Discussion There are multiple treatment options available for the management of pastern dermatitis in horses. Many of the available treatments hinder rather than promote healing because they provide an occlusive barrier over necrotic tissue, and an anaerobic environment that might benefit the bacteria involved in the infective inflammatory process. The ideal treatment for pastern dermatitis will have an antimicrobial effect as well as assisting with the debridement and healing phases of the affected skin. These clinical cases highlight the value of using manuka honey dressings left in situ for three days in the management of pastern dermatitis. Honey is being used increasingly in wound management and the benefits of its use for wounds may translate to the management of pastern dermatitis. The cases presented were all moderate in severity with exudative crusts and in case 3 the affected skin appeared necrotic. In all cases the honey had a debridement effect, allowing for exposure of infected, inflamed underlying tissues. Following debridement the continued presence of the honey dressing had an antimicrobial effect as well as providing factors that would promote healing of the damaged skin. Once the dressings were removed there were no crusts with healthy granulation tissue in all cases. With case 3 despite a massive improvement with the original dressing, a second dressing was applied to achieve resolution. This bandaging approach had the benefit of providing a none-invasive technique. Daily washing of the legs and manual removal of the scabs as dictated by some approaches is avoided which is beneficial; this can be painful for the patient and thus dangerous for the owner/keeper, and in some cases can aggravate the condition through excessive wetting of the skin. Case 1 and case 4 presented for lymphangitis/cellulitis and so were also given a course of procaine penicillin/dihydrostreptinomycin 3 days or trimethoprim-sulfa 5 days respectively along with none-steroidal anti-inflammatory for 5 days. Case 1 was additionally given a single injection of dexamethasone to reduce the associated lymphangitis. These medications may have helped the healing process, however in case 1 there was a more significant improvement where the honey was used topically when compared to conventional methods. Whilst this report is not accurately controlled and does not consider the multiple variables involved in the pathology of pastern dermatitis, it highlights the relevance for using honey dressings as a minimally invasive and effective option in treatment. Honey provides a holistic approach and topical use in this way provides a means for treating pastern dermatitis without the risk of generating antibiotic resistance associated with the inadvertent use of parenteral and topical antibiotics. References n Colaham, P.T., Mayhew, I.G., Merrit, A.M. and Moore, J.N. (1999) In: Equine Medicine and Surgery Volume II, 5th Edition, Mosby USA pp1924-1925 Colles, C.M., Colles, K.M. and Galpin, J.R (2010) Equine Pastern Dermatitis. Equine Veterinary Education 22 (11) pp 566-570 Knottenbelt, D.C. and Pascoe, R.R. (1994) Colour Atlas of Diseases and Disorders of the Horse, W.B. Saunders, Philadelphia. pp281-5 Mathews, K.A. and Binnington, A.G. (2002) Wound Management Using Honey. Compendium 24 (1) pp53-59 Molan, P.C., (2001) Potential of Honey in the Treatment of Wounds and Burns. American Journal of Clinical Dermatology 2 (1) pp13-19 n n n n This article has been published in Equine Health - July/August 2013 www.kruuse.com KRUUSE© June 2016 11373
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