Joint Infections in Horses

Key Takeaways

Joint infections are infections found in the joints of horses which cause pain, inflammation, fever, and lameness. 

Joint infections are always an emergency and require immediate medical assistance

• Can be caused by physical injuries to the joint, spreading of infection from other areas of the body, or through joint injections

• In foals, acquiring infection from the mother is the most common cause

• Diagnostics include a physical examination and bacterial identification

• Treatment ranges from lavaging the joint to surgical intervention

• Prognosis is best when treated immediately after an injury occurs to the joint and before infection causes serious symptoms

A Closer Look: What are Joint Infections in Horses?

Joint infections are infections found in the joints of horses which cause pain, inflammation, fever, and lameness. 

Joint infections are always an emergency and require immediate medical assistance

• Can be caused by physical injuries to the joint, spreading of infection from other areas of the body, or through joint injections

• In foals, acquiring infection from the mother is the most common cause

• Diagnostics include a physical examination and bacterial identification

• Treatment ranges from lavaging the joint to surgical intervention

• Prognosis is best when treated immediately after an injury occurs to the joint and before infection causes serious symptoms

Risk Factors

Joint infections are always an emergency and require immediate attention. Infected joints left untreated are likely to develop severe complications that often result in euthanasia. Horses unable to bear weight on a limb always require medical attention.

Possible Causes

Joint infections are most commonly caused by a puncture or cut around the joint that enters the joint space and allows bacterial entry. Joint fluid is a highly nutritious medium for bacterial growth, rapidly resulting in severe bacterial infections. 

Joint infections are a rare complication from routine joint injections. Veterinarians mitigate this risk by thorough scrubbing and cleansing of the injection area, however any object entering the joint space can potentially introduce bacteria into the joint. Bacteria can also enter the joint space through a blood infection. This type of joint infection is most common in foals.

In foals, an infection can begin in the womb after bacterial transfer from the mother, or through contamination of the umbilical stump after birth. In some cases, foals can inhale or ingest bacteria, causing a blood infection, leading to joint infections.

Main Symptoms

The main symptoms of joint infection in horses include:

Lameness

Swelling around the joint 

• Swelling of the affected limb

• Joint pain

• Fever

Testing and Diagnosis

If an infection is suspected, it is crucial to begin treatment as soon as possible. Diagnostics include:

• Physical examination

• Synovial fluid analysis

• Imaging (X rays, ultrasound, MRI, CT scan)

• Culturing of bacteria from in or around the wound

Steps to Recovery

If the infection is acute, primary treatment involves antibiotics and flushing the joint with sterile saline to remove contamination. Standard wound care such as stitches, routine cleaning, topical medications, bandaging, and stall rest are often a component of treatment. 

Chronic infection requires more aggressive treatment including open joint drainage, surgery, prolonged antibiotic treatment, and arthroscopy. 

Treatment depends on severity and the level of progression, but includes:

• Antimicrobial drugs

• Intra-articular antibiotic injections

• Regional limb perfusion: Localized treatment where the site of infection is isolated and concentrated antimicrobials are injected directly into the veins

• Arthroscopy

• Supportive care

Treatment can be intensive and requires repeated monitoring and time. In more extreme cases, long term effects of treatment can lead to osteoarthritis, bone infections, and an inability to return to previous performance level. Foals, regardless of whether the infection is acute or chronic, often require intensive treatment protocols.

If the condition is rapidly recognized and treatment begins immediately, prognosis is good for recovery and return to previous athletic performance. The longer the infection is left untreated, the poorer the prognosis. Complications include osteomyelitis (bone infection) and opposing limb laminitis. Severe joint infections can also result in osteoarthritis that may prevent return to athletic careers. In some extreme cases, euthanasia is the only humane option.

Prevention

The best way to prevent a joint infection is to check for wounds around the joint routinely and seek medical care immediately when any injuries are noticed. Infections that are caught and treated early have the best prognosis. Joint infections in horses are not contagious.

Are Joint Infections Common in Horses?

Joint infections are common in horses.

Typical Treatment

• Antibiotics

• Flush with saline

• Open joint drainage

• Surgery

• Arthroscopy

• Stall rest

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