Bovis ISSN 2398-2993

Joint lavage: through-and-through

Contributor(s): Ash Phipps, Paul Wood

Introduction

  • Lavage of a joint(s) affected by septic arthritis.
  • Septic arthritis may occur in adult or neonatal cattle. It may occur in one or multiple joints and may be as a result of a primary trauma that introduces microorganisms to the joint or as a result of hematogenous spread from infectious processes elsewhere in the body (navel ill, respiratory infections, etc). Affected animals are invariably lame, with hot and swollen joints. Pyrexia is often present.
  • Clinical signs may be diagnostic, but diagnosis may be confirmed by culture and sensitivity of an arthrocentesis sample. Commonly cultured bacteria include E. coli, Salmonella spp, Streptococcus and Trueperella pyogenes.
  • Radiography can be useful to assess the chronicity of a lesion and to advise as to prognosis. For example, if osteolytic lesions are present radiographically, then prognosis will be more guarded. In acute infections, there are often limited changes seen radiographically.
  • Treatment involves appropriate antibiotic use – ideally following culture and sensitivity, but in the initial stages a broad spectrum systemic antimicrobial active is warranted.
  • Non-steroidal anti-inflammatory drugs should be used.
  • Joint lavage may be a useful technique to treat an affected joint and is most useful if performed in the early stages of infection.

Uses

Advantages

  • This procedure can be carried out on farm.
  • This procedure does not require specialized equipment.
  • Does not require a general anesthetic.

Disadvantages

  • Requires facilities to restrain the patient.
  • It is an invasive procedure.
  • For improved patient outcome, the procedure should be carried out every day or every other day for a further 2-3 treatments.
  • Some joints cannot be easily assessed, eg the coxofemoral joint due to the regions being deep to the musculature of the hindlimb.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • The duration of septic arthritis can influence the prognosis. Long-standing septic arthritis carries a poor prognosis.
  • The location of the joint affected influences the prognosis, with better outcomes associated with the fetlock joint (metacarpo-/metatarsophalangeal joint) when compared to the stifle (femorotibial), carpal (antebrachiocarpal) and hock (tarsocrural) joints.
  • Overall, the prognosis for clinical resolution is considered poor.
  • Clinical improvement (improved gait) should be evident 24-48 h post-treatment.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Anderson D, Dresrochers A & van Amstel S (2017) Surgical procedures of the distal limb for the treatment of sepsis in cattle. Vet Clin North Am Food Animal Pract 33 (2), 329-350 PubMed
  • Bailey J (1985) Bovine arthritides: Classification, diagnosis, prognosis and treatment. Vet Clin North Am Food Anim Pract 1 (1), 39-52 SciDirect.

Other sources of information

  • Parkinson T J, Vermunt J J & Malmo J (2019) Diseases of Cattle in Australasia: A Comprehensive Textbook. New Zealand Veterinary Association Foundation for Continuing Education, New Zealand. pp 972-974.
  • Divers T J & Peek S (2007) Rebhun's Diseases of Dairy Cattle. Elsevier, USA. pp 491-494.
  • Fubini S L & Ducharme N (2004) Farm Animal Surgery. Elsevier, USA. pp 334-335.


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