The above structures are
very susceptible to infection and once established can
result in a horses unfortunate demise! The following
pictures of real life and death scenarios show how we are
overcoming many infections. The following horse had a
serious infection in his coffin bone. Most abscesses luckily
break out but occasionally the infection can invade the bone
as you can see from the x-ray above which has an eaten away
appearance to one edge - looks like someone took a bite out
of it. The above picture shows the
special hollow bone screw which was drilled into one of the
pastern bones followed by a tourniquet applied to the area
above. The tourniquet stops blood from escaping from the
area. A normal dose of antibiotic (amikacin) is injected
through the screw into the bone marrow. The antibiotic
travels from the bone marrow into all the tissues below the
tourniquet achieving a concentration of local antibiotic
hundreds of times greater than can be obtained by normal
intravenous injection. This is called regional perfusion.
The tourniquet was left on for the duration of the surgery
and then released. In some cases the screw can be left in
the bone for additional perfusions on a daily
basis. Intravenous Perfusion works
in a similar fashion to a bone perfusion but is simpler in
that only a vein has to be catheterised. The above pictures
shows a catheter placed into the digital vein. A tourniquet
is placed above it and 250ml of an amikacin /DMSO/LR is
being infused to a standing patient to control a pastern
bone infection. This is administered over 30 minutes daily
for 3 days. This horse actually had an infection associated
with a severe fracture and implants in the pastern bone. It
responded to this therapy and was walking sound upon
discharge. The above pictures show an
exposed infected cannon bone before closure. The surgical
picture shows a long strip of white bone cement placed along
the incision. Bone cement pellets saturated with antibiotics
are routinely implanted into various tissues to control
local infections. The infections resolve quite quickly but
the healthy tissue encapsulates the pellets which will show
up on x-rays forever! A small price to pay for control of
infection. The pellets or strips can be removed at a later
date. Inrathecal (joint or tendon
sheath) infusion systems are implanted frequently after
initial tenoscopic lavage of serious long standing
infections. The system shown administers a continuous flow
from a balloon distended with antibiotics Our
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Kleider
Veterinary Services
8036 - 232 Street RR#6 Langley, British Columbia V1M 3R8
Office (604) 888-7565 Fax: (604) 888-4033 nkleider@aol.com
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