Treating Cellulitis in horses

Freedom's knee is swollen with cellulitis
Freedom's knee is swollen with cellulitis
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 with cellulitis. I had wrapped his legs because he’d felt a bit stocked up the night before and because the swelling had nowhere 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. Its 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 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?

42 thoughts on “Treating Cellulitis in horses

  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.

    1. 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

    1. My horse has it in her rear leg and going up into her teets. Hard as a rock. Only been 2 days. Giving antibiotics. Vet didnt said anything about walking horse. Guess I’ll try it.

  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?

    1. 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.

    1. Sarah I’m having the same worries. My TB mare has had the same – on going cellulitis now lymphangitis from a cut started as a cut with a lump, then went onto being a puffy leg now all odd lumps that move all over the limbs. Vets were slow in diagnosing as I live so far away but its gone on a year now trying all sorts of treatments, and bacterial cultures are never proving positive for Corynebacterium so its hard to get to the bottom of it. Best results I’ve had are from changing feed (apparently Soya can cause it in some cases and alfalfa ) very little hard feed and mainly grass and hay, exercise (when sound), epsom salt poltices (the best!), and magnetic boots. I’ve now been told to try 3 month antibiotic treatment so I’ll do all the above with that and try some herbal blood cleansing treatments and see how I get on…but its hell! and expensive, and apparently if its Corynebacterium its contagious and can be transferred by flies moving between wounds. So you also have to isolate the horse. I am not isolating her as she will injure herself worse trying to find her ‘boyfriend’ but I am making sure wounds are always covered and the stables are regularly ‘blitzed’ to get rid of the bacteria.

      I’m also trying to look into giving Ascorbic Acid, I don;t know if its possible for horses but this is given to humans recovering from cellulitis with great results to boost immunity and help healing, I’m still waiting to hear from my vet but if anyone else knows anything that would be great?

      I’m also trying to find holistic remedies as I feel bad for her with all these meds. For instance Honey and tumeric are great on wounds, Coconut oil is great in feed and on wounds too, but it needs to be good pure cold pressed stuff…again expensive but Ideally to want to cut down on hard feed as that does not help cellulitis so maybe you can cut costs there.

      I’m worried that it’ll never go though and some vets have said I have to put her down, which I refuse to do right now as she is still happy, fat and full of energy…so I’m plugging on.

      1. Wow, your poor horse. It must be very frightening when a simple wound progresses that far. Honey is, indeed good for wounds. Manuka honey is even better! Another very powerful antifungal, antibacterial natural treatment is Tamanu Oil. It’s very good at treating skin issues in humans. Maybe look into that?

      2. hi i was wandering how your horse is now we have gone through the same as you mare is sound but leg is still swollen after nearly four months .when she is out leg goes back to normal but as soon as she comes in it swells up

      3. I have a thoroughbred who capped her hock and developed cellulitis. I tried everything but she still had chronic swelling. I found a holistic treatment and began to use it. It consists of a charcoal based salve with a wrap. It works like a charm. is where you can buy it. You cold hose the horse, apply a charcoal base rub, apply olive oil and then the salve. Wrap in cotton. It has been a miracle for her. I had tried everything else but this stuff really works… it is also great for summer sores. Heals them up. Denise is awesome. Her number is on the site. she is committed to helping, you might call her.

      4. Sorry to say, I lost my mare Holly after one month, the cellulitis involved her elbow joint and when x rayed there was bony damage and infection in the joint fluid. She had liver damage also. The vets had never seen this happen to a horse before, very rare and just really bad luck.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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 ??? .

    1. 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!

  17. I have been reading all your comments about cellulitis and have been through all the above , in the last 6 weeks .We finally have a pacer back in light work ,but what I am finding ,He tends to sweet up more then he should has anyone else experienced this look forward to your reply

  18. My Shire x mare sudden had a big fat foreleg and was hopping lame a couple of weeks ago, the leg was double normal size above the knee. She had a small patch of scabby skin just behind her elbow and we think it was a tiny bit of rain scald. She is 23 lives out 24/7 and it has been very wet (UK). Anyway it took a few days on antibiotics and bute in her feed twice a day, Flamazine cream and hibiscrub for the skin patch. it flared up again once or twice but within the week she was trotting around as normal and we thought all was well. A few days later it was back again, leg not as big but she was very lame on it again and spent almost a whole day lying down. The vet said this was very common, and has given me 10 days of the same antibiotic and bute. She says there is another strain to try yet but as Holly reacted favourably last time, she thinks it will work again but she needs a longer time on it. Yesterday she was very much better and motoring round the field, spent a full 16 hours on her feet and I was happy. Today at 6am she was lying down and the leg still looks sore, I can’t decide if it is worse or not as she is often stiff after first getting to her feet . I was told to walk her 3 x 10 times a day but the legs is sore and it seems cruel. Im going to ring them this morning and see if theres any more nursing I can be doing to help, like cold water bandages? I dont know. It feels helpless just waiting to syringe the next lot of meds down her tonight.

  19. My mare had cellulitis from the ankle up to her hock. All the swelling is gone but the ankle and I have been doctoring on it for two months now. DMSO poultice, hosing, Penicillin shots. No lameness and no one told me I could ride her. I am getting so discouraged. I will try riding her to see what that does. Thank you for the article.

    1. I had a similar episode. I ended up cold hosing twice daily with wrapping for two weeks. DMSO did not work for me.The cellulitis developed to lymph edema which is possibly what you are dealing with now. (you can tell the difference because the skin will look and feel different, kind of hard. You can google some pics to see) I simply cold hosed, wrapped with layers of cotton covered with vet tape to keep compression daily . I found massage helped the most. I would cold hose and then gently massage from her stifle down and back up. If she acted like it hurt, I would use a soft bristle brush with small circles working down and up her whole leg. The most important thing was to get the lymph system to work again so it would carry away the inflammation. I later moved from the soft bristle to using the hose nozzle in small circular motions just like I had with the brush. It created a handheld whirlpool for her. I started lightly and over a week increased the water pressure. During this time, I did in hand work with no constant lunging. We played games. This time increased our bonding. I was able to get the lymph edema completely cleared with this method and her hock completely back to normal. She is an OTTB and resumed running around the paddock like she had before. It was a scary time but worked…. .FYI, she kicked the stall a few months later. The swelling was bad and immediate. I repeated this method for 8 weeks and she is back to normal again with intervention to prevent a repeat 🙂

  20. Our horse, eighteen and a rescue from shelter that we have had for over two years, just got a swollen right front knee three days ago. She has no lameness and I doesn’t seem to have any apparent wound or bug bit area there. It just looks like her knee is much larger now on the right side and the swelling goes upward on that leg. She has no symptoms but it just doesn’t look right and never looked this way before so I am concerned. What should I do?

    1. I always call my vet first. Often they can give you instructions on how to treat it. If it is cellulitis, your vet will need to prescribe antibiotics.

      In the meantime, cold hosing the knee will help will the swelling. Good luck!

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