Leaking fluid from knee joint

[kallieballie]

Help please - my 2 year old gelding, 15.2hh, tried to jump barb wire as a foal and ripped the skin off his back legs and punctured and cut open his front knee. The knee was stitched but due to where it was the stitches kept on bursting open. However the wound did pull together and healed. He was left with a scar on his knee.

About a month ago he was lame from the front leg that had the knee injury around the fetlock area. There was a small wound, finger nail size, and it was leaking fluid. After a week of antibiotics and bute he was sound again.

Yesterday I went to the field and found the old wound had opened up and there was what looked like joint fluid coming from it. Called the vet who gave him antibiotics and painkillers. The wound was bandage. He is not lame at all.

My vet wasn't sure what the prognosis is or how best to treat it. He took advice from another vet and said I have 3 options - 1 -surgery -can't afford and he is not insured, 2 - sedating him and flushing the joint, 3 - more antibiotics and wait and see.

 

[Silent Knight]

It needs flushing and antibiotics. If infection sets into the joint the prognosis is not good.

 

[AmyMay]

What is the recommended treatment?

 

[AengusOg]

Synovial fluid from the joint is slightly viscous, and normally light-coloured. If you get some between finger and thumb, and part those digits, it will remain attached and 'stretch' across a small gap.

It could be that this is a fistulus wound; ie, one which has not healed properly inside and, building up a reserve of fluids associated with such a wound, occasionally leaks.

The worst case scenario would be an infection in the joint. Flushing of the joint capsule has risks; the main one being the introduction of further infection.

I'm unsure from your post whether the 'old wound' you mention is the one on the knee or the one on the fetlock.

There may be no connection between the two, of course, and it may be an infection from a foreign body.

At the moment, it looks as if option 3 may be the best course of action. Surgery seems a bit invasive at this point without the knowledge required to target a problem.

You are free to ask for another vet's opinion, perhaps one more experienced in that field, although I think the second vet would appreciate knowing that his opinion is being sought on those grounds. He does not, however, need to know anything of what the first vet said.

 

[kallieballie]

Thanks, the injuries were on the same leg. I am scared to flush as I have read that once I start flushing you have to do it over and over again.

 

[crabbymare]

The idea of flushing is to get rid of the infection, so although it may need doing again it is not something that goes on forever. once the joint has healed there is no need to keep doing it. I would want to know the prognosis from the vet and would be looking at getting it flushed if it was my horse otherwise an infection could get hold and could result in you losing the horse. definitely speak to the vet and see what they say though.

 

[GreedyGuts]

Your vet needs to establish whether or not the joint is open and treat accordingly, or refer for investigation. Horses with open/septic synovial structures may remain sound while the wound is able to drain freely, but then become very lame when the wound begins to close. Treatment is easier, cheaper and more successful when carried out soon after the injury occurs. I think you need to speak to your vet about doing a little bit more to find out what is going on if there is any suspicion that it has penetrated the knee.

 

[Box_Of_Frogs]

Gently dip your finger tip in the substance leaking from the wound. If it's synovial (joint) fluid it will feel oily if you then rub your fingers together. It could be that the wound has broken down again and if so you might be looking at skin grafts. If it is joint fluid leaking out then your horse only had an 8 hour window to get the joint flushed. If not treated within that time my understanding is that the prognosis is very very poor.

 

[Darcydoo]

Hi this needs sorting before infection gets in worse case scenario pts ?possible new puncture wound.my mare had a open rupture of her tarsometatarsal cru joint due to a kick leaking joint fluid had hers flushed she was never lame back in work 4wks later well worth the money ( not insured ) got change from £1000 inc stay a horsepital after care .vet said they don't show signs of lameness until all joint fluid has leaked out leaving a dry joint.got mine to vets within 2hrs happened in April

 

[applecart14]

My previous horse ripped open his fetlock joint from one side to the other on a hind leg. He severed two tendons (not important ones) and the joint was open.. The joint was flushed, the fluid replaced and a cast put on. He had three general anaethetics within the three weeks but as the wound refused to heal and he kept getting terrible heel rubs from the plaster casts the decision was made to euthanise. They said if they had a horse with a similar injury again they would pts straight away.

In your horses case I would suggest to flush the joint, and see if you can put your horse in a horspital for a few days as it would be the most sterile place for an infection free result.