What are Cellulitis?
Cellulitis is a common malady among horses. This infection of soft connective tissue under the skin can develop in any place in the body but it is most commonly found in horses in either of the hind legs. The swelling associated with cellulitis can be a laming situation for your horse, at least until it is brought under control. Lameness is often seen first; this is a symptom that should always be evaluated by a veterinarian if it persists, particularly if fever or malaise accompany it.
Cellulitis is a skin infection that usually results from a scratch, scrape or puncture of the skin.
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Symptoms of Cellulitis in Horses
Here are some of the symptoms you will notice with cellulitis in your horse:
- Swelling and pain in the area of the injury
- Skin that is hot to the touch
- Fever sometimes in the horse
- Lameness in the affected limb which can be acute
Sometimes the lameness will come on before the significant swelling appears in the wound area. This lameness is sometimes confused with possible fractures of the various bones in the limbs. While cellulitis can develop in any place in the body, the most common location for development on horses is the limbs, specifically most often found in the hind limbs.
There are two types or categories of cellulitis in horses:
- Primary cellulitis - Those cases in which no root cause can be established (most commonly found in Thoroughbred horses but can happen in any breed of horse)
- Secondary cellulitis - Those cases in which there is a known root cause (can develop in any breed of horse and, surprisingly, only about 50 percent of the reported equine cellulitis cases are secondary to a known cause)
Causes of Cellulitis in Horses
While bacterial activity is what actually fuels the infection, there are a number of situations that are considered to predispose horses to cellulitis:
- Joint infections
- Wounds (scratches, scrapes, cuts, puncture wounds)
- Blunt trauma
- External parasites
- Poor hygiene
- Bacterial populations which exist on the skin
- Decreased blood or lymphatic circulation
- Drying and irritation of the skin (long exposures to mud or sand can dry the skin and cause cracks and breaks in the skin into which the bacteria present on the skin can enter the body)
Diagnosis of Cellulitis in Horses
Your veterinarian will need to do a thorough physical examination of your horse. He will be interested in ruling out causes of lameness like fractures and septic joints as these conditions can exhibit similar symptoms and clinical signs. Most of his evaluation of your horse’s condition may come from this thorough physical examination but don’t be surprised if he also may wish to utilize some other diagnostic tools to develop his diagnosis. He may wish to use radiography, ultrasonography and blood work to tie down the diagnosis.
If there is swelling, he will likely be interested in getting a sample of the fluid for laboratory evaluation. This will enable him to isolate the bacterial component and develop a treatment plan that is specific to that bacterial component. Identification of the cause for the cellulitis can’t always be determined but your veterinarian will provide the best treatment plan for this scenario as well.
Treatment of Cellulitis in Horses
Depending on the cause of the cellulitis in your horse as determined by your veterinary caregiver, treatment options will vary. Most often, treatment plans will include administration of antibiotics and anti inflammatory medications (like phenylbutazone or flunixin meglumine) to treat the bacterial infection, the inflammation and pain associated with the cellulitis episode. Your veterinarian will likely also recommend keeping the affected area clean, and surrounding hair clipped closely.
Your veterinarian may require cold-hosing to reduce swelling in the leg and follow with a pressure wrap and he will instruct you in the appropriate way to apply the pressure wrap to assure no further damage is done. A note here for those of you who have never dealt with a horse with cellulitis: exercise is one of the best treatment options available. This will help the lymphatic system of the horse to drain the fluid accumulation and improve the circulation in the afflicted area.
Recovery of Cellulitis in Horses
For some horses, cellulitis episodes will keep repeating, while for others, careful monitoring will reduce the opportunity for repeat infections. Generally, the horse will heal adequately from the cellulitis episode but, if there is damage to the underlying tissues from this episode or from previous episodes, the risk of repeat is higher. Resolution of the cellulitis will take some time and will require some adjustment on your part to comply with the treatment regimen. Once your horse is healed from his bout with cellulitis, you may wish to consider making some changes in his routine to avoid repeat episodes. These changes might include:
- Establishing or changing his exercise routine to make it more regular to keep the lymphatic circulation flowing
- Make every effort to keep the leg clean and dry and try to eliminate or significantly reduce the times when your horse is turned out in standing water, muddy or sandy conditions
- Closely monitoring the condition of your horse will help you catch those repeat episodes earlier to enable more timely treatment and reduce the chance of further damage to the underlying tissue
Cellulitis Questions and Advice from Veterinary Professionals
When I got my warmblood she had a swollen hind leg on the hock joint where she had surgery in 2008 (I only got her this year) the swelling or enlargement is firm, not painful although there is a bit of fluid underneath so I wrap her leg and keep it compressed which seems to keep it under control, she is not lame in anyway. Would this be damage from cellulitis that was left untreated or is the infection still active? It doesn't seem to bother et or effect her movement. The only thing really is the noticeable enlargement and fluid.
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I have a 25 year old pony who presented with swelling in the hind legs and unable to move, a small splinter, swelling and puss were discovered in the soft skin under his tail. Thus seemed to be the cause of his infection type symptoms. Still swelling in one hind despite, a week of antibiotic and anti inflammatory treatment!
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My filly had one swollen hind leg for two days and this afternoon all four legs are swollen. Is it possible that cellulitis can spread to all four legs?
The affected leg had a small scratch and was slightly but not badly swollen. Ll her legs are swollen from the hoof to the knee.
Swelling in a single leg would probably be attributable to the scratch on the leg; the swelling of all four limbs by be due to inactivity and subsequent reduction in lymphatic drainage from the limbs as lymph return is a passive process where movement moves the lymph. Other possible causes for all four limbs being swollen may be due to liver disease, hypoproteinemia or severe infection. I would call your Veterinarian out as I cannot examine her myself. Regards Dr Callum Turner DVM
Thank you for the reply. I treated her with antibiotics and she has responded very well.
Scrubbed old scratches once I learned what they were on my horses hind fetlocks and treated with desitin and furizon , no swelling and no open skin. Went on a ride the next day and the. The next morning both hind legs are swollen and warm. He is 37 years old.
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