The chal­lenge of

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dam­age to the un­der­ly­ing tis­sues that the bar­rier is com­pro­mised.”

On the other hand, sec­ondary cel­luli­tis de­vel­ops when bac­te­ria gain en­try through a wound, sur­gi­cal in­ci­sion or an­other known route. Breaks in the sur­face caused by der­mati­tis, the tech­ni­cal name for in­flam­ma­tion of the outer lay­ers of skin, can also al­low bac­te­ria in. “When the in­tegrity of the skin is com­pro­mised, bac­te­ria can gain en­trance and repli­cate in the un­der­ly­ing tis­sue,” says Ham­mond. “It is im­pres­sive what can hap­pen when that bar­rier is dam­aged.”

A va­ri­ety of bac­te­rial species have been im­pli­cated in cel­luli­tis, but the in­fec­tion is usu­ally caused by Sta­phy­lo­coc­cus au­reus and Strep­to­coc­cus species. “Th­ese are com­mon bac­te­ria that are of­ten found on skin,” Mudge says. Other bac­te­rial species that may be in­volved in­clude En­te­ro­coc­cus and Acti­nobacil­lus species. “Oc­ca­sion­ally, cel­luli­tis can be due to in­fec­tion with Corynebac­terium or Clostrid­ium or a gram-neg­a­tive bac­terium such as Escherichi­a coli,” says Cal­lie Fogle, DVM, of North Carolina State Univer­sity.

Sec­ondary cel­luli­tis can de­velop any­where on the body where a wound oc­curs. Pri­mary cel­luli­tis usu­ally de­vel­ops on a leg, and most of­ten the hind legs. “The term ‘cel­luli­tis’ is very gen­eral, re­fer­ring to in­fec­tion un­der the skin and some­times in­volv­ing the skin,” says Mudge. “But when we talk about cel­luli­tis in horses we tend to think of the hind limb.”

Even when it ini­tially seems mild, cel­luli­tis is not an ail­ment to take lightly. The swelling can progress quickly, even within a few hours, to the point where fluid leaks from cracks in the over­stretched skin.

Plus, if the in­fec­tion is not con­trolled quickly, a num­ber of se­ri­ous com­pli­ca­tions can de­velop. For ex­am­ple, the bac­te­ria may spread from the skin into the deeper tis­sues and struc­tures of the leg. “A par­tic­u­larly ag­gres­sive or re­sis­tant bac­te­ria may cause tis­sue necro­sis or a more deep-seated in­fec­tion, which in rare cases can af­fect the bone, ten­don or syn­ovial struc­tures such as a joint or ten­don sheath,” says Ham­mond.

Lamini­tis is also a pos­si­bil­ity. “It’s usu­ally a sup­port-limb lamini­tis but it can also be lamini­tis in the af­fected leg,” says Fogle.

Sys­temic in­fec­tions, such as sep­sis , can also oc­cur. “Horses can have fur­ther prob­lems if the bac­te­rial in­fec­tion does not stay con­fined to that limb and goes through­out the body,” Fogle says. “The horse can be­come very sick from sys­temic in­fec­tion. Th­ese are all risks with se­vere cel­luli­tis, but are more likely in cases with a de­lay in the start of ther­apy.”

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