A case of swelling of the right hind limb in a sheep near the stifle joint was presented for evaluation. There was non-weight bearing of the affected limb along with the slowly growing swelling from last 7 days. The case was diagnosed as abscess based on the aspiration of the contents from the swelling. Radiograph of the right femur revealed the midshaft diaphyseal fracture with overriding of the fracture ends. A case of abscess due to the open fracture of femur in sheep is being placed for record
An abscess is circumscribed inflammatory lesion consisting of purulent exudates ‘the pus’-dead neutrophils and dead tissue surrounded by a limiting membrane ‘the pyogenic membrane’. The character of pus varies with the causative organism. The most common cause of abscess, lumps and knots in case of sheep and goats is the caseous Lymphadenitis. The fracture that communicates with the outside environment is known as the open or compound fracture. This may occur through a large wound in the soft tissue and skin or through a tiny puncture wound. Regardless of wound size, any fracture that has communicated with the outside is considered an open fracture (Newton, 1985). Open fractures are orthopedic emergencies due to the risk of infection secondary to contamination and compromised soft tissue and sometimes vascular supply and associated healing problems (Buteera and Byimana, 2009). The success rate for the treatment of open fracture depends on the severity of soft tissue damage, the bone affected, the age of the patient, the duration and degree of contamination of the wound, and the economic limitations placed on fracture management (Anderson and St. Jean, 2008).
Case History and Observations
A sheep was presented to the Division of Veterinary Surgery and Radiology, FVSc and AH, SKUAST-K with the history of a lameness of right hind limb since 7 days. The cause of lameness was unknown to the owner. On examination of the right hind limb, the leg was found swollen and inflamed in the thigh region and a scar was seen on the medial side of the thigh (Fig. 1). On palpation the affected area appeared tense and light crepitation of right femur was also felt although it was not that prominent owing to the inflammation. The animal exhibited signs of pain upon palpation. Animal was unable to bear weight on the right hind limb. Medio-lateral radiograph of the right femur was taken.
Treatment and Discussion
The area was clipped and prepared aseptically with the betadine scrub solution. The needle aspiration was performed which yielded off smelling thick yellowish material that was sent for isolation of the microorganism and antibiotic sensitivity test. The swelling was lanced with no. 11 BP blade and the contents of the swelling were evacuated by applying firm pressure from the outside followed by flushing with Potassium Permagnate (KMnO4) solution then filling the cavity with gauze soaked in the Povidone Iodine solution. Around half a kg of thick yellowish pus was drained from the affected part. The most common cause of the abscess in sheep and goat has been ascribed to the caseous Lymphadenitis. Abscesses have also been reported following shearing in sheep (de la Fuente et al., 1997). However in the present case, no organism could be cultured and isolated which could be due to the anaerobic organisms as the cause of abscess. Similarly Al Qudah and Al Majali (2003) could not isolate bacteria from the 40 cases of liver abscesses in sheep. The animal was kept on the empirical antibiotic combination of Ampicillin and Cloxacillin @10mg/kg b.wt till the bacterial susceptibility results were received and the Melonex @ 0.5 mg/ kg b.wt for 3 days. Medio-lateral radiograph of the right femur was taken before the aspiration of the abscess that revealed the mid-shaft femoral fracture with overriding of the fracture ends. In the present case, the prime cause of abscessation appeared entry of organism through the wound caused by fracture that
|Fig. 1: Swelling at the stifle joint of the right hind limb
Fig 2 – Pus draining out from wound
had a left a scar at the medial side of right thigh. The owner was advised to bring the animal for the repair of the femoral fracture but he did not turn up for the same.
The swelling was diagnosed as abscess on the needle aspiration and was treated as per the standard procedure. Medio-lateral radiograph confirmed the fracture of the right femur. The present case was managed with adequate debridement and copious lavage of the abscess. The present report emphasizes the need for early treatment of the open fracture in sheep to avoid complications like development of abscess due to secondary contamination and other problems osteomyelitis, healing problems and subsequent morbidity.
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Al-Qudah K and Al-Majali A. 2003. Bacteriologic studies of liver abscesses of Awassi sheep in Jordan Small Ruminant Research. 47(3): 249-253.
Newton C D. 1985. Etiology, classification, and diagnosis of fractures. http://cal.vet.upenn.edu/projects/saortho/chapter_11/11mast.htm.
Buteera A M and Byimana J. 2009. Principles of Management of Open Fractures. East and Central African Journal of Surgery. 14(2): 2-8.
Anderson D E and St. Jean Guy. 2008. Management of fractures in field settings. Veterinary Clinics of North America Food Animal Practice. 24 (3): 567-582.