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  Discussion on Swollen front leg - Lymphangitis caused by Corynebacterium pseudotuberculosis
Author Message
Member:
Lilo

Posted on Saturday, Mar 29, 2003 - 10:49 pm:

Hi, DrO and all,
This will be somewhat lengthy, because I want to include a little of the history. Colorado had a significant outbreak of Pigeon Fever last summer. My horses escaped at that time.
Almost 2 weeks ago (March 16) I noticed that my mare had a slightly swollen knee on the left front. No external wound, no pain, no lameness. I cold hosed the leg March 16 and 17, which seemed to improve it. Then we had the snowstorm of the century ( 4 1/2 ft of wet snow in 2 days). The leg did not seem to get better or worse for a few days. On March 23 I noticed swelling above the knee and a lump in her armpit (about as big as my hand). Called the Vet, who thought it did not sound like Pigeon Fever (no pain, swelling soft rather than hard). He thought I could wait until spring check up on the 28th, unless the horse went lame.
The horse went lame the evening of the 27th (and I felt very bad for her - berated myself for not getting the Vet out sooner). Anyway, on the 28th she was seen by the Vet. Diagnosis: Lymphangitis due to the bacterium which causes Pigeon Fever. The diagnosis is based on experience - to positively identify the bacterium one would have to culture the pus, I was told.
This is the treatment regimen: Bute twice daily, 1g per dose. Hand walking twice daily, about 20 minutes, and a standing wrap on the affected leg (left front) below the knee. The concern was the swelling which affected the entire leg at that time. The Vet thought it could lead to laminitis.
I looked up everything I could find on swollen legs and bandaging and bute. So far the treatment prescribed seems reasonable, and after wrapping the lower leg for 1 night and 1 day the swelling below the knee has subsided somewhat, but not completely.
My questions: 1) The article states: Bute is relatively nontoxic at repeated doses of 1g/1000 lbs twice daily (Horse weighs about 1100 lbs). I am looking possible at several weeks of this treatment - what length of time would be a concern. The horse is 17 years old.
2) I am using a polo wrap for the standing wrap, without cotton underneath (my experience with wrapping horses legs is strictly preventative, wrapping horses for long trailer rides). Does this sound reasonable? A friend suggested Vetrap instead, over a cushioning layer, because it would be more waterproof (there is still snow on the ground).
Thanks a lot in advance about any advice or insight you could give.
Lilo
Member:
Lilo

Posted on Saturday, Mar 29, 2003 - 10:52 pm:

Regarding previous message: Sorry for any spelling mistakes - somehow it would not allow me to edit my message.
Lilo
Moderator:
DrO

Posted on Sunday, Mar 30, 2003 - 9:19 am:

Several weeks would be fine for the vast majority of horses. If you are worried, the article gives you ways to monitor it.

Polos would be fine, and much cheaper, unless you want to develop more pressure, which vet wrap is better at. I am not that sure it is that much more water resistant.
DrO
Member:
Lilo

Posted on Monday, Mar 31, 2003 - 9:23 am:

Thanks a lot for your quick reply. I could not get on my internet from home yesterday, so had to wait to get to work to see your response.
So far Moonlight is doing OK - when first starting to walk her, she is quite lame, but seems to improve after a while. The Vet thought I could leave the standing wrap on for several days without a problem. Since I have to leave the horse in my husband's care for 5 days (business trip), I would like to do that unless it could cause a problem in your opinion.
Thanks again,
Lilo
Moderator:
DrO

Posted on Tuesday, Apr 1, 2003 - 6:10 am:

It really is best to change these bandages daily or at least every 2 days: you never know what is going on underneath unless you look.
DrO
Member:
Lilo

Posted on Tuesday, Apr 1, 2003 - 8:37 am:

Thanks so much for your input. That is what I have been doing. I'll be sure to have someone come and re-wrap the leg at least every second day. Alternately, my poor husband will have to be trained in applying bandages - I'll let him decide!
Thanks again,
Lilo
Member:
Lilo

Posted on Wednesday, Apr 2, 2003 - 8:32 am:

Just an update on Moonlight: She is very lame now - can only move at a snail's pace. I checked her out last night and a second abscess is starting, on the right side in front of the chest, at typical pigeon fever location. Per Vet's instructions, we are increasing the Bute to 2g twice daily, for two days only, then back to 1g twice daily. Will also start hot compresses on the abscess, and are considering lancing them if they seem ready (by the Vet, of course). It looks like we are in for a lengthy treatment course. If anyone has had a similar experience, or some tips on treatment options that have worked well for them, I would love to hear about it.
Thanks,
Lilo
Moderator:
DrO

Posted on Wednesday, Apr 2, 2003 - 9:38 am:

Liselotte, have you read our article on Pigeon Fever, see Equine Diseases » Skin Diseases » Pigeon Fever, Dryland Strangles, & Distemper?
DrO
Member:
Beezle

Posted on Wednesday, Apr 2, 2003 - 9:41 am:

Hi Lilo -

You have probably seen my posts about my mare with pigeon fever. I 'think' she is finally over it - no new abscesses since the beginning of February. She had a total of about 7 abscesses since the end of August last year. Most were in her girth area, and one on her chest. Some drained on their own, one was lanced by the vet, one I lanced myself(!) and one that was very deep in the chest area was ultrasounded, then numbed up and opened by the vet. The big chest one initially swelled up the whose chest, then after a few weeks went down, leaving a big hard bump that looked like a baseball was imbedded in her chest. It sat there like this for 2 months with no change. Since it was not about to drain on its own, the vet lanced it - it was about an inch deep and they had to go down into the muscle.

Throughout the whole illness, I did the hot compresses, bute only when the mare seemed to be reluctant to move, Swat around the abscesses during fly season (in hopes to prevent spread to my other horses), and at one point, when she started getting some swelling in her legs, we had her on anitbiotics (SMZ) for about 10 days.

There are different ideas on whether to do antibiotics or not. Some vets automatically give them - ours only recommends them if the horse gets depressed or off its feed, or looks like it is getting abscesses in its legs. The problem with the antibiotics is that they think they may cause the horse to internalize the infection rather than allowing it to come to the surface and drain.

I am almost afraid to say my mare is over it - every time I thought it was going away a new abscess appeared. They don't know why it took so long to go away for her. Some theories were that she had more trouble fighting it off because of her age (17), or that the antibiotics prolonged it. Who knows. I hope it is really gone.

Hope this helps. It is a very annoying illness - I sure hope we don't have an epidemic in Colorado again this summer.

Becky
Member:
Dres

Posted on Wednesday, Apr 2, 2003 - 9:54 am:

when the wound opened, i would use a turkey baster to flush it twice daily, worked great at getting in deep to keep the wound draining...

good luck..

Ann
Member:
Beezle

Posted on Wednesday, Apr 2, 2003 - 10:45 am:

Yes, Ann reminded me of that now. Once the abscesses drained or were lanced, we flushed them twice daily with a water/betadine solution using syringes (without the needle) that our vet gave us. Did this twice daily until the wound closed (about 2 weeks for each one).
Member:
Lilo

Posted on Wednesday, Apr 2, 2003 - 1:56 pm:

DrO and all,
Thanks for your responses. I remember reading the article last year when we had that huge outbreak of pigeon fever. Everything the vet recommended seemed to be in line with the recommended treatments. It talks about hot packing the abscesses. For how long a time would one apply the hot pack? Because of the location, it is not really feasible to apply a bandage.
Thanks to all for your feedback. Becky - you really had a long time of it. I do hope your horse is totally over it.
Now, if I could only convince my horse that bute is not so bad ....
Thanks,
Lilo
Moderator:
DrO

Posted on Thursday, Apr 3, 2003 - 10:22 am:

About 20 or 30 minutes would be effective for bringing the abscess to a head but while the leg is so painful it may not be indicated. Hot packing may increase the pain: it increases the cytotoxic action of the purulent material. Is it possible that this could be lanced, possibly with the help of ultrasound.
DrO
Member:
Lilo

Posted on Thursday, Apr 3, 2003 - 1:57 pm:

Thanks for your insight, DrO. The leg is still very painful. I will talk to the vet about your suggestion to lance with the help of an ultrasound - I would do anything to speed up the course of this disease. At least I have found a way to get the bute into the mare: powdered bute tablets + applesauce + a little molasses over a small amount of her horsechow seemed to do the trick!
Thanks again,
Lilo
Member:
Lilo

Posted on Friday, Apr 4, 2003 - 1:47 pm:

An update on Moonlight: Last night an abscess opened up at the top of the very sore leg. I discussed lancing with the help of an ultrasound with the vet, and she would rather wait a while longer to see if the abscesses open and drain by themselves. Fortunately, that process seems to be starting now. I know the next weeks will involve lots of hands-on care, and am trying to line up some help for my husband. Will probably update in a week or so.
Lilo
Member:
Beezle

Posted on Friday, Apr 4, 2003 - 3:24 pm:

Good! Now that it is draining, she will probably be more comfortable.

More info I remember now: My vet also said to make sure I wash my hands really good after working with the infected horse, before doing anything with the others to prevent spread of the bacteria to the other horses.

Hope this is the end of it for you!

Becky
Member:
Dres

Posted on Friday, Apr 4, 2003 - 5:15 pm:

not only wash your hands but...anything you use in her paddock/stall.. ie: the pitch fork that you use to muck out her stall, i use a diluted bleach and water mixture and kept a bucket of it by the paddock to dip my boots in as well...

throw away rubber gloves worked well for me... just try to keep everything separate as possible...

ya its a lot of work...

Ann
Moderator:
DrO

Posted on Saturday, Apr 5, 2003 - 10:51 am:

Lilo, be sure these abscesses are draining near their lowest point, to prevent pocketing up of purulence. The advice above is good, this organism almost certainly persists in the dirt. Unfortunately clorox is a poor disinfectant for dirt and wood: the other organic material inactivates it almost instantly, better are some of the quaternary ammonium compounds that may be available at some good livestock supply stores or certainly from your veterinarian.
DrO
Member:
Lilo

Posted on Saturday, Apr 5, 2003 - 2:56 pm:

Thank you all for your advice. It sure is helpful to have this site for a sounding board - therapeutic, too. I had been thinking of chlorox for a disinfectant - will look into alternatives.
Thanks again,
Lilo
Member:
Lilo

Posted on Saturday, Apr 12, 2003 - 4:02 pm:

Update on Moonlight: Thanks to my husband's and a neighbor's diligent care, Moonlight's abscesses finally started draining and her lameness, which had been extreme, improved dramatically. I am back from my business trip and can take over her care now. Now she has a large wound (about 2 x 3 inches) in the front - unfortunately she can reach it with her mouth. She keeps messing with it, which will make it hard for healing to occur. The vet came out today and examined the wound, flushed it with Betadine, and thought that she was progressing well. So, we will keep on with the therapy, including the walking. So far, no new abscesses. Could I be that lucky?
Lilo
Member:
Lilo

Posted on Monday, May 12, 2003 - 2:22 pm:

Update on Moonlight:
Fortunately, recovery has gone well. She finally stopped biting at the wound, and it seems to be healing fine. The upper leg stayed swollen for a long time - it is only now starting to look normal. A secondary problem developed on the front of the cannon bone - probably due to having been wrapped so long? It seemed most like rain scald and was very tender for a while. I cleaned with Betadine solution and used Neosporin & later Novalsan creme. I tried Desitin (normally my favorite for surface wounds) - but it was hard to clean off. Anyway, it is much improved now. I have been warned that the Pigeon Fever could recur, so am staying vigilant.
Dr.O - if you think this fits better under Pigeon Fever, feel free to move this discussion.
Thanks,
Lilo
Moderator:
DrO

Posted on Monday, May 12, 2003 - 9:47 pm:

That's great to hear. I have to admit when I hear some of these stories I am so thankful this is not a problem seen in piedmont NC. I think we have had as many as 10 case reports on this site which puts the incidence at 0.3 percent of the horse population. I think this is one of the problems that really needs a lot more research done on it.
DrO
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