A multi‐centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement
Isgren, C. M., Salem, S.E., Singer, E.R., Wylie, C. E., Lipreri, G., Graham, R. J. T. Y., Bladon, B., Boswell, J. C., Fiske‐Jackson, A. R., Mair, T. S., Rubio‐Martínez, L. M.
This cohort study reports the outcome of horses with contamination/sepsis of the calcaneal bursae following endoscopic treatment in addition to identifying prognostic factors associated with survival.
Medical records from seven referral hospitals in the UK were reviewed to identify horses that presented with synovial contamination/sepsis of the calcaneal bursae between 2002 and 2016. A total of 128 horses were included in the study; 123 of which recovered from anaesthesia. Following surgery, clinical signs improved in of 74.8% (n = 92) of cases. A total of 21 horses underwent a second surgery. Both the calcaneal bursa and the subcutaneous bursa were affected in 42.5% (n = 54) of horses, and in 48.0 % (n = 61) only the calcaneal bursa was affected. All horses with only the subcutaneous bursa involvement survived. There was bone involvement in 23.6% (n = 30) of horses. The most common bacteria isolated were Staphylococcus spp., followed by Streptococcus spp. and Escherichia coli.
Administration of systemic antimicrobials prior to referral was associated with reduced mortality. Bone fracture/osteomyelitis, tendon involvement, duration of general anaesthesia, post‐operative synoviocentesis, and post‐operative wound dehiscence were associated with increased mortality. At follow‐up, 87.1% horses were alive, 7.1% had been euthanised due to the calcaneal injury and 5.7% had been euthanised for unrelated reasons. From 57 horses with athletic performance follow‐up, 91.2% returned to the same or higher level of exercise.
Bottom line: Endoscopic treatment of calcaneal bursae contamination/sepsis in horses has a good survival rate with the majority of horses returning to their previous athletic use at the same or higher level.