What is greasy heal and how do I treat it?

Author: The Vet Shed  

What is Greasy Heel?
Greasy Heel, also known as pastern dermatitis, is an inflammatory skin condition that affects the lower limbs of horses, particularly where the skin is not pigmented. It manifests as scaling, crusting, erosion, and exudation, and can be triggered by various skin conditions. Common culprits include fungi, bacteria, and mites, especially in horses with feathering at their fetlocks.

How does it occur?
Several environmental factors can make horses more susceptible to Greasy Heel. Horses with white limbs and feathering at the fetlocks are particularly at risk. Conditions that promote Greasy Heel include:

• Constant or repeated exposure to moisture, such as wet bedding, muddy paddocks, or access to a dam
• Low heel conformation
• Insect bites on the lower limbs
• Abrasions from loose surfaces like gravel

These factors compromise the skin's ability to act as a barrier, allowing organisms to invade and cause dermatitis.

What does it look like?
In the early stages, Greasy Heel presents as mild dermatitis with swelling and reddening of the back of the pastern. While hind limbs are more frequently affected, lesions can appear on all four limbs. As the condition progresses, scabs and crusts may form, matting the hair. Without treatment, the infection can spread up the limb, leading to pus discharge and increased swelling. Horses with feathering tend to have more severe and widespread lesions compared to short-haired horses.

Is Greasy Heel painful?
Initially, Greasy Heel is not usually painful but may cause some discomfort. If left untreated, it can become painful or itchy, leading to scratching, further trauma, and potential lameness.

How can Greasy Heel be prevented?
Prevention is key. Factors that contribute to Greasy Heel include sun exposure, abrasive weeds or grasses, pink skin, and persistently wet or muddy environments. Keeping horses in a clean, dry environment and regularly monitoring their lower limbs for signs of dermatitis, such as swelling or reddening, can help prevent the condition.

What can I do as an owner to treat Greasy Heel?
Effective treatment involves addressing and removing the factors that caused the condition. Steps to treat Greasy Heel include:

1. Clean the affected areas gently: You may need to clip the hair.
2. Soak the limbs: Soak the affected areas for 10 minutes with water.
3. Remove scabs: Use a soft cloth to gently remove scabs. Avoid causing bleeding, as this can worsen the condition. Once softened, use a betadine or chlorhexidine solution, or medicated shampoo to help remove the scabs.
4. Rinse and dry: Rinse off any cleaning solution with water and towel dry the area.
5. Apply antiseptic ointment: After drying, apply an antiseptic ointment  suitable for greasy heal and lightly bandage the area to protect it from contamination and sunlight.
6. Repeat treatment: Follow steps 1-5 every one to two days.
7. Keep the environment dry: House the horse away from moist conditions to keep the lower limbs dry.

Does this condition require veterinary attention?
If Greasy Heel is detected early, following the above steps should help. However, if the lesions worsen despite treatment or if severe symptoms such as lameness, significant swelling, cracking, or bleeding occur, consult a veterinarian. They may recommend additional treatments like antibiotics or topical probiotics.

How long will it take to heal?
Greasy Heel can be persistent, and improvement may take weeks or even months. Consistent treatment, along with maintaining a clean and dry environment, is crucial. Most horses will eventually improve as the condition is self-limiting in many cases.

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