Treatment of infectious arthritis and osteomyelitis

Case report: Imaging of septic arthritis in the hip joint of a calf treated with femoral head ostectomy

A 24-day-old male Japanese Black calf presented with weight-bearing lameness in the left hind limb and a swollen pelvis. Ultrasonography revealed the accumulation of fluidity materials with a mixture of hyper- and hypo-echogenicity, enclosed by 5-10-mm-thick capsular structures. On the ventral-dorsal radiograph of the pelvis, irregular and radiolucent osseous changes were evident in the femoral head and acetabulum within the swollen hip joint, with soft-tissue density. Computed tomography (CT) confirmed the relationship between the bony and soft tissue lesions, which was suspected following ultrasonography and radiography, and provided additional findings, such as intra-articular accumulation of gas and the degree of osteolytic changes. Based on the imaging findings and cytology of the arthrocentesis specimen, the patient was diagnosed with hip arthritis and osteomyelitis of the femoral head. Additionally, the severity of the lesions supported our decision to perform a femoral head ostectomy. The postoperative radiographic and CT findings of the treated pelvis were helpful in evaluating the efficacy of this technique. Following treatment, the animal could walk and showed normal development, although it was three postoperative months before weight-bearing lameness improved. To the best of our knowledge, this is the first report to describe the combined use of ultrasonography, radiography, and CT in the diagnosis, preoperative planning, and evaluation of the postoperative effects of bovine hip arthritis. Additionally, this report details the therapeutic efficacy of femoral head ostectomy for bovine hip arthritis, a technique that has not been reported previously.

Diagnostic imaging in bovine orthopedics

Although a radiographic unit is not standard equipment for bovine practitioners in hospital or field situations, ultrasound machines with 7.5-MHz linear transducers have been used in bovine reproduction for many years, and are eminently suitable for evaluation of orthopedic disorders. The goal of this article is to encourage veterinarians to use radiology and ultrasonography for the evaluation of bovine orthopedic disorders. These diagnostic imaging techniques improve the likelihood of a definitive diagnosis in every bovine patient but especially in highly valuable cattle, whose owners demand increasingly more diagnostic and surgical interventions that require high-level specialized techniques.

Clinical management of septic arthritis in cattle

Synovial fluid, ultrasound, and radiographic imaging are common diagnostic tools for septic arthritis. Mycoplasma septic arthritis is suspected in calves with clinical signs of otitis and pneumonia. Commonly affected joints are carpus, stifle, and tarsus. Treatment strategy must include long-term antibiotics, anti-inflammatories, and joint lavage. Knowledge of communication and boundaries for commonly affected joints is essential to perform joint lavage and arthrotomy.

Ultrasonographic examination of important aspects of the bovine shoulder--physiological findings

The left and right shoulder region of 19 healthy cattle and the left and right shoulders of six bovine cadavers were examined ultrasonographically using a 7.5 MHz linear and a 3.5 MHz convex transducer. The lateral shoulder muscles were successfully imaged in all cases; the joint space appeared as a funnel shaped interruption of the hyperechoic bone surfaces of the distal part of the scapula and the proximal and lateral part of the humeral head. In healthy cattle, the synovial cavities of the scapulohumeral joint, the bicipital bursa and the infraspinous bursa could not be clearly defined. After experimental filling with water, the synovial cavities could be differentiated as discrete anechoic zones. In this study, the normal ultrasonographic appearance of the soft tissue structures and bone surfaces of the scapula and proximal humerus is presented, providing basic reference data for the ultrasonographic evaluation of the bovine shoulder region.

New surgical approach to the plantar fetlock joint through the digital flexor tendon sheath wall and suspensory ligament apparatus in cases of concurrent septic synovitis in two cattle

A new surgical approach to the infected fetlock joint is described in two cattle suffering from septic tenosynovitis of the lateral digital flexor tendon sheaths of the right lateral hind-digits with concurrent septic serofibrinous arthritis of the adjoining fetlock joints, caused by penetrating wounds. In both patients, the infected sheaths were opened and the superficial and deep digital flexor tendons were removed. Intraoperatively, a small entry through the fetlock joint capsule was detected, directly distal to the lateral proximal sesamoid bone. The tract was surgically enlarged and a second approach into the plantar fetlock joint pouch was created proximally by making a 3 cm long and 0.5 cm wide incision between the two lateral suspensory ligament branches. This allowed easy access to the plantar joint pouch, removal of fibrin clots and an effective joint lavage using 5L of sterile saline solution. The incisions of the fetlock joint capsules remained unsutured and were drained using soft polyurethane foam to preclude premature closure. The tendon sheath wounds remained unsutured. In both patients, the digital flexor tendon sheath and the fetlock joint were lavaged daily for the following three days. The infection was eliminated in both cattle and both fully recovered without residual lameness.

Antimicrobial issues in bovine lameness

This article reviews some of the issues surrounding antimicrobial use in treating diseases that cause lameness in cattle. The discussion includes sections on selection of an antimicrobial, regimen design, and medication of multiple animals. Pathogen susceptibility testing is covered, along with empiric selection of antimicrobials. Other issues covered include regional perfusion and topical application of antimicrobials, antimicrobials in footbaths and in feed, and withdrawal time estimates.

Influence of pH and temperature on kinetics of ceftiofur degradation in aqueous solutions

The objective of this study was to evaluate the stability of ceftiofur (1 mg mL(-1)) in aqueous solutions at various pH (1, 3, 5, 7.4 and 10) and temperature (0, 8, 25, 37 and 60 degrees C) conditions. The ionic strength of all these solutions was maintained at 0.5 M. Ceftiofur solutions at pH 5 and 7.4 and in distilled water (pH = 6.8) were tested at all the above temperatures. All other solutions were tested at 60 degrees C. Over a period of 84 h, the stability was evaluated by quantifying ceftiofur and its degradation product, desfuroylceftiofur, in the incubation solutions. HPLC was used to analyse these compounds. At 60 degrees C, the rate of degradation was significantly higher at pH 7.4 compared with pH 1, 3, 5 and distilled water. At both 60 degrees C and 25 degrees C, degradation in pH 10 buffer was rapid, with no detectable ceftiofur levels present at the end of 10 min incubation. Degradation rate constants of ceftiofur were 0.79+/-0.21, 0.61+/-0.03, 0.44+/-0.05, 1.27+/-0.04 and 0.39+/-0.01 day(-1) at pH 1, 3, 5, 74 and in distilled water, respectively. Formation of desfuroylceftiofur was the highest (65%) at pH 10. The rate of degradation increased in all aqueous solutions with an increase in the incubation temperature. At pH 7.4 the degradation rate constants were 0.06+/-0.01, 0.06+/-0.01, 0.65+/-0.17, and 1.27+/-0.05 day(-1) at 0, 8, 25, 37 and 67 degrees C, respectively. The energy of activation for ceftiofur degradation was 25, 42 and 28 kcal mol(-1) at pH 5, 7.4 and in distilled water, respectively. Desfurylceftiofur formation was the greatest at alkaline pH compared with acidic pH. Ceftiofur degradation accelerated the most at pH 7.4 and was most rapid at pH 10. The results of this study are consistent with rapid clearance of ceftiofur at physiological pH.

Arthrosonography--the use of diagnostic ultrasound in septic and traumatic arthritis in cattle--a retrospective study of 25 patients

The case records, clinical, radiographic, ultrasonographic and arthrocentesis findings from 25 cattle with septic or traumatic arthritis were reviewed. The total of 30 joints involved were: articulatio cubiti (elbow joint)-1, articulatio carpi (carpal joint)-10; articulatio genus (stifle joint)-4, articulatio tarsocruralis (tarsocrural joint)-8; articulatio metacarpo-/metatarsophalangea (metacarpo-/metatarsophalangeal joint -7. Ultrasonographic investigation was performed using 7.5 MHz linear and 5 MHz sector transducers. In eight cattle, a concurrent infection of periarticular tendon sheaths or hygroma was diagnosed. The distension of the joint cavities could be imaged in all cases. Assessing echogenicity, acoustic enhancement, ultrasonographic character of the exudate (liquid or clotted) and findings revealed by aspiration, arthrotomy or at necropsy, the synovial effusion was classified as: serous, fibrinous or fibrino-purulent. Diagnostic ultrasound provided a comprehensive preoperative diagnosis in septic and traumatic arthritis by imaging the accurate localization of soft-tissue swelling and the extent and consistency of joint effusion.