skin prevention series problems - equus prime · izers, hemorrhoid creams and other home remedies...

skin problemsP r e v e n t i o n

s e r i e s

E q U U S2 P r e v e n t i o n s e r i e s • s k i n p r o b l e m s

P R E V E N T I O N By Laurie Bonner with

Melinda Freckleton, DVM

PROUD FLESH

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When your horse shows up at the gate with yet another cut or scrape, it’s wise to tend to it right

away to head off infection, aid healing and prevent complications.

One complication you’ll want to be especially careful to avoid is proud flesh. Also known as exuberant granu-lation tissue, proud flesh is the exces-sive growth of the connective tissue and blood vessels that begin to fill in a healing wound. In severe cases, the mounds of pink tissue can take on a cauliflower-like appearance and pro-trude beyond the surface of the skin. New skin is unable to grow over the tissue, and healing stalls. Proud flesh develops most frequently in wounds on the lower legs, but under the right circumstances it can appear anywhere on the body.

Several factors increase the risk for proud flesh, including the wound’s severity, level of contamination and location---the potential for disruption of fragile healing tissue in wounds over joints and other mobile areas makes them more vulnerable. Also, some horses are simply more prone to developing proud flesh than others. Consult your veterinarian if your horse

When your horse cuts himself, especially on the lower leg, take steps to ensure that healing proceeds smoothly.


has a wound that “gapes” when he moves, affects a joint, tendon or bone, or contains embedded debris or other contamination. In some wounds, sutures may be the best option, and your veterinarian will want to address any other issues that might compromise healing.

In most cases, you can probably manage your horse’s minor injuries yourself. But if you have any doubts do not hesitate to call your veterinar-ian. It is far better to get healing on the right path from the outset than to try to compensate once complications have developed.

1. Rinse the wound well. Dirt and debris---including hair, rope

fibers, fragments of metal or wood, or dead tissue---can create chronic inflammation and infection that in-hibits proper healing and encourages

growth of proud flesh. Saline solution, which has the same salt concentra-tions as blood, is the safest way to flush impurities out of a wound without dis-rupting injured tissues. If you don’t have any saline at hand, water from a hose can do the job. In fact, the cool water has the added benefit of helping to reduce swelling and inflammation. Inspect the area closely to make sure it is completely clean.

2. Apply appropriate treatments. Flushing

a clean wound with a dilute antiseptic wash, such as Betadine or Nolvasan, can

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Definition: overgrowth of granulation tissue that rises over the edges of a wound, making healing impossible Causes: Proud flesh is more likely to develop in

wounds to the lower limbs, wounds that remain contami-nated with foreign matter, and those in more mobile areas. Signs: The granulation tissue—which fills in the deeper portion of a wound that penetrates all the way through the skin—will take on a lumpy, reddish-yellow, rubbery ap-pearance. If infection is pres-

ent, it may exude fluids and have a noxious odor. Diagnosis: X-rays or ultra-sound may be used to look for damaged bone or embedded foreign matter. Testing may be necessary to distinguish proud flesh from sarcoids and vari-ous types of infections that can create similar-looking lesions in open wounds.

Treatment: Surgical re-moval of the excess growth is the primary treatment for proud flesh. For more moderate cases, a topical corticosteroid may shrink the tissue enough to allow proper healing. The leg may be placed in a splint or case to keep it still while heal-ing progresses. Skin grafts may be used for larger wounds.

IN FOCUS:Proud flesh (overgranulation)

reduce the risk of infection even fur-ther. If you choose to apply a wound ointment, use a water-based gel dur-ing the earliest stages of healing---these help protect the tissues with-out inhibiting healing. At the outset, avoid heavy, greasy ointments such as ichthammol---these are more effective for protecting tissues during the later stages of healing. At any stage of heal-ing, your best bet is to stick to products labeled for use on horses. Meat tender-izers, hemorrhoid creams and other home remedies may control inflamma-tion, but they will also damage normal tissue and may inhibit healing.

3. Bandage, if appropriate. Apart from superficial scrapes, almost

any wound on the lower leg will benefit from bandaging to keep it clean while it heals. You’ll want to first cover the exposed tissue with non-stick gauze


or other wound dressings that won’t adhere to the fragile healing tis-sues. Wounds above the level of the elbow or stifle can often be left open to heal; the relative immobility of the horse’s torso means the healing tissues won’t be disturbed as often, and these areas are likely to remain cleaner. You’ll want to change the bandage at least daily while healing progresses; more frequent changes may be necessary if the gauze is getting soaked with exudates.

4. Keep your horse still. Too much motion in a healing

wound pulls at the tissues and can prevent the skin from closing over it.

Bandaging is an important part of wound care. Not only does it help keep the wound clean, it can hold topical med-ications in place. But it’s im-portant to do the job carefully. A bandage that is too loose or too tight can slow healing or even make a wound worse. If you’re unsure of your tech-nique, ask your veterinarian to help you improve your skills.

Before you start, you’ll need to choose the best dressing for your horse’s wound. For years, sterile gauze squares were the pri-mary choice for covering the wound surface before apply-ing the wraps to cover it—and these will still get the job done. However, a better option may be one of the newer products designed to keep the healing tissues moist, such as calcium alginate or foam pad dressings. Although it was once believed that the best way to promote healing was

to let a wound dry out, recent research has shown that open wounds will close faster and with less risk of infection if the surface remains evenly moist. In addition, specialized dressings are now available that can help debride infected wounds or restore moisture to wound surfaces that dried out before the injury was discov-ered. If you’re unsure of which type to use, ask your veteri-narian for a recommendation. As with any product, read the labels carefully and follow the instructions.

Once you have wound dressing, you’ll also need rolled gauze, padding such as a quilt or cotton sheet, self-adhesive bandage and elastic bandaging tape (Elastikon).

1. Wrap the rolled gauze just above the wound,

pulling it just tightly enough to remain in place but not so hard as to stretch out the weave.

Make sure it lies smoothly and that each layer overlies the preceding layer by about 50 percent. The highest risk of injury to healing tissues come from shifting or slippage of this gauze layer.

2. When you reach the level of the wound,

place the gauze pad or other dressing over the exposed tissue, holding it carefully to ensure it lies flat with no wrinkles. Then continue with wrapping the gauze roll down the leg to cover the dressing and extend beyond its lower edge.

3. Wrap the cotton padding around

the leg, taking care that it lies flat.

4. Apply an ad-ditional layer

of rolled gauze to help

hold the padding in place as you continue wrapping.

5. Start the self-adhesive wrap about a half-inch

below the top of the padding and work downward, taking care to overlap it by about half with each turn and to prevent it from bunching up or wrinkling. Also leaving about a half-inch of padding exposed at the bottom, continue wrap-ping back up the leg for a total of two layers. You want to finish with a smooth, snug covering.

6. To help secure the ban-dage more firmly, apply

two or three rounds of elastic bandaging tape at both the top and bottom, over-lapping both the horse’s leg and the bandaging mate-rial by two or three inches.

Bandaging will help keep the limb still as your horse heals, and for larg-er wounds your veterinarian may rec-ommend splinting. Keep your horse in his stall or in a small corral or round pen until the wound is stable.

5. Seek help quickly if healing stalls. Even with the best of

care, some wounds may develop proud flesh. Call your veterinarian immediately if you start to detect rounded, bumpy tissue in a healing wound. In addition to curbing the growth of proud flesh, it’s important to rule out similar-looking condi-tions, such as ulcerated sarcoids0 or various fungal, bacterial or parasitic infections.P

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Applying a bandage

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P R E V E N T I O N By Laurie Bonner with Melinda Freckleton, DVM

AURAL PLAQUES

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Aural plaques are raised, crusty, white areas, which may include firm, rounded growths, that appear on

the inner surface of a horse’s ear. Usually, both ears are affected. If the crusts flake off, the skin underneath will be pink and sensitive. The plaques are caused by a papillo-mavirus probably spread by black flies. The chronic skin irritation and inflam-mation resulting from fly bites may also contribute to the formation of the plaques. Although some individuals ap-pear to be more susceptible to the aural lesions than others, plaques can appear in horses of any age or breed.

Normally, aural plaques are consid-ered to be only a cosmetic problem, but they can cause itchiness and sensitiv-ity. Your horse may resent having his ears handled, and trying to pull off the plaques may be painful and increase the skin irritation.

Aural plaques cannot be “cured,” and they will not diminish on their own. If they are causing no harm, it’s probably best to leave them alone. If the plaques bother the horse enough

These crusty white lesions inside the ears are generally just a cosmetic concern, but they can cause sensitivities that lead to behavioral issues.


to lead to behavioral issues, your vet-erinarian may prescribe treatment with imiquimod, a topical cream that modifies the immune response, to re-duce the size of the plaques and make them less sensitive.

A better approach is to minimize aural plaques before they grow severe, and that means taking steps to protect your horse’s ears against biting flies.

1. Cover the ears. One of the most effective ways to protect

your horse’s ears is to cover them during fly season. One option is a fly mask with ear protection. You may also want to attach ear nets to your bridle, especially if you ride in wooded

areas near running water. Because black flies are attracted to darker col-ors, choose white or pale colors for your horse’s garments. Another protective tactic is to smear petroleum jelly over the ears to provide a barrier against insect bites.

2. Apply repellents. A liberal use of fly sprays will protect your

horse’s entire body, but make sure you pay special attention to the ears. Ointments or oils that contain pyre-thrins may provide better-targeted and more thorough protection for the ears. Make sure the products you buy are labeled for use on sensitive areas around the face.

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3. Stable your horse during peak fly activity. Black flies

can emerge in great numbers for a few weeks each year, usually in late spring or early summer, particularly in northern climates. Although they may bite throughout the day, especial-ly when it’s overcast, they are most active at dawn and dusk. Black flies prefer to fly in sunlight and do not generally go indoors, so stabling your horse during peak periods of activity can help protect him. Also, make sure your pastured horses have access to a deep, dark run-in shed so they can escape biting flies on their own as needed.

Definition: benign, raised, crusty, white skin growths on the interior surface of the ear Causes: a papillomavirus infection, most likely spread by the bites of black flies; the bites may also cause irritation and inflammation that stimulates

the growth of the lesions. Signs: unpigmented thickening of the keratinous (structural) layer of the skin; the lesions are raised, with a hard, scaly appearance. Rounded, knoblike protuber-ances may also develop within the scaly area. Usually the plaques are painless, but in some horses they cause itchiness and sensitivity. In

these cases, the pain may cause a horse to resist having his ears handled. Diagnosis: observation of signs. Aural plaques have a distinctive appearance, but it’s wise to have a veterinarian look at them to rule out other skin tumors, such as sarcoids, that can also appear on the ears. This is especially true if the growths develop rapidly, are

tall or cause the horse pain. Treatment: If aural plaques are causing no pain or discom-fort, no treatment is necessary. In cases where the plaques cause severe itchiness or dis-comfort, a veterinarian may prescribe topical cream con-taining imiquimod, a drug that can help reduce the size and severity of the plaques by modi-fying the immune response.

IN FOCUS:Aural plaques

black fly




SWEET ITCH

Sweet itch can make a horse miserable. The intense itchi-ness can cause him to rub away

patches of hair, leaving the skin under-neath raw and weepy. If a case is severe enough, the horse may become rest-less and thin, as he spends more time scratching than eating.

Technically known as equine insect hypersensitivity or insect bite hypersen-sitivity, sweet itch is a severe allergic reaction to the saliva of biting insects, primarily Culicoides spp. midges and gnats but also possibly blackflies or deer flies. Sweet itch reactions can occur any-where on a horse’s body but are usually seen on the areas where the insects tend to bite: on the underside of the belly, under the mane or the dock of the tail.

The condition is usually at its worst at the times of year when insects are most active, and it may subside during the winter. Less than 10 percent of horses in the United States develop sweet itch, and most won’t begin to show signs until they are at least 2 to 4 years old. The con-dition is more common among Shires, Welsh Ponies and horses imported from Iceland, but it can occur in any breed.

Research is underway to develop a reliable immunotherapy treatment for sweet itch. In the meantime, veterinar-ians may prescribe antihistamines and corticosteroids to help relieve the signs

Here are steps you can take to protect your horse from this allergic reaction to insect bites.

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of the condition. But steroids carry a low but real risk of serious side effects, including laminitis. So if your horse is susceptible to sweet itch, you’ll want to reduce his exposure to the insects that cause it. Here are steps you can take:

1. Stable your horse during peak biting hours. Culicoides spp. are

most active at dusk and dawn, so bring your horse into a stall during those hours. For additional protection, install ultra-fine screens in stall windows and set up fans to provide a continuous breeze over stabled horses. Gnats are weak flyers and even a slight breeze will keep them away. You might also consider applying a spray repellent designed for use on stall walls and other surfaces inside the barn.

2. Keep him covered. One way to reduce bites is to keep a fly sheet

on your horse during insect season. Made of fine mesh and equipped with closures

to keep out bugs, clothing designed spe-cifically for horses with sweet itch has extensions to cover the neck, belly and tail, the areas where Culicoides spp. are most likely to bite. A fine-mesh mask may also be needed to protect the horse’s face and ears.

3. Use fly-control products. The most potent products combine

repellents with pesticides. Look for ones labeled for use against gnats and midges. You’ll need to be diligent about applying the sprays and wipes as often as the manufacturers’ instructions allow.

4. Restrict your herd’s access to marshy areas. Gnats breed in

marshy, shady ground with rotting vegetation. If possible, move your horse to a pasture in a drier, more exposed location away from boggy terrain. Around your barn, clear up standing water in ditches and gutters and keep them free

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)of leaves and other debris. Place manure and compost piles as far away from the horses as is feasible.

5. Try over-the-counter products. You’ll find a number of products

for horses with sweet itch, from feed supplements formulated to reduce inflammation, to topical preparations meant to soothe itchy, inflamed skin. Thick, oily or sticky ointments are messier but may keep gnats from landing on the horse’s skin. They may also help keep bugs from getting to the skin to bite. Anecdotal evidence suggests that these products offer some relief, at least in some horses. When trying a new topical product, start by applying it to a small area to make sure it will not further irritate sensitive skin. Be careful with tea tree oil, lavender and other herbals---they are soothing to some horses but can irritate the skin in others.

Definition: Technically known as equine insect hyper-sensitivity (EIH), sweet itch is an allergic reaction to the saliva of biting insects, most often the Culicoides species of midges and gnats. Signs: intense itchiness,

wheals and swelling, primarily on the neck (under the mane), face, shoulders, withers, belly and rump (over the tail). The skin may be rubbed until it is crusty, weepy, raw and hairless. Location of the lesions may depend on the specific species of gnat; most prefer to bite on the neck and along the topline, but some target the chest, belly, tail and groin. Diagnosis: Skin scrapings

and cultures may be needed to distinguish EIH from other causes of itchy dermatitis, such as mites, lice and fungal infections. Treatment: Antihistamines or corticosteroids may help ease the itch and inflamma-tion, providing relief to the itchy horse; antibiot-ics or antimi-crobial shampoos

can help prevent secondary infections. Pentoxifylline can be used to decrease skin reactivity, and in some cases allergy serum is worth trying.

IN FOCUS:Sweet itch


corticosteroids0 or other immune sup-pressing drugs are also at increased risk of developing the infection.

Rainrot is easy to treat with antimi-crobial shampoos and, for severe cases, oral or injectable antibiotics. But it’s even better to take steps to prevent the condition, especially in horses who may be prone to developing the infection.

1. Keep susceptible horses as dry as possible. Chronic wetness

helps foster rainrot. It isn’t necessary to bring horses into the barn before every rain shower, but make sure that

There’s no mistaking the crusty, matted tufts of hair rising along your horse’s topline and flanks, clinging

to tight scabs that are painful if disturbed. It’s rainrot, a bacterial in-fection also called “rain scald.” The organism that causes it, Dermatophilus

P R E V E N T I O N By Christine Barakat with Melinda Freckleton, DVM

RAINROT

With just a few simple steps you can reduce your horse’s risk of developing this minor but aggravating skin condition.

congolensis, normally resides on the horse’s coat without causing trouble. But persistent moisture enables the bac-teria to flourish and infect the skin.

Years ago, rainrot was believed to appear only in poorly kept, chronically dirty horses, but now we know better. Under the right circumstances, out-breaks can occur even in the most rigor-ously groomed herds. In addition, some horses are more susceptible than oth-ers. Those who are old or sick, especially with Cushing’s0 disease, may not have the immune defenses to keep D. con-golensis in check, and those receiving

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E q U U S1 0 P r e v e n t i o n s e r i e s • s k i n p r o b l e m s

your run-in shed is dry and has enough room for the whole herd. Keep an eye on the herd dynamics---sometimes the lowest ranking members can get pushed out into the rain. Another option is to outfit a suscepti-ble horse with a waterproof sheet. You’ll need to check underneath it daily, how-ever, to make sure moisture hasn’t been caught and held against the coat.

2. Treat your horse’s skin tenderly. Fly bites, scratches

from prickly vegetation and other tiny wounds increase the chances of a rain-rot infection. Use fly spray regularly, remove thorny undergrowth from pas-tures and groom your horse carefully--- particularly when using a shedding blade---to help prevent small abrasions that can make your horse’s skin suscep-tible to infection.

3. Keep brushes and tack clean. D. congolensis can be passed

from horse to horse on brushes and tack. If you are treating a member of your herd for rainrot, use a separate set of tools for him and wash your hands when you’re done. Once the infection has cleared up, decontaminate the tools you used on the affected horse by scrub-bing them in a mild bleach solution and allowing them to dry in the sun. Even if your herd appears healthy, it’s a good idea to wash communal brushes weekly or keep a separate set for each horse. Otherwise, you might transfer the bacteria from a healthier horse, who can keep them in check, to one who is more susceptible.

4. Groom often. Mud and dirt by themselves do not cause rainrot,

but they can hold moisture against the

skin and enable infection to take hold. Regular grooming will not only help keep a horse’s coat clean and dry but can also reveal the earliest signs of in-fection---heat emanating from the skin, hairs standing on end or tiny scabs.

5. Act quickly if signs of infection appear. If you notice any signs

of rainrot, a prompt bath with an antimicrobial shampoo might prevent a full-blown case. If the infected area is still small, you can “spot” treat it with wipes infused with chlorhexidine or another antiseptic. If you don’t see rap-id improvement, get your veterinarian involved to confirm the diagnosis and possibly prescribe stronger treatment. Resist the urge to pick at any scabs you may find, however; it’s unnecessary in mild rainrot cases and your horse will find it painful.

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IN FOCUS: RAINROT Definition: infection of the

skin and hair follicles with Der-

matophilus congolensis bacte-

ria, which are ubiquitous in the

soil and on a horse’s skin, but

are activated only in the pres-

ence of persistent moisture Causes: Prolonged expo-

sure to moisture, coupled with

minor abrasions or insect bites,

enable the bacteria to gain a

foothold in the skin. Horses

whose immune systems are

compromised by advanced

age, illness or medications

are more likely to develop the

infection. Signs: small, gray/white

scabs clustered along a horse’s

back, hindquarters and other

areas that remain consistently

wet. The hair may stand up in

tufts over each scab. When the

scabs slough away, patches of

hairless skin are visible. Diagnosis: Most cases

of rainrot can be identified by

visual inspection alone. Howev-

er, ringworm0, allergic reactions

and other conditions some-

times look similar to rainrot.

When there is doubt, rainrot

can be definitively diagnosed

by examining the scabs under

a microscope.

Treatment: Most cases

clear up after the coat is

cleansed with an antimicrobial

shampoo and allowed to dry

thoroughly. If weather permits,

it may be helpful to clip a long

winter coat to expose the in-

fected areas to more air. Treat-

ment with antiseptic wipes may

be enough to resolve milder

infections. Severe cases may

require oral or injectable anti-

biotics.




RINGWORM

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Ringworm is a fungal infec-tion that feeds off of kera-tin, the protein that forms the structure of hair, skin

and hoof horn. It is characterized by rounded areas of scabby, flaky, hair-less skin that can be itchy but often cause no physical discomfort. Many moderate cases of ringworm would heal on their own within 60 to 90 days, but it’s not a good idea to let the infec-tion go untreated. Ringworm is highly contagious---it spreads easily by di-rect contact as well as via shared tools, fences, tack and equipment. What’s more, the same fungal organisms that cause ringworm in horses can also in-fect you as well as dogs, cats and other livestock. Preventing an isolated case from spreading throughout your farm requires some basic steps.

This highly contagious fungal infection of the skin is more nuisance than threat. But you can take steps to minimize the chances of an outbreak.

Trichophyton spp. DR

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1. Avoid sharing tack and equip-ment. The fungal spores that

cause ringworm can survive for months on fabrics and hard surfaces around the barn. To avoid transferring the in-fection from horse to horse, keep a sep-arate set of brushes and other grooming tools for each one in your care. Color-coding each item with brightly colored electrical tape is one convenient way to avoid mix-ups. It’s best to keep a sepa-rate halter, fly mask, blanket and other tack for each horse, too. At shows, use only your own gear and tools, and do not let others borrow them.

2. Quarantine new horses on your farm. Horses can carry

the fungal spores that cause ringworm for up to three weeks before develop-ing signs of infection, and during that time they are contagious. Keeping new-comers separate for up to a month will make sure they aren’t carrying ring-worm as well as other diseases. Ideally, the new horse would be in his own cor-ral, with no over-the-fence contact with

others. If you don’t have a separate en-closure, you can use temporary fencing to cordon off a section of your pasture---erect two fences, one at least six to eight feet inside the other, to prevent nose-to-nose touching.

3. Treat outbreaks promptly. If you notice signs of ringworm on one

horse, you need to take quick action to prevent the outbreak from spreading throughout the herd and around the farm. First, isolate the affected animal from all others. To treat the ringworm, clip the hair around the lesions, and remove loose scabs and crusty material. A number of over-the-counter antifungal medi-cations and shampoos are effective against ringworm, but you may need to try several products to find one that best targets the specific fungal species affecting your horse. Clean the lesions with a general antisep-tic, such as chlorhexidine, then dry thoroughly before applying an anti-fungal ointment or wash. Repeat the

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treatments daily. Exposure to air and sunshine will also help kill the fungi. With diligent treatment the infection ought to clear up within a week or two, but if it doesn’t, contact your veterinar-ian to rule out other skin conditions that can resemble ringworm. She may also recommend more aggressive treat-ment measures.

4. Clean up thoroughly. While treating ringworm, wear gloves

and wash well after handling the af-fected horse. Once the infection has healed, disinfect all the buckets, brush-es and other tools and equipment you used while you were treating him. First, scrub each item in a diluted bleach so-lution, then use a commercial sanitizer that works against fungi. You’ll also want to disinfect the stall walls and/or paddock fence where the horse was kept---your veterinarian can recom-mend a product that is appropriate for the type of surfaces you need to clean (wood vs. metal, for example) as well as the organisms you need to kill.

Definition: skin infection that can be caused by sev-eral fungal organisms, usu-ally members of the genera Trichophyton or Microsporum Causes: either direct contact with another infected

animal or indirect contact with tack, grooming tools and other surfaces that are infected with the fungi Signs: rounded, hairless patches of crusty, scabby skin. The lesions are most common on the face, neck, shoulders, chest or under the saddle or girth, although they can appear anywhere on the

body. The affected areas may sometimes be sore or itchy, but often they cause no dis-comfort, and the horse may appear otherwise healthy. Diagnosis: Ringworm le-sions are fairly distinctive, but they can resemble other skin conditions. For a definitive diagnosis, a veterinarian may take skin scrapings to exam-

ine under a microscope. Treatment: A number of over-the-counter antifungal topical treatments and sham-poos are effective against ringworm. For a severe infec-tion or a widespread outbreak in a herd, a veterinarian may also prescribe oral medica-tions.

IN FOCUS:Ringworm

Microsporum spp.

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