Osteomyelitis in horses is a condition characterized by inflammation of the bone and bone marrow, typically caused by bacterial infection. This condition can result from direct bone trauma, surgical procedures, or the spread of an infection from nearby tissues. Common bacterial culprits include Staphylococcus spp., Streptococcus spp., and Escherichia coli. Osteomyelitis may lead to lameness, swelling, and pain in affected horses, and can be diagnosed through clinical examination, imaging techniques, and microbiological cultures. Treatment often involves antimicrobial therapy and may require surgical intervention. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, treatment, and outcomes of osteomyelitis in equine patients.
Orsini JA, Kreuder C.Musculoskeletal disorders in newborn foals are complex, multifactorial, and associated with prematurity, dysmaturity, and twinning. They include incomplete ossification of cuboidal bones, tendon laxity, congenital angular limb deformities, septic arthritis, osteomyelitis, and septicemia. Other deformities associated with nutrition, large size, and rapid growth include osteochondrosis, physitis, ruptured tendons, acquired flexural deformities, and postnatal angular limb deformities. Optimal management of the complexly interrelated musculoskeletal disorders of the neonate also is discussed.
Firth EC, Alley MR, Hodge H.Two cases of Rhodococcus equi infection in foals are described, in which osteomyelitis was a feature. Because rhodococcal infection is usually low grade and chronic, and because the signs of early metaphysitis can be subtle, any articular or periarticular swelling in a foal from a farm with a history of rhodococcosis should be strongly suspected to be associated with R equi until proven otherwise.
Trostle SS, Dubielzig RR, Beck KA.Nine horses with clinical and radiographic findings of cervical vertebral malformation that were necropsied and examined using frozen cervical spinal cord cross sections were reviewed. Only cases with actual distortion of the spinal cord due to compression were selected. The goal of the study was to determine the morphologic features responsible for narrowing of the spinal canal and compression of the spinal cord. In individual cases, bony changes are associated with osteochondrosis and osteomyelitis of the dorsal articular facets and osteosclerosis of the dorsal cervical lamina. Soft tissue p...
Foley JP, Legendre AM.Itraconazole, a tricyclic azole effective against a number of deep mycotic diseases, was used to treat a Quarter Horse filly with coccidioidomycosis. The horse was almost normal after 90 days of treatment. Five months after discontinuing itraconazole treatment, the filly had severe neck pain and neurologic signs from recurrence of coccidioidomycosis and was treated with itraconazole for an additional 6 months. Her clinical condition improved to almost normal and the filly has remained normal for 2 years. There was no evidence of drug toxicity.
Whitehair KJ, Adams SB, Parker JE, Blevins WE, Fessler JF.Antibiotics were delivered to chronically infected tissues by regional limb perfusion in three horses with osteomyelitis associated with orthopedic implants. Two infections were resolved with implants in place; in one, a sequestrum was resorbed. In one horse, regional antibiotic perfusion was applied to treat progressively worsening bone infection after initial implants loosened and were removed.
Kramme PM, Ziemer EL.Coccidioidal osteomyelitis was diagnosed in a horse after a 6-month period of coughing, weight loss, and lameness. The horse was euthanatized and the diagnosis was confirmed by gross and microscopic findings.
MacDonald MH, Honnas CM, Meagher DM.Medical records of 28 horses with osteomyelitis of the calcaneus were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information. Trauma was the most commonly reported cause (24). Physical examination revealed lameness in 27 horses, and 22 (79%) had a wound or draining tract over the plantar aspect of the calcaneus. Radiography of all horses was done prior to the initiation of treatment, and follow-up radiography was done on 20 horses. The most common radiographic findings were soft tissue swelling (25), bony lysis of the calcaneus ...
Crawley GR, Grant BD, Krpan MK, Major MD.Thirteen cases of partial limb amputation in horses were reviewed. Nine horses (69%) survived 18 to 111 months (mean, 41 months). Four unsuccessfully treated horses were euthanatized within 21 days of surgery. The horses' ages at amputation were 4 to 13 years (mean, 7.3 years). There was no predilection for the left or right limb nor for fore or hind limb involvement. Osteomyelitis in six horses (46%) was the most common cause for amputation. Severe, open, comminuted fractures of the third metacarpal bone that were impossible to stabilize by any currently available technique in four horses (31...
Vaala WE, Clark ES, Orsini JA.Gram-negative neonatal septicemia was diagnosed in a premature Standardbred colt. Clinical signs included lethargy, weakness, loss of suckle reflex, tachypnea, and injected mucous membranes. Sequelae included pneumonia, omphalophlebitis, septic arthritis, and osteomyelitis. Prepartum maternal uterine infection, premature delivery, abnormal parturition with premature fetal membrane separation, and failure of passive transfer of colostral immunoglobulins increased the foal's risk for developing sepsis. Treatment included administration of moxalactam disodium and cefadroxil. The clinical efficacy...
Dart AJ, Pascoe RR.A 12-year-old Quarterhorse stallion was presented with a severe lameness in the left forefoot. There was a 3 cm diameter cavity in the sole that extended to the solar surface of the distal phalanx. Radiographs revealed an osteomyelitis and a sequestrum which probably developed following the prolonged topical application of 10 percent formalin. The sequestrum was removed and the infected bone curetted under general anaesthesia. The horse was shod with heart bar shoes on both front feet 7 days after the surgery. Eight months later, radiographs showed marked rotation of the distal phalanx despite...
Firth EC, Goedegebuure SA, Dik KJ, Poulos PW.Nine foals with haematogenous osteomyelitis of the tarsal bones were studied clinically, radiologically and pathologically. Clinical examination, including aspiration of articular or periarticular effusions in the tarsal area, and radiological study provide definitive diagnosis in most cases.
Dik KJ.Radiographically, joint ill in foals is subdivided into four different types: Type P - osteomyelitis in the meta- and/or epiphysis adjacent to the physis. Type E - osteomyelitis in the epiphyseal subchondral bone. Type S - synovitis confined to the joint itself. Type T - osteomyelitis in the small tarsal bones. The radiographical features corresponding with the different types, the relationship between the radiological, pathological, bacterial and clinical findings, and the recommended radiographic procedure are discussed in detail.
Rose RJ, Taylor BJ, Bellenger CR.The technique of internal fixation of intra-articular fractures of the third phalanx using lag screw interfragmentary compression is described. Three cases are discussed and the successful treatment of infection and osteomyelitis described in one of them. Despite this potential complication internal fixation offers a better prognosis and also a more rapid return to work than non-operative treatments.
Rose RJ.The case histories of four horses with osteomyelitis involving the metacarpal and metatarsal bones are reviewed and the surgical treatments discussed. The horses recovered after curettage of all infected tissue and post operative drainage. The role of antibiotics in treatment is considered and reference is made to the acute treatment of deep wounds to avoid osteomyelitis.
Pilsworth RC, Head MJ.The differential diagnoses of tarsal joint infection, fracture and peritarsal focal infection are of particular importance in practice. The objective of the present report is to provide additional clinical data to assist in the understanding of one of these conditions. The haematological parameters, clinical signs, treatment and outcome of 10 cases of severe lameness associated with peritarsal infection are reviewed. All horses had a significant rise in rectal temperature. The majority of cases (6/10) had haematological changes consistent with acute bacterial infection on the day of first exam...
Dart AJ, Pascoe RR.A 12-year-old Quarterhorse stallion was presented with a severe lameness in the left forefoot. There was a 3 cm diameter cavity in the sole that extended to the solar surface of the distal phalanx. Radiographs revealed an osteomyelitis and a sequestrum which probably developed following the prolonged topical application of 10 percent formalin. The sequestrum was removed and the infected bone curetted under general anaesthesia. The horse was shod with heart bar shoes on both front feet 7 days after the surgery. Eight months later, radiographs showed marked rotation of the distal phalanx despite...
Firth EC, Goedegebuure SA, Dik KJ, Poulos PW.Nine foals with haematogenous osteomyelitis of the tarsal bones were studied clinically, radiologically and pathologically. Clinical examination, including aspiration of articular or periarticular effusions in the tarsal area, and radiological study provide definitive diagnosis in most cases.
Vaala WE, Clark ES, Orsini JA.Gram-negative neonatal septicemia was diagnosed in a premature Standardbred colt. Clinical signs included lethargy, weakness, loss of suckle reflex, tachypnea, and injected mucous membranes. Sequelae included pneumonia, omphalophlebitis, septic arthritis, and osteomyelitis. Prepartum maternal uterine infection, premature delivery, abnormal parturition with premature fetal membrane separation, and failure of passive transfer of colostral immunoglobulins increased the foal's risk for developing sepsis. Treatment included administration of moxalactam disodium and cefadroxil. The clinical efficacy...
Kay AT, Hunt RJ, Rodgerson DH, Spirito MA, Santschi EM, Payne RJ.To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. Methods: Retrospective case series. Methods: Foals (n = 8). Methods: Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic si...
Newquist JM, Baxter GM.To determine whether high plasma fibrinogen concentration (> or = 900 mg/dL) is a valid indicator of physeal or epiphyseal osteomyelitis in foals. Methods: Retrospective case series. Methods: 17 foals with physeal or epiphyseal osteomyelitis with or without septic arthritis, 17 foals with septic arthritis alone, 20 foals with non-Rhodococcus equi pneumonia, and 22 healthy foals. Methods: Medical records were reviewed for information regarding signalment and total WBC count, segmented neutrophil count, and plasma fibrinogen concentration measured when foals were initially evaluated at the ho...
Foley JP, Legendre AM.Itraconazole, a tricyclic azole effective against a number of deep mycotic diseases, was used to treat a Quarter Horse filly with coccidioidomycosis. The horse was almost normal after 90 days of treatment. Five months after discontinuing itraconazole treatment, the filly had severe neck pain and neurologic signs from recurrence of coccidioidomycosis and was treated with itraconazole for an additional 6 months. Her clinical condition improved to almost normal and the filly has remained normal for 2 years. There was no evidence of drug toxicity.
Kuroda T, Minamijima Y, Niwa H, Mita H, Tamura N, Fukuda K, Kuwano A, Sato F.Cephalothin (CET) concentrations in body fluids (plasma, synovial fluid, pleural fluid, peritoneal fluid, and aqueous humor) and tissue samples (bone, lung, jejunum, hoof, and subcutaneous tissue) were investigated to consider the treatment of infectious diseases in horses. CET 22 mg/kg body weight was intravenously administered to 12 horses. Samples were collected from four different horses at 1, 3, and 5 hr after administration. The CET concentration in body fluids other than aqueous humor was maintained above the MIC90 values of Streptococcus zooepidemicus and Staphylococcus aureus until 5 ...
Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM.Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. Objective: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. Methods: Retrospective analysis of clinical records. Methods: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-...
Neil KM, Axon JE, Todhunter PG, Adams PL, Caron JP, Adkins AR.To determine the clinical characteristics and outcome of foals with septic osteitis of the distal phalanx. Methods: Retrospective case series. Methods: 22 foals. Methods: Information obtained from medical records included signalment; clinical, laboratory, and radiographic findings; treatment method; and outcome. Foals included in the study had lameness referable to the foot, radiographic evidence of localized lysis or focal loss of bone density of the distal phalanx, and suppurative discharge or necrosis of the affected bone evident at surgery. Foals with a history or evidence of penetrating w...
Gosai F, Gosai N.Strangles is a contagious upper respiratory tract infection primarily affecting equines. It is rare disease with zoonotic transmission. It is caused by the bacterium, . We present the rare case of strangles in an elderly patient complicated by bacteraemia, osteomyelitis and native valve endocarditis. The patient was treated successfully with appropriate antibiotics and no surgical intervention was needed. In an age of accelerated emerging zoonosis, this is an important entity clinicians should be aware of to prevent delay in diagnosis and poor outcome. Conclusions: Strangles is a disease of eq...
Rose RJ.The case histories of four horses with osteomyelitis involving the metacarpal and metatarsal bones are reviewed and the surgical treatments discussed. The horses recovered after curettage of all infected tissue and post operative drainage. The role of antibiotics in treatment is considered and reference is made to the acute treatment of deep wounds to avoid osteomyelitis.
Trostle SS, Dubielzig RR, Beck KA.Nine horses with clinical and radiographic findings of cervical vertebral malformation that were necropsied and examined using frozen cervical spinal cord cross sections were reviewed. Only cases with actual distortion of the spinal cord due to compression were selected. The goal of the study was to determine the morphologic features responsible for narrowing of the spinal canal and compression of the spinal cord. In individual cases, bony changes are associated with osteochondrosis and osteomyelitis of the dorsal articular facets and osteosclerosis of the dorsal cervical lamina. Soft tissue p...
Neil KM, Axon JE, Begg AP, Todhunter PG, Adams PL, Fine AE, Caron JP, Adkins AR.To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis. Methods: Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age. Results: Mean age of...
Rose RJ, Taylor BJ, Bellenger CR.The technique of internal fixation of intra-articular fractures of the third phalanx using lag screw interfragmentary compression is described. Three cases are discussed and the successful treatment of infection and osteomyelitis described in one of them. Despite this potential complication internal fixation offers a better prognosis and also a more rapid return to work than non-operative treatments.
Dik KJ.Radiographically, joint ill in foals is subdivided into four different types: Type P - osteomyelitis in the meta- and/or epiphysis adjacent to the physis. Type E - osteomyelitis in the epiphyseal subchondral bone. Type S - synovitis confined to the joint itself. Type T - osteomyelitis in the small tarsal bones. The radiographical features corresponding with the different types, the relationship between the radiological, pathological, bacterial and clinical findings, and the recommended radiographic procedure are discussed in detail.
Barton CK, Samol MA, Nelson BB, Piquini G, Smanik LE, Goodrich LR.To raise awareness of the potential for intra-articular subchondral bone sequestrum formation secondary to a traumatic or septic process to enable more rapid identification of this uncommon but possible outcome in future cases. Methods: A client-owned 12-year-old Appaloosa mare. Unassigned: The mare had a wound to the lateral aspect of the fourth metatarsal bone (MT4) that communicated with the distal tarsal joints. Radiographs revealed a displaced, comminuted fracture of MT4. Results: The horse underwent aggressive debridement of the wound and MT4 as well as, on 2 occasions, needle joint lava...
Waitt Wolker LH, Black A, Lee JK.Clinical and histologic examination of a 12-y-old client-owned Quarter Horse gelding with pituitary pars intermedia dysfunction revealed dermatitis, cellulitis, and osteomyelitis caused by , confirmed by a PCR assay. This novel presentation of a fungal disease in a horse was characterized by aggressive local invasion and failure to respond to all medical therapy attempted over a 1-y period. Treatments included systemic and topical antifungals, anti-inflammatories, and use of cellular matrices. Surgical excision was not attempted but should be strongly considered early in the disease process in...
