Cellulitis

[Skips11]

Hi all, just after a bit of reassurance or any tips!
Horse has cellulitis on one hind leg. Out of hours vet diagnosed this morning after doing X-rays to check no fractures. Breathing rate was very high, sweating, shaking - she was in a lot of pain. She had Danilon and antibiotics but was still not weight bearing. Eventually got her to move very slowly around the field with us and have done that for 20m and cold hosed for 20m every couple of hours since about 10am.
Leg is still oozing (came from an old cut) and swelling not changed. Vet advised that all we can do is keep her moving.
When will it start to go down? Is there anything else I can do? She’s had it once before and it went within a few hours of turnout!

 

[Skips11]

This is what it looks like currently!

 

[DabDab]

Get the vet back out. They can treat with steroids as well as ABs, ime they would usually come back out the next day to follow up with more IV drugs anyway.

Given the way that leg looks it is still an emergency situation.

 

[Red-1]

Cellulitis is awful, I too would have the vet back as it is serious. However, it doesn't look the worst I have ever seen, and if you could get to the sea, I would consider paddling in the salt water for half an hour or so. I had a horse who would get this annually, and the sea water treatment would bring it down. I believe it drew the fluid out, skin being a semi permeable membrane. I would struggle for days to get any fluid movement, but one trip to the sea (4 hours of travelling ) would take 80% of it away in one go, then the horse was onto of it and would do the rest. I would consult the vet first though.

 

[Skips11]

Thank you - Vet is on the way. All we seem to have achieved with what we’ve done so far is to get her temperature back down to normal and she will now hobble around and graze!
Will speak to the vet but we could get to the sea providing he thinks she’s okay to travel. It’s only 40m from us, whether she’d go in or not is another matter as she’s never been before!

 

[milliepops]

it can take a fair bit of effort to get on top of. When one of mine got it, she needed an extra long course of 2 kinds of ABs and was visibly lame for several days, and then generally uncomfortable.
It's a horrible condition and can make them feel very sorry for themselves. Hope she turns a corner soon.

 

[Ossy2]

Takes a lot of getting on top of unfortunately. It’s is essential to try get onto of the infection, when mine had it the vet had to come out every day for 4 days to do antibiotic Injections. Then it’s getting the moving however painful it is to see mine was literally dragging it’s leg along when we were walking her but got to done and then cold hosing as often as possible.

 

[Skips11]

We did night shifts doing 20m of walking and 20m of hosing every 1.5/2 hours ish and have continued today. Movement is definitely improving but swelling hasn’t so get is coming back to try the steroid injection, and we’ll be going to the beach this evening.
She picked a hot weekend to have us all dragging her around the field!
Thank you all for your replies, the vet assures me that we’re winning, even though it doesn’t feel like it yet!

 

[racebuddy]

It looks horrible and looks a bit lymphangitsis especially with the high temp , maybe needs to go in for intensive treatment at vets x how did u get on xx

 

[TPO]

I lost one in February with cellulitis and this is the thread. It might not be what you want to read as it wasnt a happy ending but some posters offered some helpful suggestions so it might help you.

The whole thing was really brutal and I hope you get a very different outcome. According to my vet it's very rare to get cellulitis as bad as Vinnie did and even rarer not to recover. I really hope that you and your horse are luckier than we were.

Anyway this is the link but I fully appreciate it if you dont want to read about it while going through it. I had to take a break from my own thread ?

https://forums.horseandhound.co.uk/threads/anyone-seen-swelling-like-this.800280/

 

[Skips11]

Thank you TPO, definitely some useful reading, and I’m really sorry to hear that you lost yours.
Steroid was actually a big step forward, definitely the biggest improvement since the beginning.
We continued the night shifts, and she has started to try and not be caught to avoid being dragged round the field which is good ?
On our way back from the beach (was too hot to travel her last night) and it’s made such a difference. My vet suggested that even if we couldn’t get her in the sea, travelling and having to use that leg in the box would be good for her, and it was visibly smaller by the time we unloaded. Again smaller after 30m in the sea, so 110% worth the 5am start and the wet knickers, thank you everyone who suggested it ?

 

[racebuddy]

hows your boy today hope some improvement xx

 

[Skips11]

I think so. Really hard to tell when you’re staring at it every hour, but she is less lame and the progress from the sea and travelling this morning seems to have stuck. Vet is happy to keep going as we are, but I’m a little nervous that it is still *very* fat, and seeping serum.
She still hasn’t eaten any hard food so syringing a sachet of ABs and 2 of danilon twice a day, plus some preventative gastroguard all twice a day, is all an ordeal!
The plan is to get her in the sea every day whilst we can, so fingers crossed ??

 

[Skips11]

This is the leg this morning after the sea and another hose. Not the best pic but having compared to previous, it looks better than I thought.
My night shift assistant managed to get some lovely pics whilst I was wading around this morning ?

 

[TPO]

If it helps (?) my horses leg was much worse then your boy. My vet said cellulitis normally resolves, or is well on it's way to, within 3 days. Its was approx 80hrs before Vinnies leg stopped getting bigger and gradually started going down.

I started taking photos every hour because it's so hard to tell when you are stating at them constantly.

Another things that I didnt think to do until the final week was measure the leg.

I took measurements above hock, just below it, mid cannon, above fetlock, fetlock and pastern. I did this first thing in the morning after syringing in the drugs and last thing after his final walk. It did help because visually 1/2" reduction isnt always visible. It wasnt always easy because his leg was understandably sore but if you can manage to take them it helps keep a record of his progress.

Yours definitely sounds much better than my boy. There is no way that he could have travelled so all positive signs for you.

Wishing your boy a full and speedy recovery

 

[Skips11]

Thank you - good idea re measurements. I’m hopeful, whereas on Saturday I was far less positive.
I read your thread and I don’t know how you did it for so long and in such horrible weather - I have no grounds to complain about the heat!

 

[Skips11]

Hi everyone, unfortunately not a great update.

Cellulitis got better but not fully, but we were all happy we were winning. Then a week later leg was back to a tree trunk and vet diagnosed now chronic lymphangitis. Nothing we tried worked, vet put her on Equipred steroids and a rigorous lunging regime. Leg went down and lameness improved after lunging and riding (was horrible to get on her but vet assured me I needed to!) for 2 days, then yesterday no amount of lunging would improve it, and actually made her more lame.
New antibiotics, still on the steroids and now at a rehab yard where she is being taken on the gallops and doing hydrotherapy in cold salt water twice a day. Rehab lady says she almost thought she couldn't get on her this morning as she wasn't weight bearing, but managed to get her to bowl up the gallops. Leg size decreased but goes straight back up when she stops.
She thinks that if no improvement by tomorrow lunchtime, she will be going into the vets and the prognosis is unlikely to be positive.

I know she is in the best place and I don't think there is anymore we can do than we already are, but is there anything else I should be pushing for from my vet?

I have a feeling we are prolonging the inevitable, but is it possible she could turn a corner at this stage?

 

[TPO]

Very sorry to read your update. It sounds like you have done everything possible and then some

 

[Pearlsacarolsinger]

I'm so sorry to read this. I have been there.

 

[Skips11]

Miraculously, we have turned a corner. Very little progress made at the rehab yard which led everyone to think there was a secondary injury as lameness was severe and not improving. Admitted to the hospital and put straight on IV antibiotics and a pressure bandage while in. They have continued the same routine of 2 hourly walks and cold hosing but with only a few hours turnout each day.
Scanned and re x-rayed the whole leg. All looks clean other than 3-4 times the normal amount of fluid in the tendon sheath. Fluid was tapped and investigated and luckily no infection. Vet would expect the swelling of the leg to actually reduce fluid in the sheath due to pressure, so the presence of this is very odd. Tendons and ligaments all look fine.
She's improved hugely; within 12 hours of IV she'd gone from 7-8/10 lame to 2/10 lame (in walk) and is happy and comfortable. It has been 3 days now and she has remained happy and comfortable, but swelling has only decreased by a small amount, and very slowly.

Has anyone ever experienced this kind of fluid in the tendon sheath and found a cause? Vet can't find any reason for it so we are hoping it is a knock on effect of the lymphangitis?

 

[Pearlsacarolsinger]

I am so pleased that she seems to be on the mend.