Management Plan

1. Attempt to lavage the joint under local anesthesia (lidocaine) in order to 
improve antibiotic efficacy.  However, considering this is a very young foal 
attempts may be unsuccessful and general anesthesia is an unnecessary risk.
2. Systemic Antibiotics - Amikacin and Potassium Penicillin long term (4-6 
weeks)
3. NSAIDS to limit inflammatory response and improve patient comfort 
(Phenylbutazone).
4. Prolonged rest from exercise to allow damage of soft tissues and articular 
cartilage DO NOT immobilize the joint.
5. Passive motion- important in rehabilitating and maintaining the range of motion 
of recovering joints.
6. Intra-articular antibiotics  - should be considered if no progress is noticed 
within 2 weeks of the start of the systemic antibiotic treatment.
7. Regional antibiotic perfusion and  intra-articular beads are unnecessary for 
this case at this stage.

Prognosis

Guarded, better for foals with single joint infections than for adults.  If bone involvement occurs or if 
the problem becomes chronic the prognosis will be significantly reduced.