Unfortunately this is the second horse on the property with this problem. I’ve been at many barns, and there seems to be something SPECIAL in the mud here…
UPDATE 03/16/2016
While there was infection with this wound, and antibiotics were beneficial, the source of this ongoing lameness was determined to be a fractured fibula 3 days after initial vet visit and cellulitis treatment track. Horse now has very little swelling and is on stall rest for the month (at which point we will re assess). SMZs on board until the wound has completely closed. Equioxx and Reserpine for stall rest stint.
**
I had an ugly case a couple of years ago with my mare. She’d just foaled, we did Excede and something else on the day it showed up. A few days later, I’d lost ground with it, switched to SMZs. By the time I got her swapped over, she’d blown out an abcess on the leg. I dealt with ugliness for 6 months. NEVER again. She’s still got a small scar and the leg has never gone back to what it was before the incident.
Since then she’s had one more less severe bout. Hit it with steroids and SMZs and it was down and gone pretty quickly. I like to cold hose and keep the horse moving as much as possible. I’ve done sweat wraps as well. After what I had after the foaling, I will not play around and take a chance, the vet gets called immediately and I go pick up some meds.
Reviving this thread because my 14 year old gelding is currently dealing with cellulitis. At this point he is on the road to recovery after three Excede injections and four days of Banamine. I’ve been walking him every day for 8 days - ever since he felt good enough to walk, and yesterday I started to slowly ease him back to work by letting him trot under saddle for five minutes at a time, he is sound so far. The vet thinks he is doing great. My question to everyone is, from your experience how long did it take for the swelling to go away? In my horse’s case it’s his front leg. At the beginning it doubled in size all the way to his shoulder. Since then, the swelling above the knee went away, but the leg is still puffy below the knee. After walking/riding swelling goes down significantly, but by next morning leg gets puffy again. So far it’s been exactly two weeks to the day since he got sick.
Years ago when dealing with cellulitis my vet had me doing the cold hosing, walking, wrapping, etc. He said to keep doing it and when all the swelling is gone, keep doing it another week. Cellulitis is stubborn.
He should be wrapped indefinitely until there is no longer any residual swelling then the wraps should be weaned off over a period of a few days.
I know several horses who’ve had cellulitis and despite all the correct treatment, the affected leg never went back to 100% normal. I also know some horses who’ve had cellulitis treated with just antibiotics and turn out, and they healed perfectly. It’s a crapshoot…
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