Swollen sheath...can't figure out the cause

[Raleigh_s_Mom]

I have a 9-year-old QH gelding that has had a swollen sheath for many, many months. It appeared after he had been on stall rest for a tendon injury. My vet was not very worried about it at the time, and I thought maybe he was “stocking” up from the stall rest. However, it never went away, even with turnout in a paddock and hand walking.

Swelling is on the right side of the sheath, about the size of my hand, is somewhat firm, and has some heat. We have cleaned the sheath, done serum amyloid test, CBC, chem panel, insulin/glucose test, (blood work all came back great) and he recently had a 7 -day round of Bute and Dex. Swelling has not improved. I have recently read that sheath swelling can be a sign of hindgut ulcers, but my vet doesn’t think that is the cause because blood work looked good and he has zero other signs of ulcers. But… we are at a loss. Vet says to keep an eye on it (he also does not think it is a tumor based on blood work and appearance.) Horse is still on limited turnout (paddock only) and limited work.

Any ideas on what it could be?

[mmeqcenter]

IMO, it’s most likely some “stocking up” in the area from lack of movement. I’ve seen it take 4-6+ weeks of significant turnout (18+ hours per day) to go back down to normal.

[Bluey]

Our now 21 year old gelding’s sheath has been swelling as a first sign of Cushing’s since he was 16.

Since you had blood work done and yours is so young, probably not one possible cause, but keep that in mind if something changes in his blood work when you repeat it later, as your vet surely will to compare with previous one and be sure nothing new is showing now?

Our gelding’s sheath goes down on Prascend and when it starts swelling, we add more Prascend for a few weeks and its goes right down in some days.

That could have been trauma or a bug bite also.

Hope your horse’s swelling will eventually go away on it’s own, as some times that does.

[Critter]

Sheath swelling was also one of the initial signs of probable Cushings for my old guy too. He had always had a long/think coat. He had always tested negative for all Cushing’s. He had sheath swelling and stopped sweating first. Then developed runny eyes (allergy type response). Vet was always involved and we never came up with anything. Then he foundered very badly. After some reading, the swollen sheath, anhidrosis and allergy eyes all do show up with Cushings. Hopefully not that with yours, but worth a check if everything else is coming up negative.

[buck22]

My QH’s sheath stocks up when he’s overweight, despite living out 24/7 and moving quite a bit.

My aged mustang’s sheath stocks up when he’s dealing with a very mild respiratory issue. He has battled heaves his entire life, but the sheath swelling is the very first indication, before he has any other outward signs of breathing difficulty.

[Raleigh_s_Mom]

Thanks for the replies. I would be shocked if he had Cushings, but it is something to keep in mind. I guess maybe I should just see if it improves once he goes back into work.

[J-Lu]

Dear OP,

Something else to think about is allergy to maybe something that bites? I note you are in Georgia and we’ve had some very warm weather this fall. For the first time, my gelding had a swollen sheath in Aug that took months to go down. My vet looked at it also. He has an overall mild fly allergy, but something came out in August that swelled up his sheath and made if very itchy. (yea, I figured out it was itchy and now he points with his nose and lifts his leg when he wants it scratched…so embarrassing. Embarrassing because I reward the behavior by obliging). I used fly spray and cortisol topically and it eventually went away. About 5 weeks ago we had record heat and the flies were out and biting! Ugghhh, were they in Georgia as well?

[IndysMom]

Okay, you may laugh at this but my boy had the same swelling for the same reason (stall rest), I found that gentle massage helped relieve the swelling. Needless to say he enjoyed it as well 🤣🤣