Cutaneo-Muscular Necrosis of Cervical and Pectoral Region Following Intramuscular Injection of Flunixin Meglumine in an Arabian Stallion

Case Description- A five-year-old Arabian stallion weighing approximately 300 kg with large infected chronic torn wound on the neck and pectoral region 5 days after IM injection of flunixin meglumine with history of anorexia, depression and lack of response to antibacterial treatment referred to the Veterinary Teaching Hospital of Lorestan University. Clinical Findings- The clinical symptoms observed during the examination were hematuria and watery diarrhea with very large skin laceration in the affected area. External examination revealed the infectious cervical and pectoral muscles and necrosed skin with purulent discharge and odorous smell. Skin and surrounding tissues were warm, edematous and swelled. Treatment and Outcomes- Surgical treatment started with physical debridement and maggot therapy using Lucilia (Phaenicia) sericata. Then medical treatment continued with intravenous fluid therapy, antimicrobial and anti-inflammatory drugs (NSAID) along with topical treatment. Clinical Relevance- The present case demonstrates the serious complications that can occur following non-sterile IM injections and/or as a consequence of flunixin meglumine IM administration. An aggressive pharmacological and surgical therapy is very essential in similar cases. In conclusion, successful management of the cutaneo-muscular necrosis depends upon the condition of wound and selection of proper antibacterial drugs along with early surgical intervention.