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  Discussion on Osteomyelitis of the hock
Author Message
Member:
Brnrat

Posted on Friday, Jul 30, 2004 - 12:16 pm:

Dear Dr. O:

Friend has 9 year old warmblood mare (dressage, 3rd level) just diagnosed with osteomyelitis of her left hock by UC Davis. She has been placed on Chloramphenicol orally x8 weeks with a 50/50 chance of recovery. This horse presented 8 weeks ago with asymptomatic swelling of her left hock, no warmth, no tenderness or lameness; no history of soft tissue injury or trauma, no history of previous joint injections. Temperature was normal. Taken to local equine hospital for further evaluation where multiple x-rays, ultrasound and nuclear scintigraphy were performed as well as C&S of joint fluid. Exploratory surgery recommended. At surgery no definitive pathology found other than small piece of unknown fragment being removed (cartilage, occult OCD lesion? - no previous history of OCD). No history of septic arthritis. Culture and sensitivity results negative at that time. Postoperatively she had been doing well without any sign of wound infection, etc. Swelling had nearly resolved. 8 weeks postoperatively she became severely lame along with pronounced swelling in her hock at which time she was taken to UC Davis for further evaluation and treatment. Diagnosis of osteomyelitis was made at that time and treatment instituted. Given that osteomyelitis is extremely difficult to treat orally, wouldn't antibiotic impregnated beads be a better choice here? If not, could you explain why they can't be used in the hock joint and why surgery to the hock is so difficult. Could this have been a latent (aseptic) infection now flaring due to the surgery? Or of iatrogenic causes? Are there any other treatment options?
Moderator:
DrO

Posted on Friday, Jul 30, 2004 - 6:49 pm:

Hello Kristie,
Is the type of second hand case I avoid addressing for two reasons:
There are too many folks between the case and me with the result being a problem getting enough accurate information to answer. There is also the problem that it takes me away from addressing members questions.

If your friend is concerned with improper treatment they should find a practitioner they trust who can carefully examine the horse and review the history to answer the questions you pose.
DrO
Member:
Brnrat

Posted on Monday, Aug 2, 2004 - 11:53 am:

Dear Dr O:
The above question was not posed for litigation purposes only to receive more information on antibiotic impregnated bead usage in horses and as to why surgery on the hock joint is difficult. But thanks for being so honest and I certainly can appreciate your position. KB
Moderator:
DrO

Posted on Monday, Aug 2, 2004 - 6:25 pm:

It was not litigation I was concerned about Kristie, it was being able to make accurate recommendations with the case. If you are asking, "are antibiotic impregnated beads useful for treating septic osteomyelitis/arthrits," I would have answered, "yes it has been useful is selected cases". If you run a search on antibiotic impregnated beads in the big search engine, you will find a scientific report on it. But, that is not the same as saying that is what your friend should be doing.
DrO
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