Pastern leukocytoclastic vasculitis

[frazzled]

Does anyone have any experience with this condition and what care plan did you follow? Our boy has signs of it and am getting the vet out tomorrow. Am hoping it is "just" mud fever but have a bad feeling about it.

 

[mightymammoth]

just bumping this as also wondering.

 

[Beausmate]

Holy post-bumps Batman!

I think there was a post about this a couple of months back.

 

[Fun Times]

My horse had it last year. Started in summer, treated it like mud fever and got no where. Eventually got on top of it using fuciderm and cortivance spray from the vets. The fuciderm was the more effective of the two in my view and easier to apply. It seems to take ages to improve and he was most unhappy with me touching the scabs. It was only his white legs that were affected and he didn't have it THAT badly bit it was still a bu&&er to get on top of. Good luck, hope you manage to get it sorted soon.

 

[JillA]

What's the difference between that and pastern dermatitis? I have one with the latter and was treating with an aloe vera gel. The flies were making it worse once the scabs began to come off, so I have found if I loosely tape (duct tape) some soft cloth or gamgee over the area it heals much better. The scabs are off and the heat has gone after a couple of days of covering the gel and the area up. I was going to put a sock over it but couldn't get one over his foot

 

[mightymammoth]

good question JillA but I think pastern dermatitis is an umbrella term and is the result of pastern leukocytoclastic vasculititis. The pastern dermatitis is the symptom but the cause is the leukocytoclastic vasculititis. Whats happening with your horse? Mine came down with "mud fever" last august but it was never mud fever as it's now been going on for a cream. Lots of lotions and potions vets treatments etc I'm convinced its a form of this.

"Pastern leukocytoclastic vasculitis
Pastern leukocytoclastic vasculitis (photoaggravated vasculitis) is an additional clinical cause of equine pastern dermatitis. This disease is poorly understood and affects mature horses. It is unique to horses and often, but not exclusively, targets unpigmented distal extremities[11]. Pastern leukocytoclastic vasculitis is believed to be due to immunocomplex deposition on the blood vessel walls of the distal limbs, triggering vasculopathy and resulting in clinically well-demarcated circular, erythematous, exudative lesions with tightly adherent crusts. The prevalence of clinical signs in the summer suggests that it is photoaggravated. The medial and lateral aspects of the pasterns are most commonly affected. The lesions appear painful rather than pruritic. Edema of the affected limb(s) and lameness are common sequelae. Chronic cases may develop a rough or warty surface."

 

[soloequestrian]

I could write you an essay on this....
Mine started with it about six years ago, as a result of putting sun cream on his white legs. Fast forward several years of various treatments for mud fever, months of antibiotics, finally had skin biopsy and confirmed lv. I have to say the time taken to diagnosis was a direct result of my vets being totally useless - it was only once I came on this forum that I started to have an idea of what it might be and how to treat. It then took me a couple more years to realise that he is sensitive to anything oil-based, including vet wrap. Now I treat with honey (just ordinary, not manuka) and wash with only water regularly. He wears UV boots all the time. I haven't tried steroids because I was only ever offered oral and he is Cushings so I worry about laminitis. I might look at topical steroids now a few people have mentioned them. It doesn't bother him now, but the constant battle to keep it that way is quite wearing.

 

[Jim bob]

My boy too has this. We're do I start? It was diagnosed 3 months ago and have been battling since ours it's quite a severe case and he is on oral steriods at the moment. Feel free to pm if needs be Btw soloequestrian what uv boots do you use?

 

[mightymammoth]

Wish it was easier to upload photos and I would post them. It's a very frustrating condition as I just think its clearing then feel fresh scabs. ATM I'm soaking the scabs in aqueous to see if I can lift a few before using the cortavance spray again. The scabs themselves aren't too bad but it worries me that his back leg looks filled around the fetlock. He's only just finished a course of antibiotics.

I've emailed the vet with an update and latest pics, I'm just getting fed up of paying £100 plus fro vet visits, antibiotics and creams/sprays etc and getting no where.

I tried filta bac (sudacrem type cream with factor 50 in ) without success.

 

[soloequestrian]

I use the Equilibrium sun chaps - they don't make them any more but I have collected many pairs now from different sources. I do have a pair that are too small that I bought by mistake that I would be willing to sell (they are the next down from the largest size).
I also have some Cashel boots, and use the Equilibrium close contact chaps in the winter, though I'm a bit wary of them now because of the neoprene (assume it's made from oil).

 

[soloequestrian]

I've emailed the vet with an update and latest pics, I'm just getting fed up of paying £100 plus fro vet visits, antibiotics and creams/sprays etc and getting no where.

I worked out that I spent around £1500 before I resorted to cheap honey and UV boots - at least have my costs down now!

 

[JillA]

As a matter of interest are they all on pink skin (white hair)? Mine is

 

[soloequestrian]

No, my boy has some on his coloured leg too. He only gets it on his hind legs thankfully.

 

[mightymammoth]

my horse just has it on the white part of his hind legs, (around the heels).

 

[AdorableAlice]

Nightmare and heartbreaking to deal with.

My selle francias is just recovering from a nasty session. He has sensitive skin and is cushingoid, needing one prescend daily. He has had various mud fever episodes in the past.

In June we had those few excessively hot days and I noticed some pink patches appear on his socks, I put factor 50 good quality sun screen on him and within 24 hours his legs simply exploded into a yellow sticky mess, swollen and solid. The horse was distressed, elevated breathing and frightened. Much the same could be said for me when I found him, as it was totally my fault.

Flamazine helped him, bute, anti b's and finally we had to risk steroids at a low dose because lami was a real threat. The picture shows him with linen table napkins covering the rotten areas and bandaged above to keep them in place.

The treatment calmed the yellow gunge down and scabbing took over to such an extent he could not flex the pastern. I tried aloe vera and cling film in the hope the scabs would soften and come off, that worked but the wet mess soon turned to solid crusty scabs. The horse was so miserable the discussion took place about letting him go.

The bute was upped, more drugs and I bought Cashel UV boots which I could not use because he was so sore. The discussion was made to clip the scabs off. Unbelievably the horse just stood there with no sedation. Underneath there was healthy skin, fragile but healthy. Sudocream was used and remains being used daily. He is wearing his uv boots. Some crustiness is still there and I take one day at a time.

 

[Jim bob]

Alice: sounds very much like my boy. My horse had bee in overnight his leg were a little swollen before he went in which I found strange as he had been in the field all day. The following day his leg was 3 times the size and I thought be had broken something. It went down a little with exercise but still quite big, cold hosing and bandages didn't help. I had also been using sun cream on his legs and it looked like the suncream had ran down his legs and stained him. Patches on his legs turned were like a faint yellow colour with yellowy small scabs appearing on his legs. It was ,at the time his fat leg that worried me so after a few days I got my vet out. He diagnosed my horse straight away. Told me to keep his legs bandages,cold hosing, exercise and a course of bute, antibiotics and an steriod injection was given. Told me to update him a week later.
My boy wouldn't let me pick up his worst leg and would just lift up his other leg he wouldn't let me bathe his legs or hardly touch them so I felt it was best not to work him. Within 5 days of my vet seeing him I had to get him back down. My boys legs exploded into large sticky, painful looking scabs ,again he was refusing to lift his legs up and the antibiotics and bute didn't seem to have much affect neither did the cold hosing or bandages for turnout.

Vet came back and gave him another injection, took a blood test, put him on a 10 day course of stronger antibiotics and we had a chat about using steriod cream with the next step up if the cream didn't work was oral steriods. We went with the cream. The blood test on his liver came back normal.

A week or so later, still no massive improvement. It was now were I was questioning my horses quality of life . This had been going on only 3 weeks or so. But nothing appeared to be getting better. He was still refusing to lift his legs up. Still found it all painful,the cold hosing seems to help sooth his legs. But not much seems to remove the thick hard scabs that were now covering alot of his lower legs. He found me putting the cream on the most painful. But it must have been so painful for him to be walking.

Around... 10 days later I spoke to one of the vets at the particle who asked for photos of my horses legs (vet treating my horse was on leave ) the vet in question was cautious about the oral steriods and wanted to use as a last resort really. I sent her some photos of how his legs were that night. The following morning she got back to me,having looked at then herself and had the medical specialist look at then they comfirm my vets findings that it was LV and that due to the 'state of his skin' oral steriods were discussed. The go ahead was given my boy has been on them on and off ( had to watch him like a hawk for laminintis!!) For around a month now and yes his legs are finally looking better. Scabs are now starting to come off and he will let me pick them off if there ready. He does wear uv boots alot but we are finally getting there.

 

[JillA]

I worked out that I spent around £1500 before I resorted to cheap honey and UV boots - at least have my costs down now!

Has the honey made a difference then?

 

[soloequestrian]

Yes, honey is the only thing I've found that keeps the scabs in check. We have a cycle now - scabs form, loosen and come off, skin looks red but not broken, doesn't heal fully, scabs return. Without the honey, the scabs get bigger and angrier.

 

[mightymammoth]

Adorable alice how did you get your diagnosis? We have the scabs but not the yellow wet sores, although we had that last october when it got infected. It was sorted with anti biotics but I thought at that point it was mud fever.

Was he prone to sensitive skin/ allergies? Or do you think it was just a reaction to the cream. Sounds like it's been dreadful for you both!

Mines also cushings which makes it tricky with the steroids..

 

[JillA]

I have to say the one thing that has helped mine is covering them up - I use gamgee taped round with duct tape, not too tight, with the gel applied first. The scabs are coming off and not reforming, which was what was happening before, but what is looking more and more like healthy skin underneath. He has a small scab on the front as well - pink skin again, nothing on the ones that are chestnut.

 

[mightymammoth]

I've been in touch with the vet again,they have told me to soak the scabs off with aqueous cream then use the cortavance spray. Also going to have oral steroids.

 

[AdorableAlice]

What a nightmare a lot of us are having this summer. Can I ask what type of horses do you have. My lad is a thin skinned blood horse, his coat is like gossamer and there is no chance of him wearing a saddle cloth or boots more than once, everything has had to be kept clean. He is not an itchy horse. In winter he wears mud boots once it gets really deep.

His skin problems started after he was tested for cushings. His liver is fine which was a massive relief and the deciding factor to carry on treating him. At the moment he is ok, I apply sudocream twice daily, some crustiness has come back and I have loosened the scabs by putting a tiny dab of neem in with the sudocream on the morning application. He wears UV boots.

Happier days in 2009.

 

[JillA]

He's lovely Alice. Mine is also a TB but not under any terms of reference a show horse - he is one of those everything seems to be a problem for. He is a big rangy horse, very poor doer, has awful feet, slightly raised liver enzymes in a blood test, came back off loan with ulcers and a couple of years ago reacted to buttercups on his skin. My vet says "Oh, it's Reg"

 

[Meowy Catkin]

I went through this two years ago with my gelding. He didn't have a square inch of pink skin on his legs that wasn't affected. He's a chestnut arab and is very fine skinned and furred. He started off with just a few scabs where the pastern and the heel bulbs join which has hardly any fur at all. I got the Vet and he was treated with flamazine and it just got worse and worse so quickly. Other treatments were tried (sedated, legs cleaned, scabs removed, various creams) and he also had antibiotics as his legs got infected. It got to the point where he just wouldn't let the vet within 10m, he was that sore. When it got better, he was being treated with honey and hypocare if I couldn't get the honey on (as I could spray that on without touching him). In hindsight, I really think that the improvement was due to the fact that by then it was autumn.

Last year he had no problem (I also blitzed the buttercups and stopped feeding alfalfa as that does make him itchy) but this year he's had a few scabs in the pastern/heel bulb area as I was unable to get sun cream on for a couple of days (he won't wear sun chaps). I sat on my hands and didn't touch them at all. Now they are falling off of their own accord (about two weeks later) and I'm really hoping that it won't flair up again. I really do think that the fact that his legs got exponentially worse once they were fiddled with the first time could be more than just a coincidence.

So I know it's only one horse, but so far not removing the scabs and leaving well alone (no creams) has been far, far better. I am wondering about trying him in sheepskin trimmed over-reach boots. I'll probably practice over the winter as they would shade the area that it seems to start on if I can't get suncream on.

 

[Jim bob]

Faracat your the second person I know who left the scabs and saw results. I am just wondering. In winter etc would i still need to cover his legs from the sun?

 

[JillA]

I left mine alone as long as I could but the flies were getting in the splits between the scabs - how do you keep the flies off Faracat?

 

[Meowy Catkin]

It probably helped that they are grazing standing hay, so luckily I didn't have an issue with flies on his legs. If the flies had started to go for the scabs it would have been a real bind as he just won't wear sun chaps.

ETA - I've never had an issue in the winter. It's always been really scorching, hot, summer days that have set it off.

 

[mightymammoth]

Mines ID x Friesian. They are dry scabs so no problem with flies. I've removed them with aqueous cream but they are as usual coming back although not as bad. Am using cortevene spray.

I wish there was more known about it and the causes and prevention.