Horse owners are probably more familiar with phlegmon under the colloquial term "shooter." It is a purulent inflammation of the connective tissue and lymph vessels of the subcutaneous tissue, which occurs primarily on the limbs and can lead to massive swelling and pain.
This inflammation is usually triggered by tiny skin injuries on the legs, which serve as entry points for dirt and pathogens. The injuries can be caused by kicks, sharp objects, barbed wire, thorns, improperly administered injections, or as a result of mud fever, as the skin's protective barrier is already damaged in this case. Such skin injuries are often so small and covered by fur that they go unnoticed in many cases. Dirt and bacteria can thus penetrate the tissue unhindered before the wound quickly closes again from the outside. Without access to air, the pathogens find an ideal environment in which to multiply. The inflammation then spreads very quickly along the lymph vessels in the subcutaneous tissue, usually leading to extensive swelling. If left untreated, the inflammation can also spread to deeper layers of tissue.
Phlegmon most commonly occurs in horses on the limbs, but can also occur on all other parts of the body. At the onset of the disease, the area around the injury swells slightly, but this often goes unnoticed. In most cases, phlegmon is only discovered once extensive swelling has already formed. The affected leg is swollen all around, hot, and painful to the touch.
Depending on the severity and extent of the inflammation, other general symptoms such as fever, fatigue, increased sweating, and loss of appetite may also occur. Depending on the location and size of the phlegmon, lameness may also occur due to the tension in the tissue and the pain.
Phlegmons in the head area, especially in the throat or behind the eyeball, are not immediately noticeable but can quickly lead to life-threatening symptoms such as breathing difficulties or meningitis due to their location.
If you notice warm and painful swelling in your horse, please contact a veterinarian immediately so that the inflammation can be treated quickly. As an immediate measure, cooling the affected leg with cold water has proven to be very helpful.
The veterinarian will make a diagnosis based on the clinical picture and your preliminary report. In some cases, the underlying injuries can be identified during a thorough examination, but the characteristic symptoms of the disease usually allow for a clear diagnosis.
In most cases, the veterinarian will administer a broad-spectrum antibiotic over several days to stop the bacterial infection from spreading. Depending on the severity and other general symptoms, anti-inflammatory and fever-reducing medications may also be necessary. The veterinarian will also check whether the horse still has adequate tetanus protection.
Externally, the phlegmon is treated with circulation-promoting or cooling ointments or disinfectant dressings to support the removal of inflammatory products and healing.
During treatment, the affected horse should not be ridden intensively, but should be exercised gently under supervision to promote lymph drainage and blood circulation. Discuss the exact treatment plan with your veterinarian, especially with regard to any upcoming competitions, as individual medications have different withdrawal periods (the recommended time between administration of a substance and the horse's participation in competition).
With early diagnosis and treatment, the prognosis is good that the lesion will heal without problems. However, if phlegmon is detected and treated too late or not at all, temporary swelling can develop into permanent swelling. The destruction of lymph vessels in the area of inflammation and the formation of connective tissue can result in permanent swelling, known as elephantiasis.
When keeping horses, it is almost impossible to prevent minor injuries and, as a result, phlegmons from occurring occasionally. However, the risk of injury can be significantly reduced by taking a few precautions. These include regularly checking pastures, paddocks, stable aisles, riding arenas, and stalls for sharp or pointed objects that could cause injury. Every horse owner should also check their horse daily for any injuries or swelling so that potential inflammation can be detected and treated at an early stage.
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