Clinical experiences of treating septic arthritis in the equine by repeated joint lavage: A series of 39 cases

The condition of septic arthritis was treated in 12 foals with 21 affected joints (Group I) and in 27 adult horses. The adult horses were divided into three groups, based on aetiology of the condition: haematogenous (Group II , n = 6), iatrogenic (Group III, n = 6), and perforating trauma (Group TV, n = 15). The treatment consisted of an initial systemic antibiotic that ant icipated the microbial agents that were considered most likely per group, r epeated through-and-through joint lavages every other day and nonsteroidal anti-inflammatory drugs. The antibiotics were adjusted to the results of ba cteriological culture and susceptibility tests. Joint lavages were continue d until the white blood cell count dropped below 15 G/1 and bacteriological culture was negative, after which a single dose of a short-acting corticos teroid was administered intra-articularly. Joint recovery rats in soup T wa s 71 %. Patient recovery rate of the foals, however, was lower (42 %). Thre e foals were killed for reasons other than arthritis; one foal because of a n arthritis-related problem and three foals because of persistent arthritis . Overall joint recovery rate, equalling patient recovery rate, in the adul t horses was 81 %. The expected predominance of Streptococcus spp. in haema togenous arthritis in adult horses was not confirmed, indicating that in th ese cases also, an initial antibiotic treatment with a broad-spectrum combi nation is preferable. It is concluded that with intensive treatment, the pr ognosis of septic arthritis in the adult horse can be classified as fair to even good. Results in the foals are nor as good, but this seems to be more due to the specific problems surrounding the equine neonate than to unresp onsiveness to the treatment.