Septic inflammation of the bicipital bursa in horses
The aim of this study was to describe the etiologies, clinicopathologic findings, diagnostic modalities employed, treatments and outcome of horses with septic bicipital bursitis.
Medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021 were reviewed. Horses were included if synoviocentesis of the bicipital bursa revealed a total nucleated cell count of ≥ 20,000 cells/µL with a neutrophil proportion of ≥ 80%, a total protein concentration of ≥ 4.0 g/dL or the presence of bacteria on cytology, or positive culture of the synovial fluid.
Information retrieved from medical records included signalment, history, clinicopathologic variables, diagnostic imaging findings, treatment and outcome.
Overall, nine horses were enrolled in the study. Trauma was the most common inciting cause (n = 6).
Synoviocentesis using ultrasonographic guidance was performed in all cases and showed alterations consistent with septic synovitis.
Radiography identified pathology in five horses, whereas ultrasonography identified pathology in all horses.
Treatment consisted of bursoscopy (n = 6) of the bicipital bursa of which one was performed under standing sedation, through-and-through needle lavage (3), bursotomy (2) or medical management alone (2).
Five (55.6%) horses survived to discharge. Long-term follow-up was available for three horses, and all were serviceably sound, with two in training as pleasure horses and one case continuing retirement.
In conclusion, ultrasonography was the most informative imaging modality and paramount in obtaining synovial fluid samples for definitive diagnosis of septic bicipital bursitis.
Bursoscopy performed under standing sedation is a feasible treatment option. Horses treated for bicipital septic bursitis have a fair prognosis for survival and may return to some level of athletic performance.
Pius Spiesshofer et al. “Septic inflammation of the bicipital bursa: clinical, imaging, and surgical findings in nine horses.” J Am Vet Med Assoc. 23 May 2023;1-8. doi: 10.2460/javma.23.02.0074.
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