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Equine veterinary journal2021; 54(3); 523-530; doi: 10.1111/evj.13485

Comparison of equine synovial sepsis rate following intrasynovial injection in ambulatory versus hospital settings.

Abstract: Frequency of synovial sepsis in horses following intrasynovial injection has been reported, but not compared with respect to the environment in which the injection was performed. Objective: To describe occurrence of synovial sepsis following intrasynovial injections performed in ambulatory vs hospital settings. Methods: Retrospective cohort study. Methods: Records from the Colorado State University were evaluated (2014-2018) and horses receiving intrasynovial injections were identified. Patients presenting for septic synovial structures were excluded. Patient signalment, primary supervising service, medications injected, location (field/hospital), whether synovial sepsis resulted, and at what time sepsis was recognised were recorded. Logistic regression was used to estimate the contributions of covariates to the occurrence of synovial sepsis following injection. Results: During the study period, 3866 intrasynovial injections were performed in 1112 horses during 1623 sessions, with 643/1623 sessions performed in the field. The most frequently used medications were hyaluronate (846/1623, 52.1%), triamcinolone acetonide (780 /1623, 48.1%) and amikacin sulfate (684/1623, 42.1%). Four horses developed synovial sepsis (0.2% sessions, 0.1% synovial structures); 3/4 were injected in the field, 2/4 received antibiotics with the injection. The frequency of septic synovitis was 10.4 cases per 10 000 injections, or 1 in 967 injections. All horses recovered following synovial lavage and antibiotic therapy. Performing injections in the field (P = .2) or without antibiotics (P = .7) did not alter the risk of synovial sepsis. Conclusions: Limitations include the retrospective nature of data collection and low rate of infection overall, which prohibited evaluation of individual medication regimes as factors associated with resultant infection. Conclusions: The frequency of synovial sepsis in this population of horses was not higher when injections were performed in the field or without concurrent antibiotic administration. These data may help to inform practitioners and clients regarding the relative potential risk of complications following intrasynovial medication in different environmental settings.
© 2021 EVJ Ltd.
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Publication Date: 2021-07-08 PubMed ID: 34115426PubMed Central: PMC8664890DOI: 10.1111/evj.13485Google Scholar: Lookup
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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 aims to identify if there’s a difference in the rate of joint infection, or synovial sepsis, in horses after they receive joint injections in a hospital setting vs. an ambulatory or field setting. The findings conclude that there’s no significant statistical difference in the infection rates between the two settings.

Research Purpose and Methodology

The study seeks to provide a comparison of the frequency of synovial sepsis – a severe infection in the joint space, in horses following intrasynovial injection in different environments specifically, ambulatory (or field) settings and hospital settings.

The method employed was a retrospective cohort study where records from 2014-2018 from the Colorado State University were carefully scrutinized. The records of horses that had received intrasynovial injections were specifically targeted.

  • Variables such as patient signalment, supervising service, medications injected, location of injection, instances of synovial sepsis and its recognition time were noted.
  • Synovial sepsis occurrences following the injections were estimated via logistic regression to determine the impact of the variables.

Results and Findings

In the period under consideration, 3866 intrasynovial injections were performed on 1112 horses during 1623 sessions; noteworthy is that 643 of these sessions were performed out on the field.

  • The most commonly utilized medications were hyaluronate, triamcinolone acetonide, and amikacin sulfate.
  • A small number of horses (4 out of 1112) developed synovial sepsis; it should be noted that majority of these (3 out of 4) were injected in the field, and two had received antibiotics with the injection.
  • The study deduced the frequency of septic synovitis at 10.4 cases per 10 000 injections or 1 in 967 injections.
  • After synovial lavage and antibiotic therapy, all horses recovered.
  • The researchers found that performing injections in the field (P = .2) or without antibiotics (P = .7) did not significantly increase the risk of developing synovial sepsis.

Conclusions

There were some limitations to the study primarily its retrospective nature and a rather low rate of infection overall which resulted in the inability to evaluate individual medication regimes as potential infection factors.

Despite these limitations, the researchers concluded that administering injections in the field or without simultaneous administration of antibiotics did not lead to a significant increase in the frequency of synovial sepsis.

This information proves invaluable to both veterinarians and horse owners in their decision-making process regarding the relative potential risk of complications related to administering intrasynovial medication.

Cite This Article

APA
Krause DM, Pezzanite LM, Griffenhagen GM, Hendrickson DA. (2021). Comparison of equine synovial sepsis rate following intrasynovial injection in ambulatory versus hospital settings. Equine Vet J, 54(3), 523-530. https://doi.org/10.1111/evj.13485

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 3
Pages: 523-530

Researcher Affiliations

Krause, Danielle M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Pezzanite, Lynn M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Griffenhagen, Gregg M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Hendrickson, Dean A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Horse Diseases / drug therapy
  • Horse Diseases / epidemiology
  • Horse Diseases / etiology
  • Horses
  • Hospitals
  • Humans
  • Injections, Intra-Articular / adverse effects
  • Injections, Intra-Articular / veterinary
  • Retrospective Studies
  • Sepsis / complications
  • Sepsis / epidemiology
  • Sepsis / veterinary
  • Synovial Fluid

Grant Funding

  • TL1 TR002533 / NCATS NIH HHS
  • Colorado State University Young Investigator Program in Companion Animal Studies
  • 5TL1TR002533-02 / CCTSI NIH/NCATS CTSA
  • 5T32 OD010437-19 / NIH HHS
  • T32 OD010437 / NIH HHS
  • Carolyn Quan and Porter Bennett

Conflict of Interest Statement

Authors’ declaration of interests. No competing interests have been declared.

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Citations

This article has been cited 2 times.
  1. Riley JW, Chance LM, Barshick MR, Johnson SE. Administration of sodium hyaluronate to adult horses prior to and immediately after exercise does not alter the range of motion in either the tarsus or metacarpophalangeal joints. Transl Anim Sci 2024;8:txae153.
    doi: 10.1093/tas/txae153pubmed: 39554613google scholar: lookup
  2. Willette JA, Tsoi M, Frobish D, VanderBroek AR. Intrathecal enalapril reduces adhesion formation in experimentally induced digital flexor tendon sheath injuries in horses. Vet Surg 2025 Jan;54(1):141-154.
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