Discussion

Findley J.A. , Pinchbeck G.L, Bladon B.M., Boswell J., Mair T., Milner P.I., Suthers J.M. and Singer E.R.
Aims: To identify risk factors associated with mortality and failure to return to previous athletic function in horses with synovial sepsis following foot penetration. Methods: Horses with sepsis of one or more synovial structure at 4 UK hospitals, treated surgically and surviving anaesthesia, were included in the study. Multivariable logistic regression was performed, using univariable factors P<0.2, with the outcome variable mortality during hospitalisation (Model1) and the outcome variable failure to return to previous athletic function at one year post surgery (Model 2). Results: Eighty-six horses were included in the study, of these horses 28 (33%) were subjected to euthanasia during hospitalisation. Follow-up of greater than one year was available for 43 horses, of which 19 (45%) failed to return to their previous level of activity. In Model1 the variables identified as significantly, positively associated with mortality during hospitalisation (P<0.05) included penetration of frog (OR 6.5, CI 1.3, 33.2, P = 0.02) and distal phalanx involvement (OR 47, 95% CI 2.7, 828.7 P = 0.008). Days hospitalised was significantly negatively associated with mortality (OR 0.8, 95% CI0.8, 0.9, P = 0.001). In Model 2 variables positively associated with failure to return to previous level of athletic function (P<0.05) included gender (female/male) (OR 14.6, 95% CI 1.6, 137.7 P = 0.02) and number of surgeries (OR 14, 95% CI 1.2, 158.5 P = 0.03). Conclusions and practical significance: These results suggest penetration of the frog and pedal bone involvement are poor prognostic indicators for survival following foot penetration. Mares and horses undergoing more than one surgery are less likely to return to their previous level of activity; however, the number and type of structures involved does not have a significant effect on return to previous level of activity. Acknowledgements: Staff at Bell Equine Veterinary Clinic, Donnington Grove Veterinary Surgery and the Liphook Equine Hospital