Treating Cellulitis in horses


Freedom's left knee was very swollen. You can see the scrape on the outside of the knee.

Freedom's left knee was very swollen. You can see the scrape on the outside of the knee.

On Monday night I showed up at the barn around 7:00 p.m. to ride once the day cooled off. To my dismay I found that Freedom’s knee was hugely swollen. I had wrapped his legs because he’d felt a bit stocked up the night before and because the swelling had no where to go except the knee, the effect was horrifying. Visualize a grapefruit.

Almost immediately I saw the cause: a scrape less than an inch long. Before I called the vet I scrubbed the wound to make sure it wasn’t a puncture wound (didn’t look like it to me, but a puncture would where a joint is involved can be very serious). Normally I would also shave the area around the cut but I had sent my clipper blades out to be sharpened!  My guess was cellulitis but since it involved a joint I wanted to makes sure I got the right treatment for it.

Cellulitis is a skin infection that is caused by bacteria. It’s entry point is a cut or even a small scrape (it’s amazing how small that scrape can be!) and becomes a subcutaneous infection. It manifests itself in heat and swelling in just one limb. The horse frequently will run a temperature. Sometimes your horse will be lame; in Freedom’s case his knee was tender but he was sound. The treatment is generally oral antibiotics (if you don’t catch it early enough sometimes you need IM antibiotics) and cold hosing.

Treatment for cellulitis includes oral antibiotics, cold hosing and exercise.

Treatment for cellulitis includes oral antibiotics, cold hosing and exercise.

Once I  had an idea of the problem,  I started searching for my SMZs. I usually have at least a starting dose on hand for those times when I have have an “after hours” problem. This time I came up empty handed.

At this point I called my vet. I reviewed what I’d found, he confirmed that it was likely cellulitis and since I had no antibiotics on hand he offered to leave me the SMZs at his home office instead making an emergency call (and racking up the related fee).  I felt much more comfortable starting the treatment that night even if it wasn’t until 10:30 p.m. Even better, my husband was close to the vet and was able to stop by and pick up the meds.

Tuesday I was pretty disappointed. I had hoped that the antibiotics and several rounds of cold hosing would help reduce the swelling. I turned him out for a bit to get him moving but by mid-afternoon, I hadn’t seen much of a change. Once again, because it involved his knee, I was worried.

A call to the vet calmed me down and gave me another treatment: exercise. It’s been a long time since I’ve had a horse with cellulitis so I had either forgotten that exercise would help, or had never known. Certainly, his knee looked so terrible that I wouldn’t have considered riding him without my vet’s recommendation. My vet explained that antibiotics alone are often not enough to bring down the swelling. He told me that exercise was very important to improve lymphatic drainage and that I needed to take him out and get his heart rate up. Way cool. Doctor’s orders are to take my horse out for a gallop! It worked like a charm. Freedom was still sound and his knee looked much better after I being ridden.

He continued to improve this week and his knee is almost back to normal. I told my husband that I had a prescription to for daily rides that would probably be necessary for at least another week.

Doing a little research on cellulitis I found that a study conducted by the Ontario Veterinary College in Canada. Interestingly, in their study they found that most cellulitis affected hind limbs and that Thoroughbreds were “significantly over-represented compared to any other breed.” I wonder what would make them more prone to those types of skin infections.

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24 responses

  1. Well, you’ve just explained a mystery that had me going for more than a month last year! My horse (a Morgan/Paint cross, no thoroughbred) came up with a front left knee that looked just like your horse’s. The vet we have was no help at all. Took two rounds of antibiotic injections in the knee and then I just decided, “oh heck, I’m going to ride him.” Within two days of trotting rides, he was back to normal… the exercise cure worked!

  2. Your vet sounds awesome! It’s so nice to see that there are vets still out there that are more concerned about the horse’s welfare than racking up a few extra dollars in emergency call out fees. Glad to hear that Freedom is doing so much better. That’s a prescription I wouldn’t mind getting!

  3. We dealt with cellulitis this summer also, on our gelding’s right hind. It was a surprise because we couldn’t see a cut or scratch. Even though he promptly got on antibiotics and was hosed 2x/day, it seemed to take forever for the swelling to go down. Stall rest was recommended for at least the first few days, so we kept him in except for handgrazing. Maybe he would’ve been better off with more activity. Thanks for sharing your story – good food for thought!

  4. My horse is currently being treated for Cellulitis in his left hind leg. Antibiotics, bute, cold wrap 2x a day and topical smooth sweat. The vet recommended turn out in the round pen so he couldn’t run and buck. I have also been hand walking him. So I’m surprised to read that exercise is recommended. I’m assuming that’s only if the horse is sound.

    • That could be true. The times when my horses have had cellulitis they have been sound. Exercise really helped the swelling go down. As always, it’s best to follow your vet’s recommendations as there are always exceptions to any rule.

  5. my horse has cellulitis from her chest on her belly all the way to her teets- she was hard as a rock we had the emergency vet visit and went on injections but the placement of the cellulitis is unusual –has anyone heard of it on the belly like this
    thanks

  6. Hi
    I have a Paint Gelding 2 yr old, who this morning was diagnosed with cellulitis also. We bought his out of the stable and into his day yard and it looked more like elephantitis! It is mainly in his rear legs around his fetlock areas.
    My vet seems to think it was caused by an insect bite, however this evening all on his legs above his corenet bands are red raw and looking saw, similarly his mouth has a red rash all over and around his nose, we have been inundated with rain and his paddock is wet so i’m thinking that maybe the infection has entered through his skin around the hoof where it looks damp from the wet weather?

    • Cellulitis can occur even when there is just a small scrape. I’ve also found that it’s far more likely to occur in wet weather. Good luck!

  7. My horse, sound for 19 years got white line disease in near fore, x-ray showed up just a needle length in hoof but mare has presented with cellulitus in near hind due to mud rash. I need a cure…. live in Wicklow Ireland so do not have all the access to new tech stuff.

  8. Exercise is magic for cellulitis or swelling of any kind in the limbs, ie lymphangitis or oedema. However obviously the horse needs to be sound! Hosing 3 or more times a day for 10 minutes at a time is also reccommended. As well as wrapping the area (if possible) 24 hours. A cooling gel, or poultice of some type helps as well. (many cooling gels specify not to bandage after application so be careful). If you need help with a poultice I have heard that grated green soap works wonders! (like those big bricks of sunlight) Apparently you grate it up and mix with a bit of warm water and then apply to area and bandage. However I prefer to us epsom salts and a wet gauze covering then bandage. Good luck!

  9. thankyou lots this really helps first time our horse leo has had cellulitis,had vet out yesterday who gave steriod and antibiotic injection,and said turn out straight away,very shocked by how much leg was swollen and leo was in lots of pain, little better today but still swollen, on antibiotics for 5 days, thanks again.

  10. our paint mare developed left rear leg (from the hock down)cellulitis secondary to regional infusion injections for a nail puncture injury/infection through the frog of the sole. We r doing cold hosing/betadine scrub/scraping scabs/drying well and applying steroid ointment. She is not sound, so r doing short walks. Has been on smv for 14 days already for nail injury. Any other suggestions?

  11. Running out of ideas and getting very worried. My TB gelding was diagnosed with cellulitus, went down 1 night to find his hind leg swollen all the way up to his sheath, lame, trembling in pain and with a temp. Has been on various mediction, injections, powders and syringed down throat. Slowly started to improve and then suddenly got worse again. Does not want to put weight on it and becoming very sore and scabby around fetlock. Vet has now put him on a longer course of meds but said if does not work this time will need to have biopsy. Im worried that the length of time its taking and the very slow progress is going to cause more serious damage such as scarring. I would be grateful for anyones advice as cant keep watching him suffer and cost me over a grand in vet fees so far.

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  13. My thoroughbred currently has a lovely cellulitis in his hind leg and has been on a heavy course of antibiotics with some improvement. In answer to your question regarding the study as to why thoroughbreds are more typically afflicted, my trainer says that the many that come from off the track leave with severely depleted immune systems leaving them more susceptible to annoying skin infections.

  14. My mare has very unfortunately had cellulitis in her right hind for 6 WEEKS! She was not sound when I found her leg fully blown up and for the first week she was very lame. We did 7 days of antibiotics, 4 days of steriods, hosing, and hand walking. After 2 weeks another round of steriods, which did wonders. Then somehow in her stall she managed to get windpuffs in the front right leg. She was extremely lame for another week. And since she has recover her front leg, minimum 1 hour of ponying. Leg then goes 85% of the way down, but procedes to blow up just as big as before again and again.

  15. Our mare was kicked by another horse, and now has very bad swelling of hind leg.
    This has been for about 6 months. Heavy doses of penicillin and other antibiotics, and bute has given marginal improvement. But the swelling gradually resumes after treatment is stopped. It looks like elephantitis. It is more tender at the moment. Before this she was getting around ok, but it is grossly enlarged. Running out of ideas.

  16. ive only had my mare since october 2011 and i dont know much about horses as she is my first one. Shes 24 but doesn’t act like it. i went to get her out of the field on friday 23rd march 2012 and she was very lame, could barley walk in her right hind leg. It took 6-8 people 6 hours to get her out. We called a vet who said she could have an abscess but her hoof was to solid to confirm it. She also said she had a lot of swelling in her leg. Sapphire was bandaged and given pain relief and anti-inflammatory then left for the night. The next day (today) she was still the same, lame and limping. She also lost her appetite and didn’t drink much through the night. The vet came again and said her leg had swelled even more and ruled out the abscess. She re-bandaged her, but this time her leg. She had a temperature all day. She seems to have symptoms of cellulitis but the vet seems to thing she could have broken a bone that isn’t used for walking or ruptured a limb if it isnt cellulitis. I dont know much about horses but she does have symptoms of cellulitis from what i have read on here. The vet gave my mare some antibiotics and steroids and as soon as sapphire had come from the sedative, her appetite was back and she was eating like a good one! i hope that’s a good sign that she can be treated as my mum said if she does have a broken bone, we will have to get her put down because of her age and surgery isn’t fair. On monday 19th March 2012 we put sapphire out to permanently live out as she didnt want to come in (she was taking a good 45 minutes to come in at times) and had lived out for year before we got her so we dont know how shes hurt it but our field is very very muddy and i have read that bacteria can cause cellulitis and bacteria thrives in mud. I would like some feedback from anyone who might be able to help me asap please, could sapphire have cellulitis or do her symptoms show something other? I would really appreciated some feedback from anyone who could help
    thankyou x

  17. Hey …my 17.3 suffers everytime he gets a cut or kick to his legs …he is only 4 and has suffered 3 times now ….I’m so paranoid over him now that he is practically in bubble wrap to turn out …I was brave last night and left him out to graze only to find he has been kicked my heart sunk :( it was a heafty 1800 pound vet bill last time after a 3 month stint of it …I’m at the end of my tether …I’m salt bathing and he’s had bute I’m hoping it doesn’t come as antibiotics make him ill ….any suggestions what might keep it at bay ??? .

    • I’ve heard of success treating wounds early on with animalintex poultice or with medical grade manuka honey. However, I wonder if there isn’t an underlying health issue that makes your horse prone to bacterial infections. Have you asked your vet about that? Also, if there is a wound, make sure that you shave the surrounding area with clippers to help keep it clean. That’s quite a vet bill you had and I can understand not wanting it to happen again. I also keep SMZs on hand so that if a wound does start to show signs of infection I can treat right away. From what I’ve read, it seems that if the cellulitis goes untreated it can potentially affect the lymphatic system. Good luck!

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