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Discussion on Infected stifle joints
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New Member:
Mszoey
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Posted on Tuesday, Mar 11, 2003 - 1:24 pm:
My 2 week old foal was doing great, living the life of a rumbuctious foal, when I noticed he started to favor a hind leg, than abit of a swollen stifle joint, I took him to a vet he thought he had a trama to the joint, took him home, the swelling went down, then it went to the other side, but much, much worse, I took him back, he lanced the stifle area, which had a considerable amount of infection. this was flushed, he was on genocin and penic. for a week, I now have him home. he has never been depresses, always had an appetite. he still favors the last leg affected. I am now seeing some swelling in the stronger legs' hock. I have Amikacin coming tomorrow to start giving 6 cc injections 2x daily for 10 - 14 days. does this seem to be joint ill? this has been a totally guessing game, this poor little guy has a big heart, but I don't want to fight an endless battle, and have him suffering
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Moderator:
DrO
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Posted on Wednesday, Mar 12, 2003 - 6:27 am:
Hello Sherri,
Since you do not tell us what area of the stifle was lanced (subcutaneous pocket or the joint capsule itself), I do not know it that was a case of joint infection.
Swelling without lameness is not likely to be joint ill. Usually the lameness comes along with the swelling but this should be examined for a diagnosis. Amikacin alone should not be used as it is poor against common gram positive pathogens, see the article for reccomendations.
DrO
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Member:
Mszoey
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Posted on Friday, Mar 14, 2003 - 1:09 pm:
I had post earlier as joint ill? I am in question because I have two vets with conflicting diagnosis. One says joint ill, treat aggressively with Amikacin, the other vet, says that the joints were probably irritated during a hold up in delivery and the joints in return got infected. first one stifle area swelled, than the other swelled imensily. The first came around okay, the second was lanced sub., not the capsule. The colt has not used this leg since it was drained, flushed for a week and on Iv's treated with genoc. and penicl. He eats well, nurses when he can. He lies down more than he is up. I was giving him 6 cc of pen daily since he has been home, (since 3-8-03) than the other vet said this was not aggressive enough, that was why I was seeing no change. the past two days I have treated with Amikacin, 5cc 2xdaily. he had had some swelling starting in the fetlock area of the leg he is not using, since I started the Amikacin the swelling has left. I think his weight could be better, but he does not nurse as well as a norm foal, since he has to work to get to his mother some of the time, ( they are in a run 20'x 40'). I am frustrated going between these 2 vets. they are both wonderful equine vets, but they are saying different things. I could use some advise as to what to do from this point.
I have been giving this colt Maxiflex a glucosmine chrondr. supplement, I have been giving him a 1/2 oz 2 x's daily. I did attempt to give him Foal lac as of last nite, he got approx 3 0z and had diareaha this morning.
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Moderator:
DrO
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Posted on Saturday, Mar 15, 2003 - 7:17 am:
I have put all the posts here: it is important to keep information about a case together.
Swelling of a joint with nonweight bearing lameness is either infected or severly traumaized. The chief clinical difference in the two is the way they begin and develop: infection develops over a 12 to 48 hour time frame while severe trauma starts instantly.
In either case a radiograph is called for to further elucidate a diagnosis and prognosis. To fail to aggressively treat for infection when the possiblity exists means to risk losing the joint to permanant degenerative joint disease. See the article for more on this.
DrO
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Member:
Mszoey
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Posted on Monday, Mar 17, 2003 - 12:11 am:
There have been several radiographs done, and there was no bone or cartlidge damage, at that time. I happened to pull the scab off of the original lanced area in the front of the stifle area, it ran clear, urine looking fluid, it seemed like a great deal. This area was the area that had been flushed and the colt had been on IV's for a week. this was Saturday the 15th. The colt is actually using this leg somewhat today. I do have concern about this area weeping onto his naval stump when he is laying down. I have noticed a lump at the lower bottom side of his neck, where it comes to his chest, at the low end of the jugular area. ?? Would this be any connection to when he was on IV's??
At the end of this week I will be taking the colt back for more radiographs and such.
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Moderator:
DrO
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Posted on Monday, Mar 17, 2003 - 7:38 am:
You should continue to promote the drainage from this area and one of the best ways is with antiseptic hot packs. Warm water with chlorhexidine and clean wask cloths is good. 20 minutes twice a day and applying nitrofurazome spray might keep this open and draining so it will heal inside out.
It is excellent news that he is improving and there are no radiographic abnormalities. You can continue to dip the stump in betadine or chlorhexidine.
The lump should be examined immediately by a veterinarian, it may be nothing, it may be important I cannot judge from here.
DrO
DrO
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Member:
Mszoey
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Posted on Monday, Mar 17, 2003 - 11:16 am:
I cannot begin to thank you enough for your imput. Especially for not seeing the colt and such. I am really concerned about this lump at the base of his neck, it seems to be settling abit deeper into his neck. I will be taking him tomorrow for final radiographs and to see what this lump is. Hopefully we will have a good report, thanks again
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Member:
Mszoey
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Posted on Wednesday, May 7, 2003 - 12:34 pm:
this is in regard to this same colt in previous threads. he has never had anymore infection, but the worse of the two hind legs, the one he did not use to speak of for nearly 2 weeks or better, it had lost all muscle tone between his hind legs and around the outer area, so when he did start using it and putting more weight on it, he started toeing out terribly, the vet kept telling me to give it time to build up muscle and he would come around. Needless to say, he has to be in some sort of pain with the degree his leg is turning out. 3 weeks ago the vet had a shoe made, it was "extremely heavy" had a wing to the outside, a 1/4" lift under the outside. with repeated efforts this shoe was never kept on. I took the colt to another equine vet last wednesday, he was amused at the shoe, said it would never work, and with the weight of the shoe it would have probably caused more damage. he has ordered a plastic shoe from a speciality company with hopes of bringing him back around. This poor colt is 3 months old today, extremely well bred, DrOp dead gorgous, less all the ordeal he has gone through. His front legs are starting to bend forward at the knees also, this same vet suggest we put the plastic shoes on the front also. Please give me some sort of advise, the colt and myself are exhausted, he even jumps in the trailer on his own now, cuz he has made so many trips, (3 hour trips one way). The expense has been high, but my priority is to get this colt headed in the right direction.
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Member:
Hwood
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Posted on Wednesday, May 7, 2003 - 2:42 pm:
Sherri, I admire you for all you are doing to help this colt. Bless your heart. Hope to hear good things in the near future.
Holly
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Moderator:
DrO
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Posted on Wednesday, May 7, 2003 - 9:06 pm:
Hello Sherri,
These are problems that require a accurate diagnosis before treatment can be suggested Sherri. What exactly does the vet say is wrong with which muscles?
DrO
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Member:
Mszoey
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Posted on Friday, May 9, 2003 - 12:47 pm:
The vet has never said there is anything wrong with the muscles, except that they have not been used for some time and they lost their tone, the colt has to build these muscles back up. The muscles I am referring to are the buttock muscles the curved muscle down the back and in between the cheeks. This is flat no curve, but they are building back, since he has started using his leg. But, since he had no real strength in it, he was turning his leg out, from the stifle joint on to his toe. Almost rubbing his hock on the other hock. The vet feels he needs a corrective shoe. Which we have ordered, has anyone used these plastic orthapedic shoes with any luck, or can you even keep them on? Are we working with this problem the right way?
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Moderator:
DrO
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Posted on Friday, May 9, 2003 - 10:16 pm:
A properly constructed shoe is able to effect foot flight Sherri, so this might be effective until the muscles improve, but I must say the remarkable changes in 60 days suggest a more serious problem than just disuse atropy. Has the stifle been reradiographed since the infection has been eliminated.
DrO
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Member:
Mszoey
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Posted on Monday, May 12, 2003 - 12:20 pm:
Yes, there were radiographs done on 4-9-03, all was okay. I just received the shoe this weekend, if I understand right the supplier suggests that the lateral side of the shoe go to the inside of the hoof, if the colt/horse is toeing out. This seems opposite to me of what it should be, would it not seem that the lateral would be to the outside if toeing out? (We are in a very, very remote area, no equine vets for hours.)
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Moderator:
DrO
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Posted on Tuesday, May 13, 2003 - 8:27 am:
Not knowing the shape of the shoe and being unable to see your horse move, I am uncertain which side should be placed out. Be sure you have the help of your vet and farrier working together here.
DrO
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Member:
Mszoey
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Posted on Wednesday, May 14, 2003 - 2:05 am:
I have had extensive help thru 3 different vets, 2 farriers, and a company that consulted with one of the vets for this particular shoe. I spoke with the company today and he reassured me that the lateral definetly went to the inside when toeing out, the farrier is coming tomorrow to help put the shoe on, on to the next saga..,
thank you
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Moderator:
DrO
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Posted on Wednesday, May 14, 2003 - 5:46 am:
What is different about the lateral vs the medial aspect of the shoe Sherri?
DrO
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Member:
Mszoey
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Posted on Wednesday, May 14, 2003 - 5:16 pm:
when I said lateral I was referring to the extension of the shoe. One of my vets. referred to the extension as the lateral, I have used the terminology also, that is used in error. I should have said the extension was being advised to be used to the outside by this same vet. The company and my other vet said to use the extension to the inside since he toes out.
The answer to your question is the lateral would be for toeing in the medial for toeing out.
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Member:
Mszoey
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Posted on Thursday, May 22, 2003 - 12:18 pm:
Dr. "O", my gosh I am now a gurro of putting on orthopedic shoes and which glue will hold, etc. What cleans the hoof an what keeps the glue from holding. Needless to say I did get the shoe on for the most of 3 days, which kept the colt from twisting his toe out when he stepped down, he lost the shoe as of yesterday, since I used acetone to clean his hoof with, instead of alcohol. since this shoe and the glue is so expensive, and not reusable, I decided to get with a professional farrier 2 1/2 hours away, (that uses this type of shoe on world class colts) and a chiropractor, the reason for the chiropractor and my question to you, this leg that was lacking in muscle tone from the beginning of his odeal, seems to be lower in the hip, smaller around the coronet band and actually abit smaller hoof. My thoughts are since we have had no correction going on that his movement has to be affecting his hip, stifle and possibly his hock joint, would this be something I should have a chiropractor look into or should I be going a different route. I am so exhausted trying to get this colt help and not getting anywhere, he came so far along with the infection he had, I just hate to see him have permanent problems that could be corrected if I had the right resources.
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Moderator:
DrO
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Posted on Thursday, May 22, 2003 - 1:45 pm:
Sherri, though this shoe may help the horse place the foot more normally and adjust the foot flight, while the upper leg heals, it will not be therapeutic for problems in the upper leg.
I still do not see anywhere in your posts either a description of a lesion or a diagnosis with what is still wrong with the upper leg, and as I stated earlier do not think this sounds simply like a problem with disuse. You need to find someone who can tell you what accurately what is wrong so a treatment plan and prognosis can be formulated.
DrO
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Member:
Mszoey
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Posted on Thursday, May 22, 2003 - 10:48 pm:
oh - I know, I just don't know what type of vet. to see, that is why I have made this appointment with the chiropractic vet. I am at a loss as to which way to go. As far as diagnosis the vet that I was going to in the beginning, and all along (until the last trip to a different vet), has said he has fully recovered. I to can obviously tell that there must be something else going on or he wouldn't be walking the way he is, this is why I am writing to horse advisor, calling farriers, vets etc. trying to figure out who to get with that can get us going in the right direction. I will try to enclose a photo approx 4 wks ago, bandages were for support, but you can see how he holds the leg and the lack of muscle tone at that stage, he had been using the leg for about 2weeks in that photos.
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Moderator:
DrO
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Posted on Friday, May 23, 2003 - 6:44 am:
I have personally found that chiropractic vets tend toward hmmm.... unsupported diagnosis of unlikely conditions. Hopefully the fellow will be a veterinarian first.
The turned out leg could be:- hip or stifle joint abnormality,
- unbalanced pull on the leg from the muscles
- a concious decision made by the foal to relieve pain.
I would think a careful exam of the way he moves, palpation, and radiography of the stifle would greatly reduce the possibilities.
The generalized mild muscle atrophy of the weight bearing muscles could be 60 days disuse, but would not be a cause of ongoing lameness. I was picturing a bit more focal area of more severe atrophy than pictured here. Let us know what the new vet says.
DrO
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Member:
Mszoey
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Posted on Saturday, May 24, 2003 - 5:57 am:
Thank you for your input on the chiropractor, I was abit hesitant about this Dr. due to some comments he made over the phone. We have a university that I have taken horses and dogs do when I have severe emergencies, this maybe the course that I should take. I have always felt the unbalanced pull on the leg from the muscles was what we were dealing with, but what to do for it was beyond me. When he steps down it is in the position you see in the photo when he steps off the hoof twists even more towards the outside, this action is the action I feel could cause damage from the fetlock joint on up to the hip joint. The shoe I had on him for a few days did keep that twist from happening.
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Moderator:
DrO
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Posted on Saturday, May 24, 2003 - 7:10 am:
I like the university idea.
DrO
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Member:
Mszoey
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Posted on Saturday, May 24, 2003 - 11:58 pm:
Thank you I needed to hear some positive direction coming from someone. This poor colt looks so rough, he really has been through the mill, but he has good spirit and heart. I will let you know what Kansas State Univ. comes up with. Thanks again
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Member:
Mszoey
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Posted on Friday, Jul 18, 2003 - 11:55 am:
I took my colt to the University of Kansas, which I should have done in the very beginning, hindsite is always better than foresite.
At first the attending vets and techs thought his hip was possibly out of joint, with xrays of him lying on his back in a butterfly position the xrays shown that the rim of his hip joint was deteriorated away from the infection, it was assumed the horrible cracking sound we heard (back in march)was some of the trauma to the hip socket at that time.
It is sad to think this colt had to be in pain for a long time, but he had a big heart and you would have never known by the way he carried on.
He had to be put down, it broke our hearts. But, the University suggest the proceedure be done there. After they explained what they wanted to do, we readily agreed. They had us leave the mare and colt in a stall, they put the colt down and left the deceased colt with the mare for alittle more than an hour, so she could except that he was gone, they sedated her abit right before they brought her to us. The mare never whinnied for him, when we got home she never searched for her foal, she excepted he was gone. It was a real blessing not having her tramatized by taking her colt away and having it done differently.
I had this appointment June 16, it has taken me awhile to come to grips with this.
Thank you for all of your time and info.
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Member:
Warwick
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Posted on Friday, Jul 18, 2003 - 12:38 pm:
Sherri
I am so sorry for you. What a valiant little fighter he was and you certainly did everything possible for him. Take comfort in knowing he's out of pain now.
You have my deepest sympathy.
Sue
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Member:
Sunny66
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Posted on Friday, Jul 18, 2003 - 1:49 pm:
Sherri,
He was a beautiful boy - inside and out - my condolences to you and prayers for you as you get through this most difficult time.
Aileen
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Member:
Mszoey
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Posted on Friday, Jul 18, 2003 - 2:59 pm:
Anyone reading this series of messages probably figured this colt to be my first colt, etc., but I raise several show colts each year, each one means just as much to me as the first colt I helped come into God's world. I sincerely love my horses, they are my life and peace of mind, so it means alot to me to have your symphathy and understanding, only a true horse lover would understand
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Member:
Paul303
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Posted on Saturday, Jul 19, 2003 - 12:36 am:
Your baby touched my heart. So did your valient efforts. Every loss is so painful - but it's far outweighed by the joy and fulfillment. Some of us just can't live without horses.
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Moderator:
DrO
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Posted on Sunday, Jul 20, 2003 - 2:41 pm:
My deepest condolences Sherri,
DrO
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