For lymphangitis, I have successfully used: SMZ/banamine/bute; evening: cold hose, walk 15 minutes, then standing wraps overnight in stall; turnout all day (no wraps, obviously).
Does she have a temp? (First time my gelding got lymphangitis, he had a 106 temp and was hospitalized for a week). Not sure if they normally get swelling in all legs. My guy only was ever affected in the left fore.
Yes, my experience also. One time, I brought him in from the pasture at end of day. He looked fine. I spent 45 minutes grooming him and by the end of the grooming session, I noticed swelling starting on the left fore. Took temp: 102.5. I swear if I had been staring at the leg, I would have been able to see it get larger.
Luckily, I got SMZs/banamine immediately into him and cold-hosed while waiting for call-back from vet. By the time I talked to vet, temp was down to 101. Vet said to do the wrap overnight with turnout in morning. I stayed until midnight until I got temp of 100 twice in two hours.
The key is catching it VERY quickly. I shudder to think if it had happened on a day I hadn’t been there. Barn staff would have seen he looked fine coming in from pasture, put him in stall for dinner, then never have seen the swelling coming on.
This should be standard treatment—I’ve got a rescue horse who has had (is having) 2 awful bouts of it and using PEMF moves the fluid. PEMF worked when steroid and bute and pasture turnout/movement weren’t unlocking that fluid. Another LOUD vote for PEMF.
Obviously, he’s on an antibiotic baytril also but his SAA numbers are not declining after 2 weeks this happened last time too, SAA did not come down (though he is clinically much better). So worried.
Both times I have caught quickly…but being a rescue, I don’t know his history
How much copper/zinc per day does your horse get?
It’s been a few years, but since I saw someone revived this topic, and it’s not like the issue is time-limited, I wanted to come back and close the loop on this.
In April 2022 I totally serendipitously saw a photo illustrating an article on thehorse.com (unrelated to cellulitis) of a horse wearing what looked like inflatable compression sleeves on all 4 legs. I had done exhaustive research on the lymphedema/cellulitis cycle in humans and knew that graduated/sequential compression devices are one of the few treatments with solid scientific evidence backing their efficacy in actually improving the condition of a limb permanently damaged and enlarged from lymphedema (eg following repeated bouts of severe cellulitis and/or lymphangitis).
From the logo I was able to track down the device in the photo, and it turned out that a young vet from NC state was aware of the same human research and wondered why there were no such devices for horses. She and a team of other equine sports vets and animal scientists from NC State established a business venture, Vetletics, to develop one, working in partnership with a reputable international manufacturer of compression devices for humans.
The product is called the EQ Press (and upon rereading this I think I ought to mention that I have no financial association or investment in them, I’m just a customer). It consists of 2 inflatable front leg garments and 2 hind leg garments that attach to a saddlepad, and each pair is controlled by a battery-operated pump that also attaches to the pad. The garment for each leg goes from hoof up to the top of the leg and has four chambers that inflate sequentially from bottom to top in a graduated fashion (so each chamber is always slightly higher pressure than the one above). After the top chamber reaches the pressure set on the pump there is a period of total deflation, and the cycle starts again from bottom to top. This pushes lymphatic fluid up the leg.
The garments for the horses are all hand made so there is no economy of scale and I won’t lie, the system is extremely expensive. (They sell to rehab facilities, as well as to large racing and event barns, which use the devices for exercise recovery.) But I considered how much I was paying for 2 hospital stays a year for my problem horse, and how close to giving up on him I was, and decided to buy a half set, the saddlepad with hind legs only.
I started using it in mid May 2022 and worked gradually up to twice a day, an hour each time, at a fairly high pressure. My horse adjusted to it easily and quickly - I can put it on him and just leave him loose in his stall to nap (which he does a lot with these on, they’re very relaxing) or eat. By August the difference in his leg was miraculous. I wish I could post photos - is there a way to post photos? I had never, ever thought it would look like that ever again. If you weren’t looking at his other leg, you’d think it was a normal leg. For the first time since his initial episode of cellulitis and 17-day hospitalization in March 2019, he was completely sound with no “mechanical” lameness caused by difficulty in fully flexing joints in the enlarged leg. I was even able to show him!
This leg was in very bad shape. I had spent years trying everything from PEMF to transdermal CO2 to cold laser to shock wave (I actually tried a course of 8 shockwave treatments on the leg, twice a week for 4 weeks, since there are some studies suggesting shockwave might help humans with lymphedema. It was expensive. It did not work.). I tried nutritional supplements and bandaging methods. Nothing made a real and lasting difference in the health of his leg until the EQ Press, and it completely changed this horse’s (and my!!) life. The infections were getting closer together and more severe. He had to be on antibiotics a minimum of 3 weeks with each one, at least a week after his SAA went to zero. He was often rideable between active infections, and riding helped the leg, but cantering was a struggle because the leg wouldn’t flex sufficiently, and to the right he had begun to canter laterally. There were a few times I came close to making the decision to put him down.
Now though - he’s had one minor infection, easily treated at the barn, since May 2022 (in July). In October he fractured his coffin bone. [This horse… :sigh: ) Of course that meant stall rest, the worst thing for a cellulitis leg, and in the past it would have meant his leg would have blown up. But using the EQ Press, either 1 hour twice a day or sometimes 2 hours once a day, after 4 months of full stall rest his leg looks only very slightly worse around the fetlock, than it did in September.
I know this isn’t going to be an option for everyone. But I still wanted to come back here and mention it, because for a horse with this condition I believe this is the gold standard treatment, and it’s not marketed much beyond vets right now. I would have loved to know that it existed when my horse came out of his first hospital stay (though it actually didn’t exist then!), which was when the injury to the leg was freshest and the EQ Press actually would have done the most good. (Paradoxically I might not have been willing to spend the money then, not appreciating how intractable and expensive the problem would become, but at least I’d have known it was a possibility, or could have looked for a rehab facility that had one.)
Maybe this info will help someone else in that same position as I was.
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Wow, pretty cool–glad you were able to find something to help your horse so much! So…just how much does it cost? 
Did you ever try a compressive icing system? Game Ready or similar? I picked up a compressive Breg system, and it was just baaaaarely tolerated. Curious how tolerance to this would compare to that.
Hooray for such success for your guy, though!
Icing is contraindicated for lymphedema. When you have an active infection going on the vets will tell you to ice or use cold therapy - though I personally never saw any positive effect, even when my horse was hospitalized and receiving Game Ready treatment twice daily. But for the damage to the lymph system and skin and resulting chronic edema, thickened skin, etc, that persists even when there’s no infection - lymphedema - studies on humans actually show that it’s heat that helps the condition. There have been studies showing positive results using infrared and (I think) steam heat. In China, where lymphedema was historically most often caused by a mosquito-borne infection, the traditional treatment in rural areas was to put the limb in a special brick oven.
I found one heat treatment for horse legs - Thermotex infrared equine leggings. But by that time I had already bought the EQ Press and was having good results and wasn’t interested in spending more money! Plus I hate the fact that it has cords instead of a battery. But I still wash his leg with hot water every day.
For pricing… I don’t mind sharing but don’t want to post publicly what I paid. If you’re interested message me! As a rough idea, when I purchased, the full price for the full system with all 4 legs (I only bought 2) cost in the low-ish 5 figures.
Oh also there was a study just published in a peer-reviewed journal (AJVR) establishing through the use of lymphoscintigraphy (I think?) that the EQ Press significantly accelerates lymphatic flow in equine limbs.
I used the Equiflexx Sleeve, basically a sock, and they worked well*
I wonder about the same idea being made with copper or ceramic like Back on Track.
*I found them easy to put on, the only issue I had was to from my horses dropped fetlocks, which pulled them down and caused them to bunch.
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I still use Silver Whinney socks on my guy’s bad leg at almost all times to keep the leg clean and protect it from minor (and possibly major!) abrasions, cuts, etc that might let bacteria in. I use electrical tape and a soft boot (flatwork wraps) to keep them up. I think they’re great - but I’ve been using them since Oct 20, and I don’t think they actually improved the overall condition or health of his leg at all.
The horse I posted about here has had recurring cellulitis episodes over many many years. Weirdly, it would pop up in the July timeframe most years (weird because he lives in mud all winter, and you would think that would make him more prone to a flare up than the super dry/“clean” weather time of the year) and we would attack it similar to what I posted here in 2013. For many years we shifted from a broad based antibiotic (e.g. Excede) and went to what we did here - penicillin and gentamicin. And then my vet retired and the new vet wanted to keep him on Excede when it happened, so went on to that.
Now, at age 22, he has started a new cycle of [maybe lymphangitis vs] cellulitis? Even my vets aren’t sure. He started blowing up once every couple of months in a way that looks identical to his cellulitis flare ups, but he’s not lame. I started treating it with SMZs each time, but then decided just to ride it out unless it went to full blown cellulitis (fever, not eating, etc.).
Then I started putting one of my Back on Track wraps on that leg and similar to what people have posted above, the difference is crazy. If I leave his wrap off, even for a night, his leg gets gigantic. As long as he has his BOT wrap on, his leg stays almost normal size. So I guess he will live in a BOT wrap on his RH for the rest of his life.
Super interested in the EQ Press, though…seems like it would be exactly what my guy needs. Hope they find a way to make it a bit more affordable in the coming years!
Does he have an elevated SAA when he has these episodes? That might help you tell whether or not it’s an active infection. We had so many episodes that eventually my vet let me buy a stall side SAA tester with the understanding that I’d only use it under his supervision with this horse. I keep the SAA testing kits on hand so I can test him if his leg blows up, and so I can do periodic test when he has an infection to see how it is progressing and whether it is responding to the antibiotics. We’ve learned that in his case we need to keep him on antibiotics for at least a full week after his SAA goes to zero, or else the infection comes right back in a few days (or probably was never really gone).
As for the BOT wraps… I have them and they made no difference for my horse, but his leg was extremely damaged. Before the EQ press, the only thing that really made any difference at all was activity - trotting or cantering would improve the leg significantly for a short period of time.
But I wonder whether the success you and others have had with the BOT wraps might possibly be due to the warming effect they have on the leg. If I understand correctly, the BOT technology is supposed to create a sort of infrared heating, and some of the studies that I referred to in my comment above (on successful treatments for human lymphedema and the use of heat vs cold) involved the use of infrared heat. It kind of makes me want to try them again now that his leg is in a better place!
I think the EQ press is exactly what many horses need, and it’s extremely unfortunate that it’s so prohibitively expensive. I understand why, but it’s still unfortunate. I know that the company, which is tiny, has given presentations to vet practices to make them aware of it and in the hope that some of them might buy a unit for rental to clients, so it might be something worth mentioning to your vet - if they know people are interested they might be more willing to consider it. I’ve talked to my vet about it a lot, as he has watched the remarkable change in my horse’s leg since I started using it. So far they haven’t felt it worthwhile to invest in one, but that could change if they had multiple people asking for it.
