Pastern Dermatitis - Archie's story up to now

The greasy heel symptoms appeared on Archie's legs in December 2009. 

My first vet gave me Illum Dermapred  to treat this. This green ointment got things under control but didn't cure the condition. I also tried FilterBac and Potties White Ointment. 

Before (inside rear leg)

Before (outside rear leg)

He had these lesions for 4 months before I found the following article.
When I read this first article I realised Archie did not have greasy heel.

Below are some links to the information Archie's skin condition.

http://www.compleatfeed.com/compleatfeed_site/Article_Greasy_Heel.html

Then I called another vet and she did some blood tests. We also investigated weeds in his paddock. We tried to find weeds that may cause Archie to be photosensitive. We could not find any. The vet did not take a biopsy because she thought it would further damage the area of skin.

My vet also did some research on the Internet. She found the following post about Pastern Leukocytoclastic Vasculitis. We used this as a basis for Archie's treatment.

http://www.chronofhorse.com/forum/showthread.php?t=115402

Hey there, I just saw your PM a little while ago. Just wanted to say please stop all the tropicals, and stop scrubbing or washing the area. First thing is to keep the legs dry and wrapped and out of the sun/dirt/mud.

My horse was the poster child for this disease at UC Davis, literally! He quickly turned around with a combination of a bland diet, oral antibiotics, prednisolone, and Pentoxyfiline, and topical Genesis spray with the legs wrapped 24/7 until the redness/inflammation went down completely, then wrapped during the day until the hair began growing back.

This is an autoimmune response, any scrubbing and topicals is going to make the inflammation worse, and disturbing the skin will only invite a staph infection which could lead to severe cellulitis or worse. The legs need to be CLEAN and DRY while you treat the issue from the inside out. The genesis spray I used was an alcohol based steroid spray that decreased the skins inflammation while drying quickly.

I worked extensively with Dr White and the UC Davis veterinary dermatology school. He's awesome, your vet might want to get in touch with them for dosage information. I seem to have lost my vet records.

Re-Rider

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Archie was put on a bland diet of Lucerne hay. We stabled him and bandaged his legs. After a few days we discovered that this alone had made a big improvement to the affected area. The vet said that medication was not necessary. The results of the blood test told us that Archie's liver was normal. Also he was not suffering from dehydration.

There were protein changes (could be from inflammation) 

PROTEIN (Normal range 55 - 70)   Archie was 70 

High Glob (Normal range 25-36)  Archie was is 43

Low Albium (Normal range 28-37) Archie was 27

Sodium Potassium was high

(Normal range 3.2 - 4.8) Archie was 5.7

I was told that Archie's Electrolytes were imbalanced. He needed a dietary supplement to correct this. The vet said Archie has Pastern Dermatitis (solar related). (I believe it may still be Pastern Leukocytoclastic Vasculitis  because this is what we treated him for and the treatment worked. I have no proof for this there was no skin biopsy).

Archie was stabled for a total of 2 weeks before he was moved to a stable with a yard attached. This yard had no grass and I had to supply all of his feed. For a few weeks we were locking him in this stable during the day and then letting him out in the yard at night. This was not a happy life for him as he gets very bored. My goal has been to design boots that he can wear in the paddock so that he doesn't have to be locked up for the rest of his life.

After 6 weeks of treatment