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Diagnosis
Conditions or ailments that are the cause of a problem that you see - your observation.

Your vet may diagnose

Clostridial Muscle & Fascia Infection (Myonecrosis)

Synonyms: Clostridial Myositis, Gas Gangrene, Malignant Edema

Summary

Clostridial myonecrosis is a rare, but massive and life-threatening infection of muscle and connective tissue. It is caused by one of the types of anaerobic (lives without oxygen) Clostridium bacteria.

The infection usually results from injection of an irritating substance into the muscle. It has been more frequently associated with the intra-muscular injection of flunixin meglumine (Banamine). Similar infections can also be caused by puncture wounds, and can be a rare complication after castration or other surgery.

It has been thought historically that the organism was carried into the tissues on the needle or was within the medication. A study has shown that dormant Clostridia (spores) actually can be found within healthy muscle tissue of normal horses. Irritation to this tissue creates a good environment for activation of the dormant spores and subsequent rapid bacterial growth.

The Clostridium bacteria produces severe toxins that damages and kills the tissue, creating an oxygen-free environment of dead tissue that allows increasingly rapid bacterial growth. The bacteria have specific toxins that destroy connective tissue, allowing the process to migrate through the tissues. The bacterial toxins also get into the bloodstream and cause signs of severe illness, shock and death.

Signs of this condition are a rapidly enlarging area of painful swelling. Often, gas can be felt crackling under the surface of the skin. Affected horses usually are depressed and lack appetite. Most have a fever, and have high heart and respiratory rates.

Diagnosis is usually assumed by the rapidly worsening signs of disease. i.e. a severe, painful swelling, fever and illness in a horse that was recently injected. Definitive diagnosis requires confirmation of gas and fluid accumulation in the tissues and detection (and culture or other identification) of Clostridium bacteria in the living horse.

Treatment requires aggressive use of appropriate intravenous antibiotics, surgical opening of the infected areas and in many cases, intensive care with IV fluids and other medications.

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OTHER DIAGNOSES CONSIDERED

Other conditions or ailments that might also need to be ruled out by a vet.

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Rare
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Treatments May Include

These treatments might be used to help resolve or improve this condition.

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PROGNOSIS AND RELEVANT FACTORS

The prognosis depends on the specific case and how quickly the problem is recognized and treated. The prognosis is fair if the infection is identified and treated early. The prognosis is very poor if signs of shock have already commenced. The prognosis also depends upon the specific Clostridium species involved.

Poor injection technique probably increases the likelihood of the condition, through increased tissue damage.

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I might observe

You might make these observations when a horse has this condition.

Very Common
Less Common
Rare
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Questions To Ask Your Vet:
  • What caused this infection?
  • Should the affected areas be opened up surgically (fasciotomy)?
Prevention

Do not inject tissue irritating solutions into the muscle. Some of these should only be given intravenously. Discuss with your vet whether a solution can be given orally rather than by intra-muscular injection. When performing IM injection, always use good injection technique.

further reading & resources


Related References:

Peek, Semrad, Perkins. Clostridial myonecrosis in horses (37 cases 1985–2000). EQUINE VETERINARY JOURNAL Equine vet. J. (2003) 35 (1) 86-92

Vengust M, Arroyo LG, Weese JS, Baird JD. Preliminary evidence for dormant clostridial spores in equine skeletal muscle. Equine vet. J. (2003) 35 (5) 514-516

Peek SF, Semrad SD Perkins GD: Clostridial Myonecrosis in Horses. AAEP Proceedings 2002

Higgins AJ, Snyder JR eds. The Equine Manual. 2nd Ed. Edinburgh: Elsevier Saunders 2006.

Author: Doug Thal DVM Dipl. ABVP