DAN: "Cellulitis, and how to bring more circulation
to the legs?"
DR LYDIA GRAY: Oh, that's it?
DAN: Ashley is to the point.
DR LYDIA GRAY: OK.
DAN: She knows what she wants.
DR LYDIA GRAY: I have a lot to say about cellulitis.
So we should probably define it first.
DAN: OK.
DR LYDIA GRAY: And not to be confused with cellulite.
DAN: Yes.
Yes.
DR LYDIA GRAY: So cellulitis.
I mean, the itis gives it away - it's inflammation.
DAN: Yeah.
DR LYDIA GRAY: Right.
And specifically, it's under the skin, and sort
of between the skin and the next layer,
which is fatty tissue and connective tissue.
And it's sort of a deep seated infection.
And usually in horses it's legs.
It's hind legs.
And it's one hind leg.
And only in about half the cases do we know what caused it.
DAN: Of course.
Horses.
DR LYDIA GRAY: Hey, half is good.
When we do know, it's from a wound, an injury,
a break in the skin.
Could be there was a surgery, and it just
allowed bacteria to go in.
But it is a bacterial infection.
And the thing about cellulitis is, one day your horse
is totally fine.
And the next day he's three-legged lame.
The leg is blown up.
DAN: I was going to say, usually.
DR LYDIA GRAY: We call it a stovepipe leg, because
from the hoof to could be the hock or knee, could be higher,
it is like one thing.
It's excruciatingly painful to the touch,
but also to stand and move on.
So it would be an emergency, because you don't
know that it's cellulitis.
And even your vet looking at it is not going to know.
So they might do some imaging.
They might do some blood work to see
if there is an infection going on,
to see if it's a local infection,
or to see if it's a body wide infection.
Because this all tells them how to treat it.
If everything points to cellulitis,
then we do try to find out what the cause is, because you
have to get rid of that.
But aggressive antibiotics.
DAN: I was going to say.
Yeah.
DR LYDIA GRAY: And then painkillers, pain relief.
And anti-inflammatory.
So non-steroidals, like your butes and banamines
and firocoxib, which is Equioxx.
And it comes down pretty quick.
Now, the things that the owner is going to have to do
is cold hosing or icing.
DAN: I was just going to say, it sounds
like you're going to do some time cold hosing.
DR LYDIA GRAY: Oh, yeah.
And you would like to use something
like a game ready or an ice horse that
has the cold and compression.
But it's so painful, you're not going
to be able to do that right away.
DAN: Well, that's what I was just going to ask.
As far as poulticing or things of that nature to help...
DR LYDIA GRAY: No.
Cause it's open.
DAN: But you don't want to touch anything.
DR LYDIA GRAY: It might be open.
And the other thing is, when the body swells,
skin has only so much room to expand.
DAN: Elasticity.
DR LYDIA GRAY: Yeah.
Whew.
That's a big word.
DAN: I tried.
DR LYDIA GRAY: And when it swells
more than it has elasticity for, there
can be microscopic breaks in the skin.
And then you'll see a yellowish--
the serum of the blood is oozing out.
And it even gets crusty.
So you don't want to put a poultice on it.
You don't want to put a liniment.
You don't want to put anything on it.
You let the antibiotics do the work, let the non
steroidals, the cold hosing or icing.
You will eventually be able to bandage it.
Bandaging and application of cold are tremendous for it.
There are things you may have to do well beyond the medication.
And even because when a horse has cellulitis in the leg,
that leg is more susceptible to it in the future.
DAN: Oh, really?
DR LYDIA GRAY: Yeah.
DAN: Even if you get rid of the infection?
DR LYDIA GRAY: Yeah.
Because you have stretched all the tissues,
maybe created scar tissue.
Now, I say "you."
It's not your fault. The circulation is impaired.
The lymph drainage doesn't work properly anymore.
And so you have to be in the future, to prevent it, I mean,
there's things you can do.
You closely monitor the legs.
So you have to everyday be looking for cuts, breaks,
scabs, abrasions.
You can't let your let your horse get scratches.
DAN: OK.
DR LYDIA GRAY: And turnout is great,
because when they're in a stall, they swell up.
DAN: So you want a little movement.
DR LYDIA GRAY: But you don't want to turn them out
early in the morning when there's
wet grass, because you want to avoid that leg getting wet.
Can't put it in.
You can't turn it out when it's muddy or sloppy.
DAN: The fun parts of horse ownership.
DR LYDIA GRAY: Oh, my goodness.
So I don't mean to be discouraging.
But there is quite a bit of care in the moment,
and then afterwards.
DAN: So that's good to know, though.
Cause a lot of times when horse owners do go down,
they see that the horse's leg is swelled up.
A lot of times, even if it's just the hock and it
doesn't seem super dramatic.
They do want to wrap, or do something
like that to kind of get the compression down.
DR LYDIA GRAY: Yeah.
But the horse will tell you.
It's so painful.
DAN: So at this point it's like, get the vet out.
Make sure.
It's important.
DR LYDIA GRAY: Because the horse probably isn't
going to be bearing weight.
And so you won't know that it's a cellulitis,
unless you've been through this with this horse.
You don't know.
I mean, this looks as bad as a fracture.
DAN: Oh, so it's--
DR LYDIA GRAY: Oh, yeah.
It's three-legged lame.
It could be an abscess.
There's a couple things that make horses-- joint infection.
When your joints get infected, the horse
is three legged, non weight bearing.
So this is an emergency, not only
to make sure it's not one of those things.
But you've got to get therapy started right away.
DAN: And get ahead of the infection.
DR LYDIA GRAY: Yeah.
DAN: So then with the follow up question
of how to bring more circulation to the legs?
Turn out's OK.
Hand walking I'm assuming.
DR LYDIA GRAY: Yeah.
Exercise is really good to keep things moving as little--
like I don't keep my horse in a stall.
Not for this reason, but for others.
So if you can find a situation where the horse is not
in a stall at night, like it's a run in, run out,
that would be ideal.
Because when they're stabled and standing still,
that leg is just going to stock up.
Trailoring even will cause them to stock up.
And you also want to protect the leg.
So when you trailer, you'll want to for sure,
if you didn't before, use shipping boots, or wraps,
however you want to do it.
This may be a horse that you now wrap when you exercise,
because they can't have a bump or booboo, because then
that's going to get the cycle going again.
DAN: Oh.
DR LYDIA GRAY: I know.
DAN: But it sounds like, though, if you get ahead of it,
there is at least hope for you.
You have some treatment and management.
DR LYDIA GRAY: Yeah.
Yeah.
DAN: OK.
We don't want to scare people too much.
DR LYDIA GRAY: Well, I want to add that it
can be life threatening.
But that's why you call your vet right away.
And you get on top of it.
DAN: Instantly.
OK.
DR LYDIA GRAY: And there are treatments.
Yeah.
DAN: Well, that is definitely great to know.
And keep us posted with how your horse is doing for sure.
DR LYDIA GRAY: Sorry.