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I am caring for a mare from a rescue that was diagnosed with lymphedema by their vet. She is 10 and arrived from the Amish with bad scratches and underweight. Her RH was swollen and a few days after she arrived it became hot and infected. Our vet put her on antibiotics and cortisone and the leg went down somewhat and her comfort improved. I trimmed her leg hair and can now feel thickened areas behind her pastern. We have the scratches almost gone but are still cleaning and drying her legs.I have read your information on lymphedema but still have a question. Belle’s leg is normally a bit swollen but the one time we called the vet it was hot, painful, more swollen, and I guess infected. Do I need to be concerned about the “everyday” swelling and try to minimize it by wrapping, etc.? Or is it only if the foot becomes hot and painful? Is it the normal constant swelling that can cause the thickened skin or is it the flares? Thank you!
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Hello mokuc,
It depends on the type swelling you have. Edema should be minimized by any means that is practical but cellular infiltration and fibrosis (think of it as scar tissue and can be on, in, and/or under the skin) is not amenable to pressure wrapping. The edema can be passive (cool) or active inflammation (hot). Start with the information on how to recognize the different type of swellings Diagnosing Swellings in Horses. The first part of the article discusses the differences in the 2 types of edema and how to differentiate it from other types of lower limb swellings.
DrO -
I read this information and the swelling appears to be edema with fibrosis in the heel area. When this horse is on smz antibiotics the swelling is cool and the horse is sound. A few days after we take her off the pills, the swelling becomes hot, and painful and she has a temperature. It seems that we are not getting rid of an infection. We are cleaning, wrapping, and protecting her leg from mud etc.but the heat and infection keep coming back.
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Hello mokuc,
How long do you keep her on the antibiotics after all the heat and pain are gone. And following removal how long before the symptoms return. Tissues that have a lot of fluid and fibrosis are prone to infection so the question becomes:
1) Flare up of the old infection?
2) Reinfection of the tissues with a new bug?
DrO -
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It sounds like the old infection is not being resolved, if 14 days does not do it discuss with your vet a 30 day course or possibly switching to a antibiotic with better penetration in most tissues perhaps doxycycline. I am still interested in how long before signs improve following starting antibiotics.
DrO
PS Talk over with your vet about folic acid deficiency with long term TMP/SMZ administration. For more on this see our article TMP/SMZ . -
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