Treatment and outcome of eight horses with limb cellulitis and septic tendonitis or desmitis.
Authors: Cooper Hannah E, Davidson Elizabeth J, Slack Joann, Ortved Kyla F
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Cellulitis with Concurrent Septic Tendon and Ligament Disease in Horses Septic tendonitis and desmitis developing secondary to limb cellulitis represent a rare but serious complication in equine practice, yet little clinical guidance exists on treatment protocols and prognosis. Cooper and colleagues reviewed eight cases presenting with cellulitis alongside confirmed septic involvement of deep digital flexor tendons or suspensory ligaments (diagnosed via ultrasound and bacterial culture between 2000–2019), documenting their management and long-term outcomes. All eight cases affected hindlimbs, with suspensory ligament infection predominating; six of eight horses underwent surgical debridement alongside systemic and regional intravenous antimicrobial therapy. Of the seven horses with available follow-up data, four returned to their intended athletic function, two resumed use as broodmares or pasture companions, and one remained in rehabilitation at the time of reporting. These findings suggest a fair to good prognosis for return to work when cellulitis is identified and treated aggressively before septic tendon or ligament involvement becomes established, though the small case series underscores the need for heightened clinical vigilance during cellulitis management and prospective investigation into risk factors predisposing to deep structure infection.
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Practical Takeaways
- •Septic tendon/ligament injury can develop secondary to limb cellulitis—maintain high clinical suspicion and use ultrasonography plus bacterial culture to confirm diagnosis
- •Aggressive treatment combining surgical debridement with systemic and regional antimicrobials offers reasonable chance of return to athletic work (57% of cases), though individual outcomes vary
- •Early identification and intervention are critical; horses that survive acute hospitalization have fair odds of functional recovery, even if timeline extends beyond initial hospitalization period
Key Findings
- •Eight horses with concurrent cellulitis and septic tendonitis/desmitis were identified over 19 years, all affecting hindlimbs with suspensory ligament involvement in 75% of cases
- •Six of eight horses underwent surgical debridement in addition to systemic and regional IV antimicrobials, with all horses discharged from hospital
- •Four of seven horses with long-term follow-up returned to intended athletic function; two returned to breeding or pasture use; one remained in rehabilitation
- •Fair to good prognosis for return to athletic function exists for horses with cellulitis and concurrent septic tendonitis or desmitis