Prognosis.—There is a constant difference in the degree of pain manifested, as well as the other symptoms of inflammation, between true arthritis, which involves much of the joint, and synovitis; or synovitis plus a small circumscribed area of joint involvement. This difference is present in all joint affections of the extremities and, in passing, it is well to say that infection usually increases every manifestation of pain. Infection occasions more pronounced local symptoms of inflammation and, because of the rapid progress of necrotic destruction of cartilage, the course of the affection is usually rapid; ankylosis is a frequent result and loss of the subject is often inevitable. However, in non-infective arthritis of the fetlock joint, prognosis is favorable.
Treatment.—The same general principles which are employed in arthritis of other joints are used here. Rest and comfort for the patient is sought in every available manner. If the subject remains standing too long, the sling should be used and a well-bedded box-stall will contribute much to the comfort of the patient.
Pain and acute inflammation is diminished or controlled, if possible, by using ice-cold packs. In nervous, well-bred animals analgesic agents may be employed; or small doses of morphin sulphate—one to two grains—given at intervals of three hours during the first stages of the affection is very beneficial. This is especially indicated in infectious arthritis.
As inflammation subsides, hot applications are used and finally counter irritants are employed. Their selection is a matter of choice with the practitioner. The object sought is the same with every practitioner and while methods employed vary, results are not markedly different except in so far as the degree of counter irritation which is produced varies in given cases. Where a great degree of counter irritation is thought necessary, line-firing with the actual cautery is the remedy par excellence.
After-care.—In the course of three or four weeks subjects may be allowed the run of a paddock and, after a complete rest of six weeks at pasture, they may be returned to work with care, if the work is not of a nature to occasion concussion or other manner of irritation to the articulation.
Neurectomy is not indicated even though there is a recurrence of lameness, unless the lameness is not pronounced and inflammation is periarticular and no osseous enlargements mechanically interfere with function of the joint. There are few cases then, where neurectomy is materially helpful.