FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2003; 35(1); 86-92; doi: 10.2746/042516403775467513

Clostridial myonecrosis in horses (37 cases 1985-2000).

Abstract: Previous reports of clostridial myonecrosis have either focused on individual case reports or have been small retrospective studies reporting very high mortality rates. Objective: The objective of this study was to describe the outcome of cases of clostridial myonecrosis submitted to 2 referral equine hospitals in the United States over a 15 year period. Methods: A retrospective study of case material selected on the basis of positive Clostridium spp. culture or the identification of Clostridium spp. by specific fluorescent antibody testing from soft tissue wounds was performed at Cornell and Wisconsin. Results: 37 cases of clostridial myonecrosis were documented. Twenty-seven horses survived, 8 were subjected to euthanasia and 2 died during treatment for an overall survival rate of 73%. Twenty-five cases (68%) were associated with Clostridium perfringens alone, 6 cases (16%) with Cl. septicum alone, 4 cases with mixed clostridial infections (11%), 1 case with Cl. sporogenes and 1 with an unspeciated Clostridium spp. The highest survival rate of 81% was documented for those cases from which Cl. perfringens alone was isolated. The most common antecedent condition prior to referral was colic. The myonecrotic lesion occurred within 6-72 h of a soft tissue injection in 34 cases but was associated with a wound or laceration in the remaining 3 cases. Of the 34 cases associated with recent injections, 24 were associated with i.m. injections in the cervical region, 4 in the semimembranosus/semitendinosus region, 3 in the gluteal region, 2 with perivascular leakage of drugs administered into the jugular vein and 1 case developed simultaneously in the gluteal and neck region following injections at both sites. Conclusions: Clostridial myonecrosis can occur following the i.m. or inadvertent perivascular administration of a wide variety of commonly administered drugs. It is most common in the neck musculature. Aggressive treatment can be associated with survival rates of up to 81% for cases due to Cl. perfringens alone. Survival rates for other Clostridial spp. tend to be lower. Conclusions: A combination of high dose i.v. antibiotic therapy and surgical fenestration/debridement is the best approach to cases of clostridial myonecrosis. With rapid diagnosis and therapeutic intervention, horses may have up to an 81% chance of survival.
Get Full Text
Publication Date: 2003-01-30 PubMed ID: 12553469DOI: 10.2746/042516403775467513Google 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.
LinkedInCopy
  • 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 research examines horses’ outcomes with clostridial myonecrosis, a bacterial infection, at two American equine hospitals over 15 years. The results suggest the infection is most likely to occur following an intramuscular injection and can be treated successfully with aggressive therapy and surgical intervention.

Study Overview

  • This study aimed to investigate cases of clostridial myonecrosis, a severe bacterial infection, in horses over a period of 15 years. The research was carried out at two referral equine hospitals in the United States.
  • The study is retrospective, involving a review of past cases that were selected based on a positive Clostridium culture or identification of Clostridium from soft tissue wounds.

Results

  • The study documented 37 cases of clostridial myonecrosis. Of these, 27 horses survived, 8 were euthanized, and 2 died during treatment. This resulted in an overall survival rate of 73%.
  • A majority (68%) of the cases were associated with a bacterium named Clostridium perfringens alone. Six (16%) cases were linked with another bacterium called Cl. septicum alone, while four cases involved mixed clostridial infections.
  • The highest survival rate (81%) was among cases from which Cl. perfringens alone was isolated. Other types of Clostridial spp. had lower survival rates.

Causes of Infection

  • Many of the cases of clostridial myonecrosis (34 of the 37 cases) developed within 6-72 hours of a soft tissue injection. The remaining 3 cases were associated with wounds or lacerations.
  • Most cases that were associated with recent injections (24 out of 34 cases) were linked to intramuscular injection in the cervical region (neck muscles), while others were connected to injections in the semimembranosus/semitendinosus region (lower hind limb), gluteal region (buttock), or perivascular leakage of drugs administered into the jugular vein.

Conclusion and Recommendation

  • The research concluded that clostridial myonecrosis could occur following the administration of various common drugs either into muscle or unintentionally into blood vessels. It is most often found in the neck musculature.
  • The study’s authors recommend aggressive treatment through high-dose intravenous antibiotic therapy and surgical debridement (removal of unhealthy tissue). This approach, when combined with quick diagnosis and therapy initiation, could lead to survival rates of up to 81% for cases due to Cl. perfringens.

Cite This Article

APA
Peek SF, Semrad SD, Perkins GA. (2003). Clostridial myonecrosis in horses (37 cases 1985-2000). Equine Vet J, 35(1), 86-92. https://doi.org/10.2746/042516403775467513

Publication

Equine veterinary journal
ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 35
Issue: 1
Pages: 86-92

Researcher Affiliations

Peek, S F
  • Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.
Semrad, S D
    Perkins, G A

      MeSH Terms

      • Animals
      • Anti-Bacterial Agents / therapeutic use
      • Clostridium / classification
      • Clostridium / isolation & purification
      • Debridement
      • Female
      • Gas Gangrene / epidemiology
      • Gas Gangrene / mortality
      • Gas Gangrene / therapy
      • Gas Gangrene / veterinary
      • Horse Diseases / epidemiology
      • Horse Diseases / mortality
      • Horse Diseases / therapy
      • Horses
      • Injections, Intramuscular / adverse effects
      • Injections, Intramuscular / veterinary
      • Longitudinal Studies
      • Male
      • Retrospective Studies
      • Survival Analysis

      Citations

      This article has been cited 17 times.
      1. Myburgh DA, da Silva NA, Haller-Caskie M, Colominas L, Castanyer P, Frigola J, Tremoleda J, Hölzel C, Unterweger D, Nebel A, Krause-Kyora B. Detection of Clostridium sporogenes in a Roman-era cattle mass grave at Vilauba. Virulence 2025 Dec;16(1):2580731.
        doi: 10.1080/21505594.2025.2580731pubmed: 41144656google scholar: lookup
      2. Ryu SH, Forbes E, Kim BS, Park KT. Injection site abscesses associated with commensal and environmental bacteria following intramuscular vaccination in horses. Vet Anim Sci 2025 Sep;29:100484.
        doi: 10.1016/j.vas.2025.100484pubmed: 40791848google scholar: lookup
      3. Oddsdóttir C, Sigurðardóttir ÓG, Friðriksdóttir V, Svansson V, Bragason BÞ, Björnsdóttir S. Severe subcutaneous infection with Clostridium septicum in a herd of native Icelandic horses. Acta Vet Scand 2025 Feb 6;67(1):8.
        doi: 10.1186/s13028-025-00792-ypubmed: 39910631google scholar: lookup
      4. Song Y, Day CM, Afinjuomo F, Tan JE, Page SW, Garg S. Advanced Strategies of Drug Delivery via Oral, Topical, and Parenteral Administration Routes: Where Do Equine Medications Stand?. Pharmaceutics 2023 Jan 4;15(1).
        doi: 10.3390/pharmaceutics15010186pubmed: 36678815google scholar: lookup
      5. Uzal FA, Navarro MA, Asin J, Henderson EE. Clostridial Diseases of Horses: A Review. Vaccines (Basel) 2022 Feb 17;10(2).
        doi: 10.3390/vaccines10020318pubmed: 35214776google scholar: lookup
      6. Sprohnle-Barrera CH, Gibson JS, Price R, Graham RM, Jennison AV, Ricca MR, Allavena RE. Fatal non-traumatic gas gangrene caused by Clostridium perfringens type A in a Siberian Husky dog. J Vet Diagn Invest 2022 May;34(3):518-522.
        doi: 10.1177/10406387221079066pubmed: 35179099google scholar: lookup
      7. Freitas NFQR, Otaka DY, Galvão CC, de Almeida DM, Ferreira MRA, Moreira Júnior C, Hidalgo MMMH, Conceição FR, Salvarani FM. Humoral Immune Response Evaluation in Horses Vaccinated with Recombinant Clostridium perfringens Toxoids Alpha and Beta for 12 Months. Toxins (Basel) 2021 Aug 13;13(8).
        doi: 10.3390/toxins13080566pubmed: 34437437google scholar: lookup
      8. Mehdizadeh Gohari I, A Navarro M, Li J, Shrestha A, Uzal F, A McClane B. Pathogenicity and virulence of Clostridium perfringens. Virulence 2021 Dec;12(1):723-753.
        doi: 10.1080/21505594.2021.1886777pubmed: 33843463google scholar: lookup
      9. Ellero N, Freccero F, Lanci A, Morini M, Castagnetti C, Mariella J. Rhabdomyolysis and Acute Renal Failure Associated with Oxytetracycline Administration in Two Neonatal Foals Affected by Flexural Limb Deformity. Vet Sci 2020 Oct 22;7(4).
        doi: 10.3390/vetsci7040160pubmed: 33105842google scholar: lookup
      10. Junior CAO, Silva ROS, Lobato FCF, Navarro MA, Uzal FA. Gas gangrene in mammals: a review. J Vet Diagn Invest 2020 Mar;32(2):175-183.
        doi: 10.1177/1040638720905830pubmed: 32081096google scholar: lookup
      11. Sacco SC, Ortega J, Navarro MA, Fresneda KC, Anderson M, Woods LW, Moore J, Uzal FA. Clostridium sordellii-associated gas gangrene in 8 horses, 1998-2019. J Vet Diagn Invest 2020 Mar;32(2):246-251.
        doi: 10.1177/1040638719877844pubmed: 31585515google scholar: lookup
      12. Zaragoza NE, Orellana CA, Moonen GA, Moutafis G, Marcellin E. Vaccine Production to Protect Animals Against Pathogenic Clostridia. Toxins (Basel) 2019 Sep 11;11(9).
        doi: 10.3390/toxins11090525pubmed: 31514424google scholar: lookup
      13. Berlin N, Kelmer E, Segev G, Aroch I, Kelmer G. Assessment of the CoaguChek-XS portable prothrombin time point-of-care analyzer for horses. J Vet Diagn Invest 2019 May;31(3):448-452.
        doi: 10.1177/1040638719832340pubmed: 30852982google scholar: lookup
      14. Hunyadi L, Sundman EA, Kass PH, Williams DC, Aleman M. Clinical Implications and Hospital Outcome of Immune-Mediated Myositis in Horses. J Vet Intern Med 2017 Jan;31(1):170-175.
        doi: 10.1111/jvim.14637pubmed: 28044365google scholar: lookup
      15. Salari Sedigh H, Rajabioun M, Razmyar J, Kazemi Mehrjerdi H. An unusual necrotic myositis by Clostridium perfringens in a German Shepherd dog: A clinical report, bacteriological and molecular identification. Vet Res Forum 2015 Fall;6(4):349-53.
        pubmed: 26973773
      16. Farias LD, Azevedo Mda S, Trost ME, De La Côrte FD, Irigoyen LF, de Vargas AC. Acute myonecrosis in horse caused by Clostridium novyi type A. Braz J Microbiol 2014;45(1):221-4.
        doi: 10.1590/S1517-83822014005000023pubmed: 24948935google scholar: lookup
      17. Palmateer NE, Hope VD, Roy K, Marongiu A, White JM, Grant KA, Ramsay CN, Goldberg DJ, Ncube F. Infections with spore-forming bacteria in persons who inject drugs, 2000-2009. Emerg Infect Dis 2013 Jan;19(1):29-34.
        doi: 10.3201/eid1901.120044pubmed: 23260795google scholar: lookup
      Subscribe to our newsletter
      Join 99,727 horse owners like you who receive our email updates on horse health and nutrition.