Temporomandibular septic arthritis in a horse

Abstract

Sonny is a 20-year-old male castrated Morgan horse that presented with the chief complaints of quidding, fevers, and a draining abscess over his left eye. He had a previous episode of fever 6 months before, which was successfully treated with oral antibiotics, but subsequently lost a significant amount of weight. The weight loss was partially reversed with addition of grain to the diet. Just prior to presentation at Cornell Sonny's owners noted that he was having difficulty chewing and prehending his food and was depressed. He also suffered from evening fever spikes as high as 103.6 degrees F. Sonny was consequently taken to the referring veterinarian who noted left masseter muscle atrophy, a nose pull to the right, and an abscess over the left temporal area. On presentation at Cornell, physical examination revealed a moderately underconditioned horse that was slightly depressed, lethargic, but non-febrile. A 10 cm diameter draining abscess was centered over the left temporomandibular joint. Moderate masseter muscle atrophy was noted on the left side as well as a slight nose pull to the right. The remainder of the physical exam was within normal limits. From the history and physical exam findings, a problem list was formulated and included: draining abscess, fever, difficulty prehending food, nose pull, masseter atrophy, weight loss, and depression.