Stubborn pastern dermatitis

[Frivian]

My horse has been dealing with a stubborn case of this since December. At the time it turned into full blown cellulitis, which we treated with antibiotics and a steroid, along with sweat wraps, cleaning the leg, etc. The cellulitis cleared up quickly under the vet’s care but the scabby things didn’t go away all the way. She prescribed a cream for the affected pastern, which helped at first, but then it’s effectiveness eventually wore off. The scabs have been on and off since then.

The kicker right now is that my horse has essentially been on stall rest since April 2 with a fractured splint in a different leg. He had the splint surgery last week, and will probably be going back in to a regular turnout schedule in just a few weeks. But the scabs have gotten worse since he started stall rest! I’m wondering if his bedding is causing it. I moved him temporarily to a rehab barn that cleans his stall like 4 times a day, so I know he’s not standing in wet bedding, and he has access to a run that is dry and clean. So I have no idea what to do at this point about his pastern.

I’ve tried all the topicals that people recommend with varying success rates, scrubbing with Betadine, etc. We tried both keeping the hair clipped and leaving it long. I ordered the Silver Whinnies Horse Sox to try next, but once he’s back in a regular turnout schedule I’m not sure those will work/stay on. I need new suggestions.

He currently gets 8 lbs of Purina Impact Pro Performance a day (split up into two feedings) and free choice grass hay. At his home barn he is turned out on a weedy grass paddock for about 12 hours (they feed hay out there too). He also gets soaked alfalfa cubes daily but I’m not sure on the amount. I was feeding him Omega Horseshine, and had temporarily switched to them Omega Horseshine Complete over the winter since it contains vitamin e and a few other things I thought might help with the dermatitis (copper, zinc). He’s back on the regular Omega Horseshine now. His weight, coat, and feet look fabulous, although he has lost a bit of topline in the last few weeks. He is a 17 year old OTTB.

Any suggestions on diet, supplements, new topicals to try, etc. are welcome. His vet is coming next week to remove the staples from his surgery so we will consult on the dermatitis again then as well.

[Maythehorsebewithme]

This may sound crazy and may be a long shot, but perhaps ask the vet to take a scraping and send it to a lab. We had a horse with such a condition and it turned out to be a parasitic infection. (I can’t remember exactly what.). He needed an oral anti-parasitic treatment and a special salve.

Your horse is lovely, and looks great otherwise.

Editing to add, you might want to run a Cushings test. Your horse certainly is young for it and has no visible symptoms, but neither did the horse I mentioned above, and he tested positive for Cushings, was put on medication for it.

[ChasseurSauteur]

Been there and tried many of the things that you have (and just ordered the Horse Sox as well!) We’ve been dealing with a stubborn dermatitis for the past nine months. Eventually killed it off this winter by using Equiderma lotion on it every day - was the only thing that helped the scabs dry off and fall off, and not regrow. After a few weeks’ respite, mud season led to a resurgence of the scabs in the exact same spots, but this time, the Equiderma won’t touch them - but my concoction of Desitin, triple antibiotic, Vagisil, athlete’s foot cream, and corticosteroid is doing the trick (whereas last time, that combo did not prevent the scabs from regrowing.) All to say, suggest cycling through things you’ve tried before - could be a different causal agent at this time of year vs. December?

[theresak]

I’d add more copper and zinc and a probiotic to the diet since I assume he was on antibiotics for the cellulitis. Increasing Vitamin E also helped mine, but the copper and zinc was the game changer. I use the powder from Uckele and mix it into grain with a bit of oil to stick.

For topical treatments, my vet says try something for a few days and if you don’t see dramatic improvement within a week, switch to something else. My homemade concoction that is the same as Chasseur’s failed me this spring for the first time ever. I switched to Finish Line Fura-Free + 30cc injectable dex mixed in and that was the fix. My vet’s cream has worked well but doesn’t contain an anti-fungal, so that’s why I started using my homemade ointment.

You may need to have the vet do a scrape, but make sure he/she scrapes every leg with scratches. My vet has found different organisms on each leg before.

[JB]

@Frivian

temporarily switched to them Omega Horseshine Complete over the winter since it contains vitamin e and a few other things I thought might help with the dermatitis (copper, zinc).

the amount of cu/zn in that is fairly insiginficant - 39mg copper for example. And it brings extra iron to the table - no idea how much, but it’s added. Generally, when people supplement cu/zn, we’re talking minimally 4-5x that 39mg. A lot of people need to add in the range of 10x that amount.

so to this point, I would be adding cu/zn separately. An easy cheap way to do it for you, with as much food as you feed, is 1/2-3/4 or so scoop each of HorseTech’s PolyCopper and PolyZinc

@Frivian

Any suggestions on diet, supplements, new topicals to try, etc. are welcome.

Not knowing exactly what you tried, my go-to is extra strength desitin, cortisone cream, and neosporin/triple B ointment, all mixed together, slathered on, and wiped off and added to 1-2 times a day depending on how dirty it is

[lenapesadie]

My vet just prescribed a new to me product to treat a “skin infection” on my new horse. Horse has thick nasty scabs from the fetlock down on his hind legs. The product is lime sulfur. I’ve just started using it so I can’t speak to its efficacy. It has to be strongly diluted as it is rather potent. It’s pretty inexpensive, I can send or post a pic of the bottle if you’re interested. Bonus it’s applied as a spray so you don’t get it all over your hands.

I’m a lover of MTG; vet described the actual amount of sulfur in MTG as minuscule compared to this stuff.

I also agree with adding copper and zinc to the diet. We have had good luck with adding sulfur as well. Which is in line with vet’s protocol as he said if the topical didn’t improve the condition he would prescribe sulfur given orally.

note this is NOT some woo woo wholistic Chinese herbs vet

[2DogsFarm]

My Walker came to me along with the same condition & a small amount of his vet’s Special (& pricy!) Ointment from previous owner.
When I ran out I used a homebrew similar to @ChausseurSauteur & @JB : diaper rash cream, triple ABX & athlete’s foot treatment < all from Dollar Tree.
Cleared it right up, never came back.
I have to think it was something in previous owner’s soil, as her horses were pasture-kept & one other had the same problem

[JB]

@2DogsFarm

I have to think it was something in previous owner’s soil

The organisms that cause these issue are in the soil pretty much everywhere. Some immune systems are strong enough on their own, some aren’t. Of my 2 that I have/had, the now-31yo has never had so much as a scab on any of his 4 whites, despite coming to me on a forage-only diet. My WB with high hind whites had terrrrrrible scratches when young, until I added copper and zinc. He went through all kinds of vet treatments, I did the furacin sweat, he had EqStim, was shaved and scrubbed with Hibiclens (vet), antibiotics, etc. Barely dented anything. Copper and Zinc? Magic.

[suzyq]

I habe one that I’ve been fighting this for years. I’ve tried added vit e, zinc, copper, removing alfalfa, etc. And tons of creams. The best ive found, and the scratches are almost gone, is kinetic equishield ck cream. The ck plus hc cream is even better, but pricey. I had to use it every day, and rub in well to soften the scabs. Then once every week or 2 I wash with betadine and let it sit for awhile and then loosen the scabs more.

[EmilyM]

Have you tried mixing in smz pills made into a paste in any of your topicals? When I have a stubborn case that usually kills it.

[phantomhorse]

A farm I used to work at a million years ago had a couple broodies who had a terrible time with this. We tried all sorts of things from the vet and nothing healed the scabs completely. The farrier - an ancient cowboy - suggested wrapping their legs with diapers soaked in sauerkraut juice. Seeing as we had tried everything else, we figured why not. We wrapped the soaked diapers in plastic wrap, then placed standing wraps over the top and left it on for 48 hours… and be darned if it didn’t work. It stank terribly and I have never been able to eat sauerkraut again, but that has been my go-to remedy ever since.

[lenapesadie]

You win the weird horse story of the week award. Have a

[Ergots]

I have used many prescription and OTC preparations for this common problem. It seems each case is different and no one thing works across the board. EXCEPT! I worked for a Vet. And he gave his own horses oral fluconazol when the dermatitis would pop up. It would be gone in 2-3 days and stay away. Sometimes using a benzoyl peroxide wash would help some ( yes acne meds) and I love to use neutrogena T Sal shampoo to keep the skin scrupulously clean. Ohh! And one horse with inch thick scabbing and whorls of hair on the pasturns, we kept it sprayed with scarlet oil initially to soften it up and that was also helpful.

[wildlifer]

I agree with (a) do a scrape if you can to try to identify cause, so you don’t contribute to possible resistance if you don’t have to, and (b) add more cu/zn. This past winter was the first that I have successfully kept my horses on increased levels of this & it was also the first winter that, despite record rain levels, we had ZERO issues with any plaguing leg crud!

[stb]

I have had great luck with Equiderma’s protocol for scratches. I use both the lotion and the zinc oxide cream for an active case and use the zinc cream alone as a preventative when turning out in wet grass in the summer.

[Simkie]

I feel your pain! I have a horse prone to winter scratches. Also cellulitis and hoof abscesses. Was never a problem until we moved here.

I finally got it in hand with copper and zinc. She needed quite a lot–she gets a full scoop poly copper/poly zinc from Horsetech daily. When she’s dumping her summer coat and growing her winter one in late summer, I go to a scoop and a half. No idea why she needs so much, everything looks fine on paper, but the horse definitely disagrees.

To turn the corner on the active scabby stuff, I use something emollient for a few days to soften and remove the scabs (udder balm or corona) and then a steroid (triamcinolone) on the fresh skin + top with an emollient. You can get triamcinolone OTC as Nasacort.

If you’re wrapping a leg with active scabby stuff, hydrocolloid dressings are awesome. You can get them pretty cheap from amazon. Leave them on and alone for as long as they’ll stick, then replace.

I never had luck with zinc cream (although sometimes use it on top of the emollient to make it last longer) or Equiderma.

[Chief2]

Another vote for Equiderma. I have used their zinc paste for pastern dermatitis and scratches, and their lotion for any body rainrot. Both products are great!

[Mouse_amp_Bay]

Dealt with this on and off for months. Multiple rounds of antibiotics, including IV. Honey finally saved the day and was the cure. Organic, local (not even the expensive Manuka stuff). Slapped it on, repeated daily, scabs were off and pink skin healing within a week.

My theory? Some sort of soil microorganism, either fungal or bacterial, that the horse’s immune system cannot beat off. Honey is one of the few substances that is both anti fungal and antibacterial, yet super kind to skin.

[LadyLawyer]

@ChasseurSauteur I use that same concoction as well and it works fantastic. the only modification I made was adding dexamethasone powder to the mix. I struck out on every other OTC and prescription medication.

[GoodTimes]

Something to think about for horses with stubborn or recurring infections.

I had my gelding in today for intradermal allergy testing. He tested very, very positive for staph bacteria. So his immune system overreacts to the bacteria, instead of just fighting if off. We were ending up with “scratches”, hives, rainrot, etc.
Never had a problem in the spring, just in the fall (turns out that the fall is when most of his allergens are present). Typically needed systemic antibiotics and steroid/antifungal/anitbacterial/zinc creams to get things under control. Last year he also got oral dex for awhile as he was having respiratory flare-ups from seasonal allergies.

Hoping that allergy shots, meds when needed, and some prescription shampoo during mud season will keep things at bay.
He has also been getting additional copper and zinc to balance the high iron here.