Leukocytoclastic vasculitis

soloequestrian

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I've posted about this before and had loads of very helpful information (my vets are completely useless about it), so now looking for some more ideas.
My boy had this for about 2 years before I finally got a diagnosis. Since having that diagnosis he has been treated by using boots to block UV and honey on the affected bits of skin. I went through a long period (about another year) where I was using various creams and soaps to clean and sooth and every so often his white bits of skin would flare up. The flare-ups were at random times and it took me a long time to cotton on to the fact that he seems to be sensitive to anything oil-based, including soap. I now use only water or mouthwash, and the honey. This has been going on for another year. He has no infection in the affected areas now, and they are really small but they are refusing to heal up fully. He has one white sock, and the areas are actually better on that leg than on his coloured leg. The coloured one has one area that is slightly chapped all the time and recently I've noticed some slight scabbing on his fetlock joint (for a long time now the only affected areas have been around his coronets). I tried a few days without honey to see what would happen and the white leg hasn't changed while the coloured leg has got slightly worse. When I was using soap etc., it was only the white leg that ever reacted. I know this sounds daft, but I'm starting to wonder if there is something slightly different about the condition on the coloured leg compared to the white leg. It's always seemed a bit odd that the coloured leg was affected at all - most LV cases are on pink skin and he has not white on that leg at all.
At the moment, I'm controlling the condition well in that the skin isn't perfect but it also isn't sore or infected - the bits that are affected look like they are grazed slightly. I'm wondering if anyone has any other ideas for treatment. I was offered steroids by the vet but they would have to be mixed with an oil-based cream for topical application, which wouldn't be a good idea, and the horse has mild cushings (treated) so I don't want to risk systemic steroids.
Any suggestions gratefully received!
 

Silverfire

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If his coronets are affected have you thought about the possibility of pemphigus?
One of mine has three times got a scab on the back of each fetlock after being treated with doxycycline, she has three white legs and one brown leg, the brown leg also had a scab on in same place as others. This last time it took over four months to get rid of the scabs and only then because she had 3 weeks betnovate steroid cream on them. The two previous times she had them, they would heal on norodine antibiotis then the first time she got water or mud on her leg they would come back overnight, this time norodine made no difference to them. I noticed last night that one has come back again on her white hindleg. She has something immune mediated going on at the moment from drugs she had over the last few months for teeth problems.
 
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soloequestrian

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I did look into that a while ago, and have just read up about it again. I think it's unlikely (thankfully). The LV was diagnosed via biopsy, and I talked with Derek Knottenbelt about it - I think he is also a pemphigus expert so presume he would have suggested it if it were a possibility.
 

amandap

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I don't know anything about this but have got my fingers crossed someone will be able to offer suggestions/experience. Has Dr Knottenbolt no more suggestions?
 

siennamum

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My gelding has an almost identical story to yours OP.
I separate the symptoms into skin & wellbeing. I can live with the skin issue, so long as he isn't sore, but if he feels unwell (I liken it to having flu) then he really is fit for nothing.

I don't treat his skin with anything as everything seems to make him worse. I use Olive Oil if he needs anything. I unfortunately used Pig Oil and Sudocreme amongst other things when I was thinking I was treating mud fever, and I think mine is also reactive to mineral oil, but I think natural oils like this are ok.

Mine only has bad skin on one leg, it was a black leg, but it goes all the way to the knee, as if he has dipped his leg in something. He wears a boot when out & the sun is a definite trigger.

The only way to treat the physical symptoms IMO is steroids. They do work, and I would personally risk the laminitis.

Even with the vet prescribed treatments mine was still completely variable. Better in the Winter (also a headshaker), always erratic & impossible to compete, as I never knew how he would be feeling.

2 months ago I had him tested for cushings. The vet and I thought he might have it (he is 8). He was lethargic, hairy, hollows above eyes filled, sweaty and I couldn't shift the weight off him.

He came back negative, but it was clear that he was generally an unwell horse. I thought he might as well be semi retired, or even in time PTS.

As a last resort I contacted Jonny Summers at Silverlining herbs. Who looked at pictures of Coco & immediately came back to me and said he thought he had Thyroid and Pituitary problems. It's possible that the thyroid problems are caused by Steroid use and we've used them for a year now.

Anyway, I thought it was interesting that he thought cushings type symptoms. he sent a pack of herbs (this had all cost £60 - £20 for 'diagnosis & £40 for herbs) The effect was immediate. The skin is slowly clearing up & Coco is feeling fantastic.

Although I don't think the herbs have cured anything. They do seem to have balanced out his metabolism, he looks a completely different horse, bright eyed, energetic & no physical symptoms like filled eyes anymore. He is off to RC camp next month which is pretty remarkable.

I am keeping on with the steroids, he may be on them for ever, though at a v low level. I'll just see how he gets on.

This is not a course which may suit you OP, but it may be worth trying the herbs to support the pituitary, and then trying steroid cream at least.

Hope things improve for you, at least I can reassure you there is hope with this.
 

soloequestrian

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Thanks for these. Being a dimwit, I hadn't really thought about contacting Prof K again - he said that steroids probably wouldn't be useful and I think just expected the condition to clear up once I knew what it was and was keeping the areas UV protected. I will get back to him.
I'll have a look at the herbs too. It's more just an irritation now - although the skin isn't quite right, it's also not sore (he doesn't react to mouthwash and I think that would sting if there were any true open bits of skin?). I'm pretty sick of treating it though and he does have days when he gets quite hot under his boots. Would love to see the back of it!!
 

amandap

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Oh, apologies I demoted the Prof. From the little reading I did it looks very difficult to deal with. Good luck in your search. x
 
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