The challenge of

challenging to resolve in the long term.”

But cellulitis can have long-term effects. Extreme inflammation can stretch and scar tissues enough to compromise the lymph system’s ability to draw out excess interstitial fluids (the fluid that fills the spaces between body cells) and return them to the bloodstream. “Damage to the lymph vessels will interfere with normal drainage of fluid from the limb,” Hammond explains. “With this decreased efficiency of the lymph system, these subcutaneous tissues may always hold a little extra fluid, making the leg appear slightly swollen even after it has healed. This is most likely to happen in the more severe cases or the ones that are not treated early.”

The change in the leg’s appearance may be permanent. “I warn owners that even when horses respond well, they may end up with a leg that is slightly bigger than the other one,” says Mudge. “Even if everything goes well and the horse makes it through and recovers without residual lameness, there may be some limb enlargement. It is yet to be determined whether prolonged bandaging or using things like compression cold therapy make a difference in the final outcome, though these strategies make a lot of sense in continued treatment for these horses. At this point in time, however, we don’t have strong evidence to say whether those will ultimately improve the cosmetic outcome.”

FROM ACUTE TO CHRONIC

Unfortunately, even a single episode of cellulitis can leave a horse susceptible to the chronic form of the condition---repeated episodes of severe, painful limb swelling. “A horse who has recovered from cellulitis is more likely to have a recurrence in that same limb,” says Hammond.