Management Plan

Joint sepsis is an emergency situation in foals. It needs to be treated immediately.  Our 
treatment plan has 3 goals: to remove the bacteria causing the infection, to minimize 
cartilage damage, and to minimize secondary osteoarthritis. First, we would lavage the joint 
with 1 to 3 liters of balanced polyionic buffered (pH adjusted) fluids to remove bacteria and 
inflammatory mediators that might be damaging the joint. Next, we want to treat with 
gentamicin injected intra-articularly, giving a high dose immediately after lavage. We would 
prefer to keep the foal in the hospital on gentamicin IV ( 3.3 mg/kg- 4.5 mg/kg BID) but if 
the owner did not want to do this, we could send the foal home with ceftiofur for the owner 
to administer 2.2mg/kg IM BID. Antibiotic treatment should be continued for 4 to 6 weeks. 
We recommend that the foal be confined to a stall to decrease pain, inflammation and 
cartilage damage. If the foal goes home, we want to recheck it in a week to 10 days. WeÕll 
assess the joint and sample joint fluid again. Prognosis in general for these cases is 
guarded, however this case only involves one joint and it seems that weÕve caught it early 
due to the lack of radiographic bone lytic lesions and the low cellularity and low protein 
content of the joint fluid. This improves our prognosis.