Abstracts | EQUINE
Synovial sepsis is rare following intrasynovial medication
in equine ambulatory practice
L. C. R. Smith, C. E. Wylie, L. Palmer, P. H. L. Ramzan
First published: 27 December 2018
Background
There are few observational studies regarding the
potentially serious complication of synovial sepsis
following intrasynovial medication in general equine
practice. Quantification of risk is fundamental to fully
inform decision‐making and owner consent prior to
undertaking procedures.
Objectives
To describe the occurrence of synovial sepsis following
intrasynovial injections in a large ambulatory equine
practice between 2006–2011.
Study design
Main limitations
Retrospective cohort study.
Methods
Medication records were cross‐referenced against
synovial cytology submissions and hospital admissions
for synovial sepsis. The occurrence of synovial sepsis
within strata of interest, including horse age, sex and
product used were described as proportions with
corresponding 95% confidence intervals, and measures
of attributable risks.
Results
83.5% [95% CI 82.4, 84.6%]) and amikacin sulphate
(4044/4331, 93.4% [95% CI 92.6, 94.1%]). Overall
four horses developed post medication synovial sepsis
(0.04% [95% CI 0.0, 0.08%] of all medications),
two of these cases were given polysulphated
glycosaminoglycans and hyaluronate (2/14, 14.3%
[95% CI 0.0, 32.6%]), two were given triamcinolone
acetonide (2/3592, 0.1% [95% CI 0.0, 0.1%]), and
hyaluronate (2/3617, 0.06% [95% CI 0.0, 0.1%]). One
of these cases had received concurrent medication
with amikacin sulphate (1/4044, 0.02% [95% CI 0.0,
0.1%]). All four cases returned to racing following joint
lavage.
In the study period, 9456 intrasynovial medications
were performed in 4331 sessions. The most frequently
used medications were: corticosteroids (3869/4331,
89.3% [95% CI 88.4, 90.3%]), hyaluronate (3617/4331,
Due to the low frequency of cases multivariable
statistical analysis was not performed. Although the
study was conducted in an ambulatory setting, the
population included a high number of racehorses,
limiting application to the general horse population.
Conclusions
The frequency of synovial sepsis in this population
of horses was 0.04%. These data may be helpful in
informing clients regarding the potential risks of adverse
complications resulting from intrasynovial medication.
https://onlinelibrary.wiley.com/doi/10.1111/evj.13063
• Volume 21 Issue 1 | March 2019 •
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