OK So I have been reading a lot of lymphangitis threads latley (not good ), but at the same time was very intrigued on how every case is treated.
For 8 years, my horsey-nephew has had the disease. He is usually treated with sulfatrim (SMZ) orally for 5 - 7 days post flare up. For extreme flare up, he has been ona third generation injectable Excenel. He has not been on any other AB's and has not had excenel in a few years.
Now, he has had a few flareups in a row, so I put him on sulfatrim. (His system is so damaged, he will sometimes flare up with no need for AB's but this time I am sure he needs them as this is the first flare up in 9 months).
What AB's or steroids (and protocols please) have YOU used to aggressivley treat lymphangitis? We are comfortable giving IM and IV injections. Our vet works closely with us on his case, but he pretty much just recommended SMZ's and excenel and naquasone.
I have had numerous horses with lynphangitis and I have used both chloremphenicol (oral) as well as naxel. I don't like giving shots if I don't have to and the chloremphenicol seemed to work pretty well for me.
One of my mares had a flare up a few years back during the last month or so before foaling. It had initially come on from a tiny cut on the back of her heel that I scrubbed at and attended to but I guess something got in there and within a day her leg was blown up like a stovepipe up to her stifles
We were limited in what we could do as she was in foal, so she went on the SMZ's, banamine initially, NO steroids (as that could cause her to abort) and warm water hosing to stimulate the circulation and I also bought one of the Thumper hand held massage units and I ran that up and down her gaskin area, her hock and softly below the hock area. It must have felt good because she would just stand there with no one holding her and I'd put a stool beside her and just thump away for as long as I could, several times per day
She was in a boarding stable at the time and I couldnt dictate the length of turnout time for her but God - I wish she could have stayed out from morning until night or even 24/7 - especially in the beginning when it first came on
Now it is completely manageable, if she is in for a bit longer than normal it will go up slightly but not even a 1/100th of what it looked like during the scary times when it first happened. I have not had to put her on anything since it first happened and during the last stages of this pregnancy it wasnt an issue at all so crossing my fingers that it is completely under control right now
I had a wonderful gelding that had lymphangitis that we kept in check with turnout, wrapping and feed. He was standing wrapped unless he was being ridden to turned out. He was turned out for long periods of time, the best situation would have been a stall with a turnout attached, but alas that was not to be. We were very careful to feed him a low protein feed and a grass hay (a timothy or orchard grass) as opposed to alfalfa. The protein really messes them up. I also used SMZ's 16 twice a day with a bute tab for flare ups. I don't recall the drug my vet used but it was IV and it stopped the flare up in one day. We kept him on that for 5 days, it was obviously an antibiotic. He actually went thru a period of 5 years without a flare up with very careful managment. It is a difficult disease to deal with, very difficult and so painful for the horses.
Resurrecting an old thread - my 27-y-o Arab came down with lymphangitis this weekend while I was out of town visiting family. Thanks to wonderful barn friends, the vet saw him right away and by the time I came home he was 85% back to normal. I'll talk to the vet tonight to ask more questions, but as far as I can tell, his antibiotic regime is 3 days of IV gentamycin, 3 days of IM penicillin, followed by some period on sulfa (uniprim, probably, I'll find out tonight). That plus banamine, wraps, hosing twice a day, hand walking "as tolerated" (he just about pulled my arm out of the socket this morning trying to go out with his buddies!).
My question is: why are they blasting him with 3 very different classes of antibiotics? is it truly one of those things we don't know the origin of, so we just hit it with everything and hope something works? secondary infection? I think it's interesting that others in different parts of the country use the tetracyclines/doxycycline and that's about the only one he's NOT getting! Any insights?
I went through an acute case (I'm sure the posts on it come up in searches) quite a while ago now. My understanding of the 'blast multiple antibiotics' theory is twofold: 1) by the time you sent off the test and waited for it to come back, the acute cases would already be gone, and 2) when the horse is in a very compromised state, he is more susceptible to other germs that are in him in small quantities, or in his environment. The first priority though is to knock the typically very high fever down fast. I'm not a fan of initial treatment with just SMZ's. IMHO, the faster and more aggressively you treat, the less likely you are to end up with a chronic case of lymphangitis, instead of a recovered case of acute lymphangitis.
My horse got a nasty case on Easter. I came into the barn and he was in his stall shaking, having severe muscle spasms, and non weight bearing on the left hind. There was a small amount of swelling through his pastern, but he has some scar tissue there so he is more prone to stocking up there. The leg was warm but not hot, foot was fine and he didn't really have a temp (100.5, he normally runs around 100.).
He looked like he had a broken leg. Called the vet who was there within forty minutes, but by that time he had swelled mid way up the cannon was was still very uncomfortable despite 2 grams bute and 10 robaxin (for the spasms). He was given 1000lbs banimine by me and then another 500 by the vet and another 1000lbs that night. He was very uncomfortable and he is not a stoic animal.
As far as drugs he got a ton. At one point he was on 8 different things a day, and you could still barely get him out into the aisle, we had to cold hose in the aisle, he couldn't even make it to the washstall.
Naxcel 20 cc 2x daily
Genetcin 30 cc 1x daily
10 (or 15) Metropridozale (spelled that wrong) 3x daily
5 mg Dex
a packet of Naqusom (combination of Dex and something else)
2 grams bute (AM PM)
1000 Banamine split into 2 doses (AM PM)
He then went on 30 SMZ's for 14 days. He also got a game ready system (70 minutes a day) for 3 weeks and we used glyercin to sweat the leg and prevent the serum from making the wrap stick. He was swollen from the cornet band to the middle of his stomach where a big edema stayed for a week or so after the main incident. The skin split and bled and he essentially rotted the top inch of his cornet band off along with his chestnut and ergot falling off. He had no hair on the leg from mid cannon down. The best, most soothing thing we used on the leg when it was so bloody was Horsemans Dream Vet Cream, and following that used Panalog/Animax cream compounded by Wedgewood.
Now he lives in hind wraps when not t/o or being ridden. Any cut on that leg immediately gets SMZ's for 10 days. It was gross and he was completely miserable, but aside from some left over swelling he came back very sound and went from lame to sound almost overnight and was back showing 2 weeks after being sound (was off for 2.5).
first bout of lymphangitis with my mare, local vet put her on smz's and oral banamine.
No response, and since this mare is immune compromised, I shipped her directly to the clinic, who know her history.
She went on IV Baytril, banamine for ten days, and then smz for a week or more after she came home.
I don't mess with that mare. It might have been overkill, but she really scared me with how dead lame and swollen she was.
She also got a second bout in the fall,6 months later. I cold hosed every 4 hours, put her on smz and oral banamine, and she was fine in a few days, although she stayed on the smz for two weeks. I was ready to take her to the clinic, but the local vet wanted to try the smz's and it was the weekend, so, that is what we did.
I think the second time I caught it early, like within an hour of her being lame, and cold hosed, cold hosed and cold hosed.
It was my 35th reunion with college friends so I went from party to party, and each time stopped home and cold hosed! When it happened, I told her, you are not ruining my weekend! Actually, since she responded so well, it worked out super. I would never be wide awake at 2 in the morning on a normal night! I think the cold hosed worked, and she is very easy about being hosed. If you don't have one who stands quietly, its awful since I think it really helps.
I also shave her legs. She is a percheron and does have slight feathers. I think it came on from scratches, which she had chronically. Not terribly, but an opening for bacteria to get in her system. Now, I am a nut about keeping her shaved, and looking for cuts. I immediatelty treat and clean the cut, and hose it, clean it and dry it. Drying is very important too.
I had a vet tech working for me, and my mare had an abcess, and the vet tech cleaned it, and put on furacin. I think that is what led to the lymphangitis. The abcess, just above her heel on her back leg never healed, and by putting furacin on it, I think we shut off the bacteria inside. I also don't think her leg was cleaned as well as if it was hosed. She treated my mare for two months that way...I should have known better. Then one day, wham, huge leg in the morning,and no weight.
Now, I hose, and really dry it off well if I see a cut. I may put something like dermagel on it while she is turned out, and I also don't turn her out in any mud whatsoever. When she comes in for the night, the cut is thoroughly cleaned and dried off. Her stall is clean, so I don't worry about too much bacteria getting in the cut.
Its a scary illness, and one that needs to be aggressively monitored and treated. I don't think of abcesses or scratches the same anymore either.
Horse that I origionally posted about is doing great! In "Lymphangitis Remission!" He went from having flareups monthly, to annually now. His leg ONCE was 3x the size of the other for about 3 years, now it is 99% normal.
HIS Prototol was:
2 days IM Excenel
Tapering dose of IV then IM Dexamethasone
Tapering dose of IM Naquasone
Horse is doing great!!!! Unfortunatley, his flare ups are rarely infection related, so we have no idea when a flareup will occur. Cuts dont trigger them, they seem to be acute and for no reason, he doesnt even have a systemic infection during a flareup. Lucky for him though, he has had a great year and is happy, fat and back in the show ring!