Regional Limb Perfusion
By Brandy Snedden DVM

What is it?
Regional limb perfusion is the intravenous (in the vein) infusion of an antibiotic near a wound of the distal (lower) limb.

When is it used?
Regional limb perfusion can be used for any wound of the lower leg that would otherwise be serious enough to warrant injectable antibiotics.  It can also be used after surgery for anything involving the lower leg.

What is the process?
The horse is first sedated and a tourniquet is applied above the level of the injury in order to both distend the vein and keep the antibiotic in place for the required time.  The site for venipuncture (venous injection) is quickly scrubbed, and the antibiotic, diluted in saline, is injected into the vein.  The needle is removed, a short-term pressure wrap is applied and the tourniquet is left on for 20 minutes, at which time it, and the pressure wrap are removed.

Pros: 

1. Smaller doses of antibiotics can be used, especially important for old or young horses or any others who may have kidney/liver issues.
2. Shorter course of drugs: Only 3 days, as compared to 5 or more of oral or injectable drugs.
3. Higher concentration of drugs at the site where they are needed.  The tourniquet gives drugs time to thoroughly perfuse the area of concern where they can be active for 24 hours until the next dose.
4. No need for owner to administer drugs.  This may be especially advantageous if your horse typically showers you with his oral drugs, or really doesn’t appreciate being poked with needles one to two times a day.

Cons:

1. Sedation three days in a row. This is a standing but relatively deep sedation similar to what would be used to inject a joint.

• Possibly higher cost, given three farm calls and procedures. However, a horse on high levels of injectable drugs over 7-10 days could incur similar costs and would not receive the other advantages listed above.