31/08/2017
a worthwhile read....
GREASY HEEL – what it is, how to prevent and how to treat the condition
Greasy heel is an extremely frustrating skin infection in the horse. Despite it being a rather common condition, treatment tends to be lengthy and arduous. There’s no one right way to go about treatment. This is, in part, because of the many different causes of greasy heel, and in part just because of all the different approaches and home remedies that exist. However, if you follow a few simple rules greasy heel is definitely treatable, and (to an extent) preventable.
Greasy heel can have a variety of causes:
• The ground is too wet for an extended period of time. This could be wet fill, or a muddy paddock, for example. If on top of this the temperature drops, the elasticity of the skin is reduced and the skin will tear, worsening the infection.
• Poor hygiene. Particularly where horses are stabled often and/or for extended periods of time, it is important to ensure that the fill is always as clean and dry as possible.
• Horses that, due to their breed, have long, thick hair around the fetlock, particularly extending over the heel, have a naturally higher tendency to develop greasy heel.
About the condition:
Greasy heel is a bacterial infection of the skin. Through small injuries or tears in the skin, bacteria gets into the system. When the conditions are optimal for the bacteria (i.e. moist and warm), it can multiply and attack layer after layer of skin. Protein-destroying enzymes damage the skin cells and through this process the skin becomes softer and even more vulnerable to bacterial infections. The bacteria continues to spread and provides a breeding ground for other bacteria, such as skin parasites and fungi. Suddenly you have a dangerous cocktail of bacteria, and the horse’s immune system reacts with typical inflammatory processes: the areas of skin affected receive increased blood flow, as the immune system tries to fend off further infection. Unfortunately what also happens is the body builds a type of “crust” over the affected area, to try and protect itself from further bacteria getting in. However, under this crust you have this dangerous cocktail of bacteria, which can now multiply completely undisturbed.
The immune system attempts to replace the infected tissue with new tissue, however with the thick crust and the continued bacterial infection, every time the horse puts weight on the foot the skin is torn again. The horse’s immune system becomes unable to repair or replace the skin, and as such becomes powerless against the infection.
Preventative Measures
Aside from the individual horse’s proneness to greasy heel, one of the main causes of greasy heel is poor hygiene and wet conditions. So when treating greasy heel, we must think not only about killing the bacteria, but also about treating the initial cause of the infection – i.e. we must change the conditions in which we are keeping the horse. If we are not willing or able to do that, we cannot combat the infection permanently.
• Feathering should not be shorn – particularly in those horses where it is typical for the breed. It is a natural defence for them against too much moisture build-up in the vulnerable heel area.
• Controlling of the moisture levels in the ground on which the horses are being kept (i.e. keep fill as clean and dry as possible at all times, and in wet conditions try find the horse the driest possible paddock)
• Keep up a good general hygiene routine for the horse
• Protect the skin where you can, and keep an eye on it during wet conditions in particular
• Supplementing with Zinc can help – but speak to your equine therapist or veterinarian first (too much Zinc can be poisonous)
Treatment options:
• At the beginning of treatment, soak the wounds in a bucket of lukewarm water, and then carefully but thoroughly remove the “crusty” bits. NEVER spray the wounds with a hose, as this will push the bacteria deeper into the tissue.
• Where the crusting has become very thick or widespread, it is recommended to soak and disinfect with wet bandages (e.g. soaked with betadine)
• Gently but thoroughly wash the affected area with a mild disinfecting soap. Again, any crusty bits must be removed
• After this initial cleaning, you should try keep water away from the leg as it will cause the skin to swell.
• Further cleaning should always be done dry – wait for dirt to dry enough to brush it off.
• Vets tend to also recommend applying antibiotic and cortisone-based ointments (however, any ointments containing cortisone should not be used for more than 3 days, because they significantly disturb the skin’s ability to regenerate itself)
• An additional ointment against parasites or applying manuka honey may be useful
• Bandaging – because the moisture content of the skin isn’t adequately regulated yet, bandages can help regulate moisture content and also prevent further dirt and bacteria getting in
• Greasy ointments such as Vaseline can be helpful too, as they are not actually absorbed into the skin (therefore don’t further soak the skin), but build a protective, airtight film which can help prevent further bacteria getting in and will keep the skin soft and flexible so it doesn’t tear that easily.
• Zinc-pastes can be useful with frequent and very bad greasy heel
• CAUTION – washing the area too often is counterproductive, because soap significantly affects the pH of the skin, as well as the skins fat/oil content.
