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  Discussion on Strange skin condition-coronet bands
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Posted on Wednesday, Jun 20, 2001 - 4:08 pm:

Help!

I am trying to figure out what my horse has. He is a 16 yr old TB gelding and has had it for years (before I bought him). The conditions under which he is kept are relatively dry (not standing around in mud.) A culture was done several years ago that showed the presence of fungus. However, no vet around here has seen anything quite like it as far as the manifestations of the problem goes. Since the horse came from another state it is quite possible that he came here (Oregon) with it. No other horses he has been stabled with over the past 7 years have ever come down with it. The condition was treated with various topical remedies including daily scrubbing with Betadine followed by Panalog ointment, which went on for months without success. As treatment progressed th horse became less and less tolerant of it and treatment had to be discontinued for the safety of the owner. Since then the problem has settled into the state described below. Are there any systemic treatments for fungus?

Description of condition
Confined to the coronet bands on the hind feet. One linear area on one pastern (seems to be along an old scar line) and two small dark gray nodules (each approx 1/8" in diameter and protruding from the skin approx 1/4-1/2") on the other pastern. Skin at coronet band has fissures (the skin is peeling up from the hoof in places) and under the fissures is a dry, grayish, adherent, scablike crust (not flaky, and not a serous crust). This can be picked off, but with difficulty, and it is painful to the horse to do so. The crusts are deep and picking them off causes bleeding. (The problem with topical meds is that they can't really get under the crust.) Otherwise the horse does not appear to be bothered by the crusts (no itching or swelling.) Hair on pasterns is bleached and dry-looking. The horn on the exterior of the hoof walls appears to be abnormal as a result of the problems with the coronet band. The hoof wall seems to be growing faster than normal, but is of poorer quality, with superficial cracks and more noticeable "growth rings" than on a normal hoof. The hoof wall on the bulbs of the heels is most severely affected (since it is so much thinner), resulting in instability of the heel. The deeper hoof wall seems to be relatively normal.

If anyone has seen anything like this, or could recommend other types of treatments (i.e. a systemic medication of some kind) please let me know!

Thanks,
Ken Morris

Posted on Thursday, Jun 21, 2001 - 7:54 am:

Hello Ken,
The problem is that you describe an infectious skin condition but we still do not know the cause, preventing specific treatment. If you think the culture was accurate, and cultures taken on the surface of diseased skin are notoriusly inaccurate, there are systemic antifungals, but they are much like antibiotics, some work on some fungi but not other therefore it is important to know which fungus you are dealing with.

If you contine to find you cannot get a handle on this problem, consider a biopsy of the area with an emphaisis on trying to identify infectious organisms. Second best is a culture for fungi and anerobes under a fresh crust.

I have had two cases of coronitis like you describe and both responded to Panalog creme. They were fairly acute cases however. Members on this site who have had poor luck with Panalog have mixed Desitin, with a antibiotic creme (I would pick one that contains both antibacterials and antifungals) and over the counter hyDrOcortisone cremes. Though similar in make up to Panalog, I think they get a little better coverage and protection from the Desitin.

I am concerned by your statement that it stays relatively dry. This is probably not dry enough, it needs to stay absolutely dry until healed.
DrO

Posted on Thursday, Jun 21, 2001 - 12:19 pm:

Dr O,

Thanks for the info. I have tried the Desitin mix just as you describe and it was no better than the Panalog, maybe a little worse. (My vet has prescribed this mix in a number of cases and this is the first time it didn't work.) Both it and the Panalog HELP, but never get rid of it. The Panalog was used daily by his previous owner for 2 years and kept the infection at a low level but never eradicated it. But stop treatment for a few days and it comes right back. I'm hoping for a permanent solution, and thus the thought about the systemic.

What systemic antifungals are out there and which fungi are they effective against? My vet is willing to try this approach but he says he is having trouble finding info on dosage. I think one of the antifungals he mentioned was fulvicin.

Thanks for your help,
Ken Morris

Posted on Thursday, Jun 21, 2001 - 12:30 pm:

Dr O,

I just read the article on fulvicin on this forum. So at this point I just need to know what other systemics antifungals are available and what types of fungi they work against.

Also should I be doing a topical treatment at the same time as using the systemic? Or is it better just to keep the horse dry?

thanks again,
Ken

Posted on Friday, Jun 22, 2001 - 7:28 am:

There are no other systemic antifungals approved for horses, so it is experimental but several have been used successfully. Also systemic antifungals also are much more toxic than antibiotics so care in monitoring during treatment is important. This reemphasizes the importance of a correct diagnosis.

I think it is important to cover all these details so since this is not an emergency I think I will put together an article on these drugs this weekend also listing the toxic potential.

Since the problem is superficial I would treat both topically and systemically when I knew what I was treating.
DrO
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