CEL­LULI­TIS OR LYM­PHAN­GI­TIS?

EQUUS - - Conversati­ons -

Cel­luli­tis and lym­phan­gi­tis may seem very sim­i­lar—both cause dra­matic and se­vere swelling that tends to af­fect the lower hind leg—but they are dis­tinctly dif­fer­ent con­di­tions. Cel­luli­tis is an in­fec­tion of the con­nec­tive tis­sues un­der the skin, while lym­phan­gi­tis is an in­flam­ma­tion of the lym­phatic ves­sels.

“Chronic lym­phan­gi­tis usu­ally refers to a ster­ile edema [fluid ac­cu­mu­la­tion], with no in­fec­tion,” says Mar­garet Mudge, VMD, of Ohio State Univer­sity. Cel­luli­tis, on the other hand, is an in­fec­tion. “Prob­a­bly the more proper term would be ‘sep­tic cel­luli­tis,’ mean­ing a bac­te­rial in­fec­tion un­der the skin, ver­sus a lym­phan­gi­tis,” she adds. “It can be­come a bit con­fus­ing and com­pli­cated, how­ever, be­cause there are types of lym­phan­gi­tis that are as­so­ci­ated with in­fec­tious agents. But usu­ally when we are us­ing this term we re­fer to just the edema and lack of lym­phatic re­turn, ver­sus cel­luli­tis [in­fec­tion].”

The signs of lym­phan­gi­tis are also sub­tly dif­fer­ent from cel­luli­tis.

• Al­though the con­di­tion causes dra­matic swelling, a leg af­fected by lym­phan­gi­tis is typ­i­cally not hot from an in­fec­tion, nor is it as painful. A horse with lym­phan­gi­tis may move stiffly, but he is not likely to be truly lame.

• The swelling takes longer to de­velop. “With cel­luli­tis you sud­denly find the horse with a huge leg, but with lym­phan­gi­tis, it’s more in­sid­i­ous and slowly pro­gres­sive,” says Cal­lie Fogle, DVM, of North Carolina State Univer­sity. “The legs may have some scabs or scratches [pastern der­mati­tis] on the back of the fet­locks and pasterns. Those crusts and scabby ar­eas may be a sign that lym­phatic drainage is not ef­fec­tive. Like a horse with chronic cel­luli­tis, a horse with lym­phan­gi­tis is also un­able to fight in­fec­tion or mount a good re­sponse against in­vad­ing bac­te­ria in the dis­tal limbs.”

• Lym­phan­gi­tis is also likely to af­fect more than one leg. “Lym­phan­gi­tis is more likely to be bi­lat­eral, af­fect­ing both front legs or both hind legs or even all four limbs,” says Fogle. “Usu­ally the hind limbs are worse, but we do oc­ca­sion­ally see cases in which the fore­limbs are worse.”

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