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To compare the analgesic and anti-inflammatory effects of the nonsteroidal anti-inflammatory drugs (NSAID), ketoprofen (2.20 and 3.63 mg/kg of body weight) and phenylbutazone (4.40 mg/kg), in an acute equine synovitis model.


4 groups of 6 horses received NSAID or saline solution in a randomized design.


24 clinically normal mares and geldings.


Left intercarpal joints were injected with sterile carrageenan to induce synovitis at the same time as IV administration of NSAID or saline solution. Clinical assessments were made and synovial fluid was withdrawn at 0, 1, 3, 6, 9, 12, 24, and 48 hours.


The eicosanoids, prostaglandin E2 (PGE2) and leukotriene B4, increased in synovial fluid after synovitis induction in all horses then returned to near baseline by 48 hours. All NSAID-treated horses had decreased PGE2, compared with saline-treated horses. This effect lasted longer in phenylbutazone-treated horses than in ketoprofen-treated horses. There were no treatment effects on leukotriene B4. In saline-treated animals, lameness, joint temperature, and synovial fluid volume, protein concentration, and nucleated cells increased 3 to 12 hours after induction, with marked reduction by 48 hours. Only phenylbutazone treatment reduced lameness, joint temperature, and synovial fluid volume.


Phenylbutazone was more effective than ketoprofen in reducing lameness, joint temperature, synovial fluid volume, and synovial fluid PGE2. Results do not support lipoxygenase inhibition by either NSAID.

Clinical Relevance

This reversible model induced synovial fluid alterations similar to those observed in horses with septic arthritis. Results indicate that phenylbutazone may be more useful than ketoprofen in treating acute joint inflammation. (Am J Vet Res 1996;57:866–874)

Free access
in American Journal of Veterinary Research


A study was done to determine whether intra-articular pressure is increased in equine metacarpophalangeal joints with increasing degrees of synovial distention, and to correlate elastance of the soft tissue forming the dorsal pouch of the metacarpophalangeal joint to maximal range of motion in flexion. Sixty-seven metacarpophalangeal joints in 36 horses were categorized by palpation and visual inspection of the palmar pouch into 1 of 4 increasing grades of distention. Intra-articular pressures were then measured, using 2 pressure transducers attached to 22-gauge needles, from the dorsal and palmar pouches simultaneously while horses stood squarely under mild sedation. Intra-articular pressure ranged from −13 to +78 mm of Hg. Mean (± sem) palmar pouch pressure was subatmospheric (−2.53 ± 2.78 mm of Hg) in joints in which the palmar pouch was not discernible (grade 0), and was markedly increased (+37.13 ± 2.775 mm of Hg) in joints in which the palmar pouch was distended laterally beyond the lateral branch of the suspensory ligament (grade 3). Grade of distention was positively correlated with intra-articular pressure (r = 0.758; P < 0.001). Significant compartmentation (P < 0.002) was observed between the dorsal and palmar pouches in all horses. In 25 of the aforementioned horses (42 joints), which were active or retired Thoroughbred racehorses with variable degree of metacarpophalangeal joint injury/disease, a third needle was inserted into the dorsal pouch, and 0.5-ml increments of saline solution were added every 10 seconds to perform a pressure/volume (elastance) study of the dorsal pouch. The elastance study for each joint ended when leakage into the palmar pouch was detected by the pressure transducer placed in that region. A flexed lateral radiographic view was taken of each metacarpophalangeal joint in maximal flexion. The maximal angle of flexion was measured from the radiograph, and this angle was subtracted from 180° to acquire the range of motion in flexion. Range of motion in flexion has strong negative correlation (r = −0.68; P < 0.0001) with elastance (stiffness) of the dorsal pouch, and moderate negative correlation with the initial baseline pressure in the palmar (r = −0.47; P < 0.0015) and dorsal pouches (r = −0.48; P < 0.0001). To adjust for the possible correlations resulting from repeated measures on limbs within horses, a normal linear mixed model was used to assess the effect of limb (right vs left), range of motion in flexion, and volume of saline solution added on the dependent variable (Δ mm of Hg) in the elastance study. There was no significant limb effect, but a highly significant effect regarding volume of saline solution added (P < 0.00001) and range of motion in flexion (P < 0.00001). Loss of range of motion in flexion of this joint is associated with shortening or loss of the initial low elastance (flat) phase of the elastance profile. Measuring the elastance of the dorsal pouch or measuring maximal range of motion in flexion provides an objective measure of the degree of metacarpophalangeal joint stiffness secondary to joint disease.

Free access
in American Journal of Veterinary Research


To evaluate the clinical, laboratory, and histologic effects of 2 methods of treatment for infectious arthritis in horses, Staphylococcus aureus (3.4 to 3.9 × 103 colony-forming units) was inoculated into the tarsocrural joints of 8 horses on day 0. Each horse was treated with phenylbutazone (2 g, po, q 24 h) and gentamicin sulfate (2.2 mg/kg of body weight, iv, q 8 h) for 14 days. On day 2, general anesthesia was induced, and each horse had 1 tarsocrural joint treated by arthrotomy, with removal of accessible fibrin and lavage with 3 L of sterile balanced electrolyte solution. An indwelling plastic drain was placed in the standing horse to provide a means for lavage with 3 L of balanced electrolyte solution twice daily for 72 hours. The contralateral tarsocrural joint was treated via arthroscopic debridement, synovectomy, and lavage with 3 L of balanced electrolyte solution. Arthrotomy and arthroscopic portals were allowed to heal by second intention. Lameness and thermographic examinations, analysis and bacteriologic culture of synovia, cbc, and wbc differential count were performed prior to inoculation and on days 1, 3, 6, 8, and 13. On day 14, each horse was euthanatized, and the joints were measured, opened, and photographed. Synovium and articular cartilage were obtained for semiquantitative histologic (H&E stain) and histochemical (safranin O fast green stain) evaluation. Lameness and joint circumference were significantly (P < 0.05) greater in limbs treated by arthroscopy, synovectomy, and lavage. Arthrotomy with lavage eliminated the S aureus infection significantly (P < 0.05) earlier than arthroscopy, synovectomy, and lavage; however, both treatments eliminated the infection in all but a single joint. Contamination with other organisms (Streptococcus spp and Enterobacter spp) developed significantly (P < 0.05) more often in joints treated by arthrotomy. These results suggested that arthrotomy with lavage was more effective in eliminating joint infection by providing better drainage than arthroscopy, synovectomy, and lavage; however, arthrotomy had a higher risk of ascending bacterial contamination of the joint.

Free access
in American Journal of Veterinary Research