Table 2 Serial clinical procedures and treatments

0^a

Orthopaedic examination, radiographic study, first arthroscopy to collect synovial fluid and synovia (membrane and villi) and to explore stifle joint

Blood and synovial analysis, bacterial culture and sensitivity testing

Perioperative analgesic treatment: carprofen 4 mg/kg IV SID and buprenorphine 0.015 mg/kg IM TID

1

Cytological examination of synovial revealed yeasts. Serological test positive for Leishmania infantum

Analgesic treatment: carprofen 2 mg/kg SC SID and buprenorphine 0.015 mg/kg IM TID

2

Positive culture for Candida spp. (post enrichment)

Analgesic treatment: carprofen 2 mg/kg SC SID

3

Second arthroscopy to obtain new samples and carry out joint lavage

New bacterial culture and sensitivity testing of synovial fluid and synovia (membrane and villi)

Perioperative analgesic treatment: carprofen 2 mg/kg IV SID and buprenorphine 0.015 mg/kg IM TID

4

Analgesic treatment: carprofen 2 mg/kg SC SID and buprenorphine 0.015 mg/kg IM TID

5

Starting antifungal treatment: joint lavage + intra-articular fluconazole (0.7 mg/kg)

Confirmation of positivity for Candida guilliermondii

Antifungal and analgesic treatment: fluconazole 5 mg/kg PO SID, carprofen 2 mg/kg SC SID, respectively

7

Joint lavage + intra-articular fluconazole (0.7 mg/kg)

Antifungal and analgesic treatment: fluconazole 5 mg/kg PO SID, carprofen 2 mg/kg SC SID, respectively

9

Joint lavage + intra-articular fluconazole (0.7 mg/kg)

Bacteriological culture of synovial fluid

Antifungal and analgesic treatment: fluconazole 5 mg/kg PO SID, carprofen 2 mg/kg SC SID, respectively

10

Antifungal and analgesic treatment: fluconazole 5 mg/kg PO SID, carprofen 2 mg/kg SC SID, respectively

11

Returned to the care of the primary practitioner

Negative to Candida spp.

19

Follow up: improvement of lameness (1/5)

Starting Leishmania treatment (by the practitioner)

49

TTA surgery (by the practitioner).

New sample of synovial fluid for bacteriological culture during TTA surgery

51

Confirm negativity to Candida spp.