Factors Associated With Survival and Return to Function Following Synovial Infections in Horses.
Abstract: Synovial infections (SI) are common in horses of all ages and can be associated with high rates of morbidity and mortality. Identifying factors influencing survival and return to function may be useful for management of affected individuals and determination of prognosis. The objectives of this study were to identify factors associated with survival and return to function of horses and foals with SI presented to an equine hospital. This study is a retrospective case series. Data were collected from medical records of all horses with SI that were presented to a single equine hospital between April 1st, 2008 and May 1st, 2017. Long-term follow up was obtained by a semi-structured telephone questionnaire of clinical outcomes and analysis of online race records. Univariate models were created using generalized linear and linear mixed models to assess factors associated with outcomes. Multivariable models were created using generalized linear and linear mixed models to determine factors significantly associated with outcomes. Of 186 horses presented with SI, 161/186 (86.6%) were treated and 145/161 (90.1%) survived to discharge. The majority of joints were treated with synovial lavage (93.8%). One hundred and twenty horses were included in the return to function analysis and 79 (65%) returned to function. Increasing number of days of treatment with systemic antimicrobials was associated with increased likelihood of survival for each horse (OR 1.15, 95% CI 1.04-1.27, P = 0.025) and when considering each individual synovial structure (OR 1.11, 95% CI 1.04-1.17, P = 0.004). Horses treated with doxycycline were less likely to return to function (OR 0.39, 95% CI 0.19-0.8, P = 0.031). The overall rate of survival of horses treated with SI is good. The likelihood of return to function is lower than for survival. The findings of this study, combined with relevant antimicrobial stewardship practices, can be used as a part of evidence-based decision-making when veterinarians are treating horses with SI.
Copyright © 2019 Crosby, Labens, Hughes, Nielsen and Hilbert.
Publication Date: 2019-10-22 PubMed ID: 31696123PubMed Central: PMC6817570DOI: 10.3389/fvets.2019.00367Google Scholar: Lookup
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- Journal Article
Summary
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The research focused on identifying factors linked to survival and recovery in horses diagnosed with Synovial Infections (SI), using data collected from a single horse hospital over a nine year period. Resulting findings suggested an association between duration of antimicrobial treatment and increased survival, while treatment with doxycycline indicated a lesser likelihood of functionality return.
Objective of the Study
- The main aim of the study was to identify factors influencing the survival rate and return to functional status in horses with Synovial Infections (SI), a common condition that can lead to high morbidity and mortality rates among horses.
Methodology
- The researchers used a retrospective case series design.
- Data for this study were retrieved from the medical records of horses presented at a particular equine hospital from April 2008 to May 2017.
- They obtained long-term follow-up details through a semi-structured telephone questionnaire and analysis of online race records.
- To ascertain factors associated with the outcomes i.e., survival and return to function, the researchers applied univariate and multivariable models using generalized linear and linear mixed models.
Results
- Of the 186 horses that presented with SI, 86.6% were treated, and 90.1% of the treated horses survived to discharge. The most used treatment was synovial lavage, used in 93.8% of cases.
- The return to function analysis included 120 horses from the treated pool, of which 65% returned to function.
- The study found that the likelihood of a horse’s survival increased with an increase in the number of days of treatment with systemic antimicrobials (antibiotics).
- In contrast, horses that were treated with a specific antibiotic, doxycycline, were less likely to return to full functionality.
Conclusion
- The overall survival rate of horses treated for SI is good while the percentage of horses returning to function is lower.
- The research suggests that longer durations of systemic antimicrobial treatment could improve survival, but the use of doxycycline might reduce the chances of a horse returning to functionality.
- These findings may be beneficial for veterinarians in making evidence-based decisions when treating SI in horses, considering proper antimicrobial stewardship practices.
Cite This Article
APA
Crosby DE, Labens R, Hughes KJ, Nielsen S, Hilbert BJ.
(2019).
Factors Associated With Survival and Return to Function Following Synovial Infections in Horses.
Front Vet Sci, 6, 367.
https://doi.org/10.3389/fvets.2019.00367 Publication
Researcher Affiliations
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
- Sharon Nielsen Statistical Consulting and Training, Wagga Wagga, NSW, Australia.
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
References
This article includes 39 references
- Schneider RK, Bramlage LR, Moore RM, Mecklenburg LM, Kohn CW, Gabel AA. A retrospective study of 192 horses affected with septic arthritis/tenosynovitis. Equine Vet J (1992) 24:436–42.
- Richardson DW, Ahern BJ. Synovial and osseous infections. Equine Surgery 4 Edn Saint Louis, MI: W.B. Saunders; (2012). p. 1189–201.
- Steel CM, Pannirselvam RR, Anderson GA. Risk of septic arthritis after intra-articular medication: a study of 16,624 injections in Thoroughbred racehorses. Aust Vet J (2013) 91:268–73.
- 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.
- Herdan CL, Acke E, Dicken M, Archer RM, Forsyth SF, Gee EK. Multi-drug-resistant Enterococcus spp. as a cause of non-responsive septic synovitis in three horses. N Z Vet J (2012) 60:297–304.
- Walmsley EA, Anderson GA, Muurlink MA, Whitton RC. Retrospective investigation of prognostic indicators for adult horses with infection of a synovial structure. Aust Vet J (2011) 89:226–31.
- Steel CM, Hunt AR, Adams PL, Robertson ID, Chicken C, Yovich JV. Factors associated with prognosis for survival and athletic use in foals with septic arthritis: 93 cases (1987-1994). J Am Vet Med Assoc (1999) 215:973–7.
- Fraser BS, Bladon BM. Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath. Equine Vet J (2004) 36:528–31.
- Wereszka MM, White NA II, Furr MO. Factors associated with outcome following treatment of horses with septic tenosynovitis: 51 cases (1986-2003). J Am Vet Med Assoc (2007) 230:1195–200.
- McIlwraith CW, Nixon AJ, Wright IM. Endoscopic surgery in the management of contamination and infection of joints, tendon sheaths, and bursae. Diagnostic and Surgical Arthroscopy in the Horse 4 Edn St. Louis, MO: Mosby; (2015). p. 407–18.
- Orsini JA. Meta-analysis of clinical factors affecting synovial structure infections and prognosis. J Equine Vet Sci (2017) 55:105–14.
- Madison JB, Sommer M, Spencer PA. Relations among synovial membrane histopathologic findings, synovial fluid cytologic findings, and bacterial culture results in horses with suspected infectious arthritis: 64 cases (1979-1987). J Am Vet Med Assoc (1991) 198:1655–61.
- Dumoulin M, Pille F, van den Abeele AM, Boyen F, Boussauw B, Oosterlinck M. Use of blood culture medium enrichment for synovial fluid culture in horses: a comparison of different culture methods. Equine Vet J (2010) 42:541–6.
- Dumoulin M, Pille F, Van den Abeele AM, Haesebrouck F, Oosterlinck M, Gasthuys F. Evaluation of an automated blood culture system for the isolation of bacteria from equine synovial fluid. Vet J (2010) 184:83–7.
- Frees KE, Lillich JD, Gaughan EM, DeBowes RM. Tenoscopic-assisted treatment of open digital flexor tendon sheath injuries in horses: 20 cases (1992-2001). J Am Vet Med Assoc (2002) 220:1823–7.
- 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.
- Cousty M, David Stack J, Tricaud C, David F. Effect of arthroscopic lavage and repeated intra-articular administrations of antibiotic in adult horses and foals with septic arthritis. Vet Surg (2017) 46:1008–16.
- Milner PI, Bardell DA, Warner L, Packer MJ, Senior JM, Singer ER. Factors associated with survival to hospital discharge following endoscopic treatment for synovial sepsis in 214 horses. Equine Vet J (2014) 46:701–5.
- Stewart AA, Goodrich LR, Byron CR, Evans RB, Stewart MC. Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis. Aust Vet J (2010) 88:115–23.
- Smith LJ, Mellor DJ, Marr CM, Mair TS. What is the likelihood that a horse treated for septic digital tenosynovitis will return to its previous level of athletic function?. Equine Vet J (2006) 38:337–41.
- Smith LJ, Marr CM, Payne RJ, Stoneham SJ, Reid SW. What is the likelihood that Thoroughbred foals treated for septic arthritis will race?. Equine Vet J (2004) 36:452–6.
- Post EM, Singer ER, Clegg PD, Smith RK, Cripps PJ. Retrospective study of 24 cases of septic calcaneal bursitis in the horse. Equine Vet J (2003) 35:662–8.
- 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.
- Meijer MC, van Weeren PR, Rijkenhuizen AB. Clinical experiences of treating septic arthritis in the equine by repeated joint lavage: a series of 39 cases. J Vet Med A Physiol Pathol Clin Med (2000) 47:351–65.
- Vos NJ, Ducharme NG. Analysis of factors influencing prognosis in foals with septic arthritis. Ir Vet J (2008) 61:102–6.
- Wright L, Ekstrøm CT, Kristoffersen M, Lindegaard C. Haematogenous septic arthritis in foals: short- and long-term outcome and analysis of factors affecting prognosis. Equine Vet Educ (2017) 29:328–36.
- Taylor AH, Mair TS, Smith LJ, Perkins JD. Bacterial culture of septic synovial structures of horses: does a positive bacterial culture influence prognosis?. Equine Vet J (2010) 42:213–8.
- Kidd JA, Barr AR, Tarlton JF. Use of matrix metalloproteinases 2 and 9 and white blood cell counts in monitoring the treatment and predicting the survival of horses with septic arthritis. Vet Rec (2007) 161:329–34.
- Steel CM. Equine synovial fluid analysis. Vet Clin N Am Equine Pract (2008) 24:437–54.
- Weese JS, Giguère S, Guardabassi L, Morley PS, Papich M, Ricciuto DR. ACVIM consensus statement on therapeutic antimicrobial use in animals and antimicrobial resistance. J Vet Intern Med (2015) 29:487–98.
- Raidal S. Antimicrobial stewardship in equine practice. Austr Vet J (2019) 97:238–42.
- Reed SM, Bayly WM, Sellon DC. Equine Internal Medicine. St. Louis, MO: Elsevier Health Sciences; (2017).
- Schnabel LV, Papich MG, Watts AE, Fortier LA. Orally administered doxycycline accumulates in synovial fluid compared to plasma. Equine Vet J (2010) 42:208–12.
- White G, Prior SD. Comparative effects of oral administration of trimethoprim/sulphadiazine or oxytetracycline on the faecal flora of horses. Vet Rec (1982) 111:316–8.
- Moore Keir AA, Stampfli HR, Crawford J. Outbreak of acute colitis on a horse farm associated with tetracycline- contaminated sweet feed. Can Vet J (1999) 40:718–20.
- 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.
- McIlwraith CW. Treatment of infectious arthritis. Vet Clin N Am Large Anim Pract (1983) 5:363–79.
- Whitehair KJ, Bowersock TL, Blevins WE, Fessler JF, White MR, Sickle DC. Regional limb perfusion for antibiotic treatment of experimentally induced septic arthritis. Vet Surg (1992) 21:367–73.
- 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.
Citations
This article has been cited 6 times.- Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
- Beggan CP, Panizzi L, Oliver LJ. Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath. Vet Surg 2025 Aug;54(6):1157-1166.
- 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.
- Ang L, Vinderola G, Endo A, Kantanen J, Jingfeng C, Binetti A, Burns P, Qingmiao S, Suying D, Zujiang Y, Rios-Covian D, Mantziari A, Beasley S, Gomez-Gallego C, Gueimonde M, Salminen S. Gut Microbiome Characteristics in feral and domesticated horses from different geographic locations. Commun Biol 2022 Feb 25;5(1):172.
- Vajs T, Nekouei O, Biermann NM. A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement. Animals (Basel) 2022 Feb 21;12(4).
- Haralambus R, Florczyk A, Sigl E, Gültekin S, Vogl C, Brandt S, Schnierer M, Gamerith C, Jenner F. Detection of synovial sepsis in horses using enzymes as biomarkers. Equine Vet J 2022 May;54(3):513-522.
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