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  Discussion on Cellulitis came raging back after 10 days on antibiotics???
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Member:
arary

Posted on Saturday, Feb 21, 2015 - 2:41 am:

So almost 2 weeks ago my horse came up slightly lame in her LH leg. The following day there was heat and swelling in the leg, mostly in the fetlock/lower cannon area. Spoke to the vet and he put her on SMZ pills for cellulitis since the swelling was in the same area where she'd gotten cut a week before. Within 24 hours of starting SMZs she was sound and the swelling slowly went down over the next few days.

Cut to Wednesdday, day 11 after starting antibiotics. We were supposed to stop the antibiotics, but the barn owner called to let me know that her leg was hot and swollen again, worse than before. Continued antibiotics. Vet came Thurs am as she was worse with HUGE amounts of swelling in both hind legs and fever of 102. Vet gave IV Banamine and started her on Dexmethasone 1X/day and 15 cc Baytril 2x/day. By evening fever was down but she appeared colicky, so vet had me start her on Ulcergard and no more Banamine, substituted Previcox in addition to the Baytril and Dex. This am, Friday, she was more comfortable moving around the field (sound at walk anyway) but temp was back to 102.

Will be speaking with the vet again tomorrow but at this point how panicked should I be? Legs are huge and I don't want to start bute/banamine because of the colic issue. Should I ask for a catheter and IV antibiotics? Is there something stronger that won't upset the stomach? Have been wrapping legs at night in the stall with no effect. Should I try poultice or a sweat? Vet didn't think it would make much difference, and it's been below freezing so cold hosing just seemed cruel. Pipes are frozen anyway. Should I be looking into getting her to a clinic (current vet doesn't have in-patient services but I know of a bigger practice that does). Please help.
Member:
rtrotter

Posted on Saturday, Feb 21, 2015 - 6:27 am:

Ang,

Has this horse been in contact with or had a strangles vaccine recently? I had this same situation happen after one of my herd horses had been vaccinated for strangles and my then 2 year old was turned out with her. The aged horse was fine the 2 year old had a reaction in her back legs as you describe.
Member:
arary

Posted on Saturday, Feb 21, 2015 - 9:53 am:

No vaccines since flu/rhino in the fall.
Moderator:
DrO

Posted on Saturday, Feb 21, 2015 - 10:26 am:

Hello Ang,
The history of bilateral involvement is strongly suggestive of a immune mediated vasculitis.
This can be a complication of infection or reaction to a vaccine or a drug. Essentially immune complexes (an immunoglobulin complexed with a antigen) lodge in the capillaries and set off an inflammatory reaction like the one you describe. Though commonly associated with Strangles vaccination it can occur with any immune stimulating event like your horse's earlier infection and treatment. The article associated with this discussion area has a subtopic on this titled "Purpura Hemmoragica" where you can read more and then follow the link in that section to the Strangles article which describes the general treatment for this condition.
DrO
PS after discussing this with your vet you feel you cannot adequately care for this at home I think moving to a hospital would be a good move.
Member:
rtrotter

Posted on Saturday, Feb 21, 2015 - 10:41 am:

And as I said in my post. The vaccination would not have to be to your horse, it could be from any horse your horse was in contact with. Although I do agree with Dr. O that this seems to be related to the cut, just not sure why it would be bi-lateral and not just in the leg with the cut.
Member:
arary

Posted on Saturday, Feb 21, 2015 - 3:40 pm:

There are only 3 other horses at the barn and nobody has been vaccinated since fall. She did look better this morning and temp was normal, so I'm hoping we're over the hump now. Outside temperatures were a little warmer so I was able to cold hose her legs for about 30 minutes, and will do so again this evening.

Vet suggested maybe a new nick or scratch on the "good" leg, and since her immune system was already over-reactive because of cellulitis on the other leg, it just blew up. That's why he started the dexmethasone to try to knock down the immune response.
Member:
arary

Posted on Saturday, Feb 21, 2015 - 10:43 pm:

So by this evening the original leg was about 50% better, a very good sign. The newly swollen leg was slightly better and at least the swelling seemed to have localized to the hock and inside of the cannon rather than the entire leg. I tried putting one of the Animalintex poultice pads on the area of greatest heat/swelling under the standing wrap. Will see if this helps. Morning temp was 99, and evening temp 100.2, so fever is down at least.

My big concern is that once again, she came in, got antibiotics & ulcergard, ate her grain, and within 15 minutes was standing in the back of the stall with head hanging down and looking uncomfortable. She does not seem to do this after am antibiotics/feed, only pm. And her temp always seems to be higher in pm also. Weird… She is turned out during the day and in at night.
Moderator:
DrO

Posted on Sunday, Feb 22, 2015 - 5:10 pm:

Hello rtrotter, it is the nature of immune vasculitis: it forms in the tissues (including the blood) then travels through the blood vessels and then lodges in the capillaries throughout the body. The capillaries of the hind legs are the most sensitive to this problem which is why it often occurs there. Think of your history above: a vaccine in the neck or up the nose and both hind limbs swell.
DrO
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