Effect of arthroscopic lavage and repeated intra‐articular administrations of antibiotic in adult horses and foals with septic arthritis

• Published in: Veterinary surgery Vol. 46; no. 7; pp. 1008 - 1016
• Main Authors: Cousty, Matthieu, David Stack, John, Tricaud, Cyril, David, Florent
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-10-2017
• Subjects: Aging; Animals; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotics; Arthritis; Arthritis, Infectious - drug therapy; Arthritis, Infectious - surgery; Arthritis, Infectious - veterinary; Female; Horse Diseases - drug therapy; Horse Diseases - surgery; Horses; Injections, Intra-Articular; Juveniles; Knee; Leukocytes (neutrophilic); Male; Neutrophils; Proteins; Retrospective Studies; Synovial fluid; Synovial Fluid - metabolism; Synovitis; Synovitis - veterinary; Therapeutic Irrigation - veterinary
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.12696

Objective
To evaluate the effect of arthroscopic lavage and repeated intra‐articular administration of antibiotic in adult horses and foals with septic arthritis.
Study design
Retrospective clinical study.
Animals
Adult horses and foals with septic arthritis (n = 62).
Methods
Age, sex, cause of septic synovitis, joint involved, hospitalization time, and outcome were recorded. Arthroscopic lavage was performed at day 0 (D 0). Synovial fluid was collected every 48 hours prior to intra‐articular administration of antibiotic, and until hospital discharge. Synovial nucleated cell count, total protein, and percentage of neutrophils were compared across time and between subjects with a favorable or unfavorable outcome.
Results
Synovial nucleated cell counts decreased progressively and were lower at all times compared to D 0. Percentages of neutrophils were lower than baseline at D 8 and 10, only. Total protein contents decreased progressively and were lower than baseline at D 2, 4, 6, 8, 10, and 14. When adult horses and foals with a favorable outcome were compared to those with an unfavorable outcome, the nucleated cell count was lower at D 10, 12, and 14 and the percentage of neutrophils was lower at D 4 only, but total protein content did not differ between groups at any time.
Conclusion
Synovial nucleated cell counts and total protein concentrations decreased after arthroscopic lavage and repeated intra‐articular administration of antibiotic in horses and foals with septic arthritis. Synovial nucleated cell count is limited as a monitoring tool during treatment of septic arthritis.