QH Mare with Cellulitis / Leg Injury ?
Hello. I am wondering if anyone has any information re. personal experiences managing cellulitis in an older horse? I have a 30 yr old Mare with cellulitis in her right rear leg, it's very swollen. How long does it take for swelling to go down once on antibiotics and anti-inflammatories? She was on IV Gentamycin for 2 days by the vet (done), Penicillin 2x day for four days (one more day to go), a steroid orally (still on), aspirin (still on), Bute (still on), and a hoof poultice (in case there's an abcess, soaks twice daily too.) It's been 48 hrs since the first antibiotic and she's putting a little pressure on the injured leg/foot, but not a lot yet. Just wondering how long this takes generally. She's eating/drinking/relieving herself fine. She is very thin, despite being on a high protein/fat diet. Had very bad teeth, still building her up. She may have Cushings, but last ACTH was negative. Mildly anemic and grade IV/IV murmur (may be due to anemia).
I was also wondering - Should I keep her on stall rest or try to start moving her around? She does not like to walk much right now, but will move around her stall. She has free 24 access to outdoors. She tends to swell in the lower legs when she doesn't exercise much, so I wonder if this is exacerbating the problem, or if she needs the rest to heal? The vet doesn't think it's a fracture, but said we'll need xrays if no improvement early this wk.
Welcome to the Horse Forum. I wish it could have been under better circumstances.
I have inherited / treated several cases of Cellulitis and Lymphangitis. It has been my experience that they need to be treated VERY AGGRESSIVELY.
To be successful, our Vet has had us use Gentomycin or Chloramphenicol IV for at least a week. [Gentomycin should be given 2X a day as blood levels drop drastically within 8 hours.] Chloramphenicol was given 1X a day. Severe cases have also been treated with IV DMSO for inflamation, especially with Lymphangitis. Amakacin can also be used.
We have also used the same antibiotic topically by mixing it with DMSO and applying it directly on the would with a dauber. The Vet mixed up the antibiotic with the DMSO 50/50 and left it in a dauber bottle so we could put it on 4 or 5 X a day.
We have always just given the IV shots because we can (plus the're cheaper and we know the horse is getting it). But our Vet also uses a 'Compounding Pharmacist' that can mix up a paste with 25 grams of Chloramphenicol in a tube. He then prescribes 5 grams AM and PM.
I would also use Bute or Banamine for an anti-inflamatory instead of a steroid. It does not sound like she is in any condition to further weaken her immune system with a steroid.
Since she is not doing well overall, I would hit her hard with injectable Vitamin A, Vitamin B Complex and injectable Liver and Iron. You do NOT have to give it in shot form. You can just squirt it in a horse's mouth and they will absorb every bit of it. Use 5cc of each at least once a week until her condition and appetite pick up. The Vitamin A strengthens the immune system, the B Complex and Iron picks up the appetite and are the best concentrated blood builders you can give.
This is how our Vet has successfully helped us treat several of them. Our Vet in Colorado used to send them to us to treat for other people because he did not have the time to mess with them. We never lost a single one and some arrived at death's door.
Cherie has covered it really well so I will just add that I'd be careful of using aspirin as well as the bute/banamine as they are both stomach irritants likely to cause ulcers - I would drop the aspirin. You might look at adding an antacid to the feed to help
IRS/metabolic syndrome are very similar in symptoms to Cushings so I would also be concerned about the steroids as they can bring on a severe laminitis attack.
Horses with serious insulin problems do struggle to put weight on so this might be the cause of the problem. A good low sugar/low starch feed is what you need. I am seeing good results with Sentinel senior, you can add rice bran for extra fat, non molassed sugar beet and hay stretcher pellets or a chaff that doesn't have high amounts of added mollasses with good hay always available. Supplements with chromium and magnesioum are proving to have good results with IRS cases - look for something like Quiessence
Mine had it a few years ago and if I remember correctly, it took about a day for it to rear it's ugly head and about 2 weeks? To fully be gone. I remember within a few days most of the swelling had gone down and I think I had a show 2 weeks later. He was still on the antibiotics for the show but he was completely sound and pain free.
The major setback is the horse's age of 30. Things aren't working very efficiently any more and the list of what goes wrong will grow. At 28 my horse was losing weight and there was nothing anyone could do to stop it. His body was old and tired.
Your choices are few.
You either have to treat it very aggressively (and for at least 10 to 14 days) or you have to put her down. She is in agony and her body is not able to get her past this. If it is not treated aggressively, she will become septic, go down and die. She needs people to either get her over it or put her out of her misery.
Thanks for all the responses!
She started showing more improvement yesterday and looks much better today. She is not constantly shifting her weight anymore, no sweating, and no more trembling in the leg. She's standing on the other foot much more, moving around in her stall, and some of the swelling has gone down. She continues to have a great appetite, and has resumed most of her normal behaviors.
Unfortunately there is no visible wound, otherwise we'd be treating it. We're treating her hoof as if there's an abcess we can't see, with disinfectant soaks and a drawing out poultice (smells like mouthwash) that the vet gave me.
She doesn't have IRS / Diabetes/etc.
We had her on Sentinel, 10 quarts a day, and she was still losing weight....She needed to be on a higher fat/protein complete feed. So we have her up to 10 qts of Triple Crown now,6 qts non-molasses beet pulp, 4 qts hay stretcher, unlimited hay, and Aniflex for joints.
So she had two days of Gentamycin and is on another course of Penicillin injections twice daily. Her Bute will be done tomorrow, as well as the apple-scented steriod. The vet said she wasn't concerned that would affect her immune system...I can't remember why, as we'd talked about so many things.
What is a good Iron supplement product? Or can they give her an injection? They'll be back on Friday.
Red Cell is a decent Vitamin Supplement.
A much faster way to build up a horse is to but the injectable Vitamin B Complex and Liver & Iron that is sold for livestock. It can be purchased from any livestock supply store or feed store that caters to Stockmen. It can be mail ordered from livestock supply places like Velley Vet or Jeffers.
If you get the 100cc bottles of the injectables, you DO NOT want to inject it in a horse but you can take 5cc and squirt it in a horse's mouth once a week. They will take off and eat and gain soooo much better that there is no comparison in how they do with and without the vitamins. I would also do the same thing with Vitamin A. It really helps a horse's immune system out.
Red cell is effective but you can find yourself duplicating viamins and minerals already in the complete feed you are using - might have a negative effect. Like Cherie I prefer to find a source of just iron or iron and B Vits. Her suggestion is worth taking up
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