Case Study 5 - Giggs

Giggs, a nine year old gelding, came into the clinic on a Saturday afternoon as a classic hunting injury, the sort of case that keeps us on our toes during the winter months! He had caught his hind leg whilst jumping a stone wall, parted with his jockey and unfortunately ripped open a hind fetlock. So the team at Peasebrook were presented with a horrible wound over the front of the joint, the extensor tendon was also exposed and damaged. Needless to say all these structures were very contaminated with mud!

Giggs was consequently very lame and feeling sorry for himself. Luckily his owners love him dearly and there was no question that he would go to surgery. In order to fully evaluate the injury we took x-rays of the fetlock region which as you can see, show a notch in the medial condyle of the cannon bone due to the impact with the wall. The prognosis was not good as joint infection is very serious.

Giggs was anaesthetised, the wounds were cleaned and debrided. We used the arthroscope to enter the fetlock well away from the wound so that we could thoroughly examine the joint. Twenty litres of sterile saline were flushed through the fetlock joint using a special pump to remove all the debris and bacteria. The damaged bone on the medial condyle was curetted so that it was left smooth. Antibiotic impregnated sponges were placed in the joint to help prevent sepsis. The wound to the extensor tendon was partially repaired and the whole lower limb was carefully dressed. Surgery time was about two hours, Giggs had a smooth recovery from the anaesthetic and was in remarkably good shape when we moved him back to a stable.

The first 24 to 48 hours are crucial in a case like this. We usually don’t give any pain killers to these patients as we need to see exactly how sore they are. The level of pain is a good indicator on whether the infection is under control. Sometimes we take joint fluid samples post surgery to check the white cell count and protein levels to give us further information. If a case is showing a sign of deteriorating i.e. the horse is becoming more painful, we might advise a second joint flush. Thankfully Giggs progressed very well, we kept him on broad spectrum intravenous antibiotics for seven days and then he was able to go home.

The picture below shows the horse when he came back to Peasebrook for a recent check-up. He was free from lameness and only needed some remedial massage on his back muscles to improve his mobility. Giggs is now back in full work but will probably stay clear of the hunting field!