An abattoir study of the prevalence of foot lesions and claw measurements in water buffalo in Egypt.

BACKGROUND: Lameness has been associated with compromised animal welfare and reduced productivity in dairy cattle herds worldwide. However, little is known about the prevalence of claw lesions in the dairy buffalo population in Egypt. Furthermore, the optimum measurements for claw trimming in buffalo are unknown. A cross-sectional cadaver study was conducted where 135 pair buffalo hind feet were collected from 4 slaughterhouses and examined for the presence of claw lesions. The proportion and associated 95% confidence interval (CI) of each type of lesion were calculated. A separate set of healthy claws (n = 26) underwent ultrasonography (US) and computed tomography (CT). The agreement between US and CT measurements was assessed using Passing-Bablok regression and intraclass correlation coefficient. The CT measurements were used to calculate trimming recommendations. RESULTS: At least one lesion was identified in 242 claws (89.6%, 95% CI = 85.4-93.0). In healthy claws, poor to moderate agreement was identified between US and CT measurements which could be due a sample size of the study. The average ± standard deviation (SD) minimum recommended external wall length of the lateral and medial claws in heifers was 7.1 ± 0.36 cm and 7.5 ± 0.35 cm, respectively. The average ± SD minimum recommended external wall length in buffaloes over five years of age was 8.2 ± 0.27 cm and 8.4 ± 0.39 cm for the lateral and medial claws, respectively. CONCLUSIONS: The study found a high prevalence of claw lesions in buffalo in Egypt, the clinical significance of which requires further elucidation. Recommended measurements will help guide claw trimming in buffalo to minimise lesions.

Initial validation of an intelligent video surveillance system for automatic detection of dairy cattle lameness.

Introduction: Lameness is a major welfare challenge facing the dairy industry worldwide. Monitoring herd lameness prevalence, and early detection and therapeutic intervention are important aspects of lameness control in dairy herds. The objective of this study was to evaluate the performance of a commercially available video surveillance system for automatic detection of dairy cattle lameness (CattleEye Ltd). Methods: This was achieved by first measuring mobility score agreement between CattleEye and two veterinarians (Assessor 1 and Assessor 2), and second, by investigating the ability of the CattleEye system to detect cows with potentially painful foot lesions. We analysed 6,040 mobility scores collected from three dairy farms. Inter-rate agreement was estimated by calculating percentage agreement (PA), Cohen's kappa (κ) and Gwet's agreement coefficient (AC). Data regarding the presence of foot lesions were also available for a subset of this dataset. The ability of the system to predict the presence of potentially painful foot lesions was tested against that of Assessor 1 by calculating measures of accuracy, using lesion records during the foot trimming sessions as reference. Results: In general, inter-rater agreement between CattleEye and either human assessor was strong and similar to that between the human assessors, with PA and AC being consistently above 80% and 0.80, respectively. Kappa agreement between CattleEye and the human scorers was in line with previous studies (investigating agreement between human assessors) and within the fair to moderate agreement range. The system was more sensitive than Assessor 1 in identifying cows with potentially painful lesions, with 0.52 sensitivity and 0.81 specificity compared to the Assessor's 0.29 and 0.89 respectively. Discussion: This pilot study showed that the CattleEye system achieved scores comparable to that of two experienced veterinarians and was more sensitive than a trained veterinarian in detecting painful foot lesions.

Painful Foot Lesions: A Case Report.

Hand-foot skin reaction (HFSR) is a documented cutaneous adverse reaction to tyrosine kinase inhibitor (TKI) chemotherapy. Cutaneous toxicities such as HFSR can be debilitating and may result in serious complications; however, continued chemotherapy is desirable to optimize the patient's odds of survival and tumor remission. We present a case of a 66-year-old male, with a history of metastatic renal clear cell carcinoma, who was diagnosed with grade 3 HFSR triggered by axitinib, a tyrosine kinase inhibitor. Our patient was able to expeditiously resume chemotherapy after temporary cessation of axitinib with concurrent application of topical steroids and keratolytics. Expedient return to life-prolonging chemotherapy is of great importance for patients with advanced malignancies; therefore, accurate diagnosis and prompt identification of the offending medication are critical to the management of this entity. We aim to increase the awareness of tyrosine kinase inhibitor-induced HFSR and review the diagnosis and current guidelines for management.

The Role of Footcare Nurses in Foot Lesions Treatment.

Footcare awareness and practice are limited in Japan, which is attributable to unavailability of specialized podiatry services, in contrast to the Western healthcare system. Japan does not have national educational courses in podiatry and footcare, and daily foot care is not routinely practiced owing to the cultural background. Moreover, medical insurance covers only diabetic footcare, which contributes to the limited popularity of footcare in Japan. Footcare in Japan is provided by qualified nurses (foot care nurses) who are certified by various organizations and societies. Footcare nurses render the following services: (a) Provision of professional footcare after evaluation and patient education for foot self-care. (b) Multidisciplinary coordination between the footcare team. Owing to lack of podiatry services in Japan, a multidisciplinary therapeutic approach to foot lesions is necessary. The footcare nurse coordinates communication of patient information across team members and interdepartmental referrals for effective multidisciplinary therapy. (c) Patient education to improve awareness of footcare. Footcare is not currently widely established as a component of medical and nursing care and patient welfare, and greater awareness regarding its role is necessary. The importance of footcare to maintain healthy walking needs to be emphasized among individuals with foot lesions. In view of the high life expectancy and rapid population aging in Japan, maintaining a healthy gait is essential to improve healthy life expectancy, and foot care nurses can play an active role in the future.

Associations between diabetes-related foot disease, diabetes, and age-related complications in older patients.

PURPOSE: To examine the relationship of diabetes-related foot disease (DFD) with diabetes and age-related complications in older patients with diabetes mellitus (DM). METHODS: We examined 562 outpatients with diabetes, aged ≥ 65 years, for DFD. The variables collected in this study were demographics, DM-related complications, treatment method, and age-related complications. Differences in the complications were compared between patients with and without DFD. Logistic regression analysis was used to determine the associations of DFD with DM and age-related complications. RESULTS: A total of 246 patients (43.8%) had DFD. Logistic regression analysis identified low grip strength [Odds ratio (OR): 1.83, 95% confidence interval (CI) 1.21-2.76), hypertension (OR: 1.81, 95% CI 1.09-3.00), and diabetes-related peripheral neuropathy (DPN) (OR: 1.92, 95% CI 1.24-2.98) to be significantly associated with DFD. Patients with DPN and hypertension had a higher risk of DFD than patients with DPN or hypertension alone. Individuals with DPN and low grip strength (OR: 1.74, 95% CI 1.09-2.81) were at a lower risk than those with low grip strength alone. CONCLUSION: Hypertension, DPN, and low grip strength were significantly associated with DFD in older patients with DM, with the risk of DFD being higher in patients with both DPN and hypertension. When considering DFD in older patients with DM, low grip strength should be considered equally important as a DM-related complication.

Understanding dairy farmer intentions to make improvements to their management practices of foot lesions causing lameness in dairy cows.

Foot lesions causing lameness in dairy cows have been demonstrated to adversely affect milk yield, reproductive performance and longevity, resulting in significant economic burden to individual dairy farmers and the dairy industry. Further, foot lesions compromise dairy cow welfare. Despite this knowledge, foot lesions remain a large problem in many dairy herds woldwide. Therefore, there is potential for dairy farmers to make changes to their current management practices of foot lesions. This study used the social-psychology framework, the Theory of Planned Behavior (TPB), to explore dairy farmers' intentions to make improvements to their current management practices of foot lesions in their dairy cows and to identify the underlying behavioral, normative and control beliefs facilitating and constraining this behavior. In accordance with the theoretical framework, Australian dairy farmers were invited to participate in an online questionnaire which included questions regarding intentions, attitudes, subjective norms and perceived behavioral control. Fifty-six dairy farmers completed the questionnaire. The overall intention of these dairy farmers to make improvements to their management practices of foot lesions in the next year was moderate. Dairy farmers believed improving their current management practices of foot lesions would improve animal welfare, increase milk production and was worth the cost involved (behavioral beliefs). They indicated that the opinions of consumers, staff, and animal welfare groups were important in their decision to make improvements (normative beliefs). Better equipment and facilities, improved knowledge and training, and a favorable cost-benefit ratio were perceived as factors that would enable dairy farmers to improve their management practices (control beliefs). While all of these beliefs may be considered as potential drivers to facilitate dairy farmers to change their management practices, the behavioral beliefs were identified as the priority beliefs that industry should target in the development of strategies to increase dairy farmer intentions to make improvements to their management practices of foot lesions.

Characteristics of patients with fibromyalgia.

BACKGROUND: Fibromyalgia is characterised by generalized pain. A search of the available literature found no previous reports describing the specific characteristics of patients with fibromyalgia. OBJECTIVES: To describe characteristics of patients with fibromyalgia. MATERIAL AND METHODS: Case-control study including 50 patients with fibromyalgia and 50 gender and age-matched controls. After obtaining written informed consent for the study, demographic data were collected and pain in the leg, ankle and foot area was measured using a visual analogue scale (VAS). A general physical examination to test mobility and rigidity of the foot joints was also performed. Patients were also asked about their shoe utilisation habits. RESULTS: The results confirm that patients with fibromyalgia experience significantly more pain in the whole leg, ankle and foot areas than the control subjects. For this reason they use significantly more pain-killing drugs than the control subjects. However, this increase in pain is not associated with stiffness or mobility abnormalities in this series. In addition, patients with fibromyalgia show no increase in the rate of hyperkeratosis or other foot lesions. CONCLUSIONS: Patients with fibromyalgia do not seem to show a higher rate of foot lesions or a peculiar pattern of foot involvement compared to age and gender-matched controls.

Inter-observer agreement for clinical examinations of foot lesions of sheep.

In sheep, the diagnosis of foot lesions is routinely based on physical examination of the hoof. Correct diagnosis is important for the effective treatment, prevention and control of both infectious and non-infectious causes of lameness. Therefore, the aim of this study was to evaluate the level of inter-observer agreement for clinical examination of ovine foot lesions. Eight observers of varying experience, training and occupation performed foot examinations on a total of 1158 sheep from 38 farms across North England and Wales. On each farm, a group of two to four observers independently examined a sample of 24 to 30 sheep to diagnose the presence or absence of specific foot lesions including white line lesions (WL), contagious ovine digital dermatitis (CODD), footrot (FR), inter-digital dermatitis (ID) and toe granuloma (TG). The inter-observer agreement of foot lesion assessments was examined using Fleiss kappa (κ), and Cohen's κ examined the paired agreement between the test standard observer (TSO) and each observer. Scoring differences with the TSO were examined as the percentage of scoring errors and assessed for evidence of systematic scoring bias. With the exception of WL (maximum error rate 33.3%), few scoring differences with the TSO occurred (maximum error rate 3.3%). This suggests that observers can achieve good levels of reliability when diagnosing most of the commonly observed foot conditions associated with lameness in sheep.

Lesões podais em ovinos da Mesorregião Sudoeste do Rio Grande do Sul / Foot lesions of sheep from southwestern Rio Grande do Sul

Lesões podais em ovinos são causas importantes de perdas econômicas por quedas na produtividade, na reprodução, por gastos com tratamentos ineficientes e com o descarte de animais afetados. Dessa forma, os objetivos foram descrever as principais características das lesões podais observadas em ovinos da Mesorregião Sudoeste do Rio Grande do Sul, seus aspectos epidemiológicos e a importância da ocorrência desses distúrbios para a criação de ovinos nessa região. Foram coletados dados epidemiológicos e clinicopatológicos de rebanhos ovinos da região entre abril de 2014 e abril de 2015 através de visitas técnicas em propriedades rurais. Foram avaliados rebanhos ovinos em 27 propriedades rurais localizadas em diferentes municípios, dos quais 21 registraram a ocorrência de lesões podais com relato de perdas econômicas significativas. Aproximadamente 1.700 ovinos, em média 10% dos rebanhos, apresentavam diferentes graus de claudicação decorrente de lesões podais que variavam de brandas a severas. Verificou-se que diversos fatores como clima e manejo foram favoráveis para o desenvolvimento das lesões podais e essas podem estar associadas a diferentes distúrbios e agentes etiológicos. No entanto, embora essas condições sejam importantes, o controle e a prevenção tem se mostrado ineficientes. Observou-se ainda que a pododermatite infecciosa dos ovinos (Footrot), parece ser a principal doença podal na região e atualmente pode ser considerada uma doença negligenciada.(AU)

Foot lesions in sheep are important causes of economic loss due to fall in productivity, reproduction, by spending on ineffective treatment and elimination of affected animals. The purpose of this study was described the main features of foot lesions of sheep from southwestern Rio Grande do Sul, as well as epidemiological aspects and the importance of occurrence of these lesions for sheep farming in the region. Epidemiological and clinic-pathological information of sheep herds from the region between April 2014 and April 2015, by means of visits to farms. In the study were evaluated 27 sheep flocks on farms located in different municipalities. In 21 farms was reported occurrence of foot lesions in sheep having caused significant economic losses. About 1700 sheep, 10% of herds, showed different degree of lameness caused by foot lesions ranging from mild to severe. It was found that several factors, such as climate and breeding were favorable for the development of foot injuries which may be associated with different disorders and etiologic agents. Although these injuries are important, the control and prevention has proved ineffective. Also was observed that infectious pododermatitis (Footrot) may be the main foot disease of sheep in the region, and can be considered a neglected disease.(AU)

Foot lesions in lame cows on 10 dairy farms in Ireland.

BACKGROUND: Little is known about foot lesions in dairy cattle in Ireland, managed under a pasture based system with housing during the winter and grazing for the rest of the year. Ten Irish dairy herds, with a lameness prevalence ranging from 9 to 17 % were locomotion scored routinely during the 2013 grazing season. Lame cows were foot trimmed and foot lesions recorded. FINDINGS: 11.8 % and 89.6 % of cows had lesions recorded on front and hind feet respectively. No lesions were found in 6.9 % of cows. Sole haemorrhage and white line disease were the most prevalent lesions, and overall 76.8 % of lesions affecting the claw horn were diagnosed on the lateral hind claw. CONCLUSIONS: Treatment success, as measured by improved LS post treatment, was not significantly affected by the LS prior to foot trimming, the presence of lesions or the type of lesion identified. Exposure to both risk factors for lameness at housing and pasture may have resulted in the development of a combination of foot lesions typically associated with zero-grazing or all-year-round grazing management systems.

Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005-2011).

REASONS FOR PERFORMING STUDY: There is limited knowledge of the foot lesions that influence the outcome of palmar/plantar digital neurectomy (PDN). OBJECTIVES: 1) To report the short- and long-term outcomes of horses that underwent PDN to alleviate chronic foot pain due to lesions diagnosed by magnetic resonance imaging (MRI) and 2) factors that may influence the outcome of PDN. STUDY DESIGN: Multicentre retrospective study. METHODS: Medical records of 50 horses subjected to PDN due to chronic foot pain were reviewed. Age, breed, sex, athletic activity, duration of lameness, affected limb(s), response to anaesthesia of the palmar/plantar digital nerves, MRI findings and surgical technique were analysed together with follow-up data to identify factors that influenced the long-term outcomes. RESULTS: Forty-six of 50 horses (92%) responded positively to surgery; 40 (80%) were able to return to their previous athletic use for a median time of 20 months (range: 12-72 months). Eighteen (36%) horses developed post operative complications including residual lameness, painful neuromas, or early recurrence of lameness. Horses with pre-existing core or linear lesions of the deep digital flexor tendon (DDFT) had significantly shorter periods of lameness resolution after surgery than horses with dorsal border lesions of the DDFT or other foot lesions. CONCLUSIONS: Palmar/plantar digital neurectomy can improve or resolve lameness in horses with foot pain unresponsive to medical therapy without serious post operative complications. However, horses with core or linear lesions of the DDFT should not be subjected to PDN as these horses experience residual lameness or early recurrent lameness after surgery. Magnetic resonance imaging can be used to identify these horses.

Pododermatite infecciosa e outras doenças podais de caprinos e ovinos no semiárido Nordestino / Foot rot and other foot diseases of goat and sheep in the semiarid region of northeastern Brazil

This paper reports the occurrence and epidemiology of outbreaks of foot rot and other foot diseases in goats and sheep in the semiarid region of Paraíba, northeastern Brazil. Four farms were inspected for the presence of foot lesion in sheep and goats and for environmental conditions, general hygiene, pastures, and disease control measures. The prevalence of foot lesions was 19.41 percent (170/876) in sheep and 17.99 percent (52/289) in goats, ranging between 5.77 percent and 33.85 percent in different farms. Foot rot was the most common disease, affecting 12.1 percent of the animals examined (141/1165), but with significantly higher (p<0.05) prevalence in sheep (13.69 percent) than in goats (7.27 percent). The frequency of malignant foot rot was also significantly lower (p<0.05) in goats (9.53 percent) than in the sheep (40.83 percent). On one farm, Dorper sheep showed significantly higher (p<0.05) prevalence of foot rot (17.5 percent) than Santa Inês sheep (6.79 percent), and the number of digits affected was also higher in the former. Dichelobacter nodosus and Fusobacterium necrophorum were isolated from cases of foot rot. White line disease was found in 3.95 percent of the animals, sole ulcers in 1.29 percent, foot abscess in 1.03 percent and hoof overgrowth in 0.5 percent. The high rainfall at the time of occurrence, grazing in wetlands, clay soils with poor drainage, presence of numerous stony grounds, closure of the flocks in pens at night, and introduction of affected animals were considered predisposing factors for the occurrence of foot diseases.

Este trabalho relata a ocorrência e aspectos epidemiológicos de surtos de pododermatite infecciosa e outras afecções podais em caprinos e ovinos no semiárido paraibano. As propriedades foram inspecionadas quanto à presença de problemas podais e aspectos relacionados às condições ambientais, higiene, locais de pastejo e medidas de controle utilizadas. Nos ovinos a prevalência de lesões podais foi de 19,41 por cento (170/876) e nos caprinos de 17,99 por cento (52/289), variando entre 5,77 por cento e 33,85 por cento nas diferentes propriedades. A pododermatite infecciosa foi a doença mais frequente acometendo 12,1 por cento dos animais examinados (141/1165), sendo a prevalência nos ovinos (13,69 por cento) significativamente maior (p<0,05) do que a nos caprinos (7,27 por cento). A frequência de lesões malignas desta doença em caprinos (9,53 por cento) foi, também, significativamente menor (p<0,05) do que nos ovinos (40,83 por cento). Em uma das propriedades a prevalência de pododermatite infecciosa entre os ovinos Dorper (17,5 por cento) foi significativamente maior do que a nos ovinos da raça Santa Inês (6,79 por cento), tendo os animais pela pododermatite infecciosa. Dichelobacter nodosus e Fusobacterium necrophorum foram isolados de casos de pododermatite infecciosa. A doença da linha branca foi constatada em 3,95 por cento dos animais, a úlcera de sola em 1,29 por cento, o abscesso do pé em 1,03 por cento, e crescimento excessivo do casco em 0,5 por cento. Os altos índices pluviométricos na época de ocorrência, o pastejo em áreas úmidas, os solos argilosos com pouca drenagem, os terrenos pedregosos, o encerramento em currais durante a noite e a introdução de animais doentes foram considerados fatores predisponentes para a ocorrência dos surtos.