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Cellulitis: A Challenging Condition To Cure

Cellulitis is a sudden, painful skin infection that requires aggressive, immediate care. Most commonly affecting the hind legs, many horses recover readily, but complications are possible, and chronic flare-ups are a possibility.

Cellulitis occurs when bacteria penetrate the epidermis of the skin and multiplies in the subcutis, which is made up mainly of fatty and connective tissues. Primary cellulitis has no specific point of origin and exactly how it penetrates the skin is often unknown. Secondary cellulitis occurs when bacteria enter tissues through a known route, like a wound or surgical incision.

Cellulitis can be caused by a variety of bacteria and needs to be treated promptly. Left untreated, the infection can affect bone, tendon or synovial structures. Sepsis and laminitis can also occur.

Signs of cellulitis include:

Dramatic swelling that comes on rapidly and feels firm
Heat
Pain that tends to appear when the horse is asked to step forward rather than bear weight
Fever
Wetness: the swelling can progress rapidly to the point where fluid leaks from cracks in skin that is overstretched

A vet may take X-rays or do an ultrasound to rule out other possible issues like a joint infection or fracture. He or she may also culture the fluid weeping from the leg; this will help determine what bacteria is involved so that the proper antibiotic can be administered.

The primary treatment for cellulitis is intravenous antibiotics, as well as nonsteroidal anti-inflammatories to help with pain and swelling. Cold hosing or ice boots or bandaging can also help.

Horses with secondary cellulitis tend to recover more rapidly. Though some cases of cellulitis can be managed at home, severe cases may need to be referred to an equine hospital.

Horses that have had even one episode of cellulitis become susceptible to chronic cellulitis, specifically in the same limb, whether the skin was permanently damaged from the extreme swelling or because circulatory and lymphatics systems have been damaged to the point that they are unable to mount an immune response. Horses that have had cellulitis even once should be monitored carefully as even the tiniest wound may initiate a new round of cellulitis.

Tips to avoid cellulitis recurrence:

Turn out the horse as much as possible in dry condition
Use shampoo sparingly when bathing
Avoid sharing grooming tools and sterilize them regularly

High-Tech Tool To Diagnose Rainrot

Rainrot is a common, painful skin condition affecting horses that are exposed to rainfall for an extended period of time. Caused by an opportunistic bacterium, a horse exposed to wet, humid conditions can rapidly develop a crusting infection that causes tight scabs in a drip pattern down his back, rump and flanks. Rainrot can also show up on areas of the horse that are in contact with wet grass, like on the lower legs and muzzle.

Though many horses can be treated for rainrot with over-the-counter products, older horses and those with comprised immune systems tend to get more-severe infections that may require veterinary intervention. When dealing with a severe case, a vet will generally sample the crusts and examine it under a microscope, looking for the specific bacteria that causes rainrot.

A New option available to veterinarians is the use of polymerase chain reaction (PCR) technology. This DNA-amplification technique is commonly used in gene sequencing and forensic analysis, as well as for diagnosing infectious diseases. Extremely sensitive, PCR is a routine diagnostic test for most labs and it's affordable: The test isn't as expensive as most cytology tests.

Once run, it can differentiate between rainrot and other skin conditions, which will assist in determining a course of treatment, shortening the trial-and-error efforts sometimes needed to assist with healing.

Study: Tap Water Fine For Flushing Wounds

Researchers have concluded that tap water, not sterile saline, should be used to wash most equine wounds. As long as water is clean, flushing an injury as soon as it's found can help remove bacteria and dirt, reducing the risk of infection. The water used to flush a wound should be potable, but if only undrinkable water is available, boiling and cooling it is still an option. Distilled water can also be used to safely lavage open injuries.

Drs. Sarah L. Freeman, Neal M. Ashton, Yvonne Elce, Anna Hammond, Anna Hollis and Greg Quinn created guidelines for equine wound management based on evidence they collected from a set of questions proposed to a panel of veterinarians. The scientists also looked at human medicine if equine studies weren't available. In total, they used 306 veterinary studies and 25 human-focused papers to produce their recommendations, which included:

Tap water is recommended for flushing wounds over saline
The best pressure for washing wounds is 13 pounds per square inch (medium pressure)
Contaminated wounds should be flushed with provide-iodine
silver sulfadiazine may slow healing of acute wounds

Botulism: A Deadly Disease

Botulism in not a disease many horse owners are familiar with—but they should be as the disease is often deadly. Caused by the Clostridium botulinum bacterium, the soil-borne disease is more common in certain areas of the country, like Kentucky. The spores of the bacterium produce a neurotoxin that block the transmission of nerve impulses to muscles. This results in progressive weakness that makes the horse unable to swallow. Up to 50 percent of horses that receive supportive care can die; those that get no assistance are even more likely to perish from the disease.

Horses can get botulism in three ways:

Ingestion of decaying plant material or animal carcasses in hay or on pasture grass
Infection through wounds
Ingestion of spores and vegetative cells that cause Shaker Foal syndrome

There are different types of botulism: Types and B are associated with forage, while Type C is associated with the accidental ingestion of decaying animals.

A vaccination for botulism type B is available, but it is not considered a core vaccination as it is found mainly in Kentucky and the mid-Atlantic states. A horse's risk of getting the disease should be discussed with its treating veterinarian to determine if vaccination is necessary.

Foals are at particular risk of developing botulism, so pregnant mares should be vaccinated against the disease before they foal. Foals born in areas of the country where botulism abounds should receive Botulism type B toxoid at 2, 4 and 8 weeks old even if the mare was vaccinated.

There are no licensed vaccines for botulism A or C.

Read the AAEP botulism vaccination recommendations here.