Omneity® Pellets
All-In-One Vitamin & Mineral Pellet
Clinical use of antimicrobial regional limb perfusion in adult horses diagnosed with synovial sepsis or penetrating synovial wounds at a single equine referral hospital in the Midwest United States-163 cases (2010-2020).
Abstract: The clinical outcomes in horses diagnosed with established synovial sepsis (SS) or minimally contaminated synovial wounds (SW)/non-established sepsis, following intravenous regional limb perfusion (IVRLP) treatment, have not been reported since 2010. Additionally, previous reports on this subject were confined to just two clinical retrospective reports. This study aimed to provide an update on the short-term (hospital discharge) and long-term (≥1 year) survival rates in adult horses diagnosed with SS or SW treated with IVRLP at a single institution in the USA from 2010-2020. The study also seeks to determine IVRLP variables associated with survival. The medical records of 163 adult equine, either diagnosed with SS (group 1) or SW (group 2), from 2010-2020 treated with IVRLP were reviewed. The short-term survival rate was 88.9% (56 out of 63) for group 1 and 99.0% (99 out of 100) for group 2. The long-term survival rate was 65.1% (41 out of 63) for group 1 and 83.6% (46 out of 55) for group 2. Gentamicin was the most commonly chosen IVRLP antimicrobial choice (153 out of 163 cases). Horses in group 1 were less likely to survive until hospital discharge (p = 0.01; odds ratio [OR] = 0.08; 95% confidence interval [CI]: [0.01, 0.68]). The total number of IVRLPs performed during hospitalization was significantly associated with non-survival to hospital discharge (p = 0.01; OR = 0.47; 95% CI: [0.22, 0.87]), indicating that horses were less likely to survive as the total number of IVRLPs increased. No variables were associated with long-term survival. Overall survival in adult horses diagnosed with SS or SW after treatment is good, and this study provides an updated clinical report on adult equine SS or SW cases that received IVRLP in the USA. This study also reports IVRLP variables, including the total number of IVRLPs and the number of consecutive IVRLPs, that may be associated with short-term survival.
Copyright © 2025 Loppnow, Kersh, Wang, Spaethe and Troy.
Publication Date: 2025-03-26 PubMed ID: 40206250PubMed Central: PMC11979138DOI: 10.3389/fvets.2025.1504486Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study investigates the survival rates of adult horses treated with intravenous regional limb perfusion (IVRLP) after being diagnosed with synovial sepsis or minimally contaminated synovial wounds. The focus is on the experiences at a single equine hospital in the Midwest US from 2010-2020. Along with a general report on survival rates, the study examines variables associated with the IVRLP treatment that impact survival.
Study Overview
- The authors aimed to investigate the short-term (survival till hospital discharge) and long-term (survival of one year or more) outcomes for adult horses diagnosed with synovial sepsis or minimally contaminated synovial wounds and treated with intravenous regional limb perfusion (IVRLP).
- The data was drawn from one equine referral hospital in the Midwest United States. The study period spanned from 2010 to 2020.
- The objective of the study was two-fold: to report updated survival rates among adult horses with these conditions, and to assess whether any variables related to IVRLP were associated with survival.
- The study went through 163 adult equine medical records. These comprised of 63 horses diagnosed with synovial sepsis (group 1) and 100 horses with minimally contaminated synovial wounds and non-established sepsis (group 2).
Findings
- The researchers found that the short-term and long-term survival rates were favourable, especially for group 2 (99.0% short-term survival and 83.6% long-term survival).
- For group 1, the short-term survival rate was 88.9% and the long term survival rate was 65.1%.
- Gentamicin was the selected IVRLP antimicrobial choice in a significant majority of cases (153 out of 163).
- The study concluded that horses diagnosed with synovial sepsis (group 1) were less likely to survive until hospital discharge.
- Another significant finding was that the total number of IVRLPs performed during hospitalization was inversely associated with survival until discharge – horses were less likely to survive as the total number of IVRLPs increased.
- However, no variables were found that were associated with long-term survival.
Significance
- This study provides an updated clinical report on adult horse cases diagnosed with synovial sepsis or minimally contaminated synovial wounds receiving IVRLP in the USA.
- It highlights the importance of the total number of IVRLPs in determining short-term survival and overall prognosis.
- The work is notable for its large sample size compared to previous studies and its clarification on the role and risks of IVRLP in treating these conditions.
- The research benefits equine veterinarians by providing them with a better understanding of the treatment outcomes and potential risks with IVRLP, guiding more informed treatment decisions.
Cite This Article
APA
Loppnow Z, Kersh K, Wang C, Spaethe S, Troy J.
(2025).
Clinical use of antimicrobial regional limb perfusion in adult horses diagnosed with synovial sepsis or penetrating synovial wounds at a single equine referral hospital in the Midwest United States-163 cases (2010-2020).
Front Vet Sci, 12, 1504486.
https://doi.org/10.3389/fvets.2025.1504486 Publication
Researcher Affiliations
- Steinbeck Peninsula Equine Clinics, Salinas, CA, United States.
- Iowa State University College of Veterinary Medicine, Veterinary Clinical Sciences, Ames, IA, United States.
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University College of Veterinary Medicine, Ames, IA, United States.
- Department of Statistics, Iowa State University, Ames, IA, United States.
- Iowa State University College of Veterinary Medicine, Veterinary Clinical Sciences, Ames, IA, United States.
- Iowa State University College of Veterinary Medicine, Veterinary Clinical Sciences, Ames, IA, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
This article includes 27 references
- Rubio-Martinez LM, Elmas CR, Black B, Monteith G. Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009).. J Am Vet Med Assoc (2012) 241:1650–8.
- Kelmer G, Tatz A, Bdolah-Abram T. Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb.. Vet Surg (2012) 41:938–43.
- Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ. Meropenem administered via intravenous regional limb perfusion for orthopedic sepsis in horses: a clinical retrospective study.. Front Vet Sci (2021) 8:629627.
- Whitehair KJ, Bowersock TL, Blevins WE, Fessler JF, White MR, Van Sickle DC. Regional limb perfusion for antibiotic treatment of experimentally induced septic arthritis.. Vet Surg (1992) 21:367–73.
- Whitehair KJ, Blevins WE, Fessler JF, Van Sickle DC, White MR, Bill RP. Regional perfusion of the equine carpus for antibiotic delivery.. Vet Surg (1992) 21. 5:279–85.
- Dahan R, Oreff GL, Tatz AJ, Raz T, Britzi M, Kelmer G. Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses.. Can Vet J (2019) 60:294–9.
- Colbath AC, Wittenburg LA, Gold JR, McIlwraith CW, Moorman VJ. The effects of mepivacaine hydrochloride on antimicrobial activity and mechanical nociceptive threshold during amikacin sulfate regional limb perfusion in the horse.. Vet Surg (2016) 45:798–803.
- Oreff GL, Tatz AJ, Daha R, Segev G, Haberman S, Britzi M. Pharmacokinetics of ceftazidime after regional limb perfusion in standing horses.. Vet Surg (2017) 46:1120–5.
- Mendez-Angulo JL, Granados MM, Modesto R, Serrano-Rodriguez JM, Funes FJ, Quiros S. Systemic and local effects of lidocaine or mepivacaine when used for intravenous regional anesthesia of the distal limb in standing sedated horses.. Equine Vet J (2020) 52:743–51.
- Hyde RM, Lynch TM, Clark CK, Slone DE, Hughes FE. The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse.. Can Vet J (2013) 54:363–7.
- Moser DK, Schoonover MJ, Holbrook TC, Payton ME. Effect of regional intravenous limb perfusate volume on synovial fluid concentration of amikacin and local venous blood pressure in the horse.. Vet Surg (2016) 45:851–8.
- Robinson CS, Timofte D, Singer ER, Rimmington L, Rubio-Martinez LM. Prevalence and antimicrobial susceptibility of bacterial isolates from horses with synovial sepsis: a cross-sectional study of 95 cases.. Vet J (2016) 216:117–21.
- Schneider RK, Bramlage LR, Moore RM, Mecklenburg LM, Kohn CW, Gabel AA. A retrospective study of 192 horses affected with septic arthritis/tenosynovitis.. Eq Vet J (1992) 24:436–42.
- Taylor A, Mair T, Smith L, Perkins J. Bacterial culture of septic synovial structure of horses: does a positive bacterial culture influence prognosis?. Eq Vet J (2010) 42:213–8.
- Tenover FC. Mechanisms of antimicrobial resistance in bacteria.. Am J Med (2006) 119:S3–S10.
- Walmsley EA, Anderson GA, Muurlink MA, Whitton RC. Retrospective investigation of prognostic indicators for adult horses with infection of a synovial structure.. Australian Vet J (2011) 89:226–31.
- . Lameness exams: Evaluating the lame horse.. American association of equine practitioners (2023).
- Wright IM, Smith MR, Humphrey DJ, Eaton-Evans TC, Hillyer MH. Endoscopic surgery in the treatment of contaminated and infected synovial cavities.. Equine Vet J (2003) 35:613–9.
- Findley JA, Pinchbeck GL, Milner PI, Bladon BM, Boswell J, Mair TS. Outcome of horses with synovial structure involvement following solar foot penetrations in four UK veterinary hospitals: 95 cases.. Equine Vet J (2014) 46:352–7.
- Werner LA, Hardy J, Bertone AL. Bone gentamicin concentration after intra-articular injection or regional intravenous perfusion in the horse.. Vet Surg (2005) 32:559–65.
- Moore RM, Schneider RK, Kowalski J, Bramlage LR, Mecklenburg LM, Kohn CW. Antimicrobial susceptibility of bacterial isolates from 233 horses with musculoskeletal infection during 1979-1989.. Equine Vet J (1992) 24:450–6.
- Miagkoff L, Archambault M, Bonilla AG. Antimicrobial susceptibility patterns of bacterial isolates cultured from synovial fluid samples from horses with suspected septic synovitis: 108 cases (2008-2017).. JAVMA (2020) 256:800–7.
- Schoster A, Amsler M, Kirchgaessner C, Saleh L, Schwarzwald C, Schmitt S. Gentamicin plasma concentrations in hospitalized horses and retrospective minimal inhibitory concentrations of gram-negative equine pathogens.. J Vet Emerg Crit Care (2021) 31:323–30.
- Auer JA, Stick JA. Chapter 7: Surgical site infection and the use of antimicrobials In: Equine Surgery.. Elsevier St. Louis, MO; (2019) 93–3.
- Gibson KT, McIlwraith CW, Turner AS, Stashak TS, Aanes WA, Trotter GW. Open joint injuries in horses: 58 cases (1980–1986).. J Am Vet Med Assoc (1989) 194:398–404.
- Lescun TB, Vasey JR, Ward MP, Adams SB. Treatment with continuous intrasynovial antimicrobial infusion for septic synovitis in horses: 31 cases (2000-2003).. J Am Vet Med Assoc (2006) 228:1922–9.
- Wereszka MM, White NA, II, Furr MO. Factors associated with outcome following treatment of horses with septic tenosynovitis: 51 cases (1986-2003).. JAVMA (2007) 230:1195–200.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
