Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar
Septic tenosynovitis involving the digital sheath is a relatively common problem in the horse and the prognosis has been considered as poor. However, there are only few studies confirming this. The purpose of this study is to increase the knowledge about the prognosis for septic tenosynovitis in the...
| Autor principal: | |
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| Formato: | L3 |
| Lenguaje: | sueco Inglés |
| Publicado: |
SLU/Dept. of Clinical Sciences (until 231231)
2007
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| Materias: |
| _version_ | 1855571920548790272 |
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| author | Nääs, Rebecca |
| author_browse | Nääs, Rebecca |
| author_facet | Nääs, Rebecca |
| author_sort | Nääs, Rebecca |
| collection | Epsilon Archive for Student Projects |
| description | Septic tenosynovitis involving the digital sheath is a relatively common problem in the horse and the prognosis has been considered as poor. However, there are only few studies confirming this. The purpose of this study is to increase the knowledge about the prognosis for septic tenosynovitis in the digital sheath.
The literature indicates that half or a bit more than half of the treated horses will return to previous use. The recommended treatment is debridement of the wound, lavage and sometimes application of drains and broadspectrum antibiotics. The prognosis is considered as worse when the infection is established. The most common complication is adhesions between the tendons and the digital sheath wall.
Journals from 21 horses diagnosed with septic tenosynovitis or a wound penetrating the digital sheath, treated at the horse clinic at SLU, during a period of almost seven years, has been studied. 71 % of the horses had a good outcome i.e. returned to previous use or were able to be used for the intended purpose. Three horses were not able to be used to the same extent as earlier because of remaining lameness and three were destroyed. The survival rate was 86 %.
The median age was 4 years (3 months to 19 years). The aetiology was a perforating wound in 19 (90 %) of the horses. All of the horses had both surgical and medical treatment. Depending on the long-time treatment outcome the horses were divided into two groups with good or bad outcome. The groups were compared regarding age, breed gender, aetiology, clinical signs, the cytological and bacteriological features of the synovia, time to surgical treatment, postoperative drainage of the digital sheath, response to surgical treatment, length of hospitalisation, medical treatment and treatment during recovery period.
The treatment outcome tended to be worse the longer time that had passed since the first signs of infection until surgical treatment and also the lamer the horse was preoperatively. The percentage of horses that had postoperative drainage was higher in the group that had a good outcome than in the group that had a bad outcome. On the fifth day postoperatively, five of the total group of 21 horses were still more than 1° lame and of these 80 % belonged to the group with bad outcome.
Owing to these results and the literature rapid surgical and medical treatment including tenoscopically guided lavage and debridement of the digital sheath is recommended. Exsudate from the digital sheath should be able to drain through the wound or through an intrathecal drain. Antibiotic treatment should be given both intrathecally and intravenously with broadspectrum antibiotics in addition to anti-inflammatory drugs. |
| format | L3 |
| id | RepoSLU11693 |
| institution | Swedish University of Agricultural Sciences |
| language | swe Inglés |
| publishDate | 2007 |
| publishDateSort | 2007 |
| publisher | SLU/Dept. of Clinical Sciences (until 231231) |
| publisherStr | SLU/Dept. of Clinical Sciences (until 231231) |
| record_format | eprints |
| spelling | RepoSLU116932017-11-23T13:29:34Z Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar Nääs, Rebecca häst kotsenskida senskida synovia septisk tenosynovit penetrerande sår perforerande sår prognos behandlingsresultat Septic tenosynovitis involving the digital sheath is a relatively common problem in the horse and the prognosis has been considered as poor. However, there are only few studies confirming this. The purpose of this study is to increase the knowledge about the prognosis for septic tenosynovitis in the digital sheath. The literature indicates that half or a bit more than half of the treated horses will return to previous use. The recommended treatment is debridement of the wound, lavage and sometimes application of drains and broadspectrum antibiotics. The prognosis is considered as worse when the infection is established. The most common complication is adhesions between the tendons and the digital sheath wall. Journals from 21 horses diagnosed with septic tenosynovitis or a wound penetrating the digital sheath, treated at the horse clinic at SLU, during a period of almost seven years, has been studied. 71 % of the horses had a good outcome i.e. returned to previous use or were able to be used for the intended purpose. Three horses were not able to be used to the same extent as earlier because of remaining lameness and three were destroyed. The survival rate was 86 %. The median age was 4 years (3 months to 19 years). The aetiology was a perforating wound in 19 (90 %) of the horses. All of the horses had both surgical and medical treatment. Depending on the long-time treatment outcome the horses were divided into two groups with good or bad outcome. The groups were compared regarding age, breed gender, aetiology, clinical signs, the cytological and bacteriological features of the synovia, time to surgical treatment, postoperative drainage of the digital sheath, response to surgical treatment, length of hospitalisation, medical treatment and treatment during recovery period. The treatment outcome tended to be worse the longer time that had passed since the first signs of infection until surgical treatment and also the lamer the horse was preoperatively. The percentage of horses that had postoperative drainage was higher in the group that had a good outcome than in the group that had a bad outcome. On the fifth day postoperatively, five of the total group of 21 horses were still more than 1° lame and of these 80 % belonged to the group with bad outcome. Owing to these results and the literature rapid surgical and medical treatment including tenoscopically guided lavage and debridement of the digital sheath is recommended. Exsudate from the digital sheath should be able to drain through the wound or through an intrathecal drain. Antibiotic treatment should be given both intrathecally and intravenously with broadspectrum antibiotics in addition to anti-inflammatory drugs. Septisk tenosynovit involverande kotsenskidan är relativt vanligt hos hästar och prognosen har traditionellt ansetts som dålig. Det finns dock endast ett fåtal studier som bekräftar detta. Syftet med denna studie är att öka kunskapen om prognosen vid septisk tenosynovit i kotsenskidan. I litteraturen anges att hälften eller något mer av behandlade hästar kommer tillbaka till tidigare arbete. Den rekommenderade behandlingen är sårrevision, lavage och eventuellt dränage av kotsenskidan och bredspektrumantibiotika. Prognosen anses sämre vid etablerad infektion och den vanligaste komplikationen är adherensbildning. Journaler från 21 hästar med diagnosen septisk tenosynovit eller sårskada med perforation till kotsenskidan behandlade på hästkliniken, SLU under en knapp sjuårs period har studerats. 71 % av hästarna hade bra behandlingsresultat dvs, de kom tillbaka till tidigare användning eller började användas inom det avsedda användningsområdet. Tre hästar kunde inte användas i samma utsträckning som tidigare pga kvarstående hälta och tre avlivades. Överlevnaden var 86 %. Medianåldern var 4 år (3 månader till 19 år). Etiologin var en perforerande sårskada hos 19 (90 %) av hästarna. Alla hästarna behandlades både kirurgiskt och medicinskt. Beroende på om det långsiktiga behandlingsresultatet var bra eller dåligt delades hästarna in i två grupper. Grupperna jämfördes avseende signalement, etiologi, klinisk bild, synovians cytologiska och bakteriella bild, tid till kirurgisk behandling, postoperativt dränage av kotsenskidan, svar på kirurgisk behandling, kliniktidens längd, medicinsk behandling och behandling under konvalescensen. Behandlingsresultatet tenderade att vara sämre ju längre tid efter symptomdebuten hästarna fick kirurgisk behandling och ju haltare de var preoperativt. Av de hästar som kom tillbaka till tidigare användning hade större andel haft möjlighet till postoperativt dränage än i gruppen med dåligt behandlingsresultat. Dag fem postoperativt var fem av totalt 21 hästar fortfarande mer än 1° halta och av dessa hörde 80 % till gruppen med dålig prognos. Med anledning av dessa resultat samt litteraturstudier rekommenderas snabbt insatt kirurgisk och medicinsk behandling samt spolning och upprensning av kotsenskidan med hjälp av tenoskopi. Vätska från kotsenskidan bör ges möjlighet att dränera antingen genom såret eller genom en intrathekal drän. Antibiotikabehandling bör ske både lokalt och intravenöst med bredspektrumantibiotika jämte allmän antiinflammatorisk medicinering. SLU/Dept. of Clinical Sciences (until 231231) 2007 L3 swe eng https://stud.epsilon.slu.se/11693/ |
| spellingShingle | häst kotsenskida senskida synovia septisk tenosynovit penetrerande sår perforerande sår prognos behandlingsresultat Nääs, Rebecca Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title | Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title_full | Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title_fullStr | Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title_full_unstemmed | Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title_short | Septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| title_sort | septisk tenosynovit i kotsenskidan hos häst : en retrospektiv studie av 21 hästar |
| topic | häst kotsenskida senskida synovia septisk tenosynovit penetrerande sår perforerande sår prognos behandlingsresultat |