Page 386 - The Veterinary Care of the Horse

• Injection of antibiotic directly into the joint cavity.

• Injection of antibiotic into infected bone.
VetBooks.ir • Implantation of antibiotic impregnated beads into joints with chronic or resistant

infections.

• Regional perfusion of antibiotic. A tourniquet is applied and antibiotic is injected into a
vein to achieve a high concentration of drug to the area.

• Intra-articular or intravenous injection of hyaluronic acid.

• Analgesic and anti-inflammatory drugs such as phenylbutazone to reduce the pain and
inflammation. This is important in the early stages to reduce the likelihood of laminitis

developing in the uninjured limb while the infected limb is non-weight bearing. These
should be stopped as soon as possible as they may mask the early signs of recurrence of

infection.
• Application of bandages to reduce joint swelling and limb oedema. This helps to reduce

the discomfort and improve the blood supply to the region.

• Support bandaging of the opposite limb.
• Box rest is essential in the early stages.

• As the patient responds to treatment and the pain is less intense, passive joint movement

and physiotherapy are important to reduce stiffness and fibrosis of the joint capsule, so
improving the joint function.

• Once the lameness has resolved, walking in hand is gradually introduced.

Monitoring of progress

It is essential that the affected joint is closely monitored as it begins to improve. Any
recurrence or increase of heat, swelling or lameness should be investigated immediately with

follow-up synovial fluid samples.

Prognosis

Prompt diagnosis and aggressive treatment of adult horses with no cartilage damage or

foreign material within the joint cavity carries a reasonably good prognosis. If the diagnosis
is delayed or the joint has pre-existing osteoarthritic changes, the outlook becomes more

guarded.

JOINT ILL IN FOALS (SEPTIC ARTHRITIS)