Lameness of the Horse | Page 8

structures and invades the
interior of the joint capsule the result is that a more or less active
disturbance is incited. The introduction of a sterile instrument into a
joint cavity, under strict asepsis, where a perfect technic is executed,
does not cause perceptible manifestation of the injury, if the opening so
made is small--such as a suitable exploratory trocar makes. But a
puncture made in a similar manner and with the same instrument
without due regard to asepsis is likely to cause an infectious synovitis
and arthritis usually follows.
A larger opening than is produced by means of an exploratory trochar
may be made into a joint cavity, causing escape of synovia as it is
secreted for days and even for weeks and no serious or permanent
trouble is experienced in some cases. If the synovitis or arthritis
remains non-infected and the wound, traumatic or surgical, is not too
large, healing by granulation occurs, and the discharge of synovia
ceases. However, if synovial discharge persists too long because of
tardy closure of an open joint, there is great danger of infection gaining
entrance into the synovial cavity, or in some instances, desiccation of
endothelial cells of the articulation occurs, in areas, and the reactionary
inflammation eventually results in ankylosis.
A small puncture which introduces into the synovial cavity infectious
material of active virulence will cause an arthritis that is more serious,
much more painful and more difficult to handle than is occasioned by a
wound of moderate size, that affords ready escape of synovia even
through the virulence of the infection be the same.
Synovia is a good culture medium and the environment is ideal for
multiplication of bacteria; consequently, the grave disturbances which
may attend the introduction of pathogenic organisms into a synovial
cavity as the result of a puncture wound are not to be forgotten. The
veterinarian is in no position to estimate the virulency of organisms so
introduced; neither can he determine the exact degree of resistance

possessed by the subject in any given case. Therefore, he is uncertain as
to the best method of handling such cases where an injury has been
recently inflicted and positive evidence of the existence of an infectious
synovitis is not present. If one could determine in advance the degree of
infection and injury that is to follow small penetrant wounds of joint
capsules, it would then be possible to select certain cases and
immediately drain away all synovia and fill the cavity by injection with
suitable antiseptic solutions.
This offers a broad field for experimentation which will in time be
productive of a radical change in the manner of treating such cases.
Metastatic arthritis is seen more frequently in colts or young animals
than in mature horses and we here take the liberty of classifying with
the arthritis of omphalophlebitis and strangles the so-called rheumatic
variety.
A specific polyarthritis or synovitis which attends navel infection of
foals is perhaps the most frequent form of arthritis that is to be
considered metastatic. This condition is truly a disease of young
animals and, while it is a specific arthritis, the cause is yet to be
attributed to any definite pathogenic organism with certainty. This
condition is well defined by Bollinger as quoted by Hoare,[1] when he
calls it a purulent omphalophlebitis due to local infection of the
umbilicus and umbilical vessels, by pyogenic organisms, causing a
metastatic pyemia.
This affection is grave; its course is comparatively brief; the prognosis
is usually unfavorable; and omphalophlebitis occasions a form of
lameness which at once impresses the practitioner that serious
constitutional disturbance exists. Its consideration properly belongs to
discussions on practice or obstetrics and diseases of the new born, and
it has received careful attention and is discussed at length in these
works.
A second form of metastatic arthritis is met with in strangles. Strangles
occurs in the young principally and is not a frequent cause of synovitis
or arthritis in the adult animal.

Strangles or distemper is, according to most pathologists, due to the
Streptococcus equi. Hoare[2] states that in this type of specific arthritis
the contagium is probably carried by the blood. He gives it as his
opinion that even laminitis has occurred as a result of the
streptococcus-equi. This, indeed, would point toward probable
extension by the blood as well as by way of lymph vessels.
Septic synovitis and infectious arthritis are always serious affections
even in young animals and much depends upon individual resistance
and early rational treatment in such cases, if recovery is to follow.
The same general plan of treatment is indicated in this kind of septic
synovitis as is employed in all cases of infective synovitis and septic
infection in open joints. There is to be considered, however, the fact
that the young animal is more agile, a better