A cross‐sectional survey of the diagnosis and treatment of distal limb cellulitis in horses by veterinary surgeons in the United Kingdom. (12th April 2021)

• Record Type: Journal Article
• Authors: Braid, H. R.; Ireland, J. L.
• Is Part Of: Equine veterinary education. Volume 34:Number 6(2022)
• Page Start: e234
• Page End: e244
• Publication Date: 2021-04-12
• Subjects: horse -- cellulitis -- lymphangitis -- management; Horses -- Diseases -- Periodicals; Horses -- Diseases -- Treatment -- Periodicals; 636.108905
• DOI: 10.1111/eve.13484
• Languages: English
• ISSNs: 0957-7734

Abstract

Summary: Background: Cellulitis is a commonly recognised condition in first opinion equine practice yet there is little published information regarding its diagnosis, treatment and management. Objectives: To describe current approaches of veterinary surgeons working in the United Kingdom (UK) to the diagnosis, treatment and management of distal limb cellulitis in horses. Study design: Cross‐sectional survey. Methods: An online questionnaire was distributed via email and social media sites for a period of 12 weeks. Descriptive statistics were produced and chi‐square or Fisher's exact tests were used to assess associations between categorical variables, with critical probability set at 0.05. Results: Distal limb cellulitis is frequently encountered in the UK, with 83.5% (n = 224/268) of respondents having treated >5 cases in the preceding 12 months. Diagnosis was predominantly made based on clinical signs alone (89.2%; n = 239/268). The majority of respondents (95.5%; n = 256/268) treated cases with nonsteroidal anti‐inflammatory drugs (NSAIDs) and antimicrobials. Phenylbutazone (93.8%; n = 240/256) and trimethoprim sulphonamide (TMPS) (72.3%; n = 185/256) were most frequently prescribed and 61.7% (n = 148/240) of respondents prescribed these drugs in combination. Duration of treatment was most frequently five days for NSAIDs (33.5%; n = 64/191), TMPS (84.4%; n = 119/141) and doxycycline (62.5%; n = 25/40), the longest prescribed duration of any treatments being 10 days. Corticosteroids were administered by 41.0% of respondents (n = 110/268). Management recommendations included cold hosing/ice packing of the affected limb (79.4%; n = 212/267) with light exercise (turnout or hand walking) if the horse was comfortable enough to do so (97.4%; n = 260/267). Main limitations: Small sample size (n = 268) and low level of item omission for a small number of questions. Conclusions: Cellulitis is common in the UK and is usually treated with NSAIDs and antimicrobials for 5–10 days, plus cold hosing and light exercise. Further study on the topics of diagnosis and treatment, with particular emphasis on the aetiology and necessity of antimicrobials, is warranted.