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Discussion on Ventral swelling
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Member:
clauee
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Posted on Thursday, Jun 25, 2015 - 9:21 pm:
Hello Dr. O
I have a 7 year old warmblood in good general health. He does have windpuffs in the fetlocks but that's about all his health problems... He lives out 24/7 and has been in the same place (with the same living conditions) for the past 4 years.
Today he showed a ventral swelling on his left side. This swelling has happened before (a couple of times last winter, in the exact same place) but it never has been as much as this time. It is painful it we press on it but there is no heat, and it doesn't have the appearance of edema (it does not take more than 5 seconds to fill back, and it feels harder then edema). It is located where there is the pectorals ascendens.
Vital signs are normal (temperature is 37,2, his average) and he seems in good condition (eats well, good energy, etc.).
Last month he had a couple of days of lameness tracking left with no identified signs of cause - no wound, swelling, heat, etc... It went away by itself and and then he has been off training for almost a week after his recovery, just to make sure he is ok... Yet today this inflammation just appeared, and I don't wonder if it can be related to his lameness the past month? Or should I be looking for something else?
Thank you!
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Moderator:
DrO
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Posted on Sunday, Jun 28, 2015 - 7:44 am:
Hello Claudelle,
Whether it is related or not does not answer the question why is this happening. It seems less likely since while he was lame he did not have the swelling but this is not definitive. The question to be answered is the nature of the swelling and the best way to answer that question is having it ultrasounded and if there is a pocket of fluid: aspirated for cytology. Knowing the nature of the swelling may answer the question about the relation to the lameness.
DrO
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Member:
clauee
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Posted on Monday, Jun 29, 2015 - 10:00 pm:
Thank you DrO;
Today I had the vet come over because my horse's condition is not getting better...
The swelling has decreased a little yet the pain has increased; Temperature has come up to 38.8 and the horse has stopped following the pasture buddies (he stays behind) and does not have the normal appetite and energy level. Heart rate and respiration are normal
My vet had never seen this before, confirmed the swelling is painful to the horse, more on the left side than the right, but there is not heat. The right side has inflammation and painful also.
A trauma from a kick is not really on top of the possibilities, there i nothing on the skin that suggests a hit, bite or external cause... The trauma would have been to the sternum according to my vet, which is unlikely?!
He took a blood test and started antibiotics until we get the results...
I'm concerned 
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Member:
clauee
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Posted on Tuesday, Jun 30, 2015 - 11:02 am:
Hello again! Looking at different articles I wonder if Pigeon Fever could be involved?
My vet said this is an "old" disease and very uncommon here in Canada so didn't really consider... He also didn't consider ultrasound or punction even though I asked for it ?!
From what I read on this site, all the symptoms point towards pigeon fever and I'm afraid of internal abcess as the abdominal pain is increasing every day... it started with an idiopathic lameness, then ventral swelling, then fever and fatigue... Should I get a second vet advice and ultrasound as well?
Is it ok that we started antibiotics or would it prevent the abcess to mature?
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Member:
clauee
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Posted on Wednesday, Jul 1, 2015 - 7:33 pm:
Hello Again
Sorry about the last post, I was worried about my horse!
Today he is better, response to antibiotics is good. He has started eating again and following the buddies.
Some little bumps appeared on the area of swelling and according to my vet, this is skin response to localized infection (sub cutaneous). Most probably it looks like a bug bite or something similar caused the infection initially.
We are still waiting for the blood count results.
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Member:
moxshi
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Posted on Wednesday, Jul 1, 2015 - 8:04 pm:
That is a relief, Claudelle. Glad it's not pigeon fever.
Maybe a bee sting or some awful tick or spider bite. Glad he's responding to the antibiotic.
Did the vet suggest soaking the swelling with warm compresses? I have found that if there is infection, the warm compresses will often open it up so that it can drain. Sounds like your horse's infection is in a good area to drain well if needed.
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Moderator:
DrO
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Posted on Friday, Jul 3, 2015 - 9:05 am:
Hello Claudelle,
Well it looks like many of your questions that are directed towards me are being answered by treatment response. If the problem worsens, yes I would recommend further diagnostics.
DrO
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Member:
clauee
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Posted on Monday, Jul 13, 2015 - 9:57 pm:
Hello again!
Thank you Holly and Dr.O for your responses!
My horse had antibiotics for 7 days and the fever never came back; His appetite and activity level are normal, too...
The swelling is not gone yet, actually it is a little more defined. It also feels harder to touch, but not warm. Looks like there is something "cooking" underneath...
I don't know if I should be upset the swelling is not going away gradually?
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Member:
moxshi
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Posted on Monday, Jul 13, 2015 - 11:10 pm:
Claudelle, sounds like he's on the mend. I wonder if maybe the swelling is just healing very slowly? I got into some ticks last year, and they ate me up. Months later, the swellings from the bites had turned to itchy, hard, irritating nodules that took "forever" to go away. What does the vet say about the hardness of the swelling? Has he felt it? I wonder about covering the swelling with ichthamol or soaking with warm epsom salt solution on a sponge or folded cloth? When you feel the swelling, does it have any soft spot? }
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Member:
clauee
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Posted on Tuesday, Jul 14, 2015 - 9:06 pm:
Hello! The swelling is quite uniform in texture... it is getting harder every day though, and more defined. Today it felt hot for the first time.... I've included some pictures: the first three ones are from june 30, when the vet came (I had some clay on) and the next day after starting treatment. You can see the swelling is more "generalized" and the little "rash" the vet said could be skin response to sub cutaneous infection. The blood test revealed nothing new, it showed only some signs of inflammation.
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Member:
clauee
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Posted on Tuesday, Jul 14, 2015 - 9:13 pm:
June 30
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Member:
clauee
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Posted on Tuesday, Jul 14, 2015 - 9:14 pm:
 
July 1st
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Member:
clauee
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Posted on Tuesday, Jul 14, 2015 - 9:16 pm:
july 14 (I have clipped the area to see better) 
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Member:
clauee
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Posted on Tuesday, Jul 14, 2015 - 9:16 pm:
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Member:
gramsey1
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Posted on Wednesday, Jul 15, 2015 - 5:19 am:
We had something similar to this happen to one of ours last summer. The vet opened a drain hole which we had to keep open by flushing it daily with a cold hose. It healed fine. We don't know what started the abscess.
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Moderator:
DrO
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Posted on Wednesday, Jul 15, 2015 - 6:20 am:
Hello clauee,
The appearance of the swelling does not tell us the cause of the swelling or even the nature of it(see the article associated with this discussion area for more on this). The next diagnostic step would be ultrasound and using it to localize abnormal tissues possibly needle biopsy. If your veterinarian is uncomfortable with this consider a referral to a hospital.
DrO
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