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  Discussion on CPL: D's Case
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Member:
Dyduroc

Posted on Tuesday, Mar 15, 2005 - 6:14 am:

DrO,

There's a possibility that my mare has CPL. We've been dealing with 'Clydesdale Crud' since the end of September. All attempts to get rid of the leg sores via oral and topical treatments have failed. My vet did biopsies on 2 of the 3 affected legs and the pathology report wasn't encouraging (will e-mail report to you if you'd like to read it).

My mare also has fat rolls (?edema?) on her right hind foot. I'm in the process of shaving her legs to get good base-line photos of the fat rolls and sores and to measure her legs as it appears the right hind is thicker/stockier than the left.

My vet is trying to get in touch with the head of the research project to get more information so a diagnosis can be confirmed.

In the interim, I've spoken with several owners of feathered drafts who are managing 'leg sores' to see what other treatments/regimens might be beneficial.

One owner switched her horse to the EPSM/PSSM diet and reported a reduction in sores and outbreaks and uses tea tree oil to dry up the lesions when they appear.

Another treats his horses' legs daily with a mineral oil/sulfur 'paint' and adds sulfur to the horse's daily feed.

One woman treats her horse with an overload of Ivermectin to get at the sores 'systemically' as she puts it.

What I've been doing is to clean my mare's legs with povidone/iodine scrub (7-1/2%) and apply anti-bacterial ointment to the sores (I shaved her feathers around the sores). We've succeeded in getting rid of them several times but they always come back. They don't make her lame but must be itchy based on her foot stomping and scratching/biting (she removed the sutures from 2 of the 3 biopsy sites herself). She didn't grow much of a winter coat this year and reacted badly to the cold temps we had in January (sub-zero) to the point that she had to be blanketed. She was also the only horse at the barn who got a cold (thick nasal discharge and raspy lungs) that responded well to SMZs. The vet who came out for the cold offered that it was possible my mare's immune system was compromised in light of everything else that's been going on and the fact that she was the only horse to get sick.

The sores haven't stopped us from trail riding or continuing our dressage lessons. I'm just trying to find out if there's anything else that can be done to keep them under control and to keep my girl comfortable and as healthy as possible, especially with mud season quickly approaching!

It's been an interesting winter!

D.
Member:
Eoeo

Posted on Tuesday, Mar 15, 2005 - 9:42 am:

This is something you might try. Clean the area well. Dry it. Get some tea tree oil and put that on. Then put some vicks vapo rub over that and see what that does. I wouldn't think it would hurt and it might help. Let us know if it works at all. EO
Member:
Dyduroc

Posted on Thursday, Mar 17, 2005 - 11:00 am:

Thanks, EO. The tea tree oil was suggested by someone else who's battling leg sores. Based on the description of her horse's reaction to having the oil applied to the sores, I guessing it must really sting. I'm not ready to go there yet!

What is the Vicks for?

D.
Member:
Chohler

Posted on Thursday, Mar 17, 2005 - 1:37 pm:

you could try a tea tree oil suspension in a spray bottle so you can spray fast and get out.
Member:
Vickiann

Posted on Thursday, Mar 17, 2005 - 3:42 pm:

Hi, D -- There was a time I was worried my gray Arab may have lymphedema (frightening!) The first couple times the sores appeared I had them cultured (both Staph and Strep were found) and the Vet. prescribed oral Bactrim plus cleaning and doctoring topically each day. After many bouts, I have found what works best for my horse is to examine the horse DAILY (THE SORES CAN APPEAR OVER NIGHT!) Immediate topical treatment has worked for me since. Using the oral antibiotics seemed to stress his immune system additionally, and a new outbreak could come as quickly as one cleared up! Using oral antibiotics did not make it clear more quickly anyway. If you trim the hair away it is good to leave enough feather so that the water can still drip off a bit of feather and to the ground rather than flood the skin. Either Betadine (Povidone) scrub (contains soap) or RELIEF Rain Rot shampoo are good scrubs. I have also seen articles suggesting use of a sheath cleaner as a scrub but haven't tried that since the others have worked well for me. Rinse thoroughly or you can get even more sores. Then I dry well and apply triple antibiotic ointment. Do this twice daily. If it is extremely humid and wet outside, an application of blue lotion (after washing) is a good drying agent that provides some protection from the elements, but if it looks infected the triple antibiotic ointment works best for a few days after which you may be able to switch over to the blue lotion. If the sores are not too large and you begin topical treatment IMMEDIATELY, sometimes they can be cleared by applying either witch hazel, betadine solution without soap, (rub it into the sore -- not necessary to rinse) or T Zone (Tea tree oil + cortisone) cream TWICE daily WITHOUT the washing part. Often, with this treatment the sores will go away in 3 - 5 days. My Vet also suggested extra Vitamin E (antioxidant) if he has extra stresses going on, and that has helped at times to prevent outbreaks. I used human gel caps, 3,000 IU daily, of natural (dAlpha rather than dlAlpha) E for a 950 - 1,000 pound horse. I cannot stress enough how much it helps to begin IMMEDIATE topical treatment. Once when I went out of town for two weeks and boarded my horses, the situation when I came home was horrible and took a long time of 2 - 3 times daily extensive (washing +)treatment to clear it up. A little time spent right away can prevent seemingly endless, labor-intensive work and avoid complications. This condition can become so painful plus itchy, it has at times caused my horse to chew the insides of his legs or to almost fall down with picking up and bending the foot where the sores are. Good luck -- hope this helps you treat your horse's sores and that you find you can manage the condition without further complications as I have for several years now. Interestingly, this particular horse, like yours does not take the cold well, shivers, and never has grown much of a coat in the winter, whether blanketed or not. It is necessary to blanket him some nights if it is cold/windy, where I live in central Florida. }
Member:
Eoeo

Posted on Friday, Mar 18, 2005 - 9:32 am:

The vicks just seems to help healing. It works great on proud flesh if you get after it right away. Try mixing the tea tree oil with some of the salve you are using and then wrap it and leave it for a couple of days. See if that works. The tea tree oil might sting but not very much. I use it on myself for cracked skin on my fingers. I have tried everything to no avail until I started using tea tree oil. I put it on, put triple antibiotic on and cover the area with bandaids as best I can. Works every time. A couple of days and they are healed. I am talking about deep cracks. EO
Member:
Dyduroc

Posted on Saturday, Mar 19, 2005 - 10:13 am:

Vicki, I can identify--it's very frustrating dealing with leg sores that just don't go away. DrO can correct me if I'm wrong, but CPL is a disorder that's found in feathered drafts (Clydesdales, Shires and Belgians). Sounds like you've spent a lot of time coming up with a course of treatment that works for your horse.

EO--thanks. Never knew that about Vicks. Might be worth putting a jar in my kit. I've used tea tree oil on sores/minor cuts on myself. You must be a lot tougher than I am because I think it stings.

Re: cracked skin on hands and feet. A friend of mine gave me a bottle of 'Soylutions' (Woodridge Labs, Van Nuys, CA) last year. I've stuck with it because this is the first year I haven't had cracked heels and fingers throughout winter. I've tried a lot of different products and this is the first one I've had success with as far as preventing the cracks!
Moderator:
DrO

Posted on Saturday, Mar 19, 2005 - 6:41 pm:

We have discussed before about problems with tea tree oil before including delayed healing of open wounds, irritation, and with repeated use contact hypersensitivity of several types. Despite some positive anti-microbial properties we do not recommend the use of this product on the skin of horses.

Dermatitis. 2004 Jun;15(2):59-66.
Tea tree oil: cutaneous effects of the extracted oil of Melaleuca alternifolia.
Crawford GH, Sciacca JR, James WD.
Department of Dermatology and the Clinical Services and Residency Program, University of Pennsylvania Medical Center, Philadelphia, PA, USA.

The use of botanical extracts for their perceived therapeutic benefits has gained increased popularity in this country and abroad. In particular, tea tree oil (the extracted oil of Melaleuca alternifolia) has gained widespread use for its purported antimicrobial and therapeutic effects. In parallel with this increased use is an expanding series of reported adverse effects, including allergic contact dermatitis, systemic contact dermatitis, linear immunoglobulin A disease, erythema multiforme-like id reactions, and systemic hypersensitivity reactions. We present a review of tea tree oil with regard to its history, chemistry, purported medicinal uses, and possible adverse cutaneous effects.

There may be a place for its use but it is uncertain exactly where this is considering how frequent hypersensitivity reactions occur with its use.
DrO
Member:
Vickiann

Posted on Saturday, Mar 19, 2005 - 8:53 pm:

Very interesting about the tea tree oil. At times over the past year it has been hard to find the T Zone cream, and have to wonder if that is in part due to the questions about its efficacy. About a month ago I attended an "equine podiatrist" clinic in Ocla, FL, where it was implied tea tree oil is potentially carcinogenic -- interesting . . . With regard to healing up bad sores that stubbornly refuse to go away -- have you heard about the treatment in the "How to be your own Vet -- sometimea" book (she works out of Colorado) -- a can of sauerkraut wrapped up next to the sores for a period of time after which the skin is new and beautiful. If anyone has horribly stubborn sores and wants to know the particulars, I will look up the details for you. V
Member:
Kari

Posted on Saturday, Mar 19, 2005 - 10:38 pm:

Unless there is a big fat weiner wrapped around that can of sauerkraut, I would be somewhat skeptical of its effectiveness.
Member:
Hwood

Posted on Saturday, Mar 19, 2005 - 11:02 pm:

I know it sound weird, but I've seen the sauerkraut treatment work as recently as last winter . . . without the weiner . . .
Moderator:
DrO

Posted on Sunday, Mar 20, 2005 - 8:03 am:

For more on sauerkraut for scratches run a search, others have used it in the past.
DrO
Member:
Ajudson1

Posted on Sunday, Mar 20, 2005 - 9:21 am:

About Tea Tree Oil: I think it has many benefits for use but I don't believe it should ever be used full strength. If you have a bottle of tea tree oil use only a few DrOps at a time diluted in water.

I can't remember the name of the salve, but there is a product that has TT Oil in it along with other good stuff, I think eucalyptus, that I used when one of our horses had warts. This would be like useing Vicks and TT Oil. I am thinking something like Professionals Prefer? It was antibiotic, antifungal and also cleaned up your sinuses with it's smell. I got it at FleetFarm.
Moderator:
DrO

Posted on Sunday, Mar 20, 2005 - 5:21 pm:

The problem with hypersensitivity reactions Angie is that they are not very dose dependent, like all allergies tiny amounts can cause serious reactions. I do not have any work to support the idea that diluted doses are less risky.
DrO
Member:
Dyduroc

Posted on Thursday, Mar 24, 2005 - 11:08 am:

DrO, I just got off the phone with my vet and he confirmed the CPL diagnosis after speaking with Dr. Ferraro at UC Davis.

Would appreciate your posting any info/updates you might come across in the future. It was the information I found here on HA that finally let us identify the underlying cause of the persistent leg sores!

Because there's no cure for CPL, we're going to try a few things to see if we can't better manage the outbreaks. Please let me know if you'd like periodic progress bulletins.
Moderator:
DrO

Posted on Friday, Mar 25, 2005 - 8:05 am:

Please keep us appraised, the information you glean from your research and personal experiences may be the best information we get, for instance, I am wondering what information allowed you to confirm the diangosis with Dr Ferraro.
DrO
Member:
Dyduroc

Posted on Friday, Mar 25, 2005 - 9:02 am:

Will keep you up to date on the effectiveness of treatments we try to control the sores. We're starting with regular cleansing of her legs with an apricot/sulfur shampoo (HyDrOSurge) followed by daily application of a sulfur/mineral oil 'paint'. Keep your fingers crossed that this will provide some relief.

The diagnosis was confirmed after my vet reviewed my mare's history with Dr. Ferraro. The failure of topical and oral treatments to get rid of the sores, an unusual pathology report that came back from skin biopsies that were done in January, and the appearance of 'fat rolls'/thickening folds of skin on her hind legs were the main points. The skin biopsy, however, was key.

There's also the fact that she caught a very bad cold (the only horse at the barn to get sick) in January, reacted very badly to the cold (have you ever hear of a Clydesdale having to be blanketed?) and didn't get her usual wooly-mammoth winter coat. The vet who treated the cold agreed this was odd and offered that it was possible my mare's immune system was compromised.

I've also noticed several 'bruises' on the hooves of the legs that are peppered with sores. My vet thinks it possible she's suffering small bleeds in her feet because of the vasculitis.

If you'd like to look at the pathology report, I'll e-mail it to you.

D.
Moderator:
DrO

Posted on Friday, Mar 25, 2005 - 10:21 am:

I will post it for the education of others if that is Ok with you.
DrO
Member:
Dyduroc

Posted on Friday, Mar 25, 2005 - 10:40 am:

Report e-mailed to administration@horseadvice.com subject pathology report--Clydesdale mare

Please feel free to post the report.

D.
Member:
Dyduroc

Posted on Friday, Mar 25, 2005 - 11:15 am:

Correction--report e-mailed to horseadvice@horseadvice.com.

Also wanted to add one more piece of info that I forgot. Vet did blood tests earlier this month to rule out Vit. E and/or Selenium deficiency. Values on both were within norms. Haven't received my copies yet so I can't be more specific.

D.
Member:
Dyduroc

Posted on Monday, Apr 25, 2005 - 2:29 pm:

DrO, per your request of 3/25 I'm posting an update to Surprise's condition.

Leg sores on 3 affected legs are responding to the Apricot/sulfur shampoo cleansing followed by application of sulfur/mineral oil 'paint' (half & half mixture). The sores on 2 of the 3 affected legs have completely healed over (new pink skin with hair). The lesions on the 3rd leg (right fore extending from back of knee downward approx. 4 inches) are beginning to shrink in size and the raised scabs on the perimeter of the sores are almost entirely gone. I'm guardedly optimistic that this leg is also going to heal.

My vet administered a series of immune system booster shots (4/11, 4/15 and 4/23) with something he called Immuboost. He described it as 'anDrOgenous bacteria that has been nuked' and I was wondering if you could provide additional info on what Immuboost is.

Surprise's energy and stamina levels are back up to normal so we've resumed our full training/conditioning routine. I've also noticed that she seems much more comfortable as she's rolling in the dirt or laying down in her stall at night on both sides (she used to only go down on her right side). She's stepping under nicely and her gaits have also smoothed out which also make be think she's more comfortable.

While 1 month is hardly sufficient time to measure any success and it could merely be coincidental that the nice weather is here, we've been riding on the beach and soaking her legs in sea water, and she's working more and losing her winter belly, I'm still pleased with her improvement in the past month.

I checked to see if you'd posted the skin biopsy e-mailed on 3/25 and could not find it. Did it get lost in cyber-space? Are you still interested in looking at it and posting it?

dyd
Moderator:
DrO

Posted on Tuesday, Apr 26, 2005 - 6:25 am:

I think I have it D. This time of the year I always am running way behind. I will redouble my effort to get it posted here and thanks for the update.

I am not familiar with Immuboost specifically but most of these products are mycobacterium cell wall products that nonspecifically stimulate the immune system.
DrO
Member:
Dyduroc

Posted on Wednesday, Oct 26, 2005 - 10:35 am:

DrO, I thought it time to post an update on my Clydesdale mare as it's been 6 months since my last one.

First of all, Surprise has a nice, fuzzy winter coat coming in! She's nice and fluffy, her color has changed to a deep, liver chestnut and her winter dapples are appearing. Last year, I posted about her not having a winter coat before the CPL diagnosis was made. She was in what I'd call an 'active' stage of the disease. Clusters of leg sores popped out on her legs and spread, her energy and stamina were low and she was very stiff behind. Is there a link between the autoimmune system and a horse's internal mechanism that controls coat growth?

This year, the leg sores are almost entirely gone. The areas of her legs that were covered with sores last year completely healed but a few isolated sores periodically pop out on others. Interestingly, the sores mostly appear one at a time vs. clusters breaking out in the past. They're smaller in size and heal in about 1 month to 6 weeks (last year's sores took over 6 months to heal).

The edema in her hind legs has also gone down a bit. I spoke with the vet about this and he believes the regular exercise is helping in this regard.

Another observation (hardly scientific data but merely my personal observation) is that Surprise gets a bit stiff behind at times and without fail, these stiffness episodes are followed by a new sore popping out on the affected leg. Once the sore(s) break out, the stiffness abates as the sore heals.

The number of 'bruises' on her feet is also down. Last year there were multiple 'bruises' on all her feet. I'm calling them bruises for lack of a better term. The bloody-looking discolorations appear under the outer horn as well as on her soles. Again, I spoke with the vet about this aspect and he thinks it's possible they're a result of the vasculitis in her legs.

We rode in a sand arena ONLY for several months because I was wondering if they were stone bruises. Two new bruises appeared even though we were working in the arena, so again I'm left to conjecture that this is just another thing we'll have to live with. Again, this is unscientific data--just an observation. It's entirely possible she bruised her feet in the pasture, but the appearance of these bruises under the outer horn vs. the soles of her feet leaves me wondering. Also, the number of 'bruises' that appear also seem to relate to how active the sores are.

Lastly, last year I had the cleanest horse for miles around! When her legs were covered with sores, she slept standing up with her butt 'sitting' on the horizontal beam across the back of her stall and she rarely rolled in the dirt.

This year, I have a mud muffin on my hands! I'm probably one of the only horse owners who smiles and is happy that my horse is filthy!

Treatment over the past 6 months consisted of an autoimmune booster series, shampooing her legs 2 times a week with the apricot/sulfur shampoo and painting the sores with a 1/2 & 1/2 mixture of mineral oil and sulfur 4-5 times a week.

I've discontinued the apricot/sulfur shampoo temporarily because her hooves got very dry and brittle, she kept losing shoes and her hooves started cracking and breaking. No feet, no horse and she can't go without shoes because her feet are extremely soft. The farrier recommended painting her hooves with mineral oil 2 times weekly and they're improving.

The vet's coming out tomorrow for a rhino/EEE (recommended by the vet because there have been several cases reported in our area) booster. I'm a little paranoid after the severe cold she caught last winter and want to be proactive this year. If there's anything else you recommend for horses with compromised immune systems, I'm interested.

Thanks in advance,

D.}
Member:
Miamoo

Posted on Wednesday, Oct 26, 2005 - 1:38 pm:

Glad all is going so well. I love happy stories and fuzzy horses!

Ella :-)
Moderator:
DrO

Posted on Thursday, Oct 27, 2005 - 7:06 am:

Thanks for keeping us updated and I wonder what did I do with the review above, I will see if I can find it and place it there.

Concerning the relation between the immune system and hair growth there is not much of a direct connection. Both are composed of areas of rapidly growing cells but other than this no direct connections. For a good immune system be sure the nutrition is top rate, (see Overview for more) and other than that keep the vaccines current.
DrO
Member:
Dyduroc

Posted on Thursday, Oct 27, 2005 - 7:50 am:

Thank you, Ella! It's such a relief having a healthy and energetic horse again! I love fuzzy horses, too!

Thanks, DrO. Am I correct in thinking that if the disease was in an 'active' stage and the immune system working overtime, other systems might be suppressed (most of the energy devoted to fighting the disease)?

The vet reviewed her nutrition/feeding and had me add a multi-vitamin/mineral supplement last year 'just in case' as he put it. He did several blood tests over the first 6 months of this year and everything looks good so I'm assuming her dietary needs are being met. Am I correct? Also, how often would you repeat blood work? It's been 6 months since her last test and the vet's coming this afternoon to do vaccinations. I'm thinking it might not be a bad idea to do a repeat.

D.
Moderator:
DrO

Posted on Saturday, Oct 29, 2005 - 9:09 am:

It is not true that normal bloodwork insures a good diet. The best way to evaluate the diet is given in the article on Overview of Nutrition. It is true that while we fight a disease our immune status can become compromised in some situations.
DrO
Member:
Dyduroc

Posted on Saturday, Oct 29, 2005 - 10:28 pm:

Thank you again, DrO. I updated the information in my profile and would appreciate your critique. I'm comfortable with the quantity of forage Surprise gets daily but am wondering about the quality of this year's hay. It's locally grown, 1st cut but was late coming in due to wet weather early in the year. The color and smell are OK but it's coarser than what we usually get (some mature seed heads, broad leaves and firmer stems).

Thank you, D.
Moderator:
DrO

Posted on Sunday, Oct 30, 2005 - 10:50 am:

I agree with you, when the grass grows dormant the chief concerns are the quality of the hay and if late cut there are concerns. During those periods that fresh grass is not available I would use the suggestions in Care for Horses » Nutrition » Equine Nutrition an Overview of Feeding Horses. Go down to the Practical Considerations and check out our recommendations for stemmy hay. By following them you may not need as much grain, the foot supplement, and if the alfalfa fresh and green the vitamin supplement.
DrO
Member:
Dyduroc

Posted on Monday, Oct 31, 2005 - 7:19 am:

Thank you again and again! My thoughts were that I need to add alfalfa to her diet until the pastures recover in the spring and the information under Practical Considerations confirmed my suspicions.

Would appreciate your thoughts on alfalfa cubes vs. bales as the cubed form may be all I can get my hands on at this time.

D.
Moderator:
DrO

Posted on Monday, Oct 31, 2005 - 9:02 am:

As long as they are fresh, cubes are fine. It can be hard to know by just the appearance and dates are not given on the bags usually. Look for a retail seller that frequently overturns there stock.
DrO
Member:
ruppert

Posted on Saturday, Feb 17, 2007 - 1:27 pm:

Hi D. and Dr. O,

First, thanks so much for the information and dedicated section you now have for CPL, and the draft horse "scratches". Prior to finding this today, I had asked my questions via the "grease heel/scratches" discussion, but draft's scratches are so drastically different, I gave up - but I was checking UC Davis' site for any updates, and then I did a internet search in general for other updates, and Horseman's Advisor came up - I was excited and thankful I could rely on this site once again for help.

D. - I too have drafts with CPL, I have two shires, full-brothers, that are about 15 yearso old. I agreed to take them from their previous home down south, and when I spoke to thier vet, he begged me to relieve them both of the heat down south, and explained to me that both suffered with what he expected was pastern dermatitis, CPL or what they simply called draft scratches.

I have been following the UCD site, and I have been using apricot sulfur shampoo (when I can) as well as sulfur and mineral oil each and every day, and although I have seen relief in one horse, one of mine still suffers, even in the dead of winter here in New England. I am hoping you might tell me what product you use for the sulfur treatment - I have previously purchased Lym-Dyp, but it has been discontinued from all sources I typically used. I have been trying a garden sulfur, but I know it is not concentrated enough, as it is only aboou 12% sulfur in the bottle.

I have to thank you as well for your comments on the bruising of the hooves too, my farrier and I both thought that my shire was simply proned to a lot of stone bruises - may not be the case at all, based on your findings.

If you would let me know the brand of sulfur you purchase, that would be a great help to me, as I just want to keep these boys as comfortable as possible, and knowing there is no cure forces us only to rely on each others recommendations for the day-to-day, so thanks much for all your help, it is great to have someone to share this with, Regards
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