Saddle sores are pressure sores seen in horses over areas of wear from tack (especially if it is ill-fitting). The area of riding horses that is under saddle, or the shoulder area of those driven in harness, is frequently the site of injuries to the skin and deeper soft and bony tissues. Prolonged focal pressure can lead to decreased capillary circulation, tissue damage, and even necrosis. Sores are frequently complicated by secondary bacterial infections. Emaciated horses are at increased risk.
Initial superficial clinical signs may only include alopecia, erythema, crusting, and folliculitis. However, lesions can progress to include erosion, ulceration, and necrosis. Affected areas may become swollen, warm, and painful. Advanced lesions are termed “galls.” When the skin and underlying tissues are more severely damaged, abscesses may develop. These are characterized as warm, fluctuating, painful swellings from which purulent and serosanguineous fluid can be aspirated. Severe damage to the skin and subcutis or deeper tissues results in dry or moist necrosis. Tissue may become undermined with inflammation or infection. Chronic saddle sores are characterized by a deep folliculitis/furunculosis with fibrosis and scarring or a localized indurative and proliferative dermatitis.
Therapy should be aimed at eliminating the causal factor (changing tack or increasing cushioning). Excoriations and inflammation of the skin of the saddle and harness regions are treated as any other dermatosis. Absolute rest of the affected parts is necessary. During the early or acute stages, astringent packs (Burow solution) are indicated. Chronic lesions and those superficially infected may be treated by warm applications and topical or systemic antibiotics. Systemic antibiotic selection should be based on cytology and bacterial culture results. Necrotic tissue should be removed surgically. Scars and/or leukotrichia (white hairs) are common sequelae of healed areas. Recurrence of hematomas, seromas, and/or sloughing skin upon initial saddling of a young Quarter horse or Paint horse should elicit suspicion of the genetic disease hereditary equine dermal asthenia. A simple DNA test, performed on the hair bulbs of the tail, will confirm this diagnosis.
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