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  Discussion on Infection in tendon
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New Member:
abc123

Posted on Wednesday, Aug 4, 2010 - 12:51 am:

I have a horse that cut his lower hind leg just below the ankle. It got an infection in it and it took almost 2 months to get the bacteria killed. We thought the whole time we were going to loose him. He had surgery on it at A&M. He will be in the pasture for 12 to 18 months for the tendon to repair itself. I was wanting to know if anyone has had this type of injury or infection in a tendon so you could possible tell me if he has a chance of ever barrel racing again.
Member:
vickiann

Posted on Wednesday, Aug 4, 2010 - 5:48 pm:

Dr. O will have to answer this but early intervention and aggressive treatment are important to having a better chance for full recovery.

There are several articles available on this site and you will want to read this one: https://www.horseadvice.com/horse/messages/4/7173.html
and others.

I wonder if it would be helpful to put the horse on an aggressive course of Adequan to help prevent arthritis.

Welcome to HA, which is a wonderful resource for horse owners and horse lovers. I hope that your horse's recovery will progress well.
Moderator:
DrO

Posted on Wednesday, Aug 4, 2010 - 6:32 pm:

Welcome nvaughn,
Your post does not really give enough information to judge whether someone else's injury is similar or not. This is a very common injury and can vary tremendously depending on the severity (depth and blunt trauma) of the injury. Often these injuries do amazingly well despite invasion of the tendon sheath but the best answer on prognosis is going to be by those who have examined the horse. What do they say?
DrO
Member:
rtrotter

Posted on Wednesday, Aug 4, 2010 - 8:13 pm:

Hello Nvaughn,
I welcome you to HA too. What kind of surgery did your horse have?

I did have a horse that had an infection in a tendon from a cut he got from hitting his knee in a race. He was not kept on antibiotics long enough and the infection traveled down his leg and abcessed out the back of his front leg. I took him on as a project after his original owner got him back in very poor condition with an ongoing infection in the leg.

He was on antibiotics for months, turned out in a large field with another calm horse. He wore a combination bandage that started at the ankle and ended halfway between his shoulder and his knee, so I could keep the wound site clean. I hyDrOgen peroxided him, hosed him and did him up in ichtamol( I would change this routine if I was doing it today, I would use Dr. O's method, no hyDrOgen peroxide and probably wouldn't cover or use ichthamol, instead I would hose more often and use something cool such as Nolvasan or Alu-shield.

After a few months, when the leg showed significant improvement. I started putting him back to work, very slowly. Six months later he was racing. The entire time he did not take a lame step, the leg got better and better, until unless you knew what you were looking for you would have never known this horse had blown an abscess out the back of his leg.

In your horses case though, you are dealing with a surgery and the cut was in a different place, so the prognosis and determination of what kind of horse he will be after he heals, may be different then what you expect and you will have to make that judgement call when he is totally healed and after his rehab period.

Rachelle
New Member:
abc123

Posted on Saturday, Aug 7, 2010 - 2:28 am:

The initial injury occurred on Sept 10, 2009. He was presented to A&M on 10/30/09. The cut to his leg did not touch the tendon, just the infection that occurred affected the tendon. He had a right hind limb tendon sheath culture on 11/5/09-streptococcus equi ssp zooepidermicus was isolated from His tendon sheath wash. It was susceptible to nearly all tested antibiotics. Culture and Sensitivity of Tendon Sheath Fluid on 11-11-09-Citrobacter freundii was isolated. The bacteria isolated was resistant to all antibiotics except for imipenem, cefepime, and levofloxacin. cytology of Tendon Sheath Fluid on 11-20-09-There were many nucleated cells and no infectious agents were seen. The findings were consistent with mild to moderate suppurative inflammation. Cytology of Tendon Sheath Fluid 11-25-09-One direct and one concentated smear, as well as one cytospin preparation from fluid collected from the tendon sheath are examined. The samples were of low cellularity with regards to nucleated cells and no infectious agents were seen. His diagnosis: Septic digital flexor tendon sheath of right hind limb. Treatment: on the day of arrival, he was enesthetized for collection of fluid samples from flexor tendon sheath, fetlock joint tap, tendon sheath flush, and entravenous regional limb perfusion wht Ticarcillin. Amikacin was infused int the fetlock joint after arthrocentesis. afresh bandage was applied to the lower limb. He was started on antibiotics and bute. Tenoscopy of his right hind digital flexor tendon sheath was performed on Monday 11-2-09. The tendon sheath was thoroughly flushed, and fibrin and other debris were removed. Post-operatively, he received regular bandage changes and daily regional limb perfusions. After receiving culture and sensitivity results on several different occassion, appropriate antibiotics were selected for each isolate,respectively. Post-operatively, tendon sheath lavages were performed every 1-2 days and on gram of amikacin was instilled into the tendon sheath. Due to his gastrointestinal irritation potassium penicillin was substituted with doxycycline. Doxycycline was discontinued and he was kept on phenylbutazone IV and gentamicin IV from 10-31-09 to 11-28-09. This was everything that happened at A&M. He came home on Dec. 6,09 where we began his rehab. He was confined to a stall for about 3 months with little hand walking during that time. He has now been in the pasture for about 3 months. His ankle is still a little swollen, but if you didnt know he was hurt you really couldn't tell. He is really walking good on it. He does still hold it up alot keeping his weight off it. He is still really stiff in the ankle area. That is one of my main concerns if he will be able to get flex back in his ankle. I will start his rehab in about 6 more months of riding in a walk.
Moderator:
DrO

Posted on Saturday, Aug 7, 2010 - 7:12 am:

Thanks for the background nvaughn. What was the prognosis from A&M and what did they attribute the stiffness in the ankle to?
DrO
New Member:
abc123

Posted on Sunday, Aug 8, 2010 - 1:04 am:

They said that in 16-18 months he should be as comfortable as he is going to be and hope that he is capable of athletic performance. My vet said that the flexability would be the last thing to come back. I was just hoping you had seen this type of situation to give me a little more hope. I will ask my vet more about the stiffness and get back to you. thanks so much
New Member:
abc123

Posted on Sunday, Aug 8, 2010 - 1:07 am:

Thanks Vickiann for your information. I will let you know how everything turns out.
New Member:
abc123

Posted on Sunday, Aug 8, 2010 - 1:13 am:

Hi rtrotter

Thanks so much for your story. I'm glad your horse is doing well. It was really hard for several months tending to him, but he is now in the pasture and getting along fairly well. My 10yr old is patiently waiting for her horse to get well.
Moderator:
DrO

Posted on Sunday, Aug 8, 2010 - 7:34 am:

nvaughn, I have not seen a infection of the flexor tendon sheath that results (if I understand your post right) in a mechanical decrease in flexion of the fetlock. But either of these events alone decrease the chance of your horse returning to a advanced level of athletic ability as required by barrel racing. Then again it sounds like you have had excellent treatment. I will keep my fingers crossed for you.
DrO
Member:
abc123

Posted on Monday, Aug 9, 2010 - 12:12 am:

Thanks Dr.O
I'm gonna stay hopeful until the end.
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