Treatment Plan

The most aggressive therapy would involve joint lavage to remove the 
inflammatory products leading to cartilage destruction, and clean the joint to 
improve efficacy of antibiotics.  While joint lavage is best performed under 
general anesthesia, a two-week old foal can probably undergo the procedure 
with sedation and local anesthetic.

Following joint lavage, injection of an aminoglycoside, such as gentamicin or 
amikacin, into the joint will decrease the bacterial load in the joint.  Direct 
injection of the antibiotic will increase the concentration at the joint, and be more 
efficacious than systemic treatment only.  Sending the foal home with systemic 
antibiotics for Klebsiella (such as enrofloxacin), along with a non-steroidal anti-
inflammatory drug (such as phenylbutazone), will most likely offer the best 
chance at recovery.  Systemic treatment should be continued for 7-14 days, with 
a recheck of the foal following completion of treatment.

In addition to medical treatment, the foalÕs activity should be limited with 
controlled exercise and prolonged rest to allow healing; however, the joint should 
not be immobilized.