Pastern Leukocytoclastic Vasculitis treatment with oral medication - 1 week later

Below is a link to a vet article on Equine Pastern Dermatitis. It includes information about Pastern Leukocytoclastic Vasculitis. My vet supplied me with print outs of these pages. It's interesting to compare some of Archie's recent photos with the image on page 4 (218) in this article.
http://www.vetlearn.com/Portals/0/Media/PublicationsArticle/PVE_02_07_214.pdf

Here are some photos taken one week after I started Archie on Trental 400 tablets. This area is not sore to touch at all. The inflammation has gone and the hair is growing back. I am covering the area with just the mesh leg wraps now.

And here is a photo of Archie's bottom. I had been applying Potties White Ointment to the area for 4 days. The morning this photo was taken these scabs just wiped off.

Last week the elastic on one of Archie's leg wraps ripped and I had to think of a way to cover his hocks while I repaired the wrap. So I put a nappies on both legs and duct taped them to his rug leg straps (if I had only put one nappy on his rug would have slipped over to one side). When I visited two days later the nappies had not moved.

Nappies used as hock bandages

Pastern Leukocytoclastic Vasculitis treatment with oral medication

The vet and I have just learned that the Trental 400 tablets we gave Archie were not meant to be crushed. They are tablets designed for people and have a protective coating. The tablets are effective when they are absorbed into the intestine. This coating stops the tablet being absorbed into the stomach so that it makes it to the intestine and/or protects the stomach. Also, the patient is not supposed to stop taking the medication abruptly.


Archie is fine and the treatment was successful. He looks healthy and happy and is hock is healing well and is not sore to touch. However, we are not going to give Archie this medication again until we find out more information. It would be near impossible to give these tablets to a horse without crushing them first. We need to find another way.

Pastern Leukocytoclastic Vasculitis treatment with oral medication

My vet has supplied me with Trental 400 (oxpentifylline 400mg). This medication is used for treating Pastern Leukocytoclastic Vasculitis. 


Action of Trental 400 ...
Reduce blood viscosity, thus improving blood flow in the microcirculation and increasing tissue oxygenation.-Reduced blood viscosity may be due to improved red blood cell flexibility, decreased plasma fibrinogen and improved platelet deaggregation.


Archie weighs 540kg and we have had to give him 10 tablets in the morning and 10 tablets in the evening with his feed. We crush these tablets into a powder and mix it with molasses, barley flakes, chaff and a little bit of water. Archie will eat it this with no problems at all. He takes his medication for 3 days.

Day 1 of treatment after I removed the white ointment.

Day 3 of treatment. A big improvement

I have also been covering the area to protect the bare skin from UV light throughout Archie's treatment. I did not want the mesh wraps I made to rub the inflamed area so I used a disposable nappy as padding. I like this idea because the nappy wicks any moisture away from the sores and keeps the area dry. The outer plastic stops the rain from entering. I have secured the nappy on the hock with duct tape.

I then rugged Archie and put his mesh wraps over the top. The mesh boots are suspended from the leg straps of his rug. I have also duct taped the nappy to these leg straps. This stops the nappy from slipping down.

It's important to leave an opening at the back. So that the hock has room to move. This is easy to achieve because this is where the nappy's waistband is.

The mesh leg wraps strap over the top, hold everything together and shelter the rest of the leg from harmful UV light.

These mesh boots used to pull down on Archie's beige coloured rug. It made it hard for him to go to the toilet because he couldn't easily lift his tail. I would find him with a dirty mess of manure over his bottom and down his legs. Archie's new blue rug gives him more room to lift his tail. When I checked his bottom it was clean.

Unfortunately I found orange sores. There are about seven of them (pictured below). I'm not sure if these sores are side effect of the medication. I hope they heal easily.

Day 3, I noticed some unusual orange sores under Archie's tail.
I wonder if this may be a side effect of the medication.
The hair on his tail is a bit messed up so he has been rubbing.

Pastern Dermatitis - November 2010

Here is a photo of the Pastern Dermatits on Archie's inside right hock. It has never been this high up his leg before. I need to purchase or sew something that fits around is hock but does not rub as the area is extremely sore. For now I am just using Potties White Ointment to cover the area. This will not cure his condition but it will keep things under control for now.


(I need to get some hock wraps like these, but I'm having problems ordering them at the moment)...

Cool Medics hock wraps

This time the scabs seem to be growing outwards like a ring. The original sore in the centre has healed and hair is growing back. Today it looked very inflamed.

Below is a photo of what I thought was an ant Archie had a few weeks ago.

Here is how it all started...

Bites

Insect bite on Archie's leg. Probably an ant bite.

Archie bit me. Now we both have painful bites.

Archie's mesh leg wraps

Happy Archie enjoying his paddock on a wet day

Here are the leg wraps I designed and made for Archie. So far I have had success with them staying up. I have seen him canter, roll and pig-root in them and they have not come loose. It's been raining here. In wet weather his legs still get damp but they dry out quickly because the fabric breathes. In a few days I will find out if they prevent him from getting Pastern Dermatitis (solar related). Fingers crossed.

They are soft, breathable and stay up!

Leg wraps are suspended from Archie's rug. The black elastic loops give him room to move.

The tiger stripe fur fabric was left over from my daughter's craft project. The fur stops the wraps from rubbing. It makes me laugh. Archie looks like something out of The Rocky Horror Picture Show wearing suspenders and fishnets.

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

Welcome to my blog

Archie is a White Quarter Horse gelding. He has very sensitive pink skin that reacts badly to UV light, wet weather and insect bites. His hooves are also sensitive and he is being treated for seedy toe.


I created this blog to document Archie's progress while sharing information with others who may be experiencing similar health issues with their own horses.