Agree with Laurierace and Martina. I keep it wrapped and cold hosed or iced until the swelling is gone, then I wean off of the wrapping by switching to wraps on overnight (or whenever he’ll be stalled) for another week or so. If the swelling comes back at all the first night he’s left unwrapped, we go back to wrapping at night for several more days or a week.
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Today my horse got a PEMF treatment and the practitioner shared photos of another client…Hind leg Cellulitis. The PEMF treatment really helped bring down the swelling. (Pulsed ElectroMagnetic frequency). He uses this equipment: https://pulseequine.com/pemf-equipment/
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Hate to keep reviving this thread but it has been so informative to me! My almost 18 year old Thoroughbred gelding came in one evening with a slight limp that progressively got worse over the next few days. Finally was 3-legged lame. His front right is what is affected. He was swollen down the entire leg. Vet came out and xray’d found no fractures/breaks/abscesses so we began treating for tendon strain/cellulitis. DMSO sweat wraps, SMZ and Bute were started. Marked improvement, but after a few days, the ‘limp’ had come back. Swelling is gone from the upper leg, and now is localized in the area between his knee and his pastern. Another vet suggested switching to Bayril, which we did for 7 days (along with Bute). Four days after coming off that, he was 3-legged lame again. So, off to the vet, who started regional perfusion using amikasin. Continuing on Baytril and have switched to Equioxx instead of Bute and getting FAR better results. Back to using sweat wraps as well, which has given us a LOT of relief too. The third and final ‘regional’ is tonight, and I hope we are starting to make better headway. He’s also got some phlebitis in the upper part of that right front leg, but it is felt that is a product of the cellulitis - and may never go away. This stuff sure is a PAIN to deal with!!! But I think we might be on the right path…It is May 6 and we’ve been dealing with this since April 16.
Great info in this thread. On Thursday last week, my horse was found 3 legged lame with swelling primarily around the hock (medial/inner) area, though it continued to fill in the whole leg within hours after discovery. Vet came that day, started with bute, SMZs and Exede, along with a sweat wrap. We continued with 30 minutes per day of icing and nightly Butacort sweat wraps. He was sound by the next day. The swelling is now virtually gone on Sunday. My question–how long do you keep wrapping and icing? Just until the swelling subsides? They have assumed cellulitis from an unknown cause, but what if it was some sort of injury around the hock? I guess I’m just worrying and afraid if I stop the previcox, wrapping, and icing, the swelling will return. He had a second Exede injection on Sunday, and SMZ’s are continuing for a few more days.
A good thing to do daily is monitor your horse’s temperature, especially if you’ve already dealt with lymphangitis. If it’s elevated from what’s normal for your horse; you have an indicator that something may be brewing. I do this religiously morning and night as well as looking and feeling for nicks or bumps on lower legs so that I can treat accordingly. I still wrap every night and have done so since his one and only episode 2 1/2 years ago. I never want to put us through that again.
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My horse had cellulitis this past winter. He was sound that morning, and by the late afternoon he was barely weight-bearing on the left hind. It started as swelling at his gaskin, and by morning the swelling was down to his hoof. He had a mild fever and the vet started him on Tric-Dex, Banamine, and SMZ’s with twice daily cold hosing and hand walks, but no sweat wraps. The swelling started going down in two days, and he was sore for about 5.
My horse had cellulitis in the middle of August. We were initially concerned it was a septic tendon sheath. So I took him to a specialist to tap the tendon sheath and get cytology back that day. Luckily just cellulitis, but since he was already there he spent a night in the clinic and was started on gentamicin IV, oral SMZs, and bute. He was on 4 days of bute and gentamicin and a week of SMZs. He had a pressure wrap and was on stall rest with hand grazing for 15 minutes a day.
Yeah, my gelding never developed a fever. Today marks one week since onset and the swelling is all gone, knock on wood. Last night was the first night I did not sweat wrap it. I iced it just in case, and turned him back out. There are no discernable knicks or scratches, so the cause is still unknown. There was no warning sign. Just all of a sudden, a huge hock, and then the leg beneath that filled in within hours. She wants my guy to stay on SMZ’s for a few more days post-swelling to be sure, but I’m hoping we caught it so quickly it should stay away. lol Guess I should also have mention that radiographs the day we noticed the swelling were all ruled out fine as well.
Has anyone dealing with chronic cellulitis ever found anything to reliably aid in preventing or protecting against flare-ups or recurrences?
One of my horses had his first bout when we were in Florida in winter 2019. He had a 105 fever and wasn’t eating, so I immediately took him to Gainesville (closest emergency hospital to my location), with no real idea what was wrong - he wasn’t lame and had no leg swelling at that point. Within hours the RH was elephant sized (though he oddly was never as painful on it as many horses are)., SAA over 2000. He was put on Penicillin and Baytril (plus Banamine & pentoxifylline) but did not respond; eventually, with ultrasound, they discovered a tiny abscess near his hock and were able to grow a culture. The bacteria were, it turned out, susceptible only to Amikacin. He received 3 regional perfusions, plus 4 days of systemic amikacin, and finally, after 17 days of hospitalization, was able to be released.
The leg was still huge, though, and never returned to normal. I tried everything from PEMF to human compression pumps for lymphadema to custom equine compression stockings - which were the most effective of anything - and put him back into work, as he was not in pain, but the leg has remained large and requires wrapping and constant attention. We take his temp every morning and monitor the leg religiously.
He suffers regular flare-ups, or recurrences, at least 3-4x/year. For the most part these have been on a smaller scale than the first; I’ve been able to deal with them at the barn, with oral antibiotics (generally metronidazole & Equisul, though this summer he required Gent & Exceed).
But…early this month he came in from t/o with a 104.5 temp, swollen up to his groin, 3-legged lame and with a significantly elevated heart rate. Local vet referred him, and he spent another 12 days in the hospital, first on the Gent & Excede the local vet had given, then on Gent & Penicillin - none of which were wholly effective - and finally on minocycline & metronidazole, which were.
I am so, so exhausted from dealing with this. He’s home, just coming off antibiotics, and is not in pain, so he can work, which helps the leg. But I feel like there must be something I could do that I’m not doing to help better protect it and possibly reduce the risk of these recurrences, only I can’t think of what. Like maybe some sort of antimicrobial barrier or something. I thought maybe covering the leg in nano silver powder or spray before turnout? Has anyone tried Silver Whinneys - I worry they wouldn’t stay up? A turnout boot, like the kind they use for mud fever?
Ugh, I don’t know. Probably if there was such a thing someone would have discovered it by now. But if any of you have ideas or suggestions that have worked for you, please share! This horse is killing me!
Following this thread, as I also have a chronic lymphangitis/cellulitis horse who flares up every few months. I have never found any way to decrease the frequency of the flare-ups so interested in others’ solutions.
I totally understand your exhaustion from dealing with this - can be so demoralizing!
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My chronic cellulitis horse HUGELY improved with copper/zinc supplementation, going from SO many ugly episodes a year to one minor threat once this year that resolved with a bit of wrapping & hosing. Such a very welcome change.
She takes a LOT more supplement than my other horses, or that I would expect based on the FeedXL report. I don’t know why, but it works so…shrug.
She’s on a full scoop each of poly copper/poly zinc a day for most of the year, and I bump her up to a scoop and a half of each when she sheds her coat in the late summer.
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Same! I also do 3,000IU Vitamin E on top of what he gets in his grain/grazing and a good quality probiotic to help promote the good bacteria in the gut and on the skin. The probiotic really seems to have helped - the vet theorized we killed all the bacteria, good and bad, in and on my horse with the antibiotics he was on for multiple cellulitis cases.
My horse is susceptible when he’s got a nick, cut, scratch, etc. on the lower limb and the grass is wet or it’s muddy. He also can get scratches and if I disturb the scabs too much, I know I’m risking cellulitis. So I don’t clip his legs and if I’m treating scratches (which the copper/zinc has also improved), I try to be very gentle and only use a topical ointment.
If you have a horse with such frequent flare ups, as much as I’d hate limiting turnout, these horses may be candidates for no turnout when wet/muddy. Also as weird as it sounds, we had a lot of improvement in stocking up when my horse was getting regular acupuncture.
I’ll third it. I was dealing with minor episodes once a month to just once total this year. Cu/Zn/Vit E.
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I also have mine on extra vit e (4000 iu for us!) and a cup of flax for the omega 3 boost.
I just really struggled with cellulitis horse until I doubled her cu/zn, though. It’s made a huge difference, and then she was really only a problem when she was shedding. Took her up even further at those times and FINALLY stopped seeing the cellulitis, scratches & foot abscess. I really don’t know why she needs SO much more than my other horses.
What a long, annoying learning experience it’s been!
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Your recommendations of Cu/Zn/E really helped me out. 100% difference in my mare. She (and I!) say thank you!!
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I am SO glad to hear that she’s improved! 
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@Simkie and @endlessclimb, would you mind sharing the amounts of Cu/Zn your horses are on - and how long it took you to notice improvement? I had my chronic case on Cu/Zn/Vit E but didn’t see much difference - now thinking I didn’t use enough?
I detailed amounts above:
Oh sorry - didn’t realize Poly Copper/Zinc were specific product names. Was looking for mg amount but will find on Uckele’s website!
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Copper and zinc sound interesting, and I will consider them - but my guy has no scratches or abscesses, so his issues might not be the same. Just a very damaged leg, from spending a full 14 days infected and blown up to elephantine proportions during his initial bout of cellulitis, which permanently compromised the skin and lymphatic system in that leg. He does already get at least 5000 IU vitamin E daily, as well as fish oil.
I did decide to try the Silver Whinny socks for turnout (in his stall during the day he wears a custom EquiCrown compression wrap that I had made for him, on my vet’s advice, when his leg stayed enlarged for so long after that initial case of cellulitis). I am working with the owner to get them sized correctly, since his leg right now is even larger than usual after his recent severe bout and hospitalization. I am trying out the regular “warmblood” size while waiting for a custom sized sock.
Obviously it’s too early to tell whether it will help prevent recurrences, or even whether it will help to heal the chronic dermatitis on that leg, but I love the fact that he comes in from turnout with his leg clean and generally dry, even if the sock is covered with dirt or mud. The main problem I’m having is keeping the sock up. I’m hoping a correctly sized sock will stay up better, but I may consider putting a soft boot over it to help keep it in place.
I spend a hugely disproportionate amount of time and worry on this one horse. It’s so never-endingly stressful, especially when I let myself think, which I try not to, that this is going to be how it is the entire rest of his life… 
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