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Lymphangitis/leg fungus...compromised immune system? UPDATE

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  • Lymphangitis/leg fungus...compromised immune system? UPDATE

    Horse in question is a 20 (soon to be 21) year old TB gelding. Overall this horse is in good health, he is energetic, a good weight, and has a beautiful shiny coat. He has a high grade heart murmur (3 1/2) and we think he might have a slightly elevated heart rate, although its hard to tell because he is a bit of a nervous nellie when being handled by someone other than myself.

    He has presented with swelling and extreme lameness in his LH 3 years in a row (which is the total time I've owned him) and has been diagnosed as Lymphangitis. First bout cleared with bute, wrapping, t/o, and SMZ's. Second bout he got 2 Excede injections plus SMZ's. Third bout (this year) he was treated with Excede and 7 days of Gentomicin. That was in September I believe. This morning I went to let him out and his leg was blown up again, although he was weight bearing and didn't seem to be in much (if any) discomfort. So I made the decision to turn him out and now I'm waiting to see if it starts to go down. Obviously if it doesn't the vet will be called.

    My question is if there might be a connection with the lymphangitis, leg fungus, and a compromised immune system? The vet mentioned it casually last time she was at the barn, and I'm wondering if this may indeed be the case. He has persistent leg fungus not cleared by any of the usual topicals.

    Now this horse had also recently started to drop weight. Nothing scary, but I have had to double his fees (he was on 3 lb. of TC Senior before) to keep his weight up. He's on free choice hay. However the dentist was just out and he was having problems chewing, which she fixed, so I'm wondering if that, plus the lack of grass, caused the weight drop. I thought I'd mention it though...

    So now I'm wondering if he has Cushings, and if I should just go ahead and test him for it. Any opinions? It was mentioned on here before when I was asking for feed suggestions for him because of his weight loss. I just don't want to overlook this.
    Last edited by SAcres; Nov. 16, 2012, 04:43 PM.
    come what may

    Rest in peace great mare, 1987-2013

  • #2
    Yes. And what you are seeing is probably NOT "leg fungus". The proper term is pastern dermatitis.

    Very often the two do go hand in hand and often it's a bacterial infection that needs to be treated with antibiotics and anti-inflammatories/steroids.
    On the Internet, nobody knows you're a dog

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    • #3
      My experience says "yes" there is a connection between lymphangitis, leg crud and compromised immune system. My heart horse sure had all three. I don't have real evidence though. When we biopsied her leg crud it came back as "overgrowth of fungus, bacteria, and yeast, likely due to allergies." Since she also had a respiratory issue at that point allergies made sense. Did she have allergies due to a compromised immune system? Possibly. I don't know enough and since she's gone I haven't kept up on research. I'd get the leg crud biopsied if you can and find out what you're actually fighting. For her crud-mix I found Equiderma (shampoo and lotion) was the best for clearing it up.

      I eventually put her down because she got the internal form of pigeon fever. Immune compromised horses tend to get the internal form and the treatment was going to be so long and she already had so many issues that it was kinder to let her go. She was 26.

      You won't be able to test for Cushings for a couple more months due to the "seasonal rise." Cushings tests aren't reliable in the fall. But, talk to your vet about it.
      Pam's Pony Place

      Pam's Pony Ponderings

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      • #4
        I have a mare that had her first bout with lymphangitis about 4 years ago. She has had a few flare-ups since then, some bad, some not. I can say I definitley have noticed that there is a correlation between dermatitis and the flare ups. It is extremely important to keep their skin in as a good of condition as you achieve, as well as keep the affected leg as dry as you can. My vet has me use antifungal scrubs (Equiderma and also Dermabenss) frequently enough that nothing bad can really start to grow.

        One thing that I'm sure would help with the swelling is a little exercise. I don't necessarily mean a long trial ride, even just hand walking followed by some cold hosing and standing bandages can really tighten things up.

        Comment

        • Original Poster

          #5
          I ended up having the vet out because he just wasn't acting right. We decided to go ahead and not wait, and are treating him for Lymphangitis (this is the 4th time). We're using Baytril this time, so hopefully this will kick the Lymphangitis's butt. I'm pretty sure we caught it early this time because he wasn't 3 legged lame like he usually gets. The vet was also talking about Aspirin therapy and steroids as continuing treatment...I'll have to speak to her more about it to get the full details.

          She definitely thinks Cushings is a possibility, and we plan to test for it soon.
          come what may

          Rest in peace great mare, 1987-2013

          Comment


          • #6
            Watch out with steroids

            Originally posted by Perfect Pony View Post
            Yes. And what you are seeing is probably NOT "leg fungus". The proper term is pastern dermatitis.

            Very often the two do go hand in hand and often it's a bacterial infection that needs to be treated with antibiotics and anti-inflammatories/steroids.
            I agree strong antibiotics are a must, but my horse then foundered thanks to the Dex. Never again! I always took that stuff for granted... sort of like injecting Banamine IM.. But when it was career-ending and heartbreaking.

            Comment


            • #7
              Originally posted by Atlas Shrugged View Post
              I agree strong antibiotics are a must, but my horse then foundered thanks to the Dex. Never again! I always took that stuff for granted... sort of like injecting Banamine IM.. But when it was career-ending and heartbreaking.
              Dex is notbthe only option. I used genesis topical spray and prednisone orally.
              On the Internet, nobody knows you're a dog

              Comment


              • #8
                I have been dealing with something similar. The pastern dermatitis seems to need a pristine, dry stall... not just clean, but pristine with fresh shavings to help pull away any moisture that gets around the leg. I also have been trying to get more exercise into this horse, so that at the very least I jog her every day moving her between stall and pasture. It is getting a bit more difficult to treat every time, so I am becoming more aggressive about prevention.

                I would add to your protocol that any time you suspect a flare up, to start monitoring body temperature. Obviously if you have a fever you need to get the antibiotics going right away.

                We elected not to wrap because we had concerns about compromising the circulation even more or about more fluid staying longer in the hock and above. YMMV.

                I'd love to find a topical treatment that would help with the dermatitis but I have not had much success over the years that I've had her.
                If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats. - Lemony Snicket

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                • #9
                  I lost my TB gelding in March 2011 after dealing with lymphangitis for ~7 years. He had multiple blow ups a year at this point. The final one became systemic (sp?) and it wasn't responding to medication at all. This thread has me really curious. How do you know if a horse has a weak immune system? My guy was never sick in the 6 years I owned him. No colic, cough, anything. Nor did he have dermititis.

                  I hope your boy does well. IME, laser acupuncture worked very well. I'd look into it.

                  Comment


                  • #10
                    Alt Univ - re the compromised immune system, I'm no vet, but age is one factor. OPs horse is 20+; also with recurrent or hard to cure things, that would appear to be another indication.

                    I would raise the question to OP re whether the horse should have a cardiac evaluation. I have a 22+ TB with a murmur and atrial fib. He has had two ultrasounds in the last 5 yrs - a baseline one at 17 when a-fib was discovered, and a comparative one last year. He is in OK shape in that catogory, not a lot of change, but edema and weight loss are symptoms of possible congestive heart failure, so I watch mine closely as a result.
                    Just a thought...........
                    We don't get less brave; we get a bigger sense of self-preservation........

                    Comment


                    • #11
                      Just a few thoughts

                      - certain foods, including some weeds and sometimes alfalfa, can cause photosensitivity which leads to lower leg issues.

                      - there is plenty of anecdotal evidence that horses who are supplemented with zinc/copper/manganese do not have these issues.

                      - if it is winter consider that your horses wet, sloppy tail is whacking his lower legs.. If your issues are more limited to hind legs, bang his tail for winter if you can. My vet told me this I would have never thought about it..
                      "Kindness is free" ~ Eurofoal
                      ---
                      The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

                      Comment


                      • #12
                        Originally posted by EqTrainer View Post
                        Just a few thoughts

                        - certain foods, including some weeds and sometimes alfalfa, can cause photosensitivity which leads to lower leg issues.

                        - there is plenty of anecdotal evidence that horses who are supplemented with zinc/copper/manganese do not have these issues.

                        - if it is winter consider that your horses wet, sloppy tail is whacking his lower legs.. If your issues are more limited to hind legs, bang his tail for winter if you can. My vet told me this I would have never thought about it..
                        Very interesting ideas, especially the last one! The simple things!
                        If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats. - Lemony Snicket

                        Comment


                        • #13
                          Originally posted by poltroon View Post
                          I'd love to find a topical treatment that would help with the dermatitis but I have not had much success over the years that I've had her.
                          Have you ever tried Genesis Spray? Dr White at UC Davis prescribed it to try with my horse with severe vasculitis, it worked miracles. It is for dogs but worked great.

                          I have had others say it has worked with their horses when nothing else would.
                          On the Internet, nobody knows you're a dog

                          Comment


                          • #14
                            If the disorder is due to a "compromised immune system", then steroids would generally make it worse, given the fact that they more or less bring the immune response to a grinding halt.

                            Hypersensitivity, allergic reactions, etc. are not a sign of a "compromised" immune system, but often of one that is OVERstimulated. One has to be really careful to have a precise diagnosis, and to avoid thinking of the immune system as a simple "on/off" system when it is infinitely more complicated.
                            Click here before you buy.

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                            • #15
                              Originally posted by Perfect Pony View Post
                              Have you ever tried Genesis Spray? Dr White at UC Davis prescribed it to try with my horse with severe vasculitis, it worked miracles. It is for dogs but worked great.

                              I have had others say it has worked with their horses when nothing else would.
                              In my case, what we are most concerned about is that infection is entering through the dermatitis and not being adequately fought and dealt with. Steroids are directly contraindicated if you are worrying about infection.

                              It might help with the dermatitis, but given the delicate balance, I'm inclined to leave it alone when in doubt, at this time.

                              I did try a steroid cream many years back, before we had the infection issue, when the problem was much milder, and was not terribly successful. The spray might have worked better just because it wouldn't be such a dirt magnet on the lower leg, so it's an interesting idea.
                              If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats. - Lemony Snicket

                              Comment


                              • #16
                                Originally posted by poltroon View Post
                                In my case, what we are most concerned about is that infection is entering through the dermatitis and not being adequately fought and dealt with. Steroids are directly contraindicated if you are worrying about infection.

                                It might help with the dermatitis, but given the delicate balance, I'm inclined to leave it alone when in doubt, at this time.

                                I did try a steroid cream many years back, before we had the infection issue, when the problem was much milder, and was not terribly successful. The spray might have worked better just because it wouldn't be such a dirt magnet on the lower leg, so it's an interesting idea.
                                This is why they biopsy the skin and figure out what is actually going on. Unfortunately it's a vicious circle. The irritated skin invites infection, the infetion makes the skin worse.

                                My horse was on a combination of antibiotics for the staph infection, oral prednisone, pentoxifylline, and genesis spray. It was an extremely severe case and healed up beautifully. But you simply HAVE to stop the chronic inflammation.
                                On the Internet, nobody knows you're a dog

                                Comment


                                • #17
                                  My best friends horse lived with chronic lympangitis for 10 years. At first, maybe it was due to infection, but after hundreds of swellings he just had reactive lymphangitis...no infection present.

                                  He also had crusty lesions on his coronet bands, with keeping them clean and wrapped they went away. Any exposure to light/air etc. they came up.

                                  He lived in a pressure bandage from coronet to above the hock, He did very well with it, even able to continue his career in the meter jumpers.

                                  A few times he had a very severe blow up, and dex/naquasone and antibiotics were used. No ill effects, and eventually he stopped having flareups...just dealt with a fat leg that would swell if unwrapped.

                                  Comment


                                  • #18
                                    Originally posted by SquishTheBunny View Post
                                    He lived in a pressure bandage from coronet to above the hock, He did very well with it, even able to continue his career in the meter jumpers.

                                    A few times he had a very severe blow up, and dex/naquasone and antibiotics were used. No ill effects, and eventually he stopped having flareups...just dealt with a fat leg that would swell if unwrapped.
                                    This is what I did for my mare. Lymphangitis, especially in older horses (IME), becomes harder and harder to treat with drugs because the tissue has stopped functioning correctly, so fluid pools where it's hardest for the heart to push it out of the tissue, generally the lower part of the hind limb(s). I always used no-bows and a standing wrap and turned my mare out almost 24/7 because the movement also helps keep the fluid moving. I changed the wrap once a day.

                                    I agree with your connection to immune issues. Since the lymph system helps transport cell waste and fluid, you can see that a buildup of waste and fluid would encourage infection. Also, since the body is spending so much (futile) energy trying to do its job despite the injured lymphatic system, it seems to be a condition that invites secondary infection. My mare had an incurable yeast infection and eventually a host of other problems and, with a heavy heart, I chose to put her down at age 23 while she was dealing with a storm of issues.

                                    But these horses can lead very productive lives if given proper maintenance. A daily wrap isn't expensive and it gives the horse so much comfort. Imagine how painful such a swollen leg can be!
                                    Kendra -- Runningwater Warmbloods
                                    Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
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                                    • Original Poster

                                      #19
                                      I may invest in som BOT wraps for him. The standing wrap overnight in his stall seems to really be helping, the swelling is going down already. The problem is trying to wrap him at night haha, it is painful for him so he tends to want to hold his leg in the air.

                                      I'd rather not keep him wrapped all the time, but if that is what it will take to keep him comfortable then I'll do it.
                                      come what may

                                      Rest in peace great mare, 1987-2013

                                      Comment


                                      • #20
                                        Originally posted by SAcres View Post
                                        I may invest in som BOT wraps for him. The standing wrap overnight in his stall seems to really be helping, the swelling is going down already. The problem is trying to wrap him at night haha, it is painful for him so he tends to want to hold his leg in the air.

                                        I'd rather not keep him wrapped all the time, but if that is what it will take to keep him comfortable then I'll do it.
                                        Just wanted to say - I've had really good luck with the BOT quick wraps for cellulitis. The quick wraps will do the job, but not have to be so firm or tight (like a standing wrap) so he may find them more comfortable as well.

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