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  1. #1
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    Question Subcutaneous emphysema -- anyone dealt with it? Pic on #23

    My friend's 6 year old mare is currently at a clinic dealing with an impaction that hasn't resolved itself yet. In the meantime, some time over the last 12 hours, she developed subcutaneous emphysema. The don't know the cause yet.

    Blood work is normal, mare is comfortable, distressed and until this morning was on fluids. She has passed small bits of manure, but not the amount the vets are hoping for.

    My friend is trying not to panic since she's two hours away from the clinic and is happy with the care her horse is receiving.

    I had never heard of this before, so I'm curious to learn if anyone else has experienced it.
    Last edited by jenm; Feb. 19, 2013 at 07:08 PM. Reason: changed title
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  2. #2
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    Strange..I'll be sticking around to see what others have to say! I work at a small animal emergency hospital and usually the only time we see that is in cases of trauma.



  3. #3
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    The one part that has them somewhat worried is that it may be caused by internal trauma, but it's still unknown. They started the mare on IV antibiotics and hope her vitals continue to hold steady.
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  4. #4
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    I've seen it in children with a pneumomediastinum and pneumothorax. I don't know why horses would get it.



  5. #5
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    Where is the subcutaneous emphysema?



  6. #6
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    Are you sure of this term??? Subcutaneous is "under the skin" and emphysema is the inability of the lungs to push the air out. This term is foreign to me????
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  7. #7
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    Quote Originally Posted by crosscreeksh View Post
    Are you sure of this term??? Subcutaneous is "under the skin" and emphysema is the inability of the lungs to push the air out. This term is foreign to me????
    This was the term my friend used in her email:

    But, she had a new development over night. She has a condition called subcutaneous emphysema. It means there is air underneath her skin. There are multiple causes - none of which seem to apply at this point. The condition itself is not particularly dangerous, but some of the underlying causes could be. Right now they are trying to figure out what is going on.

    They are wondering if there was trauma to the trachea or perhaps even the colon, but I think what has them confused is the fact the horse is acting completely normal other than she hasn't passed the poop they are looking for.
    Proud owner of a Slaughter-Bound TB from a feedlot, and her surprise baby...!
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  8. #8
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    Quote Originally Posted by crosscreeksh View Post
    Are you sure of this term??? Subcutaneous is "under the skin" and emphysema is the inability of the lungs to push the air out. This term is foreign to me????
    She's right with her terminology- it basically just means air under the skin/subQ. I think emphysema means "trapped air" or something like that. I'll ditto Vetvivi, I've only seen it in cases of trauma (one iatrogenic case in a small animal patient who jerked during a blood draw and got his trachea poked with the needle), usually when there's an open wound with gas dissecting back through the tissue layers. It feels not unlike bubble wrap. Jenm, keep us updated, I'd love to know if they figure out the underlying cause. In the meantime, I'll be jingling .
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  9. #9
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    Quote Originally Posted by faybe View Post
    She's right with her terminology- it basically just means air under the skin/subQ. I think emphysema means "trapped air" or something like that. I'll ditto Vetvivi, I've only seen it in cases of trauma (one iatrogenic case in a small animal patient who jerked during a blood draw and got his trachea poked with the needle), usually when there's an open wound with gas dissecting back through the tissue layers. It feels not unlike bubble wrap. Jenm, keep us updated, I'd love to know if they figure out the underlying cause. In the meantime, I'll be jingling .
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    Thanks for the clarification. New one for me.
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  10. #10
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    It is an old and barbaric practice used in days of yore for sore-muscled horses on the track, too. I don't know if it's still done.

    I'd be worried about a central line having sucked in some air, along with the more worrisome possibility of intestinal perforation. Was the horse scoped, by chance? That can cause it, too.
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  11. #11
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    Quote Originally Posted by Beethoven View Post
    Where is the subcutaneous emphysema?
    In the belly area.



    Quote Originally Posted by faybe View Post
    She's right with her terminology- it basically just means air under the skin/subQ. I think emphysema means "trapped air" or something like that. I'll ditto Vetvivi, I've only seen it in cases of trauma (one iatrogenic case in a small animal patient who jerked during a blood draw and got his trachea poked with the needle), usually when there's an open wound with gas dissecting back through the tissue layers. It feels not unlike bubble wrap. Jenm, keep us updated, I'd love to know if they figure out the underlying cause. In the meantime, I'll be jingling .
    Thanks, faybe. Interesting you described it as feeling like bubble wrap because that is exactly how my friend described it as well. She said she first felt it Tuesday evening when they brought the mare to the clinic Tuesday evening, but it was only about the size of a quarter, but she didn't mention it because they were all more focused on the colic.

    Thankfully, the horse finally passed oily poop last night, but they are still watching the "bubble wrap".

    Quote Originally Posted by deltawave View Post
    I'd be worried about a central line having sucked in some air, along with the more worrisome possibility of intestinal perforation. Was the horse scoped, by chance? That can cause it, too.
    To my knowledge the horse was only tubed, not scoped. They did mention the possibility of intestinal perforation, but also said the horse would be in pain if that had happened, and the horse is relaxed and happy and getting back to her marish self.
    Last edited by jenm; Feb. 15, 2013 at 01:03 PM. Reason: added quote
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  12. #12
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    Quote Originally Posted by jenm View Post
    To my knowledge the horse was only tubed, not scoped. They did mention the possibility of intestinal perforation, but also said the horse would be in pain if that had happened, and the horse is relaxed and happy and getting back to her marish self.
    Could be from passing a tube, as well, although typically you'd see it up around the neck. And if it was present right from the start it may have something to do with whatever was going on with the intestines. If the horse is bright and otherwise fine I'd be hopeful it's just one of those things that happen sometimes. Good luck to your friend's mare!
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  13. #13
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    Quote Originally Posted by deltawave View Post
    Could be from passing a tube, as well, although typically you'd see it up around the neck. And if it was present right from the start it may have something to do with whatever was going on with the intestines. If the horse is bright and otherwise fine I'd be hopeful it's just one of those things that happen sometimes. Good luck to your friend's mare!
    Thanks! The good news is they are starting the mare on forage today and she is scheduled to be released on Monday. They are keeping a close eye on the SE and I'm hoping like you wrote, "it's just one of those things that happens sometimes"!
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  14. #14
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    Hmm if she came with it then I wonder if when she was colicing she didn't thrash around or hit that area and cause trama to it.



  15. #15
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    I remember reading an article years ago about a horse who had this. If I recall correctly, the horse had a cut behind his elbow that was acting like a bellows and pulling air in every time he took a step. It was long ago that I read it but I'm pretty sure that once the cut healed the air dissipated over time and he was OK.



  16. #16
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    Is this crepitus?



  17. #17
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    Crepitus is what you feel when you smush on the skin of an animal (or person) with SQ emphysema, yes. But crepitus just means "it feels crunchy when you move or press on it" so you can also feel crepitus with a fracture, for instance.
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  18. #18
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    Some bacteria produce gas (example:gas gangrene) If there is no explaination for mechanical air leak perhaps this is a possibility.



  19. #19
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    Clostridium infections can do that also and they can be very serious, so it is important to find what it is.



  20. #20
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    Quote Originally Posted by Bluey View Post
    Clostridium infections can do that also and they can be very serious, so it is important to find what it is.
    What is a clostiridium infection? I believe they are prepared to adminster antibiotics if necessary, but apparently they haven't felt the need yet.
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