ISSN 2398-2985      

Osteomyelitis

6guinea pig

Introduction

  • Inflammation of the bone due to infection.
  • Cause: sequella to pododermatitis. Obesity, decreased weight bearing on contralateral limb, overgrown toenail preventing normal foot positioning/locomotion. Pyogenic bacteria: Staphylococcus aureus (most common), Pseudomonas spp, Escherichia coli, Streptococcus spp, Proteus spp, Bacteroides spp, Pasteurella multocida. Osteomyelitis is considered a severe aspect of pododermatitis and may be irreversible.
  • Signs: lameness, abnormal locomotion, obesity, foot sores/wounds.
  • Diagnosis: history and clinical signs, fine needle aspiration, biopsy of lesion, bacterial culture and sensitivity, radiography, bloodwork, serum chemistries.
  • Treatment: analgesia, NSAIDs, antimicrobial therapy, surgical debridement of necrotic tissue.
  • Prognosis: poor prognosis as changes may be irreversible.
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Pathogenesis

Etiology

  • Sequella to pododermatitis Pododermatitis.
  • On plantar or palmar aspect of feet extending proximally; front feet are more prone to develop pododermatitis.
  • May also involve synovitis.
  • Pododermatitis is also avascular necrosis, due to constant pressure applied to skin and soft tissue pressed between the bones of the foot and a hard surface.
  • Any condition disrupting normal locomotion or altering the padding of the plantar and palmar surface of the foot can lead to the formation of pressure sores. This includes obesity, or decreased weight bearing on the contralateral foot.
  • Overgrown toenails that prevent normal foot positioning, locomotion may set up pressure point. Feces/urine-soaked bedding may become caked to the curled nails. In rare cases, a toenail may grow and curl into palmar/plantar surface.
  • Prolonged contact with wire, abrasive, hard, wet, urine/feces soaked bedding or surface leads to dermatitis which progresses to pyoderma and necrosis.
  • Necrosis of the tissues leads to sloughing, ulceration, abscess formation Abscess, and secondary bacterial infection.
  • The bacterial infection and inflammation involves the bone:
    • Pyogenic bacteria: Staphylococcus aureus (most common), Pseudomonas spp, Escherichia coli, Streptococcus spp, Proteus spp, Bacteroides spp, Pasteurella multocida.
Osteomyelitis is considered a severe aspect of pododermatitis Pododermatitis, and may be irreversible.

Predisposing factors

General

  • Obesity.
  • Sedentary life style (guinea pig may be cage confined and rarely gets exercise).
  • Poor husbandry: wire cage flooring, wet bedding, urine/feces soiled bedding, hard cage flooring such as tile, abrasive bedding such as grass or straw which may cause punctures and microabrasions.
  • Overgrown toenails. These can grow round and embed in foot, or cake with bedding, feces, or cause abnormal weight bearing and locomotion.

Specific

  • Owner did not notice the development of pododermatitis Pododermatitis.

Pathophysiology

  • Untreated pododermatitis can lead to osteomyelitis.
  • Locomotion with pododermatitis and as osteomyelitis develops is abnormal, which further causes changes in weight bearing and potentially increases tissue damage. For many, because of the pain, the guinea pig is reluctant to move which shifts load-bearing to previously unaffected feet, causing them to develop pododermatitis.
  • As osteomyelitis progresses, it may become irreversible.
  • Chronic cases of pododermatitis and osteomyelitis may progress to include lymphadenopathy, arthritis Arthritis, synovitis, tendonitis, amyloid accumulations in kidney, liver, adrenal glands, spleen and pancreatic islets.
  • Amyloid accumulation is seen with chronic inflammatory conditions.

Timecourse

  • Development of pododermatitis is usually days to weeks.
  • Development into osteomyelitis depends on severity of the pododermatitis and what the secondary bacteria is, but may take days to weeks.

Epidemiology

  • Considered an individual problem not a contagious one.
  • If poor caging and husbandry is part of the problem, any guinea pigs in a household or colony may be subjected to initiating factors.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Blair J (2013) Bumblefoot. A comparison of clinical presentation and treatment of pododermatitis in rabbits, rodents, and birds. Vet Clin Exot Anima 16 (3), 715-735 PubMed.

Other sources of information

  • Hawkins M G & Bishop C R (2012) Disease Problems of Guinea Pigs. In: Ferrets, Rabbits, and Rodents Clinical Medicine and Surgery. 3rd edn. Eds: Quesenberry K E & Carpenter J W. Elsevier. pp 295-310.
  • Schnellbacher R (2011) Pododermatitis (Bumblefoot). In: Blackwell's Five-Minute Veterinary Consult: Small Mammal. Ed: Oglesbee B L. Wiley-Blackwell. pp 312-313.

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