Usually clean gelding has e coli infection in sheath

Has anyone had experience with e coli infection in sheath? Vet says to try wiping clean every three days for two weeks. Next option is to get compounded antibiotic cream to insert in sheath. Final option is to provide health sheath secretions from donor and transplant them. So far wiping isn’t working.

Another option, ahead of the transfaunation option, would be to put the horse on a high caliber pre-probiotic and insert pure white yogurt up in there.

Someone on another forum is going to do this with her gelding who has the most foul Smelling and massive amount of smegma she has ever seen.

I have no idea of the the dosages or even what brand of yogurt. Hopefully someone will come in that knows more than me on this subject:)

FWIW, she also did transfaunation on a different gelding and it was an epic failure. He had a serious case of the runny bums. Success for him was two rounds of metronidazole, which was really rough on him but it did the trick and he has been fine for the last two years.

Poor guy :persevere:
IIWM, I’d adios wiping & proceed to the ABX cream.
Why should he be uncomfortable any longer than necessary?


Thanks for feedback. The smell is rank. The smegma is grey and slimy. It is predominantly at the front of the sheath. My boy lets down when I groom him, so I can check for beans and crusty stuff on a regular basis, without doing a regular cleaning more than every six months to a year…but what has developed now is a whole different story. It has been swabbed and cultured, and is definitely e coli. I have messaged vet to ask if we can get on with compounding the topical meds for the sheath. If that doesn’t work perhaps an oral or IM application of something stronger is needed.

Was the metronidazole given orally or by injection? Hope the other gal chimes in on this post.

A very close friend of mine contracted C Diff out of the blue, was completely drug resistant, and he ended up in a research study run by a pharmaceutical company, run by research doctor at a teaching hospital in our area (re Covid). The only thing that worked was a human biom transplant. However, I don’t think gelding donors go through quite the same rigorous screening (that a pharmaceutical company does for human research) for healthy sheath material transplant. I can only imagine how badly that could go wrong!

Thanks again.

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I agree. What is ABX cream? Antibiotic? Pardon my ignorance!

Sorry, yes ABX is shorthand for antibiotic.

The metronidazole was oral. It was 20 pills and I THINK she had to give them twice daily.

By the time the dosing period was over, her gelding was looking for the cellphone to rehome himself, lol

. She had to crush the pills and keep finding new things to mix them with. It didn’t help this med makes some horses go off their feed and also become depressed; which he did both. He lost a little weight but is an easy keeper, so quickly gained it back.

She said it was awful enough to put her horse thru that once but the vet said to do it again and thankfully the second time worked.

Thanks for confirmation. I will post what works for my guy moving forward.

Thanks for the info on the pre-biotics and yogurt. My companion pony is on pre and probiotic for post antibiotic treatment for dental work. The dental vet recommended the following for the pony:
Saccharomyces Boulardii + MOS - 5 Billion Viable Organisms Per Serving.

I think I’ll stick my gelding on the pre and probiotic as well, particularly while I’m waiting for the compounded meds.

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FYI metronidazole is used to treat infections caused by anaerobic bacteria and it won’t work for an E. coli infection.


If you go the antibiotics route, you may want to do a culture and sensitivity. A lot of E. coli is resistant to common antibiotics like amoxicillin.


Thank you for that information, always appreciated.

Thank you. Excellent idea. I’ll message my vet and ask if she has already done a sensitivity test from the original culture, or if she requires another culture to do so.

The original culture included a sensitivity panel and it indicated that gentamicin would be the best option. The compounding pharmacy worked with our vet as to what base they should put the antibiotic in. I now have a cream that I have to apply twice, daily for ten days. Pharmacist suggested that I cleaned out with Cetaphil gentle cleanser first, rinsed well and allowed to dry before starting the gentamicin regimen. Started the process on the weekend. I’m hoping like heck that this cream application, plus the S Boulardi in his feed (10 billion IU’s twice a day) will sort the poor horse out.


As an update, did two weeks of gentamicin twice a day. Cleared things up but the infection was back within two weeks. Vet gave the horse another two week dose of gentamicin and that seems to have done the trick.


That’s interesting you were able to get gentamicin as a cream! I recently had to do a round of gentamicin given IV for my horse with chronic scratches.

Glad your boy is doing well!

It had to be compounded. The vet and pharmacist decided on a cream base that is used for women’s health issues, and I’ll leave it at that! It worked well!

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