Review of management of horses with wounds involving the hock joint

When a joint is involved in a deep wound it is critical to determine whether the synovial integrity has been broken down and if so early aggressive therapy instituted. Certainly, systemic antibiotics should be instituted but perhaps more important is local antibiotic therapy aimed at reaching inside the joint. Joint lavage, intrasynovial antibiotics, and/or local perfusion with antibiotics have a much better prognosis than good wound care and systemic antibiotics alone.
DrO

A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement
Animals (Basel). 2022 Feb 21;12(4):524.
Authors
Taja Vajs 1 , Omid Nekouei 2 , Nora M Biermann 1
Affiliations

1 University Equine Hospital, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna 1210, Austria.
2 Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong 999077, China.

PMID: 35203232
DOI: 10.3390/ani12040524

Abstract

The tarsus is one of the most common areas of traumatic injury with associated synovial involvement (SI) in horses. The aim of this retrospective study was to describe the clinical presentation, diagnostic procedures, management (emphasizing the type, duration, and route of antimicrobial administration), and outcome of cases with acute soft tissue trauma to the tarsal region. The presenting clinical features, the results of diagnostic modalities, and the initial response to therapy were assessed for their usefulness to predict SI. Medical records of 72 cases were included and SI was diagnosed in 34 cases (47.2%). Increased synovial effusion, lameness on admission (OR = 4.1; 95%CI 1.0-16.4), persistent lameness (OR = 5.7; 95%CI 1.8-17.9), increased blood SAA values (≥200 mg/L) from initial to second measurement (OR = 4.3; 95%CI 1.2-15.5), and wound location on the plantar/plantarolateral/plantaromedial compared to the lateral aspect of the tarsus (OR = 7.0; 95%CI 1.6-30.9) were associated with SI. Radiographs, ultrasonography, and the use of pressure testing when a wound was present proved to be useful in correctly diagnosing SI. The median duration of systemic antimicrobial administration was 8 (IQR: 5 to 9) days and most horses received local antimicrobial therapy. This study highlights several relevant clinical features and their association with SI and emphasizes the usefulness of local antimicrobial therapy in these cases.

Keywords: antimicrobial treatment; equine orthopedic diseases; hock; septic arthritis; wounds.