Facilitated ankylosis of the distal interphalangeal joint in a foal.

A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiographically 7 weeks following surgery. Evaluation of the horse 30 months following surgery revealed complete fusion of the middle and distal phalanges, and the distal sesamoid bone. The horse is pasture sound and is used as a breeding stallion. This report describes the surgical approach and case management employed to achieve facilitated ankylosis as a treatment for unresolved septic arthritis of the distal interphalangeal joint. This is the first report of successful facilitated ankylosis of the distal interphalangeal joint in a foal.

Continuous infusion of gentamicin into the tarsocrural joint of horses.

OBJECTIVE: To develop a method for continuous infusion of gentamicin into the tarsocrural joint of horses, to determine pharmacokinetics of gentamicin in synovial fluid of the tarsocrural joint during continuous infusion, and to evaluate effects of continuous infusion of gentamicin on characteristics of the synovial fluid. ANIMALS: 12 healthy adult horses. PROCEDURE: An infusion catheter consisting of flow control tubing connected to a balloon infuser was used. Gentamicin solution (100 mg/ml) was infused in the right tarsocrural joint and balanced electrolyte solution was infused in the left tarsocrural joint for 5 days. Synovial fluid and serum gentamicin concentrations were measured by use of a fluorescence polarization immunoassay. RESULTS: 17 of the 24 (71%) infusion catheters initially placed functioned without complications for the entire 5-day infusion period. Median gentamicin concentration in synovial fluid from treated joints during the 5-day infusion period ranged from 2875 to 982 microg/ml. Median serum gentamicin concentration during this period ranged from 2.31 to 2.59 microg/ml. Mean (+/- SD) elimination half-life and total clearance of gentamicin from the synovial fluid were 6.25+/-1.01 hours and 1.52+/-0.96 ml/min, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: An infusion catheter can be used for continuous infusion of gentamicin into the tarsocrural joints of horses for up to 5 days. At a gentamicin dosage of 0.17+/-0.02 mg/kg/h, continuous intra-articular infusion results in synovial fluid gentamicin concentrations greater than 100 times the minimal inhibitory concentration reported for common equine pathogens.

Management of rupture of the gastrocnemius and superficial digital flexor muscles with a modified Thomas splint-cast combination in a horse.

A 6-month-old warmblood filly had traumatic rupture in the gastrocnemius and superficial digital flexor muscles of the left hind limb. A modified Thomas splint-cast combination, which was custom fitted to the limb, was placed to prevent further disruption of the caudal reciprocal apparatus. The external coaptation device was removed after 21 days. The horse developed lesions consistent with osteochondrosis of the femoropatellar articulation within 8 weeks of the initial injury. Examination of the horse 6 months after injury revealed fibrous healing of the muscles and restoration of caudal reciprocal apparatus function. There was no obvious difference in the external appearance of the hind limbs.

Sepsis of the common digital extensor tendon sheath secondary to hemicircumferential periosteal transection in a foal.

A 4-month-old Quarter Horse was admitted for evaluation of infection that developed following bilateral hemicircumferential periosteal transection and elevation. Sepsis of the common digital extensor tendon sheath was diagnosed. Treatment included lavage of the tendon sheath, placement of an indwelling drain for lavage after surgery, establishment of drainage, and administration of antimicrobial and anti-inflammatory drugs. Three months after treatment, the foal was clinically normal.