Septic arthritis in 15 standardbred racehorses after intra-articular injection.
Abstract: Case histories, results of synovial fluid analyses, treatment regimens and outcome are described for 15 adult Standardbred horses with confirmed post-injection septic arthritis. Joint sepsis followed injection of corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anaesthetic. The median interval from injection to appearance of clinical signs was 2.5 days, and median interval from injection to referral was 9 days. The median initial synovial leucocyte count on admission was 57 x 10(9)/litre, but there was a wide range of values (18-258 x 10(9)/litre). The median synovial neutrophil percentage was 95% (77-99%). All bacterial isolates were Gram-positive cocci, 86% of which were staphylococci. All treated horses (12/15) initially received broad-spectrum parenteral antibiotic therapy, and the articulations of all horses except one were lavaged, either with non-surgical through-and-through techniques only (N = 3), or surgically with arthrotomy (N = 1) or arthroscopy (N = 7). The owners of all treated horses were contacted and racing records were consulted. Eleven of 12 horses returned to racing. Outcome was judged as either satisfactory (3/12) if the horse had returned to racing levels similar to or better than before treatment, or unsatisfactory (9/12) if the horse had poorer performance or could not return to racing. The 3 horses with satisfactory follow-up had been treated with arthroscopy and post-surgical closed suction drainage. The results of bacterial cultures suggest that the initial antimicrobial agents used should be effective against penicillin-resistant staphylococci.
Publication Date: 1992-11-01 PubMed ID: 1459055DOI: 10.1111/j.2042-3306.1992.tb02872.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research is a case study on 15 adult Standardbred horses that developed septic arthritis after intra-articular injection. The study details the clinical background, synovial fluid analysis results, treatment methods, and outcomes for these horses. The main findings suggest that post-injection septic arthritis can negatively affect a racehorse’s performance, and effective treatment is dependent on prompt intervention and antibiotic therapy targeting penicillin-resistant staphylococci.
Analysis of Case Histories and Synovial Fluid
- The researched horses suffered from joint sepsis after intra-articular injection with corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anesthetic.
- The median time from the injection to the onset of clinical signs was 2.5 days, and the median time to referral was nine days, indicating a rapid progression of the condition.
- Analysis of synovial fluid showed a median initial synovial leucocyte (white blood cell) count of 57 x 10(9)/litre, a sign of inflammation present in the affected joints.
Treatment Options and Responses
- All horses except one were lavaged, a cleaning process for infected joints.
- The process was either achieved non-surgically (three horses) or surgically through arthrotomy (one horse) or arthroscopy (seven horses).
- All the treated horses were initially given broad-spectrum parenteral antibiotic therapy since all the bacterial isolates identified were Gram-positive cocci, with majority (86%) being staphylococci.
Outcome and Recommendations
- Out of the 12 treated horses, 11 returned to racing. However, only three were rated as ‘satisfactory’ in their post-treatment performance, meaning they either improved or maintained their previous levels.
- The other nine horses were classified as ‘unsatisfactory’ due to diminished performance or inability to return to racing.
- The three horses that had a satisfactory outcome had been treated with arthroscopy and post-surgical closed suction drainage.
- Based on the bacterial cultures, the research suggests initiating treatment using antimicrobial agents effective against penicillin-resistant staphylococci due to the high prevalence of this bacterium in the cases studied.
Cite This Article
APA
Lapointe JM, Laverty S, Lavoie JP.
(1992).
Septic arthritis in 15 standardbred racehorses after intra-articular injection.
Equine Vet J, 24(6), 430-434.
https://doi.org/10.1111/j.2042-3306.1992.tb02872.x Publication
Researcher Affiliations
- Département de Médecine, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada.
MeSH Terms
- Animals
- Anti-Bacterial Agents / therapeutic use
- Arthritis, Infectious / diagnosis
- Arthritis, Infectious / etiology
- Arthritis, Infectious / therapy
- Arthritis, Infectious / veterinary
- Arthroscopy / veterinary
- Debridement / veterinary
- Drainage / veterinary
- Female
- Horse Diseases / diagnosis
- Horse Diseases / etiology
- Horse Diseases / therapy
- Horses
- Injections, Intra-Articular / adverse effects
- Injections, Intra-Articular / veterinary
- Male
- Prognosis
- Retrospective Studies
- Staphylococcus / isolation & purification
- Streptococcus / isolation & purification
- Synovial Fluid / chemistry
- Synovial Fluid / microbiology
- Therapeutic Irrigation / veterinary
- Treatment Outcome
Citations
This article has been cited 7 times.- Holmes TQ, Brown AF. Champing at the Bit for Improvements: A Review of Equine Welfare in Equestrian Sports in the United Kingdom. Animals (Basel) 2022 May 5;12(9).
- Krause DM, Pezzanite LM, Griffenhagen GM, Hendrickson DA. Comparison of equine synovial sepsis rate following intrasynovial injection in ambulatory versus hospital settings. Equine Vet J 2022 May;54(3):523-530.
- Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM. A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement. Equine Vet J 2020 May;52(3):404-410.
- Ekstrand C, Bondesson U, Giving E, Hedeland M, Ingvast-Larsson C, Jacobsen S, Löfgren M, Moen L, Rhodin M, Saetra T, Ranheim B. Disposition and effect of intra-articularly administered dexamethasone on lipopolysaccharide induced equine synovitis. Acta Vet Scand 2019 Jun 20;61(1):28.
- Andreassen SM, Vinther AML, Nielsen SS, Andersen PH, Tnibar A, Kristensen AT, Jacobsen S. Changes in concentrations of haemostatic and inflammatory biomarkers in synovial fluid after intra-articular injection of lipopolysaccharide in horses. BMC Vet Res 2017 Jun 19;13(1):182.
- Haltmayer E, Schwendenwein I, Licka TF. Course of serum amyloid A (SAA) plasma concentrations in horses undergoing surgery for injuries penetrating synovial structures, an observational clinical study. BMC Vet Res 2017 May 22;13(1):137.
- Bufalari A, Maggio C, Moretti G, Crovace A, Stefanetti V, Straubinger RK, Passamonti F. Management of Candida guilliermondii joint infection in a dog. Acta Vet Scand 2016 Jul 8;58(1):47.
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