Abstract:
OBJECTIVE—To describe the clinical use of regional limb perfusion with antimicrobials
(A-RLP), complications, and outcome in a large series of patients.
DESIGN—Retrospective case series.
ANIMALS—174 horses.
PROCEDURES—Medical records of horses treated with A-RLP between 1999 and 2009 were
reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs,
previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional
treatments, complications, and outcome were recorded. At long-term follow-up, 2
outcomes were investigated: survival rate and return to previous use at the same or higher
level. Univariate and multivariate logistic regression analyses were conducted.
RESULTS—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial
lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations
without evidence of established synovial infection (27 horses). Group 3 (28 horses) included
miscellaneous other conditions. Only minor complications were reported in 12.26% of
horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP.
Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations
(91.89%). Within group 2, no significant differences in short- or long-term outcomes
were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial
lacerations. For the horses returning to previous use, 80% of horses with septic
synovitis and 72.72% of horses with lacerations were performing at the same or higher
level at the time of follow-up.
CONCLUSIONS AND CLINICAL RELEVANCE—The results of the present study indicated that
A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications
than intraosseous injection. Horses with infection of synovial structures had a
lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations.
The latter had a similar prognosis for horses with extrasynovial lacerations treated with
A-RLP.
