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Cellulitis: It’s causes and treatment

 If you suspect your horse has cellulitis, the time to act is now. DR DOUG ENGLISH explains what to look for and possible treatments.  

Cellulitis is a bacterial infection that has gotten on top of the immune system, infecting the skin and underlying tissues. It can occur in all animals, including horses, and is characterised by redness, swelling, and warmth in the affected area. The pain can be so intense that your horse may quickly jerk their leg away from your touch. They’re likely to be lame due to the pressure of the swelling and associated pain.  

If left untreated, the horse may develop a fever as the infection becomes worse. As the infection spreads, it can affect the entire leg causing significant swelling  

In horses, cellulitis usually affects the lower limbs and can be caused by various bacteria and fungi as in ‘swamp cancer’. Horses can develop cellulitis through breaks in the skin (cuts, wounds, or insect bites for example) which allow bacteria to enter and infect the underlying tissues. 

Treatment for cellulitis in horses typically involves a combination of medical management and supportive care. Here are some common approaches: 

Veterinary examination: It is important to consult a veterinarian to diagnose and determine the severity of the cellulitis. The more severe and widespread the infection is, the harder and more expensive it is to treat, and the resulting scar tissue may result in a permanently distended limb and possible ongoing lameness. Your vet may perform a physical examination and will possibly take a sample for bacterial culture to identify the causative bacteria, particularly if the infection is not responding. 

Antibiotics: Antibiotics are prescribed to combat the bacterial infection. The choice of antibiotics depends on the specific bacteria involved and the results of the sensitivity test. It is crucial to administer the antibiotics since they are the major weapon in fighting a cellulitis that has overwhelmed the immune system. 

Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may be given to alleviate pain and to reduce inflammation. But they can also reduce the local immune response and I am not keen when owners use them without antibiotics, thinking that they are a cure for infection. They are pain medication and not a cure for bacterial infection. 

Hot compresses: Applying hot sponging compresses or hosing the site of the infection increases circulation, brings in more healing antibodies, accelerates local healing processes, helps reduce swelling, and provides relief. Ensure the water is not too hot! If you can’t hold your hand in it then it’s too hot. Repeat this treatment as often as you can and for more serious cellulitis three times a day is not too much. Additionally, topical osmotic agents (strong salt solutions) may help to draw out excess fluid. 

Bandaging: Proper bandaging techniques, such as using clean and non-occlusive dressings, may be employed to protect the affected area and aid in reducing swelling. Unbandaged wounds are magnets for flies which carry infectious organisms. 

Possible exercise restriction: Caution here because walking increases the circulation in all legs which is necessary. Horses with cellulitis confined to a stall and just standing about generally develop more swelling. But sometimes they need restriction and for interpretation of best practice confer with your veterinarian. Mostly I think walking is about the best option. 

Wound care: If there are any open wounds or sores, proper wound care is essential. Cleaning the wound with an appropriate antiseptic solution and applying topical treatments as advised by your veterinarian can facilitate healing and reduce the risk of secondary infections. 

Correct wound care is essential. Above is an example of a properly managed leg wound with no cellulitis present. It was bandaged daily and healed within 12 days.

Follow-up care: Regular follow-up visits with your veterinarian are crucial to monitor the progress of the horse’s condition and to make any necessary adjustments to the treatment plan. 

An ounce of prevention: Paddocks with mud, stagnant water, deep sand, or thorny plants are all hazardous and best avoided if possible. Ensure your horse’s legs are kept clean and dry, and treat all cuts as soon as you become aware of them. Regular exercise at what ever intensity your horse is fit enough to undertake will also help to improve their general circulation, and thus reduce the possibility of cellulitis. And finally, avoid excessive use of shampoos. These products can dry out your horse’s skin, making it vulnerable to cracking.