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  Discussion on Lymphangitis -- alternative treatments to IM antibiotics
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Member:
efobryne

Posted on Friday, Jan 25, 2008 - 11:31 pm:

I have posted before about my grade Percheron gelding. He had scratches on his front legs during Nov/Dec. They have cleared up but on Christmas Day his right hind blew up. No signs of scratches, no heat, no discomfort when you touched it -- just a real stovepipe leg. Vet prescribed bute and anti-inflammatories. Leg came down although there was stubborn edema in the hock.

Early last week things got really bad, very quickly. One day he developed a tiny lesion on the inside of his hock. There were also raw areas high up on the inside of his leg into his groin area. By the next day the lesion had doubled and at the suggestion of the BO had a holistic type vet (who is also a DVM) look at it. I was skeptical about that vet's suggested treatment but as I was no longer able to get my regular vet out (he's dealing with bovine patients now)-- I had to find another vet. New vet came out two days later. By then the lesions had spread upwards from the hock and downwards to just above the coronary band.

The new vet was great. Gave my horse a loading dose of antibiotic (Three injections since he such a big horse)and left instructions to pick up gentamicin from the clinic and add that to the treatment as well. I checked with the barn owner and she assured me that her husband would be fine doing IM injections. They just don't do IV treatments.

I have been out every evening this week to hand walk and check my horse. After the initial positive response to last Saturday's treatment he seemed to plateau, but the vet had said, and I know from reading up about the condition, that healing will take time.

Today I got to the barn and found a note on the barn message board that the BO's husband was not comfortable about giving him so many meds. No one was around to clarify what had happened but later I was able to reach them by phone, and it turns out they have given my horse none of his antibiotics at all.

I can't quite describe how angry I am about this. Up until now I have thought this facility has provided the best of care. Aside from boarding riding horses, they also do broodmare and racetrack layups so I know they have given IM injections in the past. I understand that my horse is big, but that is why I was so careful to ask last Saturday if they minded administering the shots.

I am hoping that the vet clinic will have enough calls in the area that one of the vets will be able to DrOp by during the week and administer some of the injections. But what if they aren't available. I am very squeamish about giving needles and I am a klutz. I don't even like to give Sub-Q needles. My husband says he will do it, but frankly his experience is limited to administering Sub-Q fluids to a cat with kidney disease.

The boarding part of the operation is small and so there are no other boarders with the experience be competent in administering the needles.

Are there alternative forms of antibiotics to give? I realize that they likely will not be as effective. Also, we have lost almost a full week's worth of treatment. What sort of impact may this have on long term outcome?

Finally how harmful would moving him to another barn be at this point? I have a friend who owns a barn and lives about an hour away and I am considering asking her to take him if necessary. Her vet lives right across the road from her and is a friend of hers. I have another friend who is a vet tech but she no longer has her own place so I would have to find a barn close to her.

Sorry for the rambling.
Moderator:
DrO

Posted on Sunday, Jan 27, 2008 - 12:07 pm:

Hello Jill,
There are some oral antibiotics that can be used like TMP-SMZ, chloramphenicol, and doxycycline. Also there are some injectable antibiotics with wider spectrums of activity that get around having to give so many injections like Naxcel (ceftiofur). For more on the antibiotics you are using and other available antibiotics see Treatments and Medications for Horses » Antibiotics and Antimicrobials. Note that antibiotic treatment should be based on likely organisms present and this is best done by culture and sensitivity testing. For more on this see the Overview article in the antibiotic section.
DrO
Member:
efobryne

Posted on Monday, Jan 28, 2008 - 7:23 am:

Thank you Dr. O.
Member:
efobryne

Posted on Wednesday, Feb 6, 2008 - 7:46 am:

Hello again,

We have finished with the IM antibiotics. I had a Percheron breeder come out and show me how to do it, however by the end of the course of medication both my horse and were wrecks. I had to have the vet come out and do the the last penicillin injection as well as the gentamicin (sp?). The horse was in such a state that he had to be tranqued.

May I just say at this point that breeding that much sensitivity into a breed that big is a very bad idea! The vet was very interesting as most of the heavy horses he has dealt with are Clydes and Belgians and seem to have a much higher tolerance for discomfort.

I am very worried that if this condition flares up again we will have to go back to IM injections although the vet has said he will come out and administer the meds.

Meanwhile my horse is remaining on the prescribed anti-inflammatories. The lesions are healing and some are growing back hair already.

Since he has basically been off since Nov. I started lunging him again. We are starting with mostly walking on a large circle (5 min each direction), with a couple of trot circles at the end. The first night we did this he kept trotting for an extra few circles but at one point his affected leg kind of gave out on him and he stumbled. So back to the walk.

How long should I be looking at rehabbing, assuming we don't have a flare up?

Also my sister sent me a site for draft horse supplies and they sell a topical tetracycline spray. Is there any benefit to the use of such a spray during flare ups?

(Re: the nerves over shots -- I am having a bomb-proofing expert come out to work with us, but he won't be back in our area until March)
Moderator:
DrO

Posted on Wednesday, Feb 6, 2008 - 6:16 pm:

I am afraid that topical antibiotics are not going to treat lymphangitis, the infection is under the skin. If you are looking for ways to teach your horse to stand adverse events there is no better way than Training & Conditioning Horses » Behavior and Training » Modifying a Horses Behavior: Conditioned Responses. Lastly is there a reason you do not want to try the recommended oral antibiotics above?
DrO
Member:
efobryne

Posted on Wednesday, Feb 6, 2008 - 7:07 pm:

Not at all, there is no reason why I would consider using anything than those medications that you mentioned -- I have already discussed with the veterinarian about the oral alternatives to IM. He will administer long acting IM for me and this will be augmented with oral antibiotics if/when we have a flare up.

I was merely curious as to whether a topical spray would have any impact at all on the lesions that result from Lymphangitis. I didn't think it would but I just wondered about it.

I had not seen this particular spray previously. Since it was advertised on a draft horse site, I imagine it might be used for scratches.

As for modifying this horse's behaviour, I have read the article about how to work with him. I am able to modify his behaviour to some degree, but I definitely need professional help with him. For example I can work with his legs and check for swelling and lesions fine although this took a bit of work to get him back to this stage. The shots are a whole different issue. Even the vet intends to tranquilize him for his next shots.

A big issue is that this horse is just so large. The other issue is how quickly he makes connections and hardwires them into his makeup. Obviously as a "prey" animal one cannot make a true analogy with a predator type of animal like a dog, but his reactions remind me of working with a border collie or other herding dog. You have to be so careful with them because they pick things up so fast and it's so easy to make a mistake with them. I took my aussie shepherd cross to a professional trainer -- I wanted to make sure I didn't mess up. I think this may be another time for professional assistance.
Moderator:
DrO

Posted on Thursday, Feb 7, 2008 - 8:42 am:

If the lymphangitis results in open sores then by all means treat with both systemic and topical antibacterials but be sure to check for compatibility, some antibiotics decrease the effectiveness of the others.
DrO
Member:
ekaufman

Posted on Thursday, Feb 7, 2008 - 9:53 am:

Hi Jill,

I have no medical advice, but I do have one training comment. It may be out of line.

Some horses are indeed very sensitive, and big horses make big reactions. But sometimes we get so concerned for our safety around these guys that we forget to be very firm in insisting that they respect us. So he may be intolerant of pain, or he may never have been taught to put up with stuff because humans insist on it. My vet has remarked that she sedates more horses for bad manners than bad temperaments. He may just need the rules explained, and he may need to have an idea that there are consequences for misbehavior.

May not fit your situation, but your guy has done a good job making his own rules for the people around him in this situation. That dynamic may need to change.
Member:
efobryne

Posted on Thursday, Feb 7, 2008 - 12:23 pm:

I understand what you're saying but I am pretty careful with making sure horses have good ground manners -- especially a horse this size. I have a permanent foot injury so I can't have a horse around who is going to be badly behaved.

This horse has had six years of decent care. But before he came to his previous owner he was likely intended to be used for logging down east.

I wouldn't say he was abused -- I think that claim as an explanation for horses' behaviours is made far too often. However I would say that this is a horse that has likely had consequences for misbehaviour made abundantly clear to him in a physical fashion at some time in the past. Also by his behaviour it would appear that he has become trapped or entangled in something at some point during his driving training; this is apparently not that uncommon.

Ironically I am less worried about getting hurt by this horse than many others I have dealt with. He is a pleasant horse to deal with; he is big but he is careful. He waits his turn when being led into a stall and turns to face you immediately in the stall. He is a pleasure to lead and doesn't need to be caught when he is turned out -- he walks up to you. He tries hard under saddle when learning new things.

When I say he is a wreck because of the shots I mean that he will try to back away from the needle, startle when it goes in, and break out into a cold sweat. The vet's decision to tranquilize him was because the horse was just so stressed by the whole process rather than because we were having to deal with some horrible intractable beast. I think he would have made the same decision if it were a pony showing the same reaction.

As a contrast, I ride a a friend's Fjord who is 400 pounds lighter than my guy, who also became a riding horse after a driving accident. This horse is totally unflappable under saddle but his ground manners leave a lot to be desired. He will barge past you at feeding time, pull when being led, or my particular favourite, refuse to be caught.

My gelding is just one of the most anxious and suspicious horses I have encountered. In the situation with the shots for my horse -- if I make a big deal about consequences for his actions (what sort of consequences would you recommend in this case btw?) I can guarantee that by forcing the issue over this, he will generalize the response to all veterinary procedures and any other action that may be out of the ordinary. Currently he stands quietly to have his temperature taken and to have chiropractic treatments. Do I really want to jeopardize that?

Because of his previous treatment for scratches when another vet shaved him down to the skin and had me using me a blow dryer on what developed into chapped and bleeding skin, I am now having to reintroduce clippers to his repertoire of non-frightening things. I was able to clip his feathers before. Currently I am using fetlock shears. It is veerry time consuming.
Member:
efobryne

Posted on Thursday, Feb 7, 2008 - 5:22 pm:

I realized I just hadn't addressed the "large" issue.

1. I find it to be an issue because of how people react to this horse. People see a large horse and naturally seem to expect the worst and feel he needs a very strong hand. When I first got him, I had a friend giving me a lesson. He wasn't standing for mounting (an issue which has been successfully dealt with) and she really got after him. Well he was a quivering mess. It took three weeks to get him settled. My previous horse would have just shrugged it off.

I just came back from the barn and one of the new workers was commenting on how my horse had made her day. She went to catch him from turnout and he did his usual whinny, looked so happy to see her and walked up to her to be led in. She seemed surprised he was so friendly. I don't know what she was expecting -- people seem to expect large horses to be aggressive and/or dumb. (I didn't have the heart to tell her that he really loves his food and probably thought he was about to be fed).

The other two points are more relevant to his current situation.

2. The one issue was how much medication he requires. His penicillin had to be divided into three individual injections and the other antibiotic was divided into two. So on days he had his penicillin he had five injections. This was actually why the barn owner's husband balked at giving him the injections.

3. You are entirely correct about his reactions being large. When he jerks his neck up to avoid a shot he is really tall! It is simply physically hard to reach him sometimes. Plus he has very dense muscles. Getting a needle in was chore.
Member:
ekaufman

Posted on Thursday, Feb 7, 2008 - 6:29 pm:

Hi Jill,

Hmmm. Sounds like he *hates* shots and is a tiny baby horse in a great big horse suit.

As an aside, I have found that Percherons are a friendly breed-- I'm surprised that folks would expect otherwise.
Member:
efobryne

Posted on Thursday, Feb 7, 2008 - 6:58 pm:

He is, indeed, a terrible wuss.

Now in total he has been off since November and he has had lymphangitis since Christmas Day. He is probably 15 to 17 years old. He has trotted out strongly sound for two days now. Any suggestions about rehabbing -- when I should consider riding again? He was doing very low level dressage before he went lame. The footing is poor outside so we will be riding inside.
Member:
paul303

Posted on Friday, Feb 8, 2008 - 1:18 am:

JJM: You might have some fun if you check out a recent discussion:

"Cordless Vibrator for Clipper Desensitization"
Member:
efobryne

Posted on Tuesday, Feb 12, 2008 - 7:38 am:

I just glanced at the title the other morning and thought cordless clippers -- huh, I already have them. Then I went back and read it properly (in a less sleep deprived state)! The people at the barn are already convinced I am crazy. This would just confirm it for them.
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