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Thread: On-farm diagnosis and initial treatment of lameness

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    Default On-farm diagnosis and initial treatment of lameness

    Protocols for on-farm diagnosis and initial treatment of lameness

    by

    D.VanMetre, J.R.Wenz and F.Garry
    ILM, CSU
    --------------------------------------------------------------------------------


    I. Diagnosis
    Evaluation of foot swelling: Since the hoof capsule is rigid and incapable of marked expansion,
    lay personnel should be instructed to examine the tissues at and immediately proximal to the
    coronet for evidence of swelling. To facilitate detection of swelling of the foot, lame animals
    should be moved, if possible, from areas of deep grass or mud onto a packed surface. Heavily
    soiled feet should be cleaned. Digital swelling can be readily visualized from behind the animal
    by comparing the distance between the dewclaws of the affected foot to that of unaffected feet.
    Because the dewclaws are loosely anchored in the soft tissues, they are spread further apart in the
    swollen foot versus the non-swollen feet. Also, when the affected foot is viewed from the rear,
    the width of the heel bulbs can be compared to determine if the swelling is more severe in one
    digit than the other.
    Is the affected foot swollen?
    Generalized swelling of the digit above the coronary band, involving the pasterns and fetlock and
    extending proximally for a variable distance, is commonly seen in cases of footrot and deep
    sepsis of the digit. If detected early, footrot is characterized by digital swelling and sole ulcers
    are not.
    Is the swelling symmetrical or asymmetrical?
    In our experience, dairy personnel frequently assume that all lame cattle with swollen feet are
    suffering from footrot; after examination by the herd veterinarian, a variable proportion of these
    animals have been determined to have deep sepsis of the digit. To differentiate between these
    two disorders, envision an imaginary line that begins in the interdigital space and extends up the
    foot, bisecting the foot into its two digits along the longitudinal (axial) midline. Because footrot
    begins in the interdigital skin, the swelling of soft tissues above the coronary band is usually
    symmetrical relative to the longitudinal (axial) midline of the foot. Asymmetrical swelling of
    the foot is usually seen in cases of deep sepsis of a digit. The majority of swelling is located on
    the side of the affected digit; in other words, the affected foot is asymmetrical swollen relative to
    the longitudinal (axial) midline of the foot. As stated above, the affected foot can also be viewed
    from the rear, and the width of the heel bulbs compared; deep sepsis of a digit is characterized by
    appreciable widening of the heel on the affected side. The reason for these findings is simple:
    The diseased bones, joints, and associated soft tissue structures are not located on the axial
    midline; therefore, the associated soft tissue swelling is greatest over the affected digit. While
    visible soft tissue swelling may be minimal in cases of septic osteitis of the third phalanx,
    swelling and erythema of the soft tissues above the coronary band is usually severe in cases of
    septic arthritis of an interphalangeal joint.
    No Generalized Swelling:
    Causes of lameness that do not typically result in generalized swelling of the foot include
    uncomplicated cases of digital dermatitis (hairy heel warts), interdigital dermatitis, sole ulcers
    (pododermatitis cirucumscripta), laminitis, subsolar abscesses, white line disease, and injuries or
    diseases of the limb above the digit.
    II. Protocols for treatment
    On many large dairies in the authors’ region, herd personnel are taught by the attending
    veterinarian to identify, record, and properly treat lameness conditions. The criteria for each
    diagnosis should be clearly described and discussed with herd personnel. The authors have
    developed treatment protocols to guide detection and direct treatment of these common digital
    disorders. Particularly for antimicrobial therapy, the duration of treatment should be evidencebased
    and clearly defined. Cattle that fail to respond as expected within the defined treatment
    period can then be scheduled for veterinary examination. Because many of the farm workers in
    our region are more fluent in the Spanish language than in English, provision of bilingual
    protocols is necessary. On occasion, producers request flow charts with photos of example
    lesions to clarify the decision-making process for lay personnel. On some operations, each
    diagnosis is coded for easy entry into computerized herd health data systems; a code for
    lameness due to unknown causes is always included in such records systems to facilitate
    identification of the animal for prompt veterinary examination. In addition, lameness records are
    regularly reviewed by the herd veterinarian to monitor trends over time in lameness incidence,
    diagnosis, and treatment response rates. Digital cameras facilitate capture of both still and video
    images of problematic or unique cases for review with the herd veterinarian. We recommend
    that the herd veterinarian regularly examine acutely lame animals as well as longer-lasting,
    problematic cases with herd personnel, so that diagnosis and treatment issues can be discussed
    on a regular basis. Ultimately, well-defined treatment protocols should reduce the number of
    animals administered inappropriate antimicrobial drugs for inappropriate periods of time.
    Summary
    The rules of thumb that form the basis for our lameness treatment protocols are summarized as
    follows:
    1. Causes of lameness can be categorized according to the likely presence or absence of
    visible swelling of the soft tissues of the foot.
    2. Because interdigital necrobacillosis is centered in the interdigital skin, early cases are
    characterized by swelling that is symmetrical relative to the longitudinal (axial) midline
    of the foot.
    3. Deep sepsis of the digit is characterized by swelling that is asymmetrical relative to the
    longitudinal (axial) midline of the foot.
    4. On-farm lameness treatment protocols should include an expected deadline for resolution
    – once the deadline is reached, if the animal has not recovered, the veterinarian should be
    consulted.
    5. Cattle that become lame from digital wounds should be scheduled for prompt veterinary
    examination.
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