Factors associated with prognosis for survival and athletic use in foals with septic arthritis: 93 cases (1987–1994)

Catherine M. Steel From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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Andrew R. Hunt From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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Paul L. E. Adams From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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Ian D. Robertson From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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Catherine Chicken From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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John V. Yovich From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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John A. Stick From the Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, WA 6150, Australia (Steel, Hunt, Robertson, Yovich); Scone Veterinary Hospital, Scone, NSW 2337, Australia (Adams, Chicken); and the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314 (Stick).

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Objective

To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis.

Design

Retrospective study.

Animals

93 foals with septic arthritis.

Procedure

Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully.

Results

43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for 6 foals. The femoropatellar and tarsocrural joints were most commonly affected. Osteomyelitis or degenerative joint disease were detected in 59% (46/78) of foals. Failure of passive transfer, pneumonia, and enteritis were common. Foals were treated with lavage, lavage and intra-articular administration of antibiotics, lavage and arthroscopic debridement with or without partial synovectomy, or lavage and arthrotomy to debride infected bone and systemic administration of antibiotics. Seventy-three foals survived to be discharged from hospital, and approximately a third raced. Isolation of Salmonella spp from synovial fluid was associated with an unfavorable prognosis for survival and multisystem disease was associated with an unfavorable prognosis for survival and ability to race; other variables were not significantly associated with survival and ability to race.

Conclusions and Clinical Relevance

With treatment, the prognosis for survival of foals with septic arthritis was favorable, whereas prognosis for ability to race was unfavorable. Multisystem disease, isolation of Salmonella spp from synovial fluid, involvement of multiple joints, and synovial fluid neutrophil count ≥ 95% at admission may be of prognostic value. (J Am Vet Med Assoc 1999;215:973–977)

Objective

To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis.

Design

Retrospective study.

Animals

93 foals with septic arthritis.

Procedure

Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully.

Results

43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for 6 foals. The femoropatellar and tarsocrural joints were most commonly affected. Osteomyelitis or degenerative joint disease were detected in 59% (46/78) of foals. Failure of passive transfer, pneumonia, and enteritis were common. Foals were treated with lavage, lavage and intra-articular administration of antibiotics, lavage and arthroscopic debridement with or without partial synovectomy, or lavage and arthrotomy to debride infected bone and systemic administration of antibiotics. Seventy-three foals survived to be discharged from hospital, and approximately a third raced. Isolation of Salmonella spp from synovial fluid was associated with an unfavorable prognosis for survival and multisystem disease was associated with an unfavorable prognosis for survival and ability to race; other variables were not significantly associated with survival and ability to race.

Conclusions and Clinical Relevance

With treatment, the prognosis for survival of foals with septic arthritis was favorable, whereas prognosis for ability to race was unfavorable. Multisystem disease, isolation of Salmonella spp from synovial fluid, involvement of multiple joints, and synovial fluid neutrophil count ≥ 95% at admission may be of prognostic value. (J Am Vet Med Assoc 1999;215:973–977)

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