Management

Joint sepsis is an emergency situation. The foal needs to be treated with antibiotics both 
systemically and regionally to manage both the infectious arthritis and the osteomyelitis 
of the growth plate.  Amikacin and ceftiofur should be given IV for 4Ð6 weeks 
(depending on when clinically signs subside). Regional profusion can be performed every 
other day as adjunct therapy. Regional profusion is accomplished by applying a 
tourniquet proximal to the infected area of bone and injecting amikacin in a local artery.  
When the foal leaves the hospital, ceftiofur should be continued to be given IM for two 
weeks.

Regional profusion and intra-articular lavage and amikacin profusion can be performed 
under general anesthesia and will provide antibiotics to the site of infection. Regional 
profusion with amikacin will provide the growth plate and surrounding bone with high 
levels of antibiotics. In order to remove products of inflammation and debris, joint lavage 
via arthroscopy, will allow visualization of the joint and passage of any large pieces of 
material. Intra-articular amikacin administration following joint ravage will provide 
antibiotics directly to the joint.  

NSAIDs such as phenylbutazone should be given to the foal to combat inflammation and 
pain in the joint.  This will allow the foal to bear more weight on the infected leg and 
prevent further breakdown of the compensating leg.

The foal should be rested while in the hospital, which is accomplished by being confined 
to a stall.  Passive range of motion exercises should be performed on the foal daily in 
order to rehabilitate and maintain the range of motion of the joint.

Since the foal is only two weeks old, the mare should be hospitalized with the foal, so 
that the foal can continue to suckle and receive optimal nutrition.