Bone Infections

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Bone Infections

This is a discussion on Bone Infections within the Horse Health forums, part of the Keeping and Caring for Horses category
  • How to tell if a horse has an infection in the bone
  • Chloramphenicol for bone infection in horses

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    10-18-2012, 12:59 PM
Bone Infections

My mare has finally been diagnosed with a bone infection after 5 weeks of scratching our heads and trying multiple different things to heal her. I've been working with my vet closely on this, she's been on antibiotics, Penicillin, Gentamicin, and now SMZ tablets for over a month. 2 sets of xrays...the first set back on Labor Day when this whole mess started...were 100% clear of anything and everything, and then yesterday, when a puncture site was visible and so was an infection on her bone, 2 joint flushes when we found out bacteria was in the joint and her joint fluid was compromised etc.

Her joint fluid has actually begun to rebuild itself. Before the 1st flush, the fluid was a watery substance. It's supposed to be really sticky like syrup. Before the 2nd joint flush...6 days later...the fluid had rebuilt itself considerably. And the culture grew no we thought we were clear. But the swelling just wouldn't go away. Hence the xrays yesterday and another wrench thrown into the recovery process.

She is still walking on it fairly well. A little bit of a hitch/ouchy moment now and then but this is much better then 4 weeks ago when she could not place weight on this leg at all. But honestly, at a walk...I don't see much change in her gait from when she was sound. At a trot, she's lame.

I'm curious if anyone here has had personal experience dealing with this. I have researched and researched online and haven't found much information on specifically what I am looking for.

My vet has recommended surgery to remove the infection. I'm wondering if it's going to be worth it. As of right now, I'm looking at more horror stories than anything good. I want to know what type of surgery I'm looking at, pros/cons, recovery time etc. My vet sent my mares xrays to 3 different vets, including Michigan State University so I'm waiting to hear back from her, but I'm impatient and want some

I don't want to go through all of this, and have a pasture pet in the end. I already have one horse I can't use for competing anymore, I don't need another one that I can't even ride.

Have you dealt with a bone infection before? How was it treated? Did your horse recover? Was it sound for riding? Competing?
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    10-18-2012, 01:52 PM
Super Moderator
I've had several joint infections. I have also had cases of actual bone infections that showed up as dark spots on the bone indicating necrotic bone. I had one in a coffin bone from a nail that went through the sole and actually hit the coffin bone. I was told to just put her down as the surgery was worth much more than the horse and they said she would probably would never be sound after that.

We opted for treating all of them with either IV Gentocin 2X a day or treating with Chloramphenicol.

Two were completely sound after treatment and two I am not sure about. One was sold as 'breeding sound only' and I lost track of the other but she was sound when she left. We were not sure she would stand hard riding so sold her cheap to a person we know. She had gotten a Bois d'arc thorn in her ankle that penetrated the joint.

I know most of the problem clearing them up is not treating aggressively enough or long enough. My preference and best results have come for using Chloramphenicol -- aggressively. 10 Grams / day, 5 AM and 5 PM is what we used. We have used the Chloramphenicol for a joint levage 2 or 3 times and then used it 2X a day systemically after that. We have never been able to culture (even anaerobically) the organism involved. I do not know why.

What joint is involved and what was the initial injury?
    10-18-2012, 02:36 PM
We were unsure what exactly happened. She had been at my trainers for 2-1/2 weeks when I got the call that she was not putting weight on her back right leg. It was worse when she was stalled, she would limp when she was turned out but wouldn't place weight on it at all when she was confined to a small area.

There was no cut. No blood. No puncture wound. Nothing to indicate anything except for swelling and a limp and it was warm to touch.

I had my vet out that day, xrays done because I wanted to make sure there was not fracture. Her hock was swollen, we decided it was sprained and to give her some time off. So I took her home the following day, and then it exploded overnight into this hugely swollen mess. Vet was out that day. Started antibiotics right away, she had a low grade temp. Vet put a cath in and we got IV Gent into her right away. She was on 30cc Gent once daily, and 30cc Penicillin twice a day. 5 shots a day for 1 week. By then end of the week, she was feeling better. Placing weight onto that leg, and would walk, extremely lamely though. When she started to get a major attitude about the shots and it became hard to give them to her, we switched to SMZ tablets.

My vet originally tried to get a sample of whatever was causing the swelling. But we were not able to. The needle that was placed only pulled out a bunch of blood, indicating trauma.

Now we know that she was punctured with something directly into the bone, causing the trauma and the start of the infection. But we just don't know what. My vet is going to send me copies of the Xrays, I'll post when I get them. Maybe someone can see something that we have missed previously? Who knows.

I don't know the specific name of the joint. It's on the inside of her right hind leg. My vet gives me the laymen's terms of "big rocker joint" which was the best place to have a joint infection she said because it didn't have all these tiny little bones linked together where the bacteria could hide. But the Xrays indicate that the puncture is actually above the joint...not into the joint.

Here are pictures I have taken from day one, throughout her "recovery" and where we are at right now. The swelling diminishes some days, and it worse on other days.

Pictures are in order from the day that this leg blew up and we found out she has cellulitis caused by a bacterial infection, to how it appears today. She wouldn't place weight on the leg for approximately 4 days. 5th picture shows the day she was comfortable enough to put weight on the leg. She was on stall rest for 1 week.

The full thread I started on this from day 1 is now 15 pages long, but can be seen here. I posted updates every few days and it's more detailed in what we have done to try and get her well. completely freaking out

Picture with the red line is the most up to date photo I have at this moment. I put the line there to indicate where the xray showed the bone infection. This is also the point that is usually the most swollen. (Makes sense, right?)
Attached Images
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    10-18-2012, 06:53 PM
Green Broke
Horses will come up w/the weirdest ailments. I imagine this has already cost quite a bit-& you don't have a clear idea of her future soundness & what that will cost to get there. At least your vet has sent records of & is asking for advice on this. Hope you get some solid answers soon so you can make a decision. Do hope your horse is feeling better soon.
    10-18-2012, 09:46 PM
Super Moderator
I think SMZs and Penicillin are pretty useless on these kinds of infections.

Gentocin / Gentomycin used to be pretty effective, but not so much any more.

I would sure switch to Chloramphenicol or Amakacin. Chloramphenicol has worked very well for us. It has the added convenience of being available from a Compounding Pharmacist in a paste form and can be given orally 2 or 3 times a day. It is really effective, but can also eliminate a lot of the 'good' bacteria from the gut. We have always replaced it as we went, but some horses still get pretty loose on it and lose weight because of it. It is worth it if it saves the horse and it soundness.

When was the last joint lavage? Your Vet missed the boat when he/she did not do a CBC the very first day the horse came up that lame when the joint was hot and the horse had a low-grade Temperature.

I have never seen a good 'useful' culture from an infected joint. They usually have a coffee colored fluid in them, but for some reason, it won't grow a culture. Good joint fluid should be oily -- not sticky.
    10-18-2012, 10:08 PM
I will ask about switching off of the SMZ's and onto the Chlorampohenicol. (Whew, what a word!)

Now, I'm not sure if you'd know this Cherie. Will a bone infection go away with antibiotics? Or will it absolutely NEED surgery to remove the infection? I've done some research, and came up with a few instances of people getting bone infections and they just were on extremely prolonged antibiotics to cure it. No surgery was involved.

Her last joint flush was...Tuesday the 9th. The first joint sample we got, you could tell immediately it was infected. I could see through the clear tube that it was cloudy, brownish and contaminated. The 2nd sample we pulled before the 2nd flush, was a ton less cloudy and very "yellowish" like urine. The first sample grew a bunch of bacteria. The 2nd grew none. Of course, like you said, it could be a bad batch. You just never know...

Tonight, when I went to catch Rumor, she took off sprinting, bucking and acting like a complete fool. She even reared all the way up playing with my other mare before she came back up to me. And she did not look lame in her gaits. Even her canter was pretty rhythmic and balanced, which since her injury/illness, it has not been because she was so lame she'd hold it up and look like a freaking deer jumping around.
    10-20-2012, 07:11 PM
This is how she is moving today. Exactly 8 weeks to the day of when all this crap started.

    10-20-2012, 07:24 PM
She appears to be healing. Good for you !
    10-20-2012, 07:32 PM
Oh yeah, by the way, she's the dark brown muddy one. LoL.

Thank you Stevenson, im happy we got her this far. Before she couldnt even walk/put weight on it. But id like to get her 110%.
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