The vet came out this morning and we began implementing Dawn's new treatment plan. The swelling is much better as a result of the DMSO treatment last night, and the heat is gone, although the skin is still badly pleated and shedding dead skin and some serum. And boy does Dawn stink! - that nasty DMSO garlicky/rotten egg smell has to be experienced to be believed - I could smell her from outside the barn as I walked up. Dawn is still somewhat lackluster - not her usual hyper alert self - although she's eating her hay and drinking. She didn't want her a.m. pellets, but we think that's due to the bad odor/taste of the DMSO in her system - that should fade over the next day or so and there's nothing absolutely essential in her pellets. There's no temperature and her blood work is back to normal. She's off the Uniprim, as she'd already had a 4 day dose and the swelling and heat was starting to come back again. She's now on Exceed, which is a cephalosporin antibiotic. This antibiotic is administered in 2 doses, 4 days apart. There is some incidence (about 4%) of injection site reactions to this drug, partly due to the volume administered, and to minimize the chances of reactions, the vet split the dose into three separate injections. I'll keep a close eye on the injection sites for any swelling. There is also some incidence (about 9%) of mild to more serious diarrhea from this drug, so I'll be watching for that, too, and also giving her daily probiotics. The vet was also glad that she's on full-day pasture turnout, as that should help minimize problems - movement and grazing will be helpful both to prevent injection site trouble and also to keep her digestive system working properly. This is, in my opinion, not a drug that should necessarily be used in a horse that won't be carefully monitored over the multi-day period the antibiotic is active.
In the afternoons, I'm to slather her neck with Thermazene, which is an antibiotic creme often used to treat burns in humans - she's had her first application and seemed to find the creme soothing. In the mornings, I'll apply a DMSO/furacin ointment, and then gently bath the area in the afternoon before putting on the antibiotic. I'll be using gloves for both treatments, as I'm allergic to sulfa (which is in the Thermazene) and you don't want to get DMSO on your skin. She'll continue to get a.m. and p.m. bute for now.
Cellulitis often takes a while to resolve and requires multiple treatments, as we're experiencing. The vet thinks this treatment plan has good prospects to get Dawn on the road to complete healing - here's hoping.