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).

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.