Steel C M, Hunt A R, Adams P L, Robertson I D, Chicken C, Yovich J V, Stick J A
Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Australia.
J Am Vet Med Assoc. 1999 Oct 1;215(7):973-7.
To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis.
Retrospective study.
93 foals with septic arthritis.
Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully.
43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for 6 foals. The femoropatellar and tarsocrural joints were most commonly affected. Osteomyelitis or degenerative joint disease were detected in 59% (46/78) of foals. Failure of passive transfer, pneumonia, and enteritis were common. Foals were treated with lavage, lavage and intra-articular administration of antibiotics, lavage and arthroscopic debridement with or without partial synovectomy, or lavage and arthrotomy to debride infected bone and systemic administration of antibiotics. Seventy-three foals survived to be discharged from hospital, and approximately a third raced. Isolation of Salmonella spp from synovial fluid was associated with an unfavorable prognosis for survival and multisystem disease was associated with an unfavorable prognosis for survival and ability to race; other variables were not significantly associated with survival and ability to race.
With treatment, the prognosis for survival of foals with septic arthritis was favorable, whereas prognosis for ability to race was unfavorable. Multisystem disease, isolation of Salmonella spp from synovial fluid, involvement of multiple joints, and synovial fluid neutrophil count > or = 95% at admission may be of prognostic value.
确定影响患脓毒性关节炎马驹生存预后及运动能力的因素。
回顾性研究。
93匹患脓毒性关节炎的马驹。
查阅病历以获取临床症状、实验室检查结果、影像学检查结果、治疗方法及预后情况。评估纯种马和标准赛马的比赛记录,以确定马驹随后是否参赛以及是否成功参赛。
43匹马驹有1个关节受累,44匹马驹有多个关节受累,6匹马驹的受累关节数量未记录。股髌关节和跗关节最常受累。78匹马驹中有59%(46/78)检测出骨髓炎或退行性关节病。被动转移失败、肺炎和肠炎很常见。马驹接受了灌洗、灌洗联合关节内抗生素给药、灌洗联合关节镜清创术(伴或不伴部分滑膜切除术),或灌洗联合关节切开术以清除感染骨并全身应用抗生素治疗。73匹马驹存活出院,约三分之一参加了比赛。从滑液中分离出沙门氏菌与生存预后不良相关,多系统疾病与生存预后不良及参赛能力相关;其他变量与生存及参赛能力无显著关联。
经治疗,患脓毒性关节炎马驹的生存预后良好,而参赛能力预后不佳。多系统疾病、从滑液中分离出沙门氏菌、多个关节受累以及入院时滑液中性粒细胞计数≥95%可能具有预后价值。