💨 Vet Alert 2025: Understanding Subcutaneous Emphysema in Horses—Causes, Risks & Treatments 🐴🩺

Author: Dr Duncan Houston, BVSc

If your horse suddenly appears to be “inflating” under the skin—looking like someone pumped air beneath their coat—you could be dealing with a case of subcutaneous emphysema. This condition, while often startling in appearance, can range from harmless to life-threatening. In this 2025 guide, Dr Duncan Houston explains the causes, diagnosis, and vet-approved management of air trapped beneath the skin in horses. 🐎🔍

🔍 What Is Subcutaneous Emphysema?

Subcutaneous emphysema refers to the presence of air trapped under the skin. It causes soft, spongy swelling that crackles under pressure. 🫧

The air becomes trapped between layers of tissue, making the skin balloon outwards. You may notice:

• 🩹 Sudden swelling—often near the chest or shoulders
• 🫧 Crackling sound (crepitus) when the area is pressed
• 📈 Rapid expansion after minor injuries

While it can look dramatic, the underlying cause determines the severity of the condition. 🔬

📍 Most Common Cause: Axillary Laceration

The most typical cause of subcutaneous emphysema is a deep laceration in the axillary area—the soft space between the front leg and the chest wall. 🩸

🧬 How It Happens:

• 🔪 A deep cut creates a one-way valve in the tissue
• 💨 Air enters as the horse moves but cannot escape
• 🧱 Air accumulates under the skin over 3–4 days

Even small punctures in this region can lead to significant swelling. 🧪

⚠️ Serious Risks of Untreated Cases

While many cases resolve on their own, subcutaneous emphysema can become dangerous if:

• 🫁 Air enters the chest cavity (causing pneumothorax)
• 🦠 Infection spreads along tissue planes
• 💥 Lung or esophageal injury occurs

These complications can result in labored breathing, sepsis, or death if not addressed promptly. Immediate vet assessment is critical. 🚨

🩺 Vet Diagnosis and Care in 2025

Your veterinarian will assess the wound and determine if air has entered the chest or other sensitive structures. Diagnostic steps may include:

• 🔬 Physical palpation and listening for crackling
• 📸 Radiographs or ultrasound to rule out pneumothorax
• 🧫 Cultures if infection is suspected

💊 Treatment Protocols for Subcutaneous Emphysema

1️⃣ Restrict Movement

• 🚷 Keep the horse on stall rest to minimize air intake through the wound

2️⃣ Wound Management

• 🩹 Pack the wound with sterile gauze to act as a temporary seal
• 🔁 Change dressing every 1–2 days under vet supervision

3️⃣ Infection Control

• 💊 Systemic antibiotics to prevent bacterial spread
• 🧼 Clean wound carefully without disrupting sealing materials

4️⃣ Observation

• ⏱️ Monitor air resorption—it typically resolves in 2–3 weeks
• 🫁 Watch for respiratory changes that could signal pneumothorax

🚫 What Doesn’t Work

• ❌ Don’t try to “pop” or puncture the air pocket—air is trapped in tissue, not a bubble
• ❌ Avoid exercise or turnout—it accelerates air entry
• ❌ Don’t delay vet care if swelling spreads rapidly or horse struggles to breathe

🧠 Vet Advice from Dr Duncan Houston

"Even when the swelling looks mild, subcutaneous emphysema should never be ignored. It can be the first sign of a life-threatening chest injury." 🐴🧬

🔄 Recovery and Follow-Up

• 🔁 Regular bandage checks and wound care
• 🩺 Vet follow-up every 3–4 days during healing
• 🧪 Adjust antibiotics if infection signs emerge

🛡️ Prevention Tips

• 🔍 Inspect the axillary area frequently for small cuts
• 🧱 Maintain safe fencing and turnout spaces
• 🧤 Always monitor healing wounds for swelling or crackling

🔚 Final Thoughts: Don’t Dismiss Strange Swelling

Subcutaneous emphysema in horses may look bizarre, but it’s often the sign of an internal issue needing vet care. Early intervention, careful wound sealing, and infection control can mean the difference between a minor recovery and a major emergency. 🐎🩺

Not sure if your horse’s swelling is serious? Visit AskAVet.com or download the Ask A Vet app for fast access to licensed veterinarians. 📱💨