Modified abaxial approach for resection of the distal sesamoid bone and distal interphalangeal joint while preserving the digital flexor tendons of three Angus bulls with septic arthritis.

CASE DESCRIPTION 3 Angus bulls, aged 2 to 3 years, with severe lameness of 2 to 4 weeks' duration and swelling proximal to the coronary band of the affected limb were evaluated after failing to respond to antimicrobial treatment. CLINICAL FINDINGS Septic arthritis of a distal interphalangeal joint (DIPJ) was diagnosed in all 3 bulls on the basis of results of a physical examination, radiographic and ultrasonographic evaluations of the affected foot, and cytologic evaluation of synovial fluid from the affected DIPJ. TREATMENT AND OUTCOME A novel modified abaxial approach was used to resect the infected distal sesamoid bone (navicular bone) and DIPJ of all 3 bulls. A window was created in the abaxial hoof wall that was lateral to and of sufficient size to extract the navicular bone. Following removal of the navicular bone, the DIPJ was debrided and resected and an orthopedic block was applied to the contralateral claw to minimize weight bearing on the infected digit. Two bulls also had a fiberglass cast applied to the affected limb to help immobilize the DIPJ. All 3 bulls recovered without complications, and 2 bulls were no longer lame, whereas the remaining bull was only mildly lame, at 4 to 5 weeks after surgery. CLINICAL RELEVANCE The modified abaxial approach described for surgical resection of the DIPJ allowed extraction of the infected navicular bone without damage to the digital flexor tendons, something that cannot be achieved with other abaxial approaches. This approach is best used for patients without septic tenosynovitis.

Traumatic Lesions of the Sole.

Traumatic lesions of the sole are a common cause of lameness in beef and dairy cattle. This article provides a brief description of traumatically induced conditions with specific attention to underlying causes, treatment, and prevention. Lameness, traumatic lesions of the sole, sole punctures, thin soles, thin sole toe ulcers, toe tip necrosis syndrome, and toe abscesses are discussed.

Surgical Procedures of the Distal Limb for Treatment of Sepsis in Cattle.

With a thorough knowledge of the anatomy of the foot, and basic surgical instruments, digit surgery can be performed in field situations. Sepsis of the distal interphalangeal and proximal interphalangeal joints should be treated surgically because conservative treatment is often ineffective. Most of the diseases described in this article are chronic and often the animals have been suffering for some time. Perioperative analgesia is important to alleviate the pain of those animals. All those procedures should be performed under local or regional anesthesia.

An Update on the Assessment and Management of Pain Associated with Lameness in Cattle.

Lameness affects the cattle industry via both economic losses and welfare considerations. In addition to production deficits, the pain and distress associated with lameness have been documented. Evaluation and prevalence of lame cattle are among the primary factors in third-party welfare audit programs. Mean lameness prevalence in herds has been reported to be as high as 36.8%, although a less than 10% prevalence of lame cattle was reported by some producers. Note that lameness is usually underreported by producers compared with independent observers, potentially because of a decreased sensitivity in detecting lame cattle.

Corkscrew Claw.

Corkscrew claw (CSC) is a conformational abnormality of the digit and affecting mostly but not exclusively the claws of the back leg, first reported during the 1950s in Dutch black and white cattle. The affected claws are longer and narrower than the claw and have an inward and upward spiral rotation of the toe. Similarly, the bearing surface of the wall is displaced inward. The animal starts to bear weight on the abaxial wall surface, particularly the caudal segment, and the sole may become completely non-weight bearing. The axial wall is displaced dorsomedially and a fold develops in the wall.

Pathogenesis and Treatment of Sole Ulcers and White Line Disease.

Sole ulcers and white line disease are 2 of the most common claw horn lesions in confined dairy cattle. Predisposing causes include unbalanced weight bearing, and metabolic, enzymatic, and hormonal changes. The white line serves as the junction between the sole and axial and abaxial wall. It is vulnerable to trauma and separation, permitting organic matter to become entrapped. Colonization contributes to retrograde movement of the infection to the solar and perioplic corium, where an abscess forms resulting in pain and lameness. Successful treatment requires an orthopedic foot block to the healthy claw and corrective trimming of the lesion.

Vesicopreputial anastomosis for the treatment of obstructive urolithiasis in goats.

OBJECTIVE: To describe a novel surgical technique for the correction of recurrent obstructive urolithiasis in male goats. STUDY DESIGN: Clinical case series. ANIMALS: Castrated male goats (n = 4). METHODS: Medical records of male goats having undergone vesicopreputial anastomosis (VPA) as a treatment for obstructive urolithiasis were reviewed for history, signalment, clinical signs, and intraoperative and postoperative complications. Long-term follow-up (≥12 months) was obtained by telephone interview with owners or by clinical examination. RESULTS: All goats had undergone at least one surgical procedure (median, 2.5, range 2-4) to correct obstructive urolithiasis before undergoing VPA. Postoperative complications included premature removal of the tube from the bladder (1 goat), bacterial cystitis (2), and abscess formation (1). One goat suffered stricture of the anastomosis site 3 months following the original procedure and underwent a second VPA and 1 goat died 7 months after surgery due to severe, acute hydronephrosis and renal failure. Long-term survival ≥12 months was good with 3/4 goats (75%) or 3/5 VPA procedures (60%) having unobstructed urine flow at 12 months. CONCLUSION: Vesicopreputial anastomosis is a feasible surgical procedure for the correction of recurrent obstructive urolithiasis in male goats and one that can result in a favorable clinical outcome. Further investigation in a larger population of goats is warranted for the evaluation of the suitability of VPA in male goats with obstructive urolithiasis.

Modified proximal perineal urethrostomy technique for treatment of urethral stricture in goats.

OBJECTIVE: To report a modified procedure for perineal urethrostomy (PU) in goats. STUDY DESIGN: Case series. ANIMALS: Adult castrated male pet goats (n = 11) that had recurrence of urinary tract obstruction after one or more surgical procedures for obstructive urolithiasis. METHODS: Medical records (May 2008-February 2011) of goats that had a modified proximal PU were reviewed for history, signalment, and intraoperative and postoperative complications. Follow up was obtained through clinical examination or by telephone interview of owners or referring veterinarians. RESULTS: Ten goats survived to discharge. Postoperative complications included hemorrhage (n = 7), misdirected urine stream (3), obstructive urolithiasis (2), and bladder atony, dysuria, dehiscence, or delayed healing (1 each). One goat died acutely 15 hours after surgery from peritonitis, pleuritis, hemorrhagic cystitis, and hepatic lipidosis, and 1 goat was euthanatized 14 months after surgery because of renal failure and persistent cystitis. Urethrostomy sites were patent and functional in 9 goats available for long-term follow-up (>12 months). CONCLUSIONS: Transection of penile body attachments from the pelvis and careful mucocutaneous apposition may decrease the risk of postoperative urethral stricture formation in goats after PU. Hemorrhage is common after the procedure but does not affect clinical outcome.

Assessment and management of pain associated with lameness in cattle.

Lameness impacts the cattle industry in economic losses and welfare considerations. In addition to production deficits, pain and distress associated with lameness have been documented. The evaluation and prevalence of lame cattle is one of the primary factors in third-party welfare audit programs. To improve earlier detection and treatment of lameness, locomotion scoring systems have been developed for routine use by farm employees. Recommendations for pain management typically include the use of a multimodal therapeutic approach. Similarly, in lame cattle, pain can best be alleviated by implementing a multimodal approach including corrective claw trimming and placement of foot blocks combined with additional benefits provided by analgesic compounds.

Clinical diagnosis of foot and leg lameness in cattle.

The causes of lameness in cattle are multifactorial and involve a combination of housing, management, and environmental factors and a variety of infectious agents. Arriving at a cause can often require concerted efforts. Diagnosis of lameness is often based mainly on clinical observations. A detailed record of those observations with time and among several animals within a herd can provide valuable information toward solving lameness problems. Advances in computer hardware and software help facilitate more detailed data collection and analysis.

Review of Pododermatitis circumscripta (ulceration of the sole) in dairy cows.

Sole ulcers are among the most frequent causes of lameness in dairy cattle. They are found most commonly in the hind lateral claw, are frequently bilateral, and have a high rate of reoccurrence. The pathogenesis of sole ulceration is primarily based on mechanical injury by the 3rd phalanx to the corium, basement membrane, and basal layers of the sole epidermis as a result of failure of the suspensory apparatus in the claw. The main pathways in the failure of the suspensory system include inflammatory (dermal vascular changes followed by disruption of keratinocyte proliferation and differentiation caused by local and systemic mediators) and noninflammatory (hormonal and biochemical changes in the peripartum period resulting in alterations of connective tissue in the suspensory system) pathways. Sole ulcers tend to occur in specific locations; the most reported site is the junction of the axial heel and sole. Other locations include the apex of the toe and the heel. Varying degrees of lameness may result, and the most severe are seen with complicated cases in which ascending infection affects the deeper structures of the claw. Pathologic changes at the ulcer site include dyskeratosis and dilated horn tubules with microcracks. Vascular changes include dilatation and thrombosis of capillaries with "neocapillary formation." Areas of dyskeratosis may remain for as long as 50 days at the ulcer site. Treatment includes corrective trimming and relief of weight bearing. Complicated cases may require surgical intervention.

Effects of dexamethasone and isoflupredone acetate on plasma potassium concentrations and other biochemical measurements in dairy cows in early lactation.

OBJECTIVE: To determine whether administration of isoflupredone acetate (ISO) to healthy cows increases the frequency of severe hypokalemia and whether dexamethasone (DEX) has detectable mineralocorticoid properties. ANIMALS: 33 cows at 20 to 25 days of lactation. PROCEDURES: Cows were randomly allocated to 5 treatment groups and received 2 IM injections (on days 0 and 2) of sterile saline (0.9% NaCl) solution (10 mL each), an injection of ISO (20 mg) or DEX (20 mg) followed by 10 mL of saline solution, or 2 injections of ISO or DEX. Milk production was measured, physical examinations were performed, and blood and urine samples were collected daily on days 0 through 7. RESULTS: Physical examination parameters did not differ among groups; however, 1 cow developed atrial fibrillation on day 4. Both corticosteroids significantly increased plasma glucose concentrations, and ISO significantly decreased plasma potassium concentrations and increased total carbon dioxide concentrations with time. One dose of ISO decreased mean plasma potassium concentration by 25% on day 2, compared with day 0, and severe hypokalemia (serum potassium concentration < 2.3 mEq/L) developed in 1 of 6 cows. Mean plasma potassium concentration was 46% lower on day 3 than on day 0 in cows receiving 2 doses of ISO, and 5 of 7 cows became severely hypokalemic. Mean urinary fractional excretion of potassium significantly increased from that on day 0 in cows receiving 2 doses of ISO. CONCLUSIONS AND CLINICAL RELEVANCE: Both corticosteroids had glucocorticoid activity; however, only ISO had mineralocorticoid activity. Compared with saline solution, administration of 2 doses of ISO significantly increased the frequency of severe hypokalemia.

Effect of dimethyl sulfoxide in the treatment of sheep experimentally infected with Ehrlichia ruminantium.

OBJECTIVE: To evaluate the clinical response of sheep experimentally infected with Ehrlichia ruminantium to treatment with dimethyl sulfoxide (DMSO). ANIMALS: 32 Merino crossbred sheep. PROCEDURES: 16 sheep were infected with E ruminantium; 8 of these were treated twice daily with a 10% solution of DMSO (1 g/kg, i.v.) in polyionic fluid for 3 consecutive days. Treatment was initiated 2 days after the onset of clinical disease. Eight uninfected control sheep were similarly treated with DMSO. Placebo treatments (polyionic fluid administrations) were given to 8 infected and 8 uninfected sheep. Arterial and venous blood samples for blood gas and total plasma protein concentration measurements were collected daily (data from 5 days before until 6 days after onset of clinical disease were analyzed); physiologic variables and food consumption were also monitored. Gross pathologic findings and cytologic confirmation of the disease were recorded for the 16 infected sheep. RESULTS: Infected sheep treated with DMSO were able to maintain pulmonary gas exchange and had reduced pleural effusion and plasma protein loss, compared with infected untreated sheep that became hypoxic. Infected treated sheep developed an uncompensated metabolic acidosis. Uninfected treated sheep had reduced appetite, whereas uninfected untreated sheep maintained normal food intake. CONCLUSIONS AND CLINICAL RELEVANCE: Results of DMSO treatment in sheep with experimentally induced heartwater disease indicated that administration of this agent, in combination with specific antimicrobial treatment, may be of some benefit in treatment of naturally occurring disease.

Ultrasound measurement of sole horn thickness in trimmed claws of dairy cows.

OBJECTIVE: To determine whether ultrasound could be used to measure sole horn thickness in dairy cattle after claw trimming with an adaptation of the Dutch method. DESIGN: Case series. ANIMALS: 24 adult Holstein dairy cows. PROCEDURE: Cows were restrained in a standing position, and claws were trimmed with an adaptation of the Dutch trimming method. B-mode ultrasonography was then performed. The transducer was placed on the sole just caudal to the apex of the toe and immediately medial and parallel to the abaxial white zone. The inner margin of the sole was identified as a thin hyperechoic line. Soles were considered to be too thin if sole horn thickness, determined by use of ultrasonography, was < 5 mm. RESULTS: Sole horn, underlying soft tissues, and the distal surface of the third phalanx were imaged in 151 claws. The inner margin of the sole could not be identified in 4 claws, and 37 claws could not be imaged because cows collapsed in the restraining chute. Mean +/- SD sole thickness for all claws was 71 +/- 1.3 mm. Only 1 sole was < 5 mm thick. The lateral front claws were significantly thicker than the medial hind claws. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasound imaging can be used to determine sole thickness in dairy cattle after routine claw trimming.