|
|
Discussion on Research Summary: A Retrospective Study of Limb Cellulits
|
| Author |
Message |
Moderator:
DrO
|
Posted on Thursday, Apr 3, 2008 - 9:41 am:
This is a fairly common, life threatening problem in horses that yields important information for treatment. It should be noted that often the cause for the cellulitis remains unknown but where present is often strep and or staph. Also note the chief reason for failure: breakdown of the laminae in the opposite foot. Getting the horse as comfortable as possible is critical and where this is not achieved in a day, consider slinging the horse up to get weight off the good leg.
Vet Rec. 2008 Feb 23;162(8):233-6.
Retrospective study of the clinical features of limb cellulitis in 63 horses.
Fjordbakk CT, Arroyo LG, Hewson J.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario n1g 2w1, Canada.
A retrospective study of 63 horses diagnosed with limb cellulitis between 1994 and 2005 was conducted. They all had an acute onset of painful, generalised limb swelling, and a clinical diagnosis of limb cellulitis was made by the attending clinician. None of the horses had more than one limb affected. Hindlimbs were significantly more often affected than the forelimbs (P<0.05). Thoroughbreds were significantly over-represented compared with the general distribution of breeds examined at the hospital. Blunt limb trauma, limb surgery and limb injections were associated with the cellulitis in most of the horses, but no plausible cause could be determined in 27 (43 per cent) of the cases. Staphylococcus aureus and Streptococcus species were frequently isolated, although mixed bacterial infections were also common. All the horses were treated with broad spectrum antimicrobials and non-steroidal anti-inflammatory agents, and ultrasound-guided surgical drainage was also applied in 14 cases. Fifty-six of the 63 horses (89 per cent) were discharged from the hospital. Laminitis affecting the contralateral limb was the most common reason for the euthanasia of the other seven horses.
|
New Member:
bellarel
|
Posted on Wednesday, Sep 17, 2008 - 11:42 pm:
Help! Our beautiful five year old TB/WB mare (baby of your beautiful stallion "Romantico") had an acute onset of swelling in her left front leg yesterday. She had come in from her night turnout in the morning perfectly happy and sound. She was fine early afternoon, but at feeding time at 5:30 p.m., her leg appeared VERY swollen from the fetlock to above the knee. The edematous area was very painful, and the mare could barely walk. Her temp was 103.8. We quickly called our local equine vet (I'm a small animal vet) who arrived within minutes. He palpated the leg up and down and could find no wounds. He clipped the hair from a large portion of the leg with a 40 blade, and still no sign of a break in the skin. Hoof testers showed no pain in the foot. She has had no injections or injuries to the leg and her stall showed no sign that the mare had had any struggle (i.e. it looked normal). Blood was drawn for a CBC/SMA, and then the vet gave the mare IV Baytril, IV Banamine, a tetanus booster, oral DMSO, oral metronidazole (we decided to use this rather than do I.M. Penicillin as the Pen injections are so painful, especially after several days of injections). He also put an IV catheter in her so that the Baytril can continue to be given IV.
Today, her temp was 101 and she seemed bright and alert, but the swelling has not gone down. We are hand walking her 2-3 times a day (slowly) for 15-20 minutes and our trainer has used the "ice horse machine" on her. We have also put a support wrap on the opposite front leg. The trainer is thinking a poltice applied to the swollen leg might help.
Anyway, we have NO idea how this could have happened. She is at an excellent boarding facility (although I know there is no perfect barn!) She is on an excellent diet, on a great deworming program; she is riden regularly and is turned out half of the time (alone)and is up in a large concrete block stall half of the time.
So, I guess my 2 questions are: 1) Any idea of what could have caused this? Could a spider bite have caused this? Snake bite? Microscopic puncture from something in the pasture?
2)Is there anything else we should be doing to help the swelling go down? Should we refer her to a tertiary care center close to us such as UGA or Auburn?
Also, what is the prognosis for a horse with this, which I assume is cellulitis? This is our "baby" and we are sick with worry about her!!!
Thank you!
|
New Member:
bellarel
|
Posted on Thursday, Sep 18, 2008 - 11:42 am:
Mare is better today. Swelling down by 1/2. Sound encouraging? She's bright and alert and walking a little better.
|
Member:
paardex
|
Posted on Thursday, Sep 18, 2008 - 2:24 pm:
To me it sounds very encouraging Peggy, but all the medical questions are Dr O's to answer, usually he already would have answered but as I saw in other posts he is traveling which means the internet and answers are often a little late.
She seems to respond to your treatment fast and good so I guess you can try not to worry[which won't work I know
Jos
|
Moderator:
DrO
|
Posted on Friday, Sep 19, 2008 - 8:53 am:
Welcome DrH,
The change certainly sounds encouraging and I think the prognosis is good. One of the questions I have is what are the possibilities of a foot abscess? They can cause a leg to blow up like this and the other symptoms are consistent. Spider bite (black widow or brown recluse) is certainly possible as is a undiscovered puncture wound. Also superficial staph dermatitis can cause such reactions.
For more on a list of possibilities be sure to see the article Diseases of Horses » Lameness » Leg Swellings » Hot & Painful Legs. Since this is a discussion in that article I am unsure you have seen it.
Let me ask who the mare to the foal is. Though my memory suffers, Janette usually has a photographic memory of mares bred to Romantico.
DrO
|
New Member:
bellarel
|
Posted on Wednesday, Sep 24, 2008 - 8:57 pm:
Hi and thanks for your reply! Bella, our mare, is much improved, I'm happy to say. The swelling is gone, her temp has been normal for several days and she looks and feels great. We discontinued the Banamine a few days ago and will continue the abx until Friday. I've been out of town, and our barn manager, trainer and our equine vet have done a fabulous job taking care of her. The farrier was out two days ago to shoe her and saw no evidence of an abscess in the foot. I hope that if it was a spider bite, such as a brown recluse, that we are out of the woods and will not see any tissue necrosis/skin sloughing. We all feel pretty hopeful that she has recovered fully; it was pretty scary last week!
BTW, her dam is a bay Hanovarian cross mare named Callie(Calendar Girl). She was bred to Romantico in 2002. Is Romantico still around? I remember him as being a real beauty, very athletic and a lovely mover. Bella is also a nice mover and is showing great promise in the ring, both on the flat and jumping. She has a wonderful temperment and is easy on the eyes. I'm glad she inherited so much from her sire! She's a keeper!
Thanks again!
|
Member:
mrose
|
Posted on Wednesday, Sep 24, 2008 - 9:15 pm:
So glad she is improved! I sure hope it was "just" a bite and there are no further problems.
|
New Member:
bellarel
|
Posted on Thursday, Sep 25, 2008 - 5:04 pm:
I checked on her today and she's looking great. Our trainer rode her a tiny bit (walk/trot) and she seems sound and happy. There is a very small amount of swelling present medially just above the knee , but other than that, all seems well. We will continue to watch her closely just in case something blows up again.
Dr O, do you think that 10 days of abx is enough? Would you do anything for the tiny bit of swelling that is still present? Also, do you like to give any probiotics after a heavy dose of broad spectrum abx or will the normal gut bacteria return on its own? Her manure is a little loose, but not bad, and that could be from eating a lot of grass lately.
|
Moderator:
DrO
|
Posted on Friday, Sep 26, 2008 - 7:33 pm:
Hello Peggy,
If that is a little edema or tissue induration, no I don't think so. As to 10 days I would let the case tell you. I like to treat for 3 days past normal if the horse is tolerating the antibiotic well. I don't have any research to indicate probiotic products helpful for the mild digestive upsets caused by antibiotics, for more see Horse Care » Equine Nutrition, Horse Feeds, Feeding » Probiotics and Yeast Culture Products.
DrO
|
|
|
