02/19/2023
Septic Fetlock Joint
ANY wound, regardless of size, near a JOINT, BURSA, OR TENDON SHEATH should be evaluated ASAP by a Veterinarian. Infection, along with inflammation, in any of these synovial structures rapidly deteriorates the tissues and produces severe lameness. The sepsis leads to permanent and irreversible damage if not treated aggressively and appropriately. Fortunately, with the odds not in her favor, this weanling filly has done very well with treatment. Read on if you'd like to know this filly's story!
As horses often have a tendency to do, this young horse made a bad decision, resulting in some nasty lacerations the week before Christmas. She presented for wound evaluation after Christmas when she had developed a severe lameness. We recognized that there was joint fluid (synovial fluid) draining from the middle wound over her fetlock. Time was not on her side, as it had been 6 or 7 days since injury. Septic arthritis will erode cartilage within the affected joint, but even before this, fibrin will form almost immediately. Fibrin makes joint lavage difficult and makes it very hard to permanently clear a joint of bacteria. This filly underwent joint lavage under high pressure (seen in video in comments) with antibiotics injected directly into the joint once the lavage was completed. She also received IV antibiotics daily while hospitalized. Multiple joint lavages (1-3 Liters of sterile fluids depending on joint involved), regional limb perfusions with antibiotics, and IV antibiotics with NSAIDS are all needed to give a joint an ideal chance at recovery. Again, early recognition-typically the day of injury, is best for getting "ahead" of the infection before the inflammation produced by the infection makes resolution more difficult (or impossible). Many a horse is euthanized due to wounds that produce sepsis in joints, tendon sheaths, and bursas. We are SO happy this lucky filly defied the odds. Her fetlock was also injected with RenoVo once the infection was cleared and she had started healing to further support her joint through the healing process. ***Pictures and story shared with owner permission***
