Osteomyelitis in foals, a retrospective case series

Abstract

In this study we examined cases involving osteomyelitis in foals without concurrent septic arthritis, we concentrated the study around cases of e-type osteomyelitis where the synovial structure was not involved. Looking particularly into clinical etiology, diagnostic approaches and treatment. To gain a better understanding of the differences, we compared the findings with findings in previous published studies on septic arthritis/ osteomyelitis. Though several studies are done on osteomyelitis with concurrent septic synovitis, not much is known about osteomyelitis without synovial involvement.

In this study we examined cases involving osteomyelitis in foals without concurrent septic arthritis, we concentrated the study around cases of e-type osteomyelitis where the synovial structure was not involved. Looking particularly into clinical etiology, diagnostic approaches and treatment. To gain a better understanding of the differences, we compared the findings with findings in previous published studies on septic arthritis/ osteomyelitis. Though several studies are done on osteomyelitis with concurrent septic synovitis, not much is known about osteomyelitis without synovial involvement. To gain a better understanding of this topic we reviewed cases from Hagyard Equine Medical Institute on osteomyelitis without concurrent septic synovitis. Foals were included in the study if they were under 1 year old, have radiographic or other imaging evidence of osteomyelitis and exhibit relevant clinical signs. In our study we found that the most common bacteria isolated was Rhodococcus equi, most foals presented with leukocytosis and hyperfibrinogenemia. The septic focus could be found all over the body but the most common placement was the vertebral column. No typical antibiotic combination was administered, though Clarithromycin was the most commonly chosen antibiotic. We also had a 90% survival rate and the number of horses raced was similar to studies published on osteomyelitis/septic arthritis. Compared to the previous published studies the survival rate in our study was significantly higher, the number of Rhodococcus equi was also significantly higher. In our study hyperbaric oxygen therapy was used as additional therapy, this is not documented in previously published studies.