Page 417 - The Veterinary Care of the Horse

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Figures 9.6a and b Sampling fluid from the digital flexor tendon sheath: a) a sample of synovial fluid is taken from the
DFTS to determine whether it has been contaminated by the wound at the back of the fetlock; b) normal synovial fluid is
clear and straw-coloured but the dark colour of the synovial fluid being withdrawn here indicates that the DFTS has been
breached

TREATMENT

Treatment includes:

• administration of broad spectrum antibiotics
• surgical drainage and flushing of the infected sheath to remove bacteria and other debris

(Figure 9.7)

• surgical removal of any adhesions or grossly infected and thickened synovial membrane
• infusion of antibiotics into the tendon sheath

• a drain may be implanted so the sheath can be regularly flushed and infused with

antibiotics
• the annular ligament may be surgically cut to release the pressure on the tendon sheath

• administration of non-steroidal anti-inflammatory drugs, e.g. phenylbutazone

• box rest and bandaging

• early introduction of walking in hand or passive flexing of the distal limb to reduce

adhesions forming
• elevating the heel in the early stages may make the horse more comfortable

• when the tendon sheath has healed and the infection resolved, the sheath may be injected

with hyaluronan as this is reported to reduce adhesions forming
• if there is extensive soft tissue injury, a cast may be applied once the tendon sheath has

healed to minimize movement of the soft tissues.