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Pastern Leukocytoclastic Vasculitis

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  • #21
    spenhouse, I had a much better reaction once I switched away from dex to the prednisolone/pentoxifylline combination. And yes, Dr White did have me put my horse on a bland grass hay only diet.

    I am sure you can find the equivalent of Genesis spray in Europe. I sent you the info for Dr White via PM, but I will also post it here
    On the Internet, nobody knows you're a dog


    • #22
      Our mare flares up if she gets any alfalfa, even if it is just a treat or base for a supplement, and also from immunizations.


      • #23
        Thank you for the link :-)


        • #24
          It's back dammit!

          My guy healed up nicely by the early part of January with Dex and Genesis.

          So on Sunday evening I see a couple rather unusual and random swellings on his butt. I pretty much ignored it when he didn't respond at all when I poked and prodded them. By late afternoon Monday more had come up, some along his shoulder to elbow region, gut region and neck. Mostly on his right side. The swellings were NOT uniform like hives that I've treated before on him but I still figured maybe hives. He had gotten hives in the heat of the summer but this is winter. So I grabbed the generic Benadryl I get from BJ's and started him on that Monday evening. Had called the vet to see if any other horses are coming up with hives recently just in case there may be something going around even though I have a closed herd. Hey, ya never know....

          Tue AM one of the swellings on his rump is oozing a slight discharge I also noticed his RH fetlock was quite swollen and hot. I took his temp, which was normal, he was able to walk and trot just fine so I kinda dismissed a cellulitis attack. But as I rubbed down just above the fetleck, sure enough a scab came off and a sticky serum discharge as well. I called the vet office, and scheduled an appointment for the next day as my boy was in no discomfort from anything, was sound, bright, alert, responsive and didn't miss a mouthful of grain or hay. I did go out every 2 hrs to check his temp and jog him though just to make sure it wasn't turning into a cellulitis.

          So the vet comes out Wed and agreed it was probably the vasculitis re-occurring again. Dammit! She didn't want to start him oral steroids (Dex) but did suggest Genesis spray and to keep an eye on a slightly warm LF hoof. So far hoof seems OK, not quite as cool as the others but not hot enough to worry. Horse seems Ok otherwise except there seem to be a few more tiny patches of the vasculitis that seem to be showing up going up his leg. I had clipped his fetlock and some below into the pastern region and up the leg as well and may have to clip more. Thank heavens it's my boy, whose coat isn't as heavy and thick and long as his buddy, who looks like a Yak.

          Vet didn't have any idea as to why he had swellings or lumps and even that they were more pronounced on his right side and only a very few on the left especially since she said his coat was in great condition.

          She's having me keep my boy on the generic Benadryl for a 5 day pd. then off for 7 days and the onto a stronger antihistamine, Hydroxyzine, for 5 days.

          So, those of you following this thread, here's some more info on this crap.

          I'm not saying let's go kill all the stupid people...I'm just saying let's remove all the warning labels and let the problem sort itself out.


          • #25
            Further to previous post I have put some photos of my horses condition on Flikr if anyone is interested at http://www.flickr.com/photos/93371203@N05/?saved=1
            I am unable to persuade my vet to prescribe pentoxifylline and I cannot get Genesis spray in the UK. So I am left to try and resolve problem with pred and antibiotics and Cortavance spray. Could I ask the forum contributors whether you would recommend washing this crud off the legs. At the moment he is turned out in boots which cover from coronet to knee/hock so his legs are clean and dry when he comes out of the field. I try to only wash once or twice a week with warm water only. Any suggestions considered. Thank you.


            • #26
              spenhouse, I wouldn't recommend washing his legs at all. With my horse, we originally treated it as if it were 'regular scratches' by washing with first Betadine shampoo and really scrubbing the scabs off with no improvement. Then the vet recommended another shampoo, Dermachlor-Ketoconazole. No luck again with scrubbing with it. From there the recommendation was for a Sulferated Lime sulfur concentrate, diluted something like 4 oz to a gallon. That actually blistered my horse. After scrubbing with the 2 shampoos above, the area was then wiped with a Desitin, Furicin, Dexamethasone ointment to no avail.

              After we did the biopsy the treatment regime was 4 mg Dexamethasone tabs dosed at 4/day for a 2 weeks. At one wk of dex treatment no improvement was shown so that's when we added the Genesis spray. After the 2 wks of dex tabs at 4/day, the dose went down to 3 dex tab/day for another wk, down to 2 dex taks/day for another wk and finally down to 1 dex tab/day for the last wk. I did the Genesis twice/day once we started it. During the entire Dex and Genesis no other washing of the area was done. When I was applying the Genesis, I was able to gently wipe the scabs off as they loosened.

              I would think the UK would have some sort of topical steroid that you could use in place of the Genesis since you can't get Genesis.

              I wish you the best of luck.

              I'm not saying let's go kill all the stupid people...I'm just saying let's remove all the warning labels and let the problem sort itself out.


              • #27
                From my experience, I would recommend washing only when really necessary, if the legs are really muddy, and then just gentle water and patting dry. Do not pick at the scabs and do not continue to clip around them. Keeping his legs protected from light is necessary, and if his current boots do that, great. The more fur he has the better his skin is protected from the sun, as well.
                The Cortavance may do the trick. I have had good luck with betamethasone spray for my horse (another steroid) that comes in combination with gentamicin. Perhaps there is an equivalent to that where you are?
                Good luck with your boy.
                As Peter, Paul, and Mary say, a dragon lives forever.


                • #28
                  Originally posted by spenhouse View Post
                  Further to previous post I have put some photos of my horses condition on Flikr if anyone is interested at http://www.flickr.com/photos/93371203@N05/?saved=1
                  I am unable to persuade my vet to prescribe pentoxifylline and I cannot get Genesis spray in the UK. So I am left to try and resolve problem with pred and antibiotics and Cortavance spray. Could I ask the forum contributors whether you would recommend washing this crud off the legs.
                  No don't wash them. Poor baby Time to get another vet IMO.
                  On the Internet, nobody knows you're a dog


                  • #29
                    Update - have posted up to date pics on Flikr as per previous post. Cortavance spray has not worked. Neither have pred and antibiotics made a noticeable difference. Have washed the crud off after 5 days of treatment to see whether there is an improvement underneath, but the PLV seems just as bad as it was before treatment. Vet reluctant to prescribe Pentoxyfilline at this stage on recommendation of dermatologist specialist UK vet. Also tempted to change grazing arrangement in case something in the field is causing the problem. Incidentally, I remembered that prior to the leg issue he had a rash over one side of his neck and shoulder, which we thought was nettle rash. I now believe this was the initial reaction and it developed into PLV. It was hard raised bumps but with no pus and was not painful or itchy. We never took a biopsy and it eventually went away. Shortly after the PLV flared for the first time.
                    When do I quit with this, I wonder. Without the magic combination of Pentoxyfilline and Genesis spray am I fighting a losing battle ? How quickly should I be seeing a response to this aggressive steroid/antibiotic/spray treatment ? Lastly is it worth keeping him stabled and wrapping legs, and if so what do I use on his legs under the bandages ? Sorry to ask all these questions but I am reaching the end of my tether on this. I'm also frustrated that what is available in the USA is not permitted in the UK !!
                    Also, I have removed all Alfalfa from his diet and he's now on hay and grazing only, plus Ready Grass and sugar beet to mix meds into.
                    Last edited by spenhouse; Mar. 1, 2013, 05:35 PM.


                    • #30
                      spenhouse, my horse was on dex for 5 wks and 4 wks on Genesis spray. It took about 2 wks on Genesis to see the scabs start to finally go away. I understand the bit about being at wits end. When we initially thought it was just scratches and the treatment wasn't working (think 2 months I treated him and then the vet for over a month), I was ready to put him down. My girlfriend found this particular topic, emailed me and I emailed the vet. They did a biopsy and determined it was vasculitis and not plain old scratches/greasy heel and whatever else we've called it.

                      I'm not saying let's go kill all the stupid people...I'm just saying let's remove all the warning labels and let the problem sort itself out.


                      • #31
                        It make take weeks to see improvement. I don't think Genesis and pentoxyfylline are the only roads to a resolution, just a common treatment. My horse was never treated with either, and is looking very good right now.
                        Try to be patient! (I know it's hard!)
                        As Peter, Paul, and Mary say, a dragon lives forever.


                        • #32
                          What antibiotic are you using?


                          • #33
                            The antibiotic is Norodine granules, 37.5gms twice daily. He was on those for five days and the final photo on Flikr was taken on the last day of Antibiotic treatment. He is still on one and a half 250mg sachets of Prednisolone powder. And the Cortavance spray lasted four days before it ran out (£23 per bottle). We are trying to reduce the quantity of steroids once PLV is under control. I am speaking to vet later re trying him on Pentoxyfilline. Fingers crossed.