Treatment of septic arthritis of the coxofemoral joint in 12 foals

• Published in: Veterinary surgery Vol. 46; no. 4; pp. 530 - 538
• Main Authors: Barceló Oliver, F., Russell, T. M., Uprichard, K. L., Neil, K. M., Pollock, P. J.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2017
• Subjects: Analgesia; Anesthesia; Animals; Anti-Bacterial Agents - therapeutic use; Antimicrobial agents; Arthritis; Arthritis, Infectious - drug therapy; Arthritis, Infectious - surgery; Arthritis, Infectious - veterinary; Arthroscopy; Arthroscopy - veterinary; Bacteria; Coliforms; Diagnostic systems; Drug resistance; Female; Hip Joint - pathology; Horse Diseases - drug therapy; Horse Diseases - surgery; Horses; Intestine; Juveniles; Kidneys; Knee; Leukocytes; Methicillin; Pain perception; Population studies; Renal failure; Retrospective Studies; Rhodococcus; Salmonella; Salmonellosis; Sepsis; Staphylococcus infections; Surgery; Synovial fluid; Synovial Fluid - cytology; Therapeutic Irrigation - veterinary; Veterinary medicine
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.12621

Objective To describe the clinical signs, surgical treatment, and outcome of septic arthritis of the coxofemoral joint in foals. Study Design Retrospective clinical study. Sample Population Foals (n = 12) with confirmed sepsis of the coxofemoral joint. Methods Lameness was localized to the coxofemoral joint based on physical examination. Sepsis was confirmed by cytological analysis of synovial fluid obtained under ultrasonographic guidance, during general anesthesia or standing sedation. Intra‐articular analgesia was used as an adjunct diagnostic modality in 2 foals. Surgical lavage of the affected joint was performed via arthroscopy or needle lavage, with repeated lavage performed in 7 foals. Results Synovial fluid contained 4.4 to 173 × 109/L white blood cells (WBCs), and 38‐63 g/L total protein. Cultures were positive in 10/12 foals. Isolated organisms included Salmonella spp., Streptococcus spp., Rhodococcus spp., Enterococcus spp., Escherichia spp., Staphylococcus spp., Acinetobacter spp., Methicillin‐resistant Staphylococcus aureus and Bacillus spp. Ten foals were discharged from hospital (83%). One of these was euthanized 15 days later due to chronic intestinal salmonellosis and renal failure, and 9 foals survived with no residual lameness detected 1 year after discharge from hospital. Conclusions Sepsis of the coxofermoral joint can be effectively treated with a combination of arthroscopic lavage and the use of systemic and local antimicrobials.