Osteomyelitis and osteonecrosis after intraosseous perfusion with gentamicin.
OBJECTIVE
To describe and discuss previously unreported complications associated with intraosseous perfusion with gentamicin in horses.


METHODS
Case report.


METHODS
Ten-year-old Warmblood gelding.


METHODS
Intraosseous perfusion with gentamicin into the proximal phalanx (P1) was used as part of the treatment regimen for distal interphalangeal joint and navicular bursa synovial sepsis. Although the sepsis responded favorably complications developed at the perfusion site, including persistent osteomyelitis, progressive osteonecrosis, and ultimately pathologic fracture of P1.


RESULTS
The progression of the clinical signs and findings at necropsy are suggestive of a toxic osteonecrosis secondary to intraosseous perfusion.


CONCLUSIONS
Further work is needed to investigate the effects of high dose gentamicin on equine mesenchymal cells that may be achieved during intraosseous perfusion.


CONCLUSIONS
Lower doses of perfusate within the medullary canal of P1 or alternative perfusion sites should be considered.
Parker
Russell A
RA
Department of Veterinary Clinical Studies, Easter Bush Veterinary Centre, University of Edinburgh, Large Animal Hospital, Midlothian EH25 9RG, UK. russell.parker@ed.ac.uk
Bladon
Bruce M
BM
McGovern
Kate
K
Smith
Ken C
KC
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects*; D006734:Horse Diseases / Q000139:chemically induced* / Q000188:drug therapy; D006736:Horses / Q000293:injuries / Q000601:surgery; D006801:Humans; D017148:Infusions, Intraosseous / Q000009:adverse effects / Q000662:veterinary*; D007794:Lameness, Animal / Q000209:etiology / Q000601:surgery; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries / Q000382:microbiology; D010019:Osteomyelitis / Q000139:chemically induced / Q000662:veterinary*; D010020:Osteonecrosis / Q000139:chemically induced / Q000662:veterinary*; D011512:Proteus Infections / Q000188:drug therapy / Q000662:veterinary
D000900:Anti-Bacterial Agents; D005839:Gentamicins