Treatment with continuous intrasynovial antimicrobial infusion for septic synovitis in horses: 31 cases (2000–2003)

Abstract

OBJECTIVE-To determine clinical findings, complications, and outcome of septic synovitis in which continuous intrasynovial antimicrobial infusion (CIAI) was used for local antimicrobial delivery in horses. DESIGN-Retrospective case series. Animals-22 adult horses and 9 foals (horses<1 year of age). PROCEDURES-Records of horses with septic synovitis that had CIAI during treatment were reviewed. The association between clinical variables and whether horses performed their intended use following treatment was determined. RESULTS-42 synovial cavities were treated via CIAI. Twenty-nine cases were chronic (>7 days) in nature, 15 had been refractory to standard treatments, and 13 synovial infections had associated osteomyelitis. Mean duration from infection to initiation of CIAI was 19.7 days, and mean duration of CIAI was 6.1 days. Temporary discharge from the catheter site at the time of removal was evident in 8 horses. Dysfunction of the infusion system occurred in 2 horses and was corrected during the course of treatment. No long-term complications were reported. Thirty-nine (93%) synovial infections in 29 (94%) horses were resolved. Twenty adult horses and 8 foals were discharged from the hospital, and 19 of 24 horses with long-term follow-up performed their intended use. CONCLUSIONS AND CLINICAL RELEVANCE-CIAI was a useful adjunctive treatment for septic synovitis and allowed intrasynovial antimicrobial delivery into a variety of synovial cavities.

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

“…Differences in study populations and treatment modalities make comparisons among studies difficult. In a recent report, 55 the use of continuous intrasynovial antimicrobial infusion provided 94% survival of horses with chronic or complicated septic synovitis, which compares favorably with our results. Continuous intrasynovial antimicrobial infusion could therefore be superior to repeated A-RLP when chronic septic synovial conditions are being treated, although the number of cases was limited.…”

Successful treatment of infectious (Salmonella type III: 44) polyarthritis and osteomyelitis in a 4-week-old foal

“…Regional limb perfusion and intra‐articular injection of ceftiofur has been proven to result in synovial fluid concentrations that exceed the MIC for many common organisms for 24 h (Mills et al . 2000; Lescun et al . 2006; Haggett and Wilson 2008).…”

Endoscopic Surgery in the Management of Contamination and Infection of Joints, Tendon Sheaths, and Bursae

“…Conventional culture and susceptibility testing of synovial fluid can be, and frequently is, unrewarding (Annear et al, 2011;Bertone et al, 1987;Frees et al, 2002;Lescun et al, 2006a;Madison, 1991;Schneider et al, 1992b;Wereszka et al, 2007). Blood culture medium enrichment appears superior to other techniques of bacterial isolation (Dumoulin, 2010).…”

“…Blood culture medium enrichment appears superior to other techniques of bacterial isolation (Dumoulin, 2010). Ideally microbiological samples should be taken before antimicrobial therapy (Bertone et al, 1987;Lescun et al, 2006a), but even in this scenario, empirical treatment is necessary before results are available. There appears to be no difference in culture rates between synovial fluid and membrane (Bertone et al, 1987;Madison et al, 1991), and submission of both together with any recovered pannus is recommended.…”