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.
Publication Date: 2003-01-30 PubMed ID: 12553469DOI: 10.2746/042516403775467513Google Scholar: Lookup
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- Journal Article
Summary
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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
Researcher Affiliations
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.
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
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