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Septic Arthritis in the Newborn Foal

By: Dr. Mary Rose Paradis

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Septic arthritis is a bacterial infection of a joint. It is often combined with osteomyelitis, infection of the bone. Lameness or increased joint swelling (effusion) in a neonatal foal should be attributed to a septic arthritis/osteomyelitis process until proven otherwise. Many owners mistakenly believe that the mare must have stepped on the foal to make her lame but in fact the foal has a septic joint. This is important because septic joints need emergency treatment.

Septic arthritis is commonly referred to as joint ill, septic polyarthritis, septic epiphysitis and septic physitis, and is associated with infection of the umbilicus (navel ill).

  • Usually foals have failure of passive transfer of maternal antibodies.

  • Clinically, the foal may present with multiple problems related to septicemia (a wide spread bacterial infection) or they may be normal with the exception of a hot, swollen joint.

  • Because septic arthritis is a painful condition, foals spend more time laying down. Pressure sores may develop over the bony prominences.

  • Fifty percent of the foals with septic arthritis have umbilical abscesses (navel ill).

  • Because the bacteria are spread through the blood stream, a single joint or multiple joints may be affected in a foal.

  • The short term outcome of septic arthritis/osteomyelitis depends on the promptness of treatment, the number of joints involved, the amount of bone destruction and the other body systems that may be involved. Approximately 60 percent of the foals survive the neonatal period.

    Diagnosis

    Lameness and joint swelling in the neonatal foal is an emergency situation. A veterinarian should be called to examine the foal and perform certain diagnostic tests and therapeutic procedures. Tests may include:

  • Complete blood count
  • Chemistry profile
  • Immunoglobulin levels (measure of colostrum intake)
  • Arthrocentesis (collecting a sample of joint fluid)
  • Joint fluid analysis
  • Culture and sensitivity of joint fluid
  • Blood culture
  • Radiographs of the affected joint
  • Ultrasound examination of the umbilical structures of the foal

    Treatment

  • Broad spectrum antibiotics for 3 to 4 weeks
  • Plasma transfusion if immunoglobulins (colostral antibodies) are less than 800 mg/dl
  • Wash the joint every other day until joint fluid is normal and foal is more sound
  • Stall rest for 3 to 4 weeks

    Home Care and Prevention

    It is somewhat difficult to provide the initial care of the foal with septic arthritis at home. Joint lavage (washing or irrigation) needed to be performed by a veterinarian in a clean area under heavy sedation or anesthesia. Because of these factors and the fact that the procedure must be repeated several times, it is probably best done in a hospital situation. Once the joint lavages are completed the foal can continue the antibiotic treatment at home.

    The most important aspect of preventive care is to make sure the foal receives good quality colostrum at birth. This is done by having the birth attended and making sure the foal stands and nurses by 3 hours after birth. If there is any deviation from this pattern or the mare has experienced premature lactation (dripped milk before the foal was born), then this foal is at high risk for septicemia, which could lead to septic arthritis/osteomyelitis.

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