Factors associated with survival and return to function following synovial infections in horses

Danielle Crosby, Raphael Labens, Kristopher Hughes, Sharon Nielson, Bryan Hilbert

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Synovial infections (SI) are common in horses of all ages and can be associated withhigh rates of morbidity and mortality. Identifying factors influencing survival and returnto function may be useful for management of affected individuals and determinationof prognosis. The objectives of this study were to identify factors associated withsurvival and return to function of horses and foals with SI presented to an equinehospital. This study is a retrospective case series. Data were collected from medicalrecords of all horses with SI that were presented to a single equine hospital betweenApril 1st, 2008 and May 1st, 2017. Long–term follow up was obtained by a semistructured telephone questionnaire of clinical outcomes and analysis of online racerecords. Univariate models were created using generalized linear and linear mixed modelsto assess factors associated with outcomes. Multivariable models were created usinggeneralized linear and linear mixed models to determine factors significantly associatedwith outcomes. Of 186 horses presented with SI, 161/186 (86.6%) were treated and145/161 (90.1%) survived to discharge. The majority of joints were treated with synoviallavage (93.8%). One hundred and twenty horses were included in the return to functionanalysis and 79 (65%) returned to function. Increasing number of days of treatmentwith systemic antimicrobials was associated with increased likelihood of survival foreach horse (OR 1.15, 95% CI 1.04−1.27, P = 0.025) and when considering eachindividual synovial structure (OR 1.11, 95% CI 1.04−1.17, P = 0.004). Horses treatedwith doxycycline were less likely to return to function (OR 0.39, 95% CI 0.19−0.8, P =0.031). The overall rate of survival of horses treated with SI is good. The likelihood ofreturn to function is lower than for survival. The findings of this study, combined withrelevant antimicrobial stewardship practices, can be used as a part of evidence-baseddecision-making when veterinarians are treating horses with SI.
Original languageEnglish
Article number367
Pages (from-to)1-9
Number of pages9
JournalFrontiers in Veterinary Science
Publication statusPublished - 22 Oct 2019

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