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What was that? Well, let’s try Mud Fever, or Scratches, or Grease Heel, or Indio Crud. Sound a little more familiar? If it does, it is because all of the above are the same condition.
Let me add a few more considerations to the mix. For example: Pastern folliculitis (staph. infection), Photoactivated vasculitis (light sensitivity), Leukocytoclastic pastern dermatitis (immune mediated dermatitis), Pemphigus foliaceus (another immune problem), Dermatophytosis (fungal) and Contact Dermatitis (chemical irritant). For reasons that may or may not be understood, many of these conditions are most often, but not always, found on a non pigmented area of the leg.
It would get a little long winded to go through all of the details of the various medical conditions that can result in those nasty skin irritations most often found in the pastern region. That being said it is important to point out and understand that there are multitudes, including several not mentioned above, of skin diseases that can on the surface appear very similar to what appears to be a simple case of “Mud Fever”. I know of few conditions in a horse which on the surface can appear so innocuous yet potentially be so serious — even deadly and can be so simple to so very complicated to treat.
Basic pastern dermatitis is a skin infection, usually bacterial, which gains entry into the skin often from an abrasion, hence the term Scratches. It may also result from moist, damp or unsanitary conditions, hence the term Mud Fever. This condition may range from a mild non painful reddening of the skin to a serious exudative mess causing thick crusting, painful scabs and lameness. On more than a few occasions I have been called to see a horse, which was perfectly normal 12 hours earlier who is now on 3 legs, painfully swollen to above the stifle with a serious life threatening infection. The cause may be a bacteria smoldering below a scab, that has gained entry under the skin infecting the entire leg resulting in a cellulitis or lymphangitis. This is a very serious condition that needs to be treated as an emergency and it needs to be treated aggressively.
Treating a mild dermatitis properly is important, as untreated they can become chronic and much more difficult to resolve. Earlier I outlined a long, although not complete list of other conditions that might mimic simple pastern dermatitis, it is important in many cases to look a little deeper if your initial treatment(s) are not working. Some of these conditions may require further diagnostics including bacterial or fungal culture. In some cases a skin biopsy needing the expertise of a veterinary Dermatopathologist may be required. Many times a secondary bacterial infection may result from a more serious underlying skin condition. An accurate diagnosis is essential in treating the problem properly.
Treatment of pastern dermatitis may often be straight forward. Cleansing with a mild antibacterial surgical scrub (Betadine or Chorhexidine) and applying an astringent or water soluble antibiotic may be all that is required. Avoid a thick greasy concoction which smothers the skin. Clipping long hair is a good idea as it helps prevent the hair matting in the exudates and contributing to the build up of bacteria. If thick crusty scabs have developed I generally prefer to soften the scabs with a surgical soap so that they can be removed exposing the infected underlying skin allowing your medication to adequately make contact with the skin. Bandaging the affected area is often helpful. Treating these conditions as you might a serious leg wound only makes good sense. In more severe cases systemic antibiotics and anti-inflammatory medications are often required.
It is interesting that we see a high incidence of this condition at horse shows. Excessive cleansing with harsh soaps can wipe out the normal bacteria, then add the abrasions from footing and perhaps irritation from a recent close clipping and a perfect scenario for a skin infection is created.
The take home message from this article can be summarized as follows: there are several serious and very complicated conditions that can affect the skin of the lower limb that can initially mimic a routine pastern dermatitis. Making an accurate diagnosis and treating appropriately is essential. Skin infections can become serious and potentially life threatening. Treatment can range from simple to difficult, extensive and prolonged.
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