I count myself very lucky in that I haven’t had to really keep up on modern “tighteners” and now, boom, here I am feeling very out of date and out of touch and would like to know if there are better options that a rotation of Uptite and Greencool. Both are helping somewhat, but hey, if there’s something that will really help to suck out/disperse the excess fluid I’d love to know.
I think the only honest to god topical anti inflammatory is Surpass, which does work well, but can be irritating to some sensitive horses if wrapped over.
For a fat leg, my go-to, at the advice of my vets, is a sweat wrap. Either the good ol stand by of furicin and DMSO, or something like this Su-Per Sweat
Sore No More also has a whole lotta fans.
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Sadly, sweating did not go well. Miss Sensitive’s body went, “Whee!!! Let’s really scare the crap out of her! FUN!”
Also, hmm, vet advised some alternating of wrapped and not wrapped days to let skin breathe between treatments so I might be able to get away with using Surpass on the unwrapped days.
Thanks - you’ve got me starting to think rather than spinning my wheels.
Depending on why there is excess fluid, ask vet about the med (tablets)Naquasone.
It’s a diuretic, but helped immensely when (many years ago) my TB had a mystery injury that blew his leg up like a tree trunk from elbow to ankle.
It was suggested by COTH, vet agreed & leg responded in days.
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You could try an Animalintex poultice under a standing wrap.
Sadly, systemic steroids are off the table. She foundered a couple years ago so we can’t risk tipping the scale.
The swelling is rear of hind fetlock, extending a few inches above the fetlock and ending there rather abruptly. If it were a little higher it would look like a classic bow. Pastern is clean as a whistle and above the abrupt end of the swelling is also clean. Picture a wind puff of alarming size and sensitivity.
Ultrasound showed thickening of and effusion around the tendon sheath and subcutaneous effusion, but no ruptures or tears of tendon or any ligaments. It’s one of those, oh this animal must belong to sascha because it has a weird thing that doesn’t make a lot of sense.
She was put on abx between initial lameness check and the ultrasound and has now been on them a week - no difference so we are reasonably certain she’s not harboring any nasties in there.
Is icing a possibility for you? Thinking whirlpool boots or 9 pocket ice boots, with actual ice.
You might explore gel cast, too. Liked it a whole lot when I had one with a bow. I used this one:
https://www.bigdweb.com/product/code/8512.do
(Poke around for the best price!)
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There is a green gel Epsom Salt that I have used. https://www.smartpakequine.com/pt/epsom-salt-poultice-5077
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Surpass is pretty magical stuff. If you go the icing route, I had great results with the Equifit Gel Compression ice boots for a tendon injury over the summer. It combines the cold therapy with compression (air pump inflates the shell of the boot). I found it effective for reducing swelling and it really got the leg cold. Pricey, but worth it IMO.
Yes! And it’s over the counter now in the US (diclofenac, not Surpass). I actually was just reminded how good it was the other day when I threw some on an old, inert puff, expecting nothing, and it reduced the effusion quite noticeably.
For what it’s worth, Back on Track also has standing wraps, in case you’re a fan of their stuff (but I would not classify that as a demonstrable technique for reducing swelling beyond the simple action of a standing wrap).
Thanks. I will stop by the drugstore on the way to the barn today. Diclofenac is definitely worth a try.
Ceramic wraps make her go poof on a good day so they are out of the question too. She does fine with a BoT blanket, but any of that sort of stuff below knee or hock is a no go. Even Telfa pads create swelling on her, for Pete’s sake. Thank goodness for BB Satin Stars and Vac’s No Bows. Honestly, it’s a wonder my hair hasn’t all fallen out lol and a damn good thing I love her to pieces!
Something similar to Surpass is Butecort or Butacort. It is compounded. Your vet can give it to you. It has DMSO in it and it draws out fluid like no other. I always wrap it, but it’s not necessary, they say.
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There’s some controversy if the human version of Surpass–Voltaren Gel–works on equine skin. We’ve had discussion in threads here, if anyone is curious.
I’ve used both, though, for horses and myself, and prefer Surpass for both me and my horses 
@sascha if you use Voltaren on your horse, do note that the carrier STINGS with any broken skin.
Interesting! Didn’t know there was uncertainty about it. I’ll have to look up the threads to see why I guess. For what it’s worth, I don’t think this was Voltaren specifically, but a diclofenac gel I brought back from Europe (no brand name) (I have multiple tubes from the US and Europe in the house, so I can never remember which one I have at the barn).
But I will happily add that a generic diclofenac does work on horses, at least it did on my mare last week, and to a greater degree than I expected. 
Update: I did some searching on here, google scholar, and pubmed, and could not find any published report directly comparing Voltaren (or any human formulation) and Surpass (or any equine formulation). If someone knows where this article is, I would love to be pointed in the right direction (presumably this study was conducted at New Bolton, if that helps). The most interesting study I found was a 2011 comparison of 5 human diclofenac preparations used on horses, and Voltaren was among the worst absorbed, but it was still absorbed, for what it’s worth (Surpass was not included in this comparison). (This was a non-US study, so evidently there are other human formulations outside the US that us Americans don’t have access to.) So Voltaren was absorbed, but poorly 
@Simkie I have checked with Madam’s doctor and been given the ok for a cautious trial of Voltaren. With my luck she will blow up like a balloon, but it’s worth a try. And thanks for the broken skin tip.
My very sensitive chestnut does ok with voltarn or surpass, but only for a max of 7 days (applied 1x daily) before his skin starts reacting. Just an FYI.
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Thanks! That is really good information that will help me not get complacent if she doesn’t have a reaction within the first 48 hours.
There used to be an astringent liniment out there that contained iron oxide or something similar that stained wraps, but worked amazingly. You could feel it puckering your hands when applying it.
It’s probably long gone, but I bet I have a bottle of it kicking around somewhere.
Regarding the use of human preparations, I recall the discussion and did do some digging at the time, but can’t put my hands on the info right now.
This, from a related paper, might be of interest:
" In humans, NSAIDs are routinely administered
in the topical therapy of traumatic conditions affecting muscles
and tendons. In equine medicine the use of formulations designed
for humans is not uncommon. Differences in epidermal anatomy
and physiology between species (skin thickness, number of cell
layers, sebaceous secretions) are important. Therefore, simple
extrapolation of transdermal drug pharmacokinetics and pharmacodynamics between species, including humans, should not be
done (Mills and Cross, 2006)."
(Ferrante, M., Andreeta, A. & Landoni, M. (2010) Effect of different penetration enhancers on diclofenac permeation across horse skin. The
Veterinary Journal, 186, 312–315)
I did find this just now:
Comparison of Diclofenac Diethylamine Permeation Across Horse Skin
from Five Commercial Medical Human Formulations
Abstract:
The aim of this study was to compare the penetration of diclofenac through horse skin in
vitro and its efficacy in vivo when applied from five, commercially available, human
medical formulations containing 1.16% diclofenac diethylamine. The rate of transdermal
penetration of diclofenac varied between formulations. Also, estimated steady-state flux
(Jss) was significantly different from that reported for human and rat skin. All the tested
formulations produced a very weak and short-lasting antiedematous effect.
(Journal of Equine Veterinary Science 31 (2011) 502-505)
.
