The first case report on metacarpal osteomyelitis in a horse in Ethiopia

The first case report on metacarpal osteomyelitis in a horse in Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report The first case report on metacarpal osteomyelitis in a horse in Ethiopia Waktole Yadeta, Sisay Girma, Takele Beyene, Reta Tesfaye This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3827809/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Osteomyelitis is a bone infection that can occur in horses and can affect any bone in the body, including the metacarpal bone. The metacarpal bone, located in the front leg of the horse between the knee and the fetlock joint, is commonly affected by osteomyelitis caused by bacterial infection. Horse metacarpal osteomyelitis disease has been reported in different countries. However, there are no previous case reports of this disease in Ethiopia. Therefore, this case report was conducted to describe a case of metacarpal osteomyelitis infection in a 10-year-old stallion brought to the Society for the Protection of Animals Abroad (SPANA), Equine Hospital of Addis Ababa University, College of Veterinary Medicine and Agriculture, on November 10, 2020. Case presentation: The horse was presented with a history of decreased work capacity, depression, swelling, and lameness in the lower left foreleg. The physical examination showed clinical signs of depression, erratic gait, poor body condition, pale mucous membranes from fever and a slightly increased heart rate with normal respiratory rates. In addition, lameness of the left foreleg, pain and hot swelling were found on the left metacarpal bone and tissue, with an abscess. Diagnostic aids and X-rays were used to identify swelling of the affected metacarpal bone, revealing soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours. Microbiological culture of the affected tissue revealed Staphylococcus bacteria. Finally, we confirmed the case as metacarpal osteomyelitis caused by Staphylococcus bacteria. A combination of antibiotics (penicillin) and an anti-inflammatory drug (phenylbutazone) was administered. The condition of the horse improved (with reduced swelling and lameness), and the horse recovered after 3 weeks. Unfortunately, since the horse was sold by the owner after recovery, long-term follow-up and health check-ups were not conducted. Conclusions : In conclusion, this is the first case report of metacarpal osteomyelitis in a horse in Ethiopia, and the findings show the importance of appropriate diagnosis and medication for successful treatment of this disease. Metacarpal osteomyelitis Horse Clinical Sign X-ray Staphylococcus Treatment Ethiopia Figures Figure 1 Figure 2 Background Osteomyelitis can occur in horses and can affect any bone in the body, including the metacarpal bone. The metacarpal bone is located in the front leg of the horse between the knee and the fetlock joint. Osteomyelitis of the metacarpal bone is commonly referred to as "big knee" in horses [1, 2]. Osteomyelitis of the metacarpal bone in horses is commonly caused by bacterial infection. Bacteria can reach the bone through a wound or injury to the leg, or they can also spread from an adjacent infected area, such as a joint or tendon sheath. Once bacteria reach the bone, they can cause inflammation and destruction of the bone tissue, leading to the formation of an abscess [3]. Clinical signs of the disease include swelling, pain, heat, and lameness. In severe cases, drainage may occur from the affected area, and the horse may experience fever [3, 4]. A diagnosis of the disease involves a physical examination; diagnostic imaging, such as radiography or ultrasound; and laboratory tests to identify the causative agent [5, 6]. Treatment for metacarpal bone osteomyelitis in horses typically involves antibiotics, anti-inflammatory medications, and rest. In severe cases, surgery may be necessary to remove infected tissue or bone. Early diagnosis and treatment are crucial for successful treatment of this disease [7, 8]. Metacarpal osteomyelitis in horses has been reported in different countries worldwide [4, 6]. However, there is no single report of this disease in horses in Ethiopia. Therefore, this case report was undertaken to describe the occurrence, clinical signs, diagnosis, treatment, and outcome of osteomyelitis in a horse diagnosed with metacarpal osteomyelitis at the SPANA Equine Hospital. Case presentation On 10 November 2020, a 10-year-old local breed stallion was presented to the SPANA equine hospital with a history of swelling and lameness and a decrease in working ability for one week. The horse was used as a carthorse and was kept under shade in the owner’s compound. It usually feeds on concentrated feed and grass. The patient had a recent history of deworming and lameness that resolved without treatment. However, there were no recent changes in diet, environment or work. On physical examination, the horse had depression, lameness of the left forelimb, painful and hot swelling of the lower left forelimb (metacarpal bone) (Figure 1a) with an abscess on needle aspiration, fever with a rectal temperature of 38.5°C, poor body condition, pale mucous membranes, and a slightly increased heart rate (48 beats/min) with a normal respiratory rate (16 breaths/min). In addition, X-ray was used to identify swelling of the metacarpal bone of the left limb. X-ray analysis revealed soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours (rough bone with irregular edges) (Figure 1b). However, all the other areas and systems appeared normal. Investigation The laboratory diagnosis of the patient involved bacterial culture to determine the etiology. To collect a sample for bacterial culture, after superficial skin disinfection, a deep part of the infected tissue was collected aseptically by a fine needle aspiration technique. The sample was immediately taken to the microbiology laboratory of Addis Ababa University, College of Veterinary Medicine and Agriculture. The sample was then streaked on prepared 5% sheep blood agar, mannitol salt agar (MSA) media and McConkey agar and incubated at 37°C for 24 hours. After 24 hours of incubation, beta hemolysis was observed on blood agar (Figure 2a), a colony of bacteria was grown on MSA medium, while no bacteria were grown on McConkey agar. The results of the bacterial culture showed the growth of circular, smooth, and shiny colonies with yellowish discoloration on the MSA media (Figure 2b). Gram staining of the colonies revealed gram-positive bacteria (purple) with a coccus shape that were arranged in clusters (Figure 2c). The culture results revealed the cause of the disease to be Staphylococcus aureus (it ferments mannitol, yellowish). Based on the patient’s medical history, clinical signs, and laboratory findings, the patient was diagnosed with metacarpal osteomyelitis caused by Staphylococcus aureus. Management and Treatment Outcomes Treatment for the disease involved a combination of antibiotics and anti-inflammatory drugs. On the first day, treatment started with a broad-spectrum antibiotic (Penstrep), but the treatment was changed to penicillin on the second day, which continued through the fifth day after confirmatory diagnosis. Phenyl butazone (pos) was used as an anti-inflammatory agent to ameliorate the disease. In addition, the abscess was opened with a 20 cc syringe and drained. The samples were subsequently washed and soaked in Savlon and iodine. Finally, the owner was advised to rest, take care of the horse by providing food and water, and follow-up. After treatment, the horse’s condition improved, swelling was reduced, lameness stopped, and the horse became active (Figure 2d). According to the owner, the horse reached full health after three weeks. Although the owner was asked to bring the horse for check-up on one mother after treatment, the horse was sold by the owner, fearing that the case might relapse. Discussion Osteomyelitis is a severe and debilitating condition that affects horses, potentially leading to decreased working ability, suffering, and reduced welfare [ 9 ]. This case report describes a patient with osteomyelitis diagnosed at AAU-CVMA, SPANA equine Hospital, in a 10-year-old stallion; this patient presented symptoms of swelling and lameness in the lower part of the left forelimb, decreased working ability, depression, fever, and poor body condition. X-ray and bacterial culture assisted in the diagnosis of osteomyelitis, and treatment involving antibiotics and anti-inflammatory medication was initiated. The horse's condition improved, with swelling and lameness stopping and the horse becoming active again. The clinical signs described in this case report, including pain, heat, swelling and poor range of motion of the affected limb and abscess, are consistent with other case reports of metacarpal bone osteomyelitis in horses [ 8 , 10 ]. In this case, clinical signs and radiography (X-ray) were used and played an important role in the diagnosis of the patient. This finding is in agreement with other case reports [ 5 , 6 ]. According to [ 6 ], a strong clinical diagnosis of osteomyelitis is usually based on a combination of clinical observations and diagnostic imaging, including radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). However, CT and MRI were not used in this case due to the unavailability of the equipment. The X-ray results revealed soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours (rough bone with irregular edges), which indicated inflammation and infection. This finding is consistent with the findings of other similar cases of osteomyelitis in horses [ 11 , 12 ]. Laboratory diagnosis of metacarpal bone osteomyelitis typically involves bacterial culture and testing for sensitivity of the draining sinus or other sources of infection [ 5 ]. This finding is consistent with the diagnosis made in this case report. However, in this case, sensitivity testing was not performed due to the inaccessibility of the antibiotic disc. In this case, Staphylococcus aureus was identified as the etiology of the disease. This finding is in line with [ 13 , 14 ], who reported Staphylococcus aureus as the cause of osteomyelitis in horses, but in contrast to [ 2 ], who reported Clostridium perfringens. Treatment of metacarpal bone osteomyelitis in horses usually involves a combination of antibiotics, anti-inflammatory medications, and surgery if severe [ 8 ]. This finding is consistent with the treatment plan, except for surgery, described in this case report. The outcome of this patient's treatment was successful, which is consistent with the findings of [ 7 ], who reported successful treatment of osteomyelitis in horses. Conclusions This is the first case report of metacarpal osteomyelitis in a horse in Ethiopia. This case highlights the importance of proper diagnosis and treatment of osteomyelitis, including abscess debridement and the administration of appropriate antibiotics, for successful clinical outcomes in horses suffering from this disease. Abbreviations AAU-CVMA Addis Ababa University, College of Veterinary Medicine and Agriculture CT Computed tomography MRI Magnetic resonance imaging MSA Mannitol Salt Agar SPANA Society for the Protection of Animals Abroad Declarations Ethics approval and consent to participate The authors confirm that the ethical policies of the journal, as noted on the journal's author guidelines page, have been adhered to. No ethical approval was needed, as this was a case report with no original research data. The owner gave informed written consent for all the investigations. Consent for publication: All the authors agreed to the publication of this case report. Availability of data and materials: All the data generated or analyzed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Funding The authors received no specific funding for this work. Authors' contributions WY followed the clinical case and drafted the manuscript. RT performed the X-ray. SG AND TB was involved in the diagnosis and treatment of the patients and improved the manuscript. All the authors read and approved the final manuscript. Acknowledgments We express our gratitude to the staff of the Society for the Protection of Animals Abroad (SPANA), Addis Ababa University, College of Veterinary Medicine and Agriculture, Bishoftu, Ethiopia, for their collaboration during the diagnosis of the case. We also extend our appreciation to the horse owner for granting consent and cooperating with us in addressing this case. References Rose, R. J. (1978). Surgical treatment of osteomyelitis in the metacarpal and metatarsal bones of the horse. The Veterinary Record , 102 (23), 498-500. Smith, C. E., Cullen, M. D., Forman, I. M., Talbot, A. M., & Stack, J. D. (2022). Diffuse osteomyelitis of the fourth metacarpal bone in a horse caused by Clostridium perfringens . Equine Veterinary Education, 34 (3), e125-e132. Goodrich, L. R. (2006). Osteomyelitis in horses. Veterinary Clinics: Equine Practice , 22 (2), 389-417. Sayegh, A. I., Sande, R. D., Besser, T. E., Ragle, C. A., Tucker, R. L., & Baker, G. J. (2001). Appendicular osteomyelitis in horses: etiology, pathogenesis, and diagnosis. Compendium on Continuing Education for the Practising Veterinarian-North American Edition-, 23 (8), 760-760. Gieling, F., Peters, S., Erichsen, C., Richards, R. G., Zeiter, S., & Moriarty, T. F. (2019). Bacterial osteomyelitis in veterinary orthopedics: pathophysiology, clinical presentation and advances in treatment across multiple species. The Veterinary Journal , 250 , 44-54. Balducci, J., Ruby, J., Hall, C., & Williams, J. (2021). Arthrotomy, curettage and medical management of septic arthritis and osteomyelitis of the temporomandibular joint in a horse. Equine Veterinary Education , 33 (1), e5-e11. Frazer, M. L., & Stewart, A. J. (2017). Osteomyelitis in horses. Veterinary Clinics of North America: Equine Practice, 33 (1), 1-16. Divers, T. J., & Ducharme, N. G. (2018). Osteomyelitis. In Equine Internal Medicine (Fourth Edition) (pp. 1079-1082). Elsevier. Hillyer, M. H., Taylor, F. G., & Taylor, K. (2017). Osteomyelitis in horses: a review of 11 cases. Equine Veterinary Education, 29 (2), 91-97. Reef, V. B. (2018). Osteomyelitis. In Current Therapy in Equine Medicine (Eighth Edition) (pp. 102-105). Elsevier. Swinebroad, E. L., Dabareiner, R. M., Swor, T. M., Carter, G. K., Watkins, J. P., Walker, M., . & Honnas, C. M. (2003). Osteomyelitis secondary to trauma involving the proximal end of the radius in horses: five cases (1987–2001). Journal of the American Veterinary Medical Association , 223 (4), 486-491. Clegg, P. D. (2011). Osteomyelitis in the veterinary species. Biofilms and Veterinary Medicine , 175-190. Tulamo, R. M., & Alitalo, I. (1986). An unusual case of osteomyelitis in a horse. Equine veterinary journal , 18 (5), 404-407. Orsini, J. A. (2017). Update on managing serious wound infections in horses: wounds involving bone. Journal of Equine Veterinary Science , 55 , 123-138. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3827809","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":265139763,"identity":"f1953534-80a1-4801-96bf-418905fde2da","order_by":0,"name":"Waktole Yadeta","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDklEQVRIie3RMUsDMRTA8ScHcQnteoegfoQHwol4nJ9FAunSQehyg0hLwVHXCn6JfoN3BNpFvTXQRRHq0iFTcWpNzlpwiOcomD8E3pAfLxCAUOhPxuy5qCe0J4vcFDeQnX592RECuSU/sO9EQSPB6aTzbDCzgxq/mstqFykqZxyyKy95kOVghNINPaTJLEJi4pSD9G5JqTMYclSA1E1jYo7wdI+D8pPqzZE1YLU4fqfVkyXtpSVrP9GytIQAdTeF8prcFmYJecmZnp/fjVDwRM978eONiBLFjk7uUSR9D0luJRpT5PutSoxNscxFazp80Ysib/u2fMUP6XMQUH8mNgHbweYd+S/uhkKh0D/rA663WDJqgBT6AAAAAElFTkSuQmCC","orcid":"","institution":"Jimma University","correspondingAuthor":true,"prefix":"","firstName":"Waktole","middleName":"","lastName":"Yadeta","suffix":""},{"id":265139764,"identity":"ad83a406-8010-4b96-b07e-4c53566605f5","order_by":1,"name":"Sisay Girma","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Sisay","middleName":"","lastName":"Girma","suffix":""},{"id":265139765,"identity":"882b6f57-c07e-44c4-8198-bfed1da8e328","order_by":2,"name":"Takele Beyene","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Takele","middleName":"","lastName":"Beyene","suffix":""},{"id":265139766,"identity":"10598ae1-0bb2-4218-8f8d-23b63989ace5","order_by":3,"name":"Reta Tesfaye","email":"","orcid":"","institution":"Society for The Protection of Animals Abroad (SPANA), Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Reta","middleName":"","lastName":"Tesfaye","suffix":""}],"badges":[],"createdAt":"2024-01-01 16:29:45","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3827809/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3827809/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49234978,"identity":"46c2b3d1-1392-48c7-ba33-3b8671607ac3","added_by":"auto","created_at":"2024-01-05 17:48:54","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":406009,"visible":true,"origin":"","legend":"\u003cp\u003eHorse metacarpal osteomyelitis\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3827809/v1/25d91142f8a98819879c4ed3.png"},{"id":49234979,"identity":"4c50708a-3fd1-465b-86f8-aafd88500dd5","added_by":"auto","created_at":"2024-01-05 17:48:55","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":670366,"visible":true,"origin":"","legend":"\u003cp\u003eLaboratory investigation of horse metacarpal osteomyelitis (a-c) and recovery (d)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3827809/v1/2a0f458b8ca39218138805ca.png"},{"id":75125028,"identity":"c30376ca-9c54-4358-90c3-48fa179ae121","added_by":"auto","created_at":"2025-01-30 19:01:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1777752,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3827809/v1/76eeb99a-651b-4637-9c4d-1d7351d678af.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The first case report on metacarpal osteomyelitis in a horse in Ethiopia","fulltext":[{"header":"Background","content":"\u003cp\u003eOsteomyelitis can occur in horses and can affect any bone in the body, including the metacarpal bone. The metacarpal bone is located in the front leg of the horse between the knee and the fetlock joint. Osteomyelitis of the metacarpal bone is commonly referred to as \"big knee\" in horses [1, 2].\u003c/p\u003e\n\u003cp\u003eOsteomyelitis of the metacarpal bone in horses is commonly caused by bacterial infection. Bacteria can reach the bone through a wound or injury to the leg, or they can also spread from an adjacent infected area, such as a joint or tendon sheath. Once bacteria reach the bone, they can cause inflammation and destruction of the bone tissue, leading to the formation of an abscess [3].\u003c/p\u003e\n\u003cp\u003eClinical signs of the disease include swelling, pain, heat, and lameness. In severe cases, drainage may occur from the affected area, and the horse may experience fever [3, 4].\u003c/p\u003e\n\u003cp\u003eA diagnosis of the disease involves a physical examination; diagnostic imaging, such as radiography or ultrasound; and laboratory tests to identify the causative agent [5, 6].\u003c/p\u003e\n\u003cp\u003eTreatment for metacarpal bone osteomyelitis in horses typically involves antibiotics, anti-inflammatory medications, and rest. In severe cases, surgery may be necessary to remove infected tissue or bone. Early diagnosis and treatment are crucial for successful treatment of this disease [7, 8].\u003c/p\u003e\n\u003cp\u003eMetacarpal osteomyelitis in horses has been reported in different countries worldwide [4, 6]. However, there is no single report of this disease in horses in Ethiopia. Therefore, this case report was undertaken to describe the occurrence, clinical signs, diagnosis, treatment, and outcome of osteomyelitis in a horse diagnosed with metacarpal osteomyelitis at the SPANA Equine Hospital.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eOn 10 November 2020, a 10-year-old local breed stallion was presented to the SPANA equine hospital with a history of swelling and lameness and a decrease in working ability for one week. The horse was used as a carthorse and was kept under shade in the owner\u0026rsquo;s compound. It usually feeds on concentrated feed and grass. The patient had a recent history of deworming and lameness that resolved without treatment. However, there were no recent changes in diet, environment or work.\u003c/p\u003e\n\u003cp\u003eOn physical examination, the horse had depression, lameness of the left forelimb, painful and hot swelling of the lower left forelimb (metacarpal bone) (Figure 1a) with an abscess on needle aspiration, fever with a rectal temperature of 38.5\u0026deg;C, poor body condition, pale mucous membranes, and a slightly increased heart rate (48 beats/min) with a normal respiratory rate (16 breaths/min). In addition, X-ray was used to identify swelling of the metacarpal bone of the left limb. X-ray analysis revealed soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours (rough bone with irregular edges) (Figure 1b). However, all the other areas and systems appeared normal.\u003c/p\u003e\n\u003cp\u003eInvestigation\u003c/p\u003e\n\u003cp\u003eThe laboratory diagnosis of the patient involved bacterial culture to determine the etiology. To collect a sample for bacterial culture, after superficial skin disinfection, a deep part of the infected tissue was collected aseptically by a fine needle aspiration technique.\u003c/p\u003e\n\u003cp\u003eThe sample was immediately taken to the microbiology laboratory of Addis Ababa University, College of Veterinary Medicine and Agriculture. The sample was then streaked on prepared 5% sheep blood agar, mannitol salt agar (MSA) media and McConkey agar and incubated at 37\u0026deg;C for 24 hours. After 24 hours of incubation, beta hemolysis was observed on blood agar (Figure 2a), a colony of bacteria was grown on MSA medium, while no bacteria were grown on McConkey agar.\u003c/p\u003e\n\u003cp\u003eThe results of the bacterial culture showed the growth of circular, smooth, and shiny colonies with yellowish discoloration on the MSA media (Figure 2b). Gram staining of the colonies revealed gram-positive bacteria (purple) with a coccus shape that were arranged in clusters (Figure 2c). The culture results revealed the cause of the disease to be \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (it ferments mannitol, yellowish). Based on the patient\u0026rsquo;s medical history, clinical signs, and laboratory findings, the patient was diagnosed with metacarpal osteomyelitis caused by \u003cem\u003eStaphylococcus aureus.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eManagement and Treatment Outcomes\u003c/p\u003e\n\u003cp\u003eTreatment for the disease involved a combination of antibiotics and anti-inflammatory drugs. On the first day, treatment started with a broad-spectrum antibiotic (Penstrep), but the treatment was changed to penicillin on the second day, which continued through the fifth day after confirmatory diagnosis. Phenyl butazone (pos) was used as an anti-inflammatory agent to ameliorate the disease. In addition, the abscess was opened with a 20 cc syringe and drained. The samples were subsequently washed and soaked in Savlon and iodine. Finally, the owner was advised to rest, take care of the horse by providing food and water, and follow-up. After treatment, the horse\u0026rsquo;s condition improved, swelling was reduced, lameness stopped, and the horse became active (Figure 2d). According to the owner, the horse reached full health after three weeks. Although the owner was asked to bring the horse for check-up on one mother after treatment, the horse was sold by the owner, fearing that the case might relapse.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOsteomyelitis is a severe and debilitating condition that affects horses, potentially leading to decreased working ability, suffering, and reduced welfare [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This case report describes a patient with osteomyelitis diagnosed at AAU-CVMA, SPANA equine Hospital, in a 10-year-old stallion; this patient presented symptoms of swelling and lameness in the lower part of the left forelimb, decreased working ability, depression, fever, and poor body condition. X-ray and bacterial culture assisted in the diagnosis of osteomyelitis, and treatment involving antibiotics and anti-inflammatory medication was initiated. The horse's condition improved, with swelling and lameness stopping and the horse becoming active again.\u003c/p\u003e \u003cp\u003eThe clinical signs described in this case report, including pain, heat, swelling and poor range of motion of the affected limb and abscess, are consistent with other case reports of metacarpal bone osteomyelitis in horses [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this case, clinical signs and radiography (X-ray) were used and played an important role in the diagnosis of the patient. This finding is in agreement with other case reports [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. According to [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], a strong clinical diagnosis of osteomyelitis is usually based on a combination of clinical observations and diagnostic imaging, including radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). However, CT and MRI were not used in this case due to the unavailability of the equipment.\u003c/p\u003e \u003cp\u003eThe X-ray results revealed soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours (rough bone with irregular edges), which indicated inflammation and infection. This finding is consistent with the findings of other similar cases of osteomyelitis in horses [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLaboratory diagnosis of metacarpal bone osteomyelitis typically involves bacterial culture and testing for sensitivity of the draining sinus or other sources of infection [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This finding is consistent with the diagnosis made in this case report. However, in this case, sensitivity testing was not performed due to the inaccessibility of the antibiotic disc.\u003c/p\u003e \u003cp\u003eIn this case, \u003cem\u003eStaphylococcus aureus\u003c/em\u003e was identified as the etiology of the disease. This finding is in line with [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], who reported \u003cem\u003eStaphylococcus aureus\u003c/em\u003e as the cause of osteomyelitis in horses, but in contrast to [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], who reported \u003cem\u003eClostridium perfringens.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eTreatment of metacarpal bone osteomyelitis in horses usually involves a combination of antibiotics, anti-inflammatory medications, and surgery if severe [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This finding is consistent with the treatment plan, except for surgery, described in this case report. The outcome of this patient's treatment was successful, which is consistent with the findings of [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], who reported successful treatment of osteomyelitis in horses.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis is the first case report of metacarpal osteomyelitis in a horse in Ethiopia. This case highlights the importance of proper diagnosis and treatment of osteomyelitis, including abscess debridement and the administration of appropriate antibiotics, for successful clinical outcomes in horses suffering from this disease.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAAU-CVMA \u0026nbsp; \u0026nbsp; \u0026nbsp; Addis Ababa University, College of Veterinary Medicine and Agriculture\u003c/p\u003e\n\u003cp\u003eCT \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Computed tomography\u003c/p\u003e\n\u003cp\u003eMRI \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Magnetic resonance imaging\u003c/p\u003e\n\u003cp\u003eMSA \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Mannitol Salt Agar\u003c/p\u003e\n\u003cp\u003eSPANA \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Society for the Protection of Animals Abroad\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors confirm that the ethical policies of the journal, as noted on the journal's author guidelines page, have been adhered to. No ethical approval was needed, as this was a case report with no original research data. The owner gave informed written consent for all the investigations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eAll\u0026nbsp;the\u0026nbsp;authors agreed to\u0026nbsp;the\u0026nbsp;publication of this case report.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll\u0026nbsp;the\u0026nbsp;data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing\u0026nbsp;interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWY followed the clinical case and drafted the manuscript.\u0026nbsp;RT\u0026nbsp;performed\u0026nbsp;the X-ray. SG AND TB\u0026nbsp;was\u0026nbsp;involved in\u0026nbsp;the\u0026nbsp;diagnosis and treatment\u0026nbsp;of the patients\u0026nbsp;and improved the manuscript.\u0026nbsp;All\u0026nbsp;the\u0026nbsp;authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe express our gratitude to the staff of the Society for the Protection of Animals Abroad (SPANA), Addis Ababa University, College of Veterinary Medicine and Agriculture, Bishoftu, Ethiopia, for their collaboration during the diagnosis of the case. We also extend our appreciation to the horse owner for granting consent and cooperating with us in addressing this case.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eRose, R. J. (1978). Surgical treatment of osteomyelitis in the metacarpal and metatarsal bones of the horse. \u003cem\u003eThe Veterinary Record\u003c/em\u003e, \u003cstrong\u003e102\u003c/strong\u003e(23), 498-500.\u003c/li\u003e\n \u003cli\u003eSmith, C. E., Cullen, M. D., Forman, I. M., Talbot, A. M., \u0026amp; Stack, J. D. (2022). Diffuse osteomyelitis of the fourth metacarpal bone in a horse caused by \u003cem\u003eClostridium perfringens\u003c/em\u003e. \u003cem\u003eEquine Veterinary Education,\u003c/em\u003e\u003cstrong\u003e34\u003c/strong\u003e(3), e125-e132.\u003c/li\u003e\n \u003cli\u003eGoodrich, L. R. (2006). Osteomyelitis in horses. \u003cem\u003eVeterinary Clinics: Equine Practice\u003c/em\u003e, \u003cstrong\u003e\u003cem\u003e22\u003c/em\u003e\u003c/strong\u003e(2), 389-417.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSayegh, A. I., Sande, R. D., Besser, T. E., Ragle, C. A., Tucker, R. L., \u0026amp; Baker, G. J. (2001). Appendicular osteomyelitis in horses: etiology, pathogenesis, and diagnosis. Compendium on Continuing Education for the Practising Veterinarian-North American Edition-, \u003cstrong\u003e23\u003c/strong\u003e(8), 760-760.\u003c/li\u003e\n \u003cli\u003eGieling, F., Peters, S., Erichsen, C., Richards, R. G., Zeiter, S., \u0026amp; Moriarty, T. F. (2019). Bacterial osteomyelitis in veterinary orthopedics: pathophysiology, clinical presentation and advances in treatment across multiple species. \u003cem\u003eThe Veterinary Journal\u003c/em\u003e, \u003cstrong\u003e250\u003c/strong\u003e, 44-54.\u003c/li\u003e\n \u003cli\u003eBalducci, J., Ruby, J., Hall, C., \u0026amp; Williams, J. (2021). Arthrotomy, curettage and medical management of septic arthritis and osteomyelitis of the temporomandibular joint in a horse. \u003cem\u003eEquine Veterinary Education\u003c/em\u003e, \u003cstrong\u003e\u003cem\u003e33\u003c/em\u003e\u003c/strong\u003e(1), e5-e11.\u003c/li\u003e\n \u003cli\u003eFrazer, M. L., \u0026amp; Stewart, A. J. (2017). Osteomyelitis in horses. \u003cem\u003eVeterinary Clinics of North America: Equine Practice,\u003c/em\u003e\u003cstrong\u003e33\u003c/strong\u003e(1), 1-16.\u003c/li\u003e\n \u003cli\u003eDivers, T. J., \u0026amp; Ducharme, N. G. (2018). Osteomyelitis. In Equine Internal Medicine (Fourth Edition) (pp. 1079-1082). Elsevier.\u003c/li\u003e\n \u003cli\u003eHillyer, M. H., Taylor, F. G., \u0026amp; Taylor, K. (2017). Osteomyelitis in horses: a review of 11 cases. \u003cem\u003eEquine Veterinary Education,\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e29\u003c/strong\u003e(2), 91-97.\u003c/li\u003e\n \u003cli\u003eReef, V. B. (2018). Osteomyelitis. In Current Therapy in Equine Medicine (Eighth Edition) (pp. 102-105). Elsevier.\u003c/li\u003e\n \u003cli\u003eSwinebroad, E. L., Dabareiner, R. M., Swor, T. M., Carter, G. K., Watkins, J. P., Walker, M., . \u0026amp; Honnas, C. M. (2003). Osteomyelitis secondary to trauma involving the proximal end of the radius in horses: five cases (1987\u0026ndash;2001). \u003cem\u003eJournal of the American Veterinary Medical Association\u003c/em\u003e, \u003cstrong\u003e223\u003c/strong\u003e(4), 486-491.\u003c/li\u003e\n \u003cli\u003eClegg, P. D. (2011). Osteomyelitis in the veterinary species. \u003cem\u003eBiofilms and Veterinary Medicine\u003c/em\u003e, 175-190.\u003c/li\u003e\n \u003cli\u003eTulamo, R. M., \u0026amp; Alitalo, I. (1986). An unusual case of osteomyelitis in a horse. \u003cem\u003eEquine veterinary journal\u003c/em\u003e, \u003cstrong\u003e18\u003c/strong\u003e(5), 404-407.\u003c/li\u003e\n \u003cli\u003eOrsini, J. A. (2017). Update on managing serious wound infections in horses: wounds involving bone. \u003cem\u003eJournal of Equine Veterinary Science\u003c/em\u003e, \u003cstrong\u003e55\u003c/strong\u003e, 123-138.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Metacarpal osteomyelitis, Horse, Clinical Sign, X-ray, Staphylococcus, Treatment Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-3827809/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3827809/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Osteomyelitis is a bone infection that can occur in horses and can affect any bone in the body, including the metacarpal bone. The metacarpal bone, located in the front leg of the horse between the knee and the fetlock joint, is commonly affected by osteomyelitis caused by bacterial infection. Horse metacarpal osteomyelitis disease has been reported in different countries. However, there are no previous case reports of this disease in Ethiopia. Therefore, this case report was conducted to describe a case of metacarpal osteomyelitis infection in a 10-year-old stallion brought to the Society for the Protection of Animals Abroad (SPANA), Equine Hospital of Addis Ababa University, College of Veterinary Medicine and Agriculture, on November 10, 2020.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation:\u003c/strong\u003e The horse was presented with a history of decreased work capacity, depression, swelling, and lameness in the lower left foreleg. The physical examination showed clinical signs of depression, erratic gait, poor body condition, pale mucous membranes from fever and a slightly increased heart rate with normal respiratory rates. In addition, lameness of the left foreleg, pain and hot swelling were found on the left metacarpal bone and tissue, with an abscess. Diagnostic aids and X-rays were used to identify swelling of the affected metacarpal bone, revealing soft tissue swelling around the affected bone, slight destruction of the bone tissue, and irregular bone contours. Microbiological culture of the affected tissue revealed Staphylococcus bacteria. Finally, we confirmed the case as metacarpal osteomyelitis caused by Staphylococcus bacteria.\u003c/p\u003e\n\u003cp\u003eA combination of antibiotics (penicillin) and an anti-inflammatory drug (phenylbutazone) was administered. The condition of the horse improved (with reduced swelling and lameness), and the horse recovered after 3 weeks. Unfortunately, since the horse was sold by the owner after recovery, long-term follow-up and health check-ups were not conducted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: In conclusion, this is the first case report of metacarpal osteomyelitis in a horse in Ethiopia, and the findings show the importance of appropriate diagnosis and medication for successful treatment of this disease.\u003c/p\u003e","manuscriptTitle":"The first case report on metacarpal osteomyelitis in a horse in Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-05 17:48:50","doi":"10.21203/rs.3.rs-3827809/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aa3b23b0-1dce-4228-8644-8f75af9e319a","owner":[],"postedDate":"January 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-30T18:53:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-05 17:48:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3827809","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3827809","identity":"rs-3827809","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}