Intermittent antimicrobial infusion for management of a septic distal interphalangeal joint in a horse.

This research study explores a case where a young horse had a puncture wound in its foot that developed into joint sepsis. The horse was then successfully treated with a new method of intermittent antimicrobial infusion, providing a high local concentration of antibiotics and frequent irrigation of the infected areas.

Background of the Case

• The subject of this study was a 13-month-old Quarter Horse colt that sustained a puncture wound to the frog region of its foot, specifically penetrating the navicular bursa and distal interphalangeal joint. This injury occurred 7 days before the horse was examined.
• The puncture wound triggered a septic infection in the distal interphalangeal joint, a condition which is generally hard to treat and often leads to severe complications in horses.

Treatment Procedure

• A “street-nail procedure” was executed to clean the wound and allow drainage of the infected areas. The term “street-nail procedure” refers to a surgical approach designed to treat penetrating foot injuries in horses, which includes debridement and drainage of the affected areas.
• Next, an in-dwelling lavage system was installed through the dorsal aspect of the joint. Lavage systems allow for continuous or intermittent irrigation of a wound or an area with infection, helping to remove debris and reduce the bacterial load.

Intermittent Antimicrobial Infusion

• The primary innovative approach taken in this study was the intermittent infusion of antimicrobials into the infected areas.
• The infusion aimed to provide a high local concentration of the antimicrobial drug, focusing its action on the specific site of infection.
• In addition to delivering antibiotics, the infusion also served to frequently lavage or rinse the infected distal interphalangeal joint and navicular bursa.
• This dual function of delivering a high concentration of antimicrobials and constantly cleansing the infected areas seems to have contributed to the successful treatment of the horse, suggesting it could be a promising method for similar infections in the future.