My friends horse has leukocytoclastic vasculitis. Does anyone in here have experience in how to treat this condition?
My horse recently developed this disorder and is under treatment by a dermatologist. Treatment is going to depend on the individual horse, but generally involves steroids (oral or topical) and pentoxifylline, along with a regimen to heal any skin lesions (this can vary drastically from horse to horse).
I am curious how your friend arrived at this diagnosis because it requires a skin biopsy. If this was done it would seem strange that a treatment plan was not also provided.
If you’ll scroll down the page here to the “Similar Threads” section, you’ll find a link to a lengthy thread on this topic. Pay attention to Perfect Pony’s posts there.
In my horse’s case, he needs to have his pasterns clipped and cleaned regularly, and the sun does not appear to be a factor at all. I believe the opposite was true for Perfect Pony’s horse, and some of the other posters’ horses.
Bottom line is you really need a dermatologist to help develop a plan.
Thank you LarkspurCO for your reply. There has not been done a skin biopsy. My friend sent pictures of the horses leg to a veterinarian. She said it was vasculitis. I am from Norway and so is my friend and my impression is that norwegian veterinarians don’t know enough about this disorder they just want to give the horse cortisone. My friend is reluctant to give the horse cortisone. Right now she has the horse on high dosages of ProFlamAid+ that is supposed to kick start the horses immunesystem so the horse can fight the disorder.
I will definitely mention that a skin biopsy should be taken and read “Perfect Pony’s” posts. Thank again!
Ditto Larkspurs post - the pentoxifylline and a topical steroid spray called Genesis was made the difference for my horse.
I don’t know if you can get these easily in Norway, but these two things seems to be what is needed to be effective.
Here’s the Genesis spray info:
http://www.virbacvet.com/products/detail/genesis-topical-spray
Since Norway is bordering on the Arctic Circle, I can’t imagine that UV radiation would be a factor right now. Not knowing the particulars of your friend’s horse, here are a few thoughts.
As noted in the other thread, definitely avoid the topical “scratches” remedies and diaper cream concoctions. My horse’s legs blew up from the desitin-based cream that my vet compounded. This set off serious inflammation and he and developed what looked like chemical burns. He was on a course of SMZ antibiotics at the time, but that was not really helping.
After realizing we were dealing with something other than standard pastern dermatitis, my vet prescribed silver sulfadiazine (SSD) cream. This helped to soothe the skin and quiet down the inflammation.
To keep the legs clean I kept them covered with tube socks. To apply, cut off the toes, place a plastic bag over the hoof and slide the sock on. Pull the sock up above the infected area, apply any medicines, then slide the sock down to cover the area. Secure with elastikon tape or it will slide down.
All of this kept him stable until we saw the dermatologist and waited for the biopsy results. Once the diagnosis was confirmed, he was started on oral prednisolone and pentoxifylline. A secondary bacterial infection with pseudomonas was also found (this bacteria is resistant to most antibiotics).
For the bacterial infection, I gently washed the legs every other day with warm water and Dial hypoallergenic baby wash, then soaked with a dilute chlorhexadine solution, rinsed and thoroughly dried the legs, then reapplied the socks and the SSD cream. I applied the SSD dream twice daily and changed socks once a day.
It is wise to be cautious with the steroids. My horse began to develop laminitis after the second week, so we had to quickly taper the dose and wean him from the drug. I was told that the Genesis spray mentioned above would have been overkill because he was already on an oral steroid. If we had known he was a risk for laminitis we might have gone that route in the beginning.
Now he will remain on the pentoxifylline for a few more months and then we will hopefully try to wean him off of it. I sure hope he is not one of those horses that needs this for his entire life, because it is $300/month.
Thank you NorCalDressage and LarkspurCo for your advice and links!!! Its much appreciated 
I have adviced my friend to get a biospy of the horses leg and to keep it protected from the wet and muddy conditions (which is a big problem in Norway now).
The whole thing started with a wound - a scratch on the outside of the right hindlimb in June (and the horse has 4 white legs). The horse had just been set out on the pasture for the summer. The horse probably got kicked by another horse. This wound got really worse over the summer - so I think maybe UV radiation played a contibuting factor here assuming its LV we are dealing with. The leg swelled up, a lot of crusts developed and yellow fluids came out from the leg.
My friend tried different things - like washing with natural skin wash, putting on some kind of oil. She also saved the infected area several times with a machine and tried to peel of crust after having the horses leg soaked in water. After giving the horse ProFlamAid+ (http://www.hiform.com.au/proflamaid-plus/) the horses leg seems to have improved. My friend has been able to easily peel of crusts. But there are still crusts and fluids coming out from the leg. The leg is not that swollen anymore. But my friend is really desperate and don’t know what the best course of action is. ProFlamAid + is very expensive - about $600/month and there is no garantee that it will really work :-/.
LarkSpurCO , I hope your horse will make a full recovery!
The biopsy has been taken and the results came back positive for LV.
I have another question with regards to feeding. Certain plants/herbs and protein (alfalfa) has been thought to play a role in increasing photosensitivity. Is it wise to stay away from for example alfalfa and hypericum perforatum for all eternity even if the horse is well from LV? Does it increase the chance of the horse getting LV again if the owner gives her alfalfa?
with my horse the biggest thing was to keep the legs protected from UV light. He wore the fly mesh leg wraps from cashel all year round, even on dull winter days and they were sufficient to keep it at bay without making the legs sweat.
this minimises the amount of steroid creams needed to control it.
[QUOTE=marthedamm;8409297]
The biopsy has been taken and the results came back positive for LV. [/QUOTE]
Sorry to hear it, but I am glad to know you have a diagnosis.
I have another question with regards to feeding. Certain plants/herbs and protein (alfalfa) has been thought to play a role in increasing photosensitivity. Is it wise to stay away from for example alfalfa and hypericum perforatum for all eternity even if the horse is well from LV? Does it increase the chance of the horse getting LV again if the owner gives her alfalfa?
This is a poorly understood disorder, and every horse is going to be a little bit different. I can tell you that my horse gets alfalfa and that his condition does not seem to be affected at all by UV radiation. His has a bacterial component, and keeping him very clean with the hair clipped short and legs bare is working for him.
It would not be a bad idea to avoid alfalfa and sun exposure until you can find the root cause for this horse. Do you have a lot of hypericum perforatum (St. John’s Wort) growing in the pastures there? Just curious why you mentioned it.
Thanks again LarkspurCO
No we don’t have a lot of St. John’s Wort growing in the pastures but it is a quite common plant here. My friend is planning on giving her horse a new kind of feed that contains both alfalfa and St. John’s Wort. She will of course wait until the horse is free from LV. Its difficult to know or find out the root cause, but it started with a wound which gradually got worse when the horse was on the pasture. There was a LOT of clover growing in the pasture so maybe that played a role?!
