title: Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis.
abstract: OBJECTIVE
  To present the technique for intra-articular catheter placement and report the clinical outcomes of 38 cases of equine synovial trauma and/or infection treated with broad-spectrum antimicrobials administered via an intrasynovial catheter (ISC).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Medical records of 38 horses treated for synovial trauma and sepsis with frequent antimicrobial administration through an ISC from 1995 to 2008 were reviewed. Follow-up information was obtained via clinical re-evaluation or telephone contact with the owners.
  
  
  RESULTS
  The majority of horses (84%) received amikacin and Timentin(R) four times daily. In addition, synovial lavage through the ISC was carried out in 27 horses (71%). Only radiological evidence of osteolysis had a significant negative impact on both lameness at the time of hospital discharge and the long-term outcome. In total, 92% of horses treated with frequent antimicrobial administration through an ISC had clinical resolution of infection. Catheter obstruction occurred in three cases, necessitating replacement or removal, and two synovial fistulae developed at sites of open drainage. The majority of horses treated had a favourable outcome, with 86% being at least pasture sound and 43% returned to riding.
  
  
  CONCLUSIONS
  Septic synovial structures treated with frequent antimicrobial administration through an ISC had a good prognosis for survival and 43% returned to riding, which is consistent with the results of other studies. The use of a simple ISC should be considered when broad-spectrum intrasynovial antimicrobial administration and lavage of a septic synovial structure are indicated.
authors.affiliation: Department of Veterinary Clinical Medicine, University of Illinois, Urbana-Champaign, Illinois, USA. aaw@illinois.edu
authors.forename: A A
authors.initials: AA
authors.lastname: Stewart
authors.forename: L R
authors.initials: LR
authors.lastname: Goodrich
authors.forename: C R
authors.initials: CR
authors.lastname: Byron
authors.forename: R B
authors.initials: RB
authors.lastname: Evans
authors.forename: M C
authors.initials: MC
authors.lastname: Stewart
mesh_terms: D000583:Amikacin / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002404:Catheterization / Q000662:veterinary*; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006734:Horse Diseases / Q000188:drug therapy*; D006736:Horses; D007270:Injections, Intra-Articular / Q000662:veterinary; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013585:Synovitis / Q000188:drug therapy / Q000662:veterinary*; D007507:Therapeutic Irrigation / Q000662:veterinary; D013982:Ticarcillin / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D000583:Amikacin; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin