Horses can develop a variety of allergic and dermatological disorders which give rise to inflammation, irritation and swelling. Many of these are represented by mild- to moderate conditions that can occur in the skin (e.g., dermatitis) or the joints (e.g., arthritis). Such common afflictions, while not usually severe, are unsightly and (more importantly) uncomfortable for the horse.

There are many different causes of skin inflammation, including external irritants, burns, allergens, trauma, and infection (bacterial, viral, parasitic, or fungal).1 During times of warm weather, hot, humid days and biting insects create optimal conditions for skin diseases.1 Horses can also be allergic to things that they ingest and other environmental factors.

Scratches refers to a condition evidenced by irritated or infected skin on the pastern or heel bulbs.2 This often occurs in horses that have been exposed to moisture for long periods. This condition can irritate the skin and cause burning, itching, inflammation, redness and ulcers. Mud and dirty surroundings then create an ideal environment for opportunistic bacteria or fungi. Mild cases of scratches usually respond to cleaning and topical treatment.

Arthritis is an inflammation of a joint or joints that causes pain and stiffness. Arthritis often develops following interference with normal structure and function. Damage to the cartilage and/or the bone via injury or infection results in abrasion (roughening) of the smooth surfaces. Movement of the roughened bone ends and damaged cartilage results in inflammation and swelling.2 

Scratches Topical Cream

Scratches Topical Cream contains:

• Triamcinolone 0.1%

• Nystatin 3.4%

• Gentamicin 1%

• DMSO 5%

Triamcinolone is a long-acting, synthetic glucocorticoid that is four to ten times more potent than hydrocortisone.3 It is widely used in equine veterinary medicine as a steroidal anti-inflammatory. Available in oral, parenteral, topical and inhaled forms, triamcinolone is indicated for the management and treatment of acute arthritis, and allergic and dermatologic disorders. It is often administered intra-articularly for the control of pain associated with inflammation and osteoarthritis in horses.

Adverse effects are generally associated with long-term administration of triamcinolone, especially if given at high dosages or not on an alternate day regimen. In horses, the potential for triamcinolone playing a role in the development of laminitis has been a concern, but clinical evidence argues against generalizations of potential risk. Contraindications include animals with systemic fungal infections, arrested tuberculosis, peptic ulcer, acute psychoses, corneal ulcer or Cushingoid syndrome. The presence of diabetes, osteoporosis, chronic psychotic reactions, predisposition to thrombophlebitis, hypertension, CHF, renal insufficiency and active tuberculosis necessitates carefully controlled use.”3

Triamcinolone carries numerous potential drug interactions and the Association of Racing Commissioners International Uniform Classification Guidelines for Foreign Substances has designated triamcinolone a CLASS 4/C DRUG.

Nystatin is an antifungal that is typically administered orally and topically. Its mechanism of action is similar to that of amphotericin B, binding to sterols in the membrane of fungal cells, altering the permeability of the membrane allowing intracellular potassium and other cellular constituents to leak out, destroying the organism. When given orally, nystatin must come into contact with the organism to be effective, and it has no activity against bacteria, protozoa, or viruses.3 

Gentamicin is a parenteral-aminoglycoside antibiotic that is active against a variety of bacteria, predominantly gram-negative aerobic bacilli, but also many staphylococci.3 It has mechanism of action and spectrum of activity similar to the other aminoglycosides, being effective against E coli, Klebsiella spp, Proteus spp, Pseudomonas spp, Salmonella spp, Enterobacter spp, Serratia spp, Shigella spp, Mycoplasma spp,Staphylococcus spp and others.

Various gentamicin products are FDA-approved for parenteral use in dogs, cats, chickens, turkeys, and swine. Although routinely used parenterally in horses, gentamicin is only FDA-approved for intrauterine infusion in this species. Oral products are FDA-approved for GI infections in swine and turkeys.3

DMSO (Dimethyl Sulfoxide) is a free radical scavenger that has anti-inflammatory, cryopreservative, anti-ischemic and radioprotective effects3 The FDA-approved veterinary indication for DMSO is: “…as a topical application to reduce acute swelling due to trauma.”3 Other indications for DMSO include: adjunctive treatment in transient ischemic conditions, CNS trauma and cerebral edema, calcinosis cutis, endometritis, skin ulcers, wounds, burns, adjunctive therapy in intestinal surgeries and analgesia for postoperative or intractable pain. 

Where to buy Scratches Topical Cream

SCRATCHES TOPICAL CREAM (Triamcinolone / Nystatin / Gentamicin / DMSO) is available in the U.S. through NexGen Pharmaceuticals. It is indicated for the treatment of a variety of immune-moderated and inflammatory skin conditions in the horse.

This product carries numerous potential drug interactions. Please consult your veterinarian prior to beginning any treatment regimen.

FOR RX ONLY: A valid prescription from a licensed veterinarian is required for dispensing this medication.

1Merck Veterinary Manual.

2vcahospitals.org.

3Plumb’s Veterinary Drugs.