Factors Associated with Outcome in 49 Horses Treated Surgically for Septic or Contaminated Digital Flexor Tenosynovitis (2008–2023)

Introduction: Contamination or infection of the digital flexor tendon sheath due to traumatic injury is common and may involve concurrent soft tissue or bony injuries. Long-term outcomes and prognoses for the athleticism of such cases are lacking.

Materials and Methods: Retrospective analysis of 49 adult horses that underwent surgical treatment for sepsis or contamination of the DFTS between 2008 and 2023. Long-term follow-up was gathered from owners via phone interview. Descriptive statistics and nonparametric analysis using Wilcoxon rank sum and chi-squared tests were performed.

Results: The most common inciting cause was trauma (i.e., wound or laceration). Survival to discharge was 84% (41/49). Lameness grade at admission was significantly higher in nonsurvivors (median 5, range: 4–5) than survivors (median 4, range: 3–5; p = 0.0106). There was no difference in survival or return to athleticism in horses with concurrent pathology (p = 0.1741). Switching antibiotics used for intravenous regional limb perfusion was associated with nonsurvival (p < 0.0001). Nine of 12 (75%) pleasure horses returned to use. For the athletic horses, 15/21 (72%) returned to the same level of performance or higher. Three of 15 horses re-injured giving a long-term return to performance of 12/21 (57%).

Discussion/Conclusion: There was no significant difference in survival in horses with concurrent pathology which is contrary to the hypothesis of the study. Overall, survival to discharge was 84%, with 72% of athletic horses initially returning to the same level of performance or higher. This study provides valuable information for clinicians and clients when prognosticating for these types of cases.

Acknowledgment

None.

 

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Publication History

Article published online:
15 July 2025