Synovial Sepsis Occurrence in One U.K. Equine Practice

With no hair clipping and a five-minute site prep, the frequency of synovial sepsis in this population of horses treated by ambulatory veterinarians was low.
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The frequency of synovial sepsis in this population of horses treated by ambulatory veterinarians was low.

A research article titled "Synovial sepsis is rare following intrasynovial medication in equine ambulatory practice" was aimed to determine the incidence of synovial sepsis following intrasynovial medication in a single UK ambulatory practice. The article was authored by Smith, L.C.R.; Wylie, C.E.; Palmer, L., Ramzan, P.L.

In this retrospective study, clinical records of all horses undergoing intrasynovial medication between January 2006 and December 2011 were analyzed. Intrasynovial injections performed for diagnostic analgesia were not included in the study. 

The hair overlying the injection site was not routinely clipped and the site prepared for a minimum of 5 minutes using a combination of chlorhexidine gluconate and surgical spirit. Sterile gloves and new vials of medication were used, with concurrent use of amikacin sulphate being dependent on clinician preference. A bandage was usually placed following medication of synovial spaces of the distal limb.

In total, 9,456 intrasynovial medications were included in the study. Four cases (0.23%) of post-medication synovial sepsis occurred in four individual horses, with sepsis being detected 1–17 days post-medication. Synovial sepsis developed following middle carpal joint medication in three horses and following metacarpophalangeal joint medication in one horse. Two of these cases were medicated with polysulphated glycosaminoglycans and hyaluronate (one of which also received concurrent medication with amikacin sulphate) and two were medicated with triamcinolone acetonide and hyaluronate.

Bottom line: The frequency of synovial sepsis in this population of horses treated by ambulatory veterinarians was low.

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