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  Discussion on Swollen infected hock for four months
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New Member:
Help

Posted on Wednesday, Feb 2, 2005 - 10:19 am:

I have a horse that has a severe swollen hock about 11/1/04 hock became very swollen and large / slightly lame no sign of being kicked / puncture are other wound. 11/9/04 called vet 1st exam he x-rayed and ultra sound, found nothing wrong, vet injected him with lvial hyuisc + 40mg depomeDrOl, 11/22/04 leg worsening vet came back applied surpass ointment (fopical nmsteroidal) for 10 days. 11/30/04 horse lameness increased. 12/13/04 brought the horse to a surgical center they evaluated and said severer, chronic effusion in the left hock, with a lameness of 4 out of 5, radiographs were took and revealed mild arthritic change. Horse was then put under anesthesia and a fluid sample was collected from the tarsocrural joint and sent for culture, the joint was examined and flushed arthroscopically. Synovitis was present and synovium was taken and sent for histopathology . The joint contained fibrin and a minor cartilage defects were present on the tibia. There diagnosis: septic (infected) hock joint. Culture report came back no anaerobes in three days, 4days, 5 days, final report no anaerobes isolated in 5 days, Culture report #1 (Aerobic) abundant growth of gram positive organisms, no growth on direct plating media and both culture in 24 hours. #2 Abundant growth of gram negative organisms. Final report Organism #1 Abundant growth (Alpha Hemolytic Streptococci). Horse was sent home with treatment of 80mL of baytril orally once daily for 30 days. On about 20 day of treatment horse became worse with no results from the baytril he was actually worse. Vet was called back he took him off the baytril and started a ejection treatment in his neck (dustal limc perfusion) 1gm gentomycv, for 10 days. Horse became a little better hock is still huge very swollen lamness 3 out of 5 he is currently on 4.7gm Doxicycline orally daily now.

Anyhow I know it’s long winded but about $7000.00 dollars later and 4 months my horse is still lame as ever his hock is just huge, and I am afraid his hock will never shrink. Do you guys have any ideas on treatment, have you heard anything like this before my vet has consulted all his experts and is about to give up he says if this 4.7gm of doxicyline treatment does not work we will have to put him down.

I need help thanks from my horse in az.
Moderator:
DrO

Posted on Thursday, Feb 3, 2005 - 8:50 am:

Oh Jerry, this is really bad news. Has no one radiographed the hock to asses the damage done with what is now 3 months of infection? If not, and the diagnosis correct, I can tell you they will find a badly degenerated joint and no hope of soundness from this horse. This may have been the known outcome as early as just a few days after the infection was first established.

For more on this condition, diagnosis, treatment, and prognosis see Equine Diseases » Lameness » Joint & Bone Diseases » Joint Infection, Joint Ill, and Septic Arthritis.
DrO
Member:
Chohler

Posted on Thursday, Feb 3, 2005 - 12:08 pm:

I'm surpised they used baytril.I thought it was mostly used on dogs. DrO do you think it was because gram negative's?

Jerry is there another vet you could consult with? I would print the treatment section of the article DrO refered you to and present it to your vet or a second vet.

Member:
Help

Posted on Thursday, Feb 3, 2005 - 3:50 pm:

Yes the equine hosptial did radiograph's I stated that above and revealed mild arthritic change, Cheryl my Vet did not put him on baytril the Equine hosptial did that. So anybody have any idea's this was a really good rope horse (I mean the best) do you think that the hock will never be the same after being so large for so log, I mean the hock is double.

Any help would be a plus thanks
Member:
Chohler

Posted on Thursday, Feb 3, 2005 - 4:21 pm:

DrO is the expert but given how long this has gone on your horse has a great chance of being lame.

I think you said there were mild changes above, so there is hope. This should have been caught sooner. The article outlines the better treatments you need to present this to your vet and get started immediately on treating this boy with the good stuff not baytril. Don't overlook the possibility of the lavage treatment at this point in time.

Baytil is a ok antibiotic but I use it primarily on dogs and fish, but this is something important you are dealing with and you need better antibiotics. I have used Amikacin with good results. There are other good ones outlined in the treatment section. With your culture results they should have chosen a better antibiotic.

I don't want to falsely give you hope a lot of time has passed but if your horse has any chance you need to act right away with the big guns. Don't forget Bute is wondeful for inflamation.

I wish you luck, time is of the essence here.

Member:
Chohler

Posted on Thursday, Feb 3, 2005 - 4:23 pm:

I forgot to say my horse had this happen but when we finally found the source we treated as in the article very aggressively, he now has just mild arthritis managed with supplements and liniment.
Moderator:
DrO

Posted on Thursday, Feb 3, 2005 - 5:55 pm:

Jerry you stated those radiographs were taken at the beginning. I am concerned that by now, if there is infection in the joint, the joint will have shown remarkable degeneration. Have them repeated so that you can prognose the future and make better decisions on whether continued expensive treatment is worthwhile. If the joint has not changed since before I think the diagnosis becomes questionable.
DrO
Member:
Help

Posted on Thursday, Feb 3, 2005 - 6:35 pm:

Thanks for the help I read your article on infected (Septic) arthritis, and it sounds like my vet and the equine hospital all did the wrong things, I sent the equine hospital and my vet a copy but they will only take it as a slap in the face I am afraid.

My vet did not take it serious for one trying just local ointment, and then he stuck a needle in the hock to drain it, which nothing came out, so he probably pushed the infection in deeper, and then he ejected it with 40 mg depumelrol ? (Can’t read his writing), he is a good vet so I do not really blame him, its hard to always be right, but the equine hospital I think should had done a better job instead of knocking him out flushing the leg scopeing it for injury’s, prescribing baytril and saying good luck. I did call the equine hospital 1 week later and said look this baytril is not working, they just said well that’s what the lab said was the best treatment and said there was nothing else that we can give him. 20 day’s later my vet took him off the baytril and now we are trying something different, which I mentioned in my first article. But I think I will call another vet for a second opinion.
Member:
Schorses

Posted on Thursday, Feb 3, 2005 - 7:42 pm:

Jerry, 4 yrs ago, my newly purchased 7 yr old TB came up with the same scenario as your horse. Although, he was put on every antibiotic known to man, including oral baytril, which everyone said, why are you giving your horse dog antibiotics? It should have been injected I'm told. Anyway, finally, chloramphenicol, did the job of kicking out the infection. This went on for 8 months, with my horse ending up with severe (according to x-rays) damage to his hock. He was literally 3 legged for for most of that time and I was told he would never be able to be ridden and we also almost put him down, because he stopped eating. I went through 4 vets. The last vet, finally flushed the joint into the 2nd month, but wasn't sure if it really helped. I quit adding up the cost after we hit the $10,000 mark. Anyway, the good news is, my horse is sound and doing 2nd level dressage movements. I will begin showing him this Spring at training level. With proper maintenance, care, and love, my horse pulled through. It was a horrible ordeal, but to me it was well worth it. I hope your story has a happy ending. Hang in there!!!!!!! Your horse is so very lucky to have you.
Member:
Help

Posted on Thursday, Feb 3, 2005 - 9:07 pm:

Thanks that is encouraging, at least bear my horse still loves to eat, tonight his hock is hot and he is sweating, and it’s around 60 degrees here in the valley of the sun (AZ). What to doooooooooooooooooooooooooooooooooo!!!!!!!!!!!!!!!!!!!!!!!!!
Moderator:
DrO

Posted on Friday, Feb 4, 2005 - 7:06 am:

It is hard to tell from the history Jerry whether infection was already present or not at the first visit.

While Sallie's experiences may sound encouraging their is a reason her outcome was good: the hock joint infected was one or two of the low motion joints. Following control of the infection the joint fused and the horse goes sound, I have had several of these following severe traumatic injuries. Your infection is in the tibiotarsal (tarsocrual) joint which once it develops severe DJD will not come sound.

Your best course seems straight forward to me: The prognosis is best determined by a set of radiographs at this time. If the prognosis is acceptable to you the treatment is the joint needs to be flushed at least daily with balanced polyionic fluids and antibiotic until the infection is cleared, a minimum of 5 days I would guess. Systemic antibiotics should be continued during this treatment and at least 2 weeks after.
DrO
Member:
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Posted on Saturday, Feb 5, 2005 - 5:15 pm:

Well” I am taking my horse to another equine hospital Wednesday for a second opinion. One last question though before I go my regular vet keeps switching medicine to fight his infection, but he never does any blood test, shouldn’t you do blood test? To see if the antibodies are going away? The medicine is working are getting better. I mean this horse has got some weird infection in his hock. If a human had an infection they would do blood test every other day.

Thanks Jerry
Moderator:
DrO

Posted on Saturday, Feb 5, 2005 - 5:41 pm:

We do not typically run blood tests for antibody (antibiotic?) levels in adult horses with a focal infection. Normally these would not e a problem in an adult. This is recommended in septic foals because of the variability of the pharmokinetics of the antibiotics and because infection lowers the antibody levels. I don't think your infection has behaved that oddly: without local aggresive flushing it is usual to have problems clearing a intra-articular infection.
DrO
Member:
Sandbox

Posted on Saturday, Feb 5, 2005 - 6:19 pm:

Hang in there, Jerry. You're doing a great job of being persistent and looking for answers. I'll be praying for a positive outcome for your & your horse. ~S
Member:
Chohler

Posted on Wednesday, Feb 9, 2005 - 1:45 pm:

Hi Jerry how is your horse doing?
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