Mare with Cellulitis after Hematoma Drain

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Mare with Cellulitis after Hematoma Drain

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    05-21-2013, 12:59 AM
Mare with Cellulitis after Hematoma Drain

Hi all; really hoping to get some input from you on this please. Sorry for the long post, but this has been going on for awhile (the vet has seen her 4 times and I'm calling again tomorrow)

I have a 2 year old mare who got kicked several months ago. A very large hematoma developed (about 10" across) on her lower right thigh and after 3 weeks of it not re-absorbing, the vet chose to drain it. 2 weeks after the initial drain, the opening healed completely and another hematoma developed. The vet drained it once again; this time with a large (about 3" long incision). After a month or so of cold hosing and some antibiotics, the incision healed and the hematoma has not returned. It has been 'healed' for about 3 weeks now. However, right when it healed, the area above it (the same area as the hematoma) became inflamed and the vet had to give her steroids and more antibiotic and said it had become a form of cellulitis. It went down after a few days and I thought it had finally healed.

Tonight when I brought her into the barn, it had come back up. I notice that she is itching it on everything possible, and thinking that is causing some of the inflammation. I'm going to have the vet come back out, but wondering if anyone has dealt with this before? And if so, can I please know how you dealt with it? This little mare is a real sweetheart and I want her to be healthy and happy. I'm really stumped at this point and I know she is just as aggravated as I am. I tried to attach a picture of the drain site while it was healing, just to show you where it is (not sure if it will show up).

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File Type: jpg stormwound.jpg (55.9 KB, 183 views)
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    05-21-2013, 02:49 AM
Sorry about your mare. I havent experienced this myself but my best friend has been through it. She is however sound asleep by now, not a late night person. I will get in touch with her and find out what I can tomorrow, well actually later today. I remember being surprised when she told me she'd been battling cellulitis with Tonto. I didn't realize it could be a horse illness I guess, she did say her vet said it was more common in white/gray horses and he was a gray TB, and I think his was preceded by an injury. I'll find out details soon as I can. Good luck with her.
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    05-21-2013, 09:32 AM
Super Moderator
Welcome to the Horse Forum. We wish it was under better circumstances.

We've treated several severe cases of Cellulitis. Most were inherited after Vets had not treated them aggressively in the beginning. Your Vet is not treating this aggressively enough.

We have had the best results when we used IV antibiotics and treated for at least 7 days after a fever is gone or have not stopped treating until a CBC comes back with a normal white count.

We had a lot better results after we changed to a Vet that advocated using IV DMSO with and IV antibiotic (usually Gentocin or Chloramphenicol -- not mixed together but given separately) He also mixed DMSO with Gentocin or liquid Furacin in a dauber bottle and it was used liberally on and in the wound 2 or 3 times a day. Never use water on a would like this as it facilitates bacterial growth and proud flesh.
    05-21-2013, 09:50 AM
Thank you Oobiedoo, I look forward to hearing from you.

Cherie - thank you also. I am calling my vet as soon as they open and will ask if they can treat it better - similar to how you advised.
    05-21-2013, 06:45 PM
Luckydog, I've sent my friend a link to this thread so she can read the details. She did say "massive amounts of antibiotics" and to cold hose and walk, she said they get dehydrated and are in pain with this.
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    05-21-2013, 07:51 PM
Maybe that wound & area needs to have an ultrasound to see if there is a foreign body causing the tracks & non-healing. It could also pin point problem areas to drain.
luckydog likes this.
    05-21-2013, 08:42 PM
Cherie-is that Gentocin (which is a topical form of Gentamycin) or did you mean to say Gentamycin, which would be the IV form?
    05-21-2013, 09:32 PM
Cellulitis definitely needs to be treated very aggressively.

I also had a mare that got kicked, in her hock. It was a little swollen at first, 3 days later, BAM! HUGE leg. From groin all the way to hoof.

I had by vet out the first day that she was injured, then when I found the leg horrendously swollen. That night we started on IV Gentamycin, and 30cc's of penicillin.

Then for an additional 6 days, she was on 30cc Gentamycin AND 30 cc's of Penicillin TWICE A DAY. She was getting 5 shots every day. When she started feeling better, around day 3, it was hell giving her shots. At day 6, she was getting dangerous. So we switched to oral SMZ pills. 9 pills 2 times a day. She was on SMZ's for an additional 5 weeks.

It was a LONG process.

Moral of the story, she needs heavy antibiotics for an extended period of time to treat cellulitis. And ontop of that, once they have had it, they can be more prone to getting it in the future.
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    05-21-2013, 09:44 PM
Super Moderator
Gentocin and Gentamicin are the same drug. They are just different trademarked names from different companies. Now, they are used interchangeably as the patents have run out and generics are available. It is not nearly as effective as it used to be as it has been used too much. I does mix very well with DMSO, so that helps it a lot for open wounds and problems like Cellulitis.

Chloramphenicol is much more effective but a lot harder to get and lot harder to use.

I can just no over-emphasize that the key to getting a horse completely over cellulitis or lymphangitis hinges on VERY AGGRESSIVE treatment from day 1. A cautious or conservative approach is a death warrant.

CBC blood tests tell you more about when you are succeeding, when you need to change antibiotic and when you can quit treating.
CLaPorte432 likes this.
    05-21-2013, 10:53 PM
I think what is happening is it isn't healing on the inside, but closing up and giving the appearance of healing. Bed sores often do this. Ask the vet about this and if it should be kept open.

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