vets stumped - sheath swelling, fever, normal appetite
Hi guys, I am writing this about a horse that is boarded with me. He is a 24 year old gelding, and in the four years that he has been at my barn, has always been healthy. He is up to date on all of his vaccinations and is on daily wormer. He was scheduled to be wormed for tapes this week, but I have postponed that due to all of his medical issues that have come up.
Last Friday, he was acting very painful at breakfast time; grinding his teeth, pawing, very reluctant to move. Slight swelling in his hind pasterns, and very significant swelling in his sheath area. Sheath was also very warm and painful to the touch. Temp was 102, elevated heart rate. Vet was called out, examined horse, and did not find anything to explain the swelling in the sheath (ie insect bite, etc). Horse was given a shot of dex, and put on oral bute and antibiotics. Temp was taken daily, and went down with the bute. Swelling in his hind legs went away, but the sheath has remained enlarged. Bute was stopped on Monday, fever returned to 102.2 by Wednesday.
Wednesday morning his left hind was completely swollen, from stifle to coronary band. In addition, as I was taking his temperature on Wednesday morning, I noticed one of his melanomas had burst overnight, leaving two holes under his tail. I now have his tail wrapped and am cleaning it out, but am worried about infection.
So, vet was called out again yesterday. Examined horse, told me not to worry about the melanomas (did not clean it?), and prescribed him more dex, to be given for the next 3 days. Today, swelling is no better, but temp is once again back to normal (99.8). Blood was drawn, haven't heard results yet. All through this entire process, horse has had a normal appetite, has been drinking, urinating, and pooping.
Owner is not around very often, so I have been doing a lot of this horse's care myself (although owner is aware of all of this and has given permission for treatment). The vets dont seem to know what is going on, any ideas??
Sounds like Lymphangitis to me. There are major lymph nodes up inside the hind legs, sort of opposite the sheath. If you caught it at the onset, it would make sense for the sheath to be swollen before the hind leg in question. My experience with lymphangitis was that the more aggressively you treated it at onset and for the initial weeks, the less residual swelling and other effects remained with the horse. I'd hope your vet would have caught it, but I'd certainly confirm that your vet has ruled it out since you'd want the horse on some serious antibiotics ASAP.
Thank you, joiedevie. I was thinking lymphangitis as well, especially given the way his hind leg looks now. Honestly, I was very dissapointed in the vet that came out to look at the horse yesterday, she seemed very inexperienced and not very confident. But not my horse, so not my decision. Good advice, I will follow up with the vet to see if she has considered lymphangitis or not.
I always think of hoary alyssum when I hear "fever and stocked up" because that is exactly what happened to my horse. He acted more or less fine, just a high fever and swollen legs. My vet nailed it in one guess when I called him--the new round bales were examined, found guilty, and sent back!