Septicemia, atrial fibrillation, cardiomegaly, left atrial mass, and Rhodococcus equi septic osteoarthritis in a foal.

The article details the successful treatment of a foal with heart and bone infections using various approaches, including medications and surgical intervention. After treatment, the foal didn’t display any symptoms related to the heart for up to 18 months, but developed lameness due to chronic degenerative joint disease.

Medical condition of the Foal

• The foal, in this case, suffered from multiple medical issues. This included a condition called vegetative bacterial endocarditis, a serious and often deadly infection of the heart’s inner lining and valves caused by bacteria.
• Other complications included septicemia (a systemic infection in the blood), atrial fibrillation (a rapid, irregular heartbeat), and cardiomegaly (enlarged heart).
• The foal also had a left atrial mass, likely resulting from the endocarditis, and Rhodococcus equi septic osteoarthritis (a bacterial infection of the joint) in the left third metatarsal bone.

Treatment and Outcome

• The foal was successfully treated using a combination of cefotaxime, erythromycin, and rifampin. These drugs helped to combat the isolated bacteria, Escherichia coli (from the blood) and Rhodococcus equi (from the affected bone and synovial fluid).
• Heart complications were managed with digoxin and quinidine sulfate, medications commonly used in cases of atrial fibrillation.
• Eighteen months post-treatment, the foal’s cardiac function was considered normal.
• As for the osteoarthritis condition, surgical debridement (removal of damaged tissue), lavage (cleaning of the wound), and local and systemic antimicrobial treatment were employed to achieve bacterial eradication.

Post-treatment Complications

• Despite successful treatment of the heart and bone infections, the foal developed lameness during its training for flat racing, 18 months post-treatment.
• Upon investigation through radiography, chronic degenerative joint disease was revealed as the cause of this lameness. This indicates the long-term effects of the Rhodococcus equi septic osteoarthritis condition that the foal initially suffered from.