Claw affection presented by dr. awad rizk


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Claw affection presented by dr. awad rizk

  1. 1. Claw affections in cattle By Dr. Awad Rizk
  2. 2. Introduction The incidence of lameness in high producing dairy cows varies between 15 and 40%. Lameness is beside infertility and mastitis the most common cause for involuntary culling. 90% of limb affections in cattle results from claw disorders. The next common seat of lameness is the stifle joint . The claw health disorders lead to traumatisation of tissue which is perceived by the affected animal as pain. The pain experience of lame dairy cows results in decreased productivity such as feed intake, fertility and milk yield as well as it may change animal behaviour.
  3. 3.  Anatomy of the bovine foot Cattle, sheep, goats, and pigs are cloven-footed animals, meaning that the hoof consists of two digits, instead of one solid entity like that of a horse The claws are named by their relative location on the foot. There is the outer, or lateral claw, and the inner, or medial claw. In cattle, the lateral claw is slightly larger in the back feet, while the medial claw is the larger claw in the front feet. bovine hooves grow about 1/5 to ¼ of an inch per month and horse’s hooves grown in general ¼ to 3/8 of an inch per month.
  4. 4. Anatomy of the bovine foot The bovine foot has two main and two accessory claws. The two main claws do not appear dissimilar from the horse’s single hoof. The space between the two digits is termed as the interdigital space. The part of each digit next to the space i.e. nearer to the longitudinal axis of the limb is called the axial surfaces while the part further away is termed abaxial surface. The bearing surface of the claw has thick prominent bulb but neither frog nor bars. The accessory claws project from the back of the fetlock joint and are non-functional.
  5. 5.  Underneath the hoof is a slightly softer region, called the sole. The tissue that makes up the sole is produced by thecorium of the sole, and is suppler than the horn of the hoof wall. The point where the hoof wall is bound to the sole is called the white line. The white line is a somewhat flexible junction between the sole and wall, allowing the hoof to be more flexible as the animal moves. The front region of the sole is called the toe, and the two bulbs at the opposite end of the foot are referred to as the heel bulbs.
  8. 8. Anatomy of the camel foot. The camel foot consists of two functional and fully developed digits- the dew claws or non functional digits are absent. Each functional digit consists of three phalanges and two proximal sesamoid bones. The distal sesamoid or navicular bone is either absent or cartilaginous in nature. The phalanges of the hind limb are shorter and less massive than those of the forelimb.
  9. 9. General consideration of the factor predisposing to lameness. The environmental condition surrounding the animals appeared to influence greatly the incidence of claw affections Breed had a significant effect, with Friesians and short horns being more prone to lameness than light breeds, such as Ayrshir and jersey. Buffaloes are more resistant to claw affection than Friesians under the same environmental and nutritional conditions.
  10. 10. In most dairy cow lameness survey revealed the following: 88% of lesion located in the foot and 12% in the leg. Of foot lesions 24% were in the front feet and 76% in the hind. the hind outer claw being affected two and a half times more than the inner claw. The predisposition of lesion towards hind feet may have been partly due to the wet and dirty environment to which animals were subjected in standing and cubicles beside stress of pregnancy and parturition and enlargement of the udder. Most foot and leg lesions occurred during the 50 days following calving because of pelvic nerve damage associated with calving. Young cows were relatively immune to foot problems , with the exceptions of interdigital necrobacillosis and laminitis. cows aged six to eight years were most susceptible to both foot and leg lameness.
  11. 11. Incidence 95% of lame cattle are dairy breeds 90% of cases involve the digits 80% of digital lameness is located in the hind limbs 50% of digital lameness involves the horny tissue and 50% the skin, mostly digital dermatitis 70% of the horny lesions involve the outer claw
  12. 12. Interdigital NecrobacillosisSynonyms: phlegmona interdigitalis, ‘foul-in-the-foot’, ‘clit ill’, ‘foot rot’, interdigital pododermatitis. A peracute form, colloquially ‘superfoul’Definition: acute inflammation of subcutaneous tissues of interdigital space and adjacent coronary band, spreading to dermis and epidermis.Etiology: interdigital microtrauma and infection with Fusobacterium necrophorum, Bacteroides melaninogenicus and other organisms.
  13. 13. Signs mild to severe lameness (LS 1–3) of sudden onset, all ages An acute lameness with swelling and erythema of the soft tissues of the interdigital space and the adjacent coronary band are the first signs. The claws typically are markedly separated due to the swelling . Depression and pyrexia along with rapid pluse and respiration follow , with greater intensity in young animals The animal tries to avoid contact with the ground if the digital region The animal is reluctant to walk and prefers to lie down and milk yield decline with general depression.
  14. 14.  On close examination of the swollen interdigital space, the skin appears discolored (darkens) and later become fissured and necrotic exuding typical foul odour and finally the necrotic skin sloughs producing an open wound. Advanced cases can develop septic arthritis and other deeper complications.Differential diagnosis: interdigital foreign body, acute laminitis, solear penetration by foreign body, severe interdigital dermatitis, interdigital changes from BVD/MD, FMD, distal interphalangeal septic arthritis, distal phalangeal fracture.
  15. 15. Treatment ceftiofur, ampicillin, LA oxytetracycline, penicillin, sulphonamides (e.g.trimethoprim-sulpha) systemically clean affected necrotic area with disinfectant and apply a topical oxytetracycline or copper sulphate, or BIPP paste (bismuth subnitrate, iodoform and petrolatum) do not bandage, but put on to dry floor or straw bedding, preferably isolated to avoid spread of infection daily cleansing with disinfectant if feasible ‘superfoul’: early cases respond well to 6 g oxytetracycline, more advanced cases to tylosin, careful local debridement under analgesia (IVRA) and local antibiotic dressing. Isolation is important.
  16. 16. Prophylaxis check and improve drainage in areas where interdigital trauma can arise (e.g. gateways, tracks, stubble) improve dry conditions underfoot (straw yard) and increase frequency of scraper removal of slurry from passageways footbaths of zinc sulphate (5–10%) copper sulphate (5%) or formalin (4%) antibacterial feed additive: sulphabromomethazine in feedlot outbreak, or ethylenediamine dihydroiodide for prophylaxis. spread quicklime in muddy tracks or around water troughs
  17. 17. Interdigital hyperplasiaSynonyms: hyperplasia interdigitalis, corn, interdigital granuloma, interdigital vegetative dermatitis, fibroma, ‘wart’.Definition: proliferative reaction of interdigital skin and/or subcutaneous tissues to form a firm mass.Incidence: usually sporadic, common in certain beef breeds (e.g. Hereford) and in bulls at AI centres.Occasionally follows severe interdigital disease in dairy cows, then is unilateral. May start in yearling bulls, but most clinical cases (with lameness) are in adults of four to six years.Predisposition: inherited in some breeds (e.g. Hereford, Holstein Friesian). Severe interdigital dermatitis or sole ulcer often precedes involvement of single limb. Frequently associated with poor conformation e.g. splayed toes
  18. 18. Signs slight or no lameness (LS 0–1) depending on size and mechanical interference in simple case large lesions develop superficial digital traumatic ulceration, and contact interdigital axial skin may undergo pressure necrosis both forms readily become secondarily infected with Fusobacterium necrophorum single abaxial hindlimb involvement suggests secondary response to recognized previous insult involving interdigital swelling and sometimes sole ulcer
  19. 19. Treatment none if small and asymptomatic local caustic (e.g. silver nitrate, copper sulphate) if small and causing lameness most clinical cases require resection by knife surgery electrocautery or cryosurgery: ideally in Wopa crush under IVRA , bandage after applying sulphadimidine powder. Remove bandage after one week. If the fibroma is a part of a significant painful process in a cow, then surgical removal is indicated. Sharp dissection of the skin around the base of the fibroma follows normal surgical site preparation.
  20. 20.  It is considered important for prompt healing to remove the interdigital fat and the protruding fibroma. Care must be taken to prevent surgical injury to the distal interphalangeal joint capsule and the cruciate ligaments when removing the fat. Some antibiotic powder may be placed in the wound, but no dressings or packings should be used before bandaging the foot to prevent splaying of the toes. The bandage may be removed in a few days because granulation tissue will fill the defect.
  21. 21. Interdigital dermatitis (scald or stable foot rot) Dermatitis interdigitalis is an inflammation of the interdigital epidermis without any swelling , pyrexia anorexia or lameness or involvement of the deeper and surrounding structures. Etiology: The common predisposing factors are wet climatic condition and a moist environment under the feet causing mild irritation in the interdigital space. Bacteroides nodosus is the most freguently isolated infecious agent.
  22. 22.  Clinical Signs The lesion starts as a reddening of the interdigital skin in the dorsal or palmar/ planter areas. This is followed by hyperkeratosis and slight exudation and finally separation of the perioplic band occur causing mild lameness and widening of the interdigital space during animal stance. The affected animal paddles with its hind feet. In advanced cases odorless discharge accumulate with crusts on the dorsal commissars of the interdigital space. Diagnosis Interdigital dermatitis is diagnosed after cleansing , by the characteristic superficial lesions of the interdigital epidermis.
  23. 23. Treatment Interdigital dermatitis should be treated topically. The lesions should be cleaned , deeply scrapped by a clean dry swap and a topical bacteriostatic agent applied such as a 50% mixture of sulfamezathine powder and anhydrous copper sulfate. 1- Foot bathing is usually recommended to keep the infection under control . 2- Systemic tratment with antibiotics has little effect except in sever cases. 3- Skin lesions usually regress spontaneously if environment is improved .
  24. 24. Control : Good management and housing system to keep claws dry and clean are most important. Regular foot trimming help to avoid complications. Foot bathing.
  25. 25. Digital dermatitis (Mortellaro, or Heel Wart) hairy heel warts, strawberry foot, verrucous dermatitis, digital warts, interdigital papillomatosis, and probably most correctly digital dermatitis (or popular digital dermatitis). Digital dermatitis (DD) is a contagious superficial inflammation of the epidermis proximal to the coronal margin.Two types of lesions have been reported :One is a circumscribed erosive/ reactive condition and the other is a proliferative wart like lesion.Both forms cause various degree of discomfort and may lead to severe lameness.
  26. 26. Incidence : When a herd becomes affected, the disease can rapidly spread within the herd and the morbidity may reach 90% Animal of all ages and bread are susceptible.Etiology : The cause is unclear The most reasonable explanation is that this is a multifactor disease in which spirochetes together with other bacteria (Bacteroides nodsus) or virus. Moist condition are thought to be the main predisposing cause. appearance and location of lesion as well as its transmission to other cattle differentiate it from foot rot
  27. 27. Clinical Features : A circular lesion 1 to 4 cm in diameter is generally seen in the plantar (or palmar) skin adjacent to the heel or , less commonly in the proximal part of the interdigital space. In the mild form of DD , the skin is hyperemic producing a serous exudates, in early stages, the hairs of the diseased areas are usually erect, and they later disappear. Mild to sever degree of lameness may be observed depending on the severity of the lesions.
  28. 28.  In the erosive form the skin is covered with a purulent, pungent - Smelling exudates. Cleansing exposes reddish granulation tissue. The lesion is very sensitive and easily bleeds but the soft tissue is not swollen. The proliferative type may give rise to the papillomatous type which is characterized by a mass of hard, fine tendrils that can be several centimeters in length and cover a considerable area.Diagnosis : The diagnosis of DD is often based on a history of an epidemic onset of discomfort and lameness in a herd. Also the characteristic lesions at the specific site are itself diagnostic.
  29. 29. DD/PDDpapillomatous digital dermatitis (PPD) and digital dermatitis (DD) arethought to be different stages of the same disease process. with PPD being the more chronic form with the development ofpapilloma-like structures usually on the plantar surface of the hind footjust proximal to the heel bulbs. characterized by epidermal proliferation that after several weeksproduces the “hairy warts” or papillomatous lesions
  30. 30. TreatmentLesion affected individual animals should be treated topically. If necessary claw shouldbe trimmed to a normal shape. Deep scrapping of the lesion, local application ofantiseptics or oxytetracycline, gentian violet aerosol and provision of dry environmentare most effective.Herd outbreaks are best treated with a footbath. DD can be successfully controlled by a single passage through a footbath containing 5to 6 grams/liter of oxytetracycline; for optimum effect the heel of the cows shouldwashed thoroughly before they enter the footbath.Repeated treatments may be needed after 4 to 6 weeks.
  31. 31.  In general, parenteral antibiotics have not shown any effect on either erosive or proliferative type of DD. For chronic lesions the only effective treatment is complete resection of the proliferation under regional anesthesia. A topical antiseptic dressing and a compression bandage should applied for several days after surgery.
  32. 32. Pododermatitis circumscripta (Sole ulcer, Rusterholz Ulcer)Definition : A sole ulcer is a specific circumscribed lesion located in the region of sole or heel- sole junction , usually near the axial than abaxial margin of the hind outer claw. Ulceration of the sole may occur in any digit but is most common in the lateral claws of the rear feet and the medial claws of the forelimbs. Symmetrical ulcers occur in both rear limbs or both forelimbs. The typical site for ulceration is in the corium that overlies the flexor process of the third phalanx
  33. 33. Sole ulceration is one of the most debilitating, costly and common causes of lameness affecting beef and dairy cattle.Ulcers may occur in the typical site:1. beneath the flexortuberosity of the third phalanx (sole ulcer)2. in the heel (heel ulcer)3. in the toe (toe ulcer) depending on the location of the insult.
  34. 34. Incidence : Sole ulcers commonly affect one or both lateral hind claws , predominantly in heavy , high-yielding dairy cattle kept under confined condition. In the fore limb , it more often involve the medial claw. Bulls are less frequently affected.
  35. 35. Etiology : The cause of sole ulcer is not fully known, but it probably results from localized damage to the corium at the heel-sole junction . Lack of exercise during winter housing , causing circulatory stasis in the foot. Bruising of the sole. Housing for long period on concrete. The cubicle system produces more sole ulcer than pasture or straw yards. Body weight. Medium-sized animal are more susceptible especially these with small feet. Wet conditions, which affect horn quantity, are associated with sole ulcers.
  36. 36.  The heritable trait of straight limb may reduce the ability of the leg to absorb shock. Heel erosion and interdigital dermatitis are considered to be predisposing or contributory causes of sole ulcer. Chronic laminitis which produces poor horn quality and increase the tendency to walk on the heel. Hoof defects , such as overgrown toes, unequally sized claw and corkscrew claws, which cause the animal to walk on the proximal sole and the heel.
  37. 37. Pathogensis : Sole ulcer originates from localized damage to the pododerm at the sole-heel junction. Initially , there is localized ischemia that get contused and thus results in an open ulcer which favors proliferation of fusiformis necrophorus, coryne bacterium pyogenes, streptococci, staphlococci and fungi. The suppuration may also involve the navicular bursa and pedal joint.
  38. 38. Clinical Signs The lesion is usually half inch in diameter, the sole get weekend and the granulating mass produce through the ulceration. The lameness is sudden in onset but its severity varies with the extent of the lesion and degree of suppuration. The affected limb is usually held abducted with weight bearing on the unaffected medial digit or on the toe. Cases suffering bilateral affection show alternative rest of the hind limb and the animal tends to lie down more than usual . the lesion varies from a soft, slightly discolored area, which may be painful under pressure to an obvious circumscribed
  39. 39. Diagnosis : The site and nature of the condition are characteristic. The area is often covered by a ledge of sole horn which protrudes toward the interdigital space, or the thickening of the heel horn may be excessive. Paring the excessive growth reveals hemorrhagic horn.
  40. 40. Treatment and management : Treatment for sole ulcer is to remove weight bearing from the affected portion of the digit. Depending on the location of the lesion and its severity, this may be accomplished by corrective trimming and lowering the heel horn of the affected claw. Most often a hoof block is applied to the healthy claw. If the ulcer is in the typical site or at the heel and there is sufficient heel depth of the healthy toe, a “heelless” trimming method may be used. Remove all necrotic tissue with the hoof knife. This may require the use of anesthesia by IVRA
  41. 41.  Clean and dress the wound with an astringent/ antibacterial spray or powder. Trim the foot to correct the shape and size. This usually distributes the weight more evenly between the two claw reducing the load on the sole ulcer. Bandage the affected claw if the wound is extensive. In more complicated cases, application of a wooden or rubber block to the unaffected medial claw removes all weight bearing from the region while healing proceeds.
  42. 42.  Important Things to Know About Sole Ulcers1. Ulceration of the sole is one of the most painful, costly, and common causes of cattle lameness2. Ulcers may occur in the typical site (sole ulcer), in the heel (heel ulcer) and in the toe (toe ulcer)3. Treatment involves removal of loose horn, thinning of the margin of the ulcer and the transfer of weight from the affected region to the sound claw through the application of a hoof block.4. Prevention is focused on performing regular functional claw trimming.
  43. 43. White Line Disease (WLD) White line disease (WLD) refers to a group of lesions hat affect the junction between the sole and the wall of the claw. These lesions of the white line include fissures, hemorrhage (pinkness in the sole), and abscesses. The outer claw of the rear foot is most commonly affected. This disease is characterized by separation and penetration by infected debris of the fibrous junction between the sole and the wall- the ‘white line’ This often leads to abscessation The lesion is usually found in the abaxial white line, immediately distal to the bulb of the heel. The outer claw of the hind foot is usually affected.
  44. 44. Incidence : White line disease is seen mainly in older, housed cows, but occasionally housed fattening cattle may be affected.predisposing factors : Wet, unhygienic conditions soften horn and provide an environment suitable for anaerobic multiplication. Hoof malformations, e.g. overgrowth, chronic laminitis and congenital axial rotation of the toe, cause excessive stretching of the white line. Poor horn quality , as a result of chronic laminitis, reduces the strength of the white line. Excessive walking on hard surfaces stretches the white line and wears the sole, thus weakening the wall/sole bond. Old age increases susceptibility , perhaps because horn quality deteriorates, resulting in feet becoming deformed .
  45. 45. Clinical symptoms. The lateral claw of the hind digit is usually involved and frequently involves both hind limb. Severity of lameness varies with the extent of tissue involved and suppuration. Initially the lesion may not be traced in the absence of any signs. In later stages, the lesions are observed as black spots in the white line and the claw is hot and percussion is painful. Coronary sinus formation or separation of the heel horn at the heel bulbs may be seen in advanced cases.Complications : Extension of infection up to the sensitive corium of the wall may lead to deep sepsis e.g. navicular bursitis, arthritis of the pedal joint and abscessation at the coronary .
  46. 46. Diagnosis : Separation of the wall from the sole can be seen distinctly, but foot examination must include careful paring of the hoof to expose and excavate any small black spots in the white line which could mark the position of an abscess The original lesion may be partially covered by new horn growth.Differential diagnosis The diagnosis may be confused by acute lameness caused by lesions of the bearing surfaces of the foot , such as sole puncture, sole ulcer, fracture of the pedal bone and bruised sole.
  47. 47. Treatment and management : Provide good drainage of the lesion by removing all necrotic tissue, thereby leaving a hole which will allow the continued flow of pus. If the lesion has extended up into the corium of the hoof wall, the sinus so formed should be exposed by cutting an inverted V, pointing towards the coronet. If the sensitive corium is extensively involved, local anesthesia by regional nerve block or local intravenous methods are necessary to allow adequate paring. Dress with an astringent/antibacterial spray. Leave open to drain and clean daily. The animal should be placed on clean bedding for several days.
  48. 48.  If the underfoot conditions are unavoidably dirty , or the wound is extensive, bandage the claw , using medicated gauze, cotton wool pad and adhesive bandage. the bandage should be removed after seven days and replaced if necessary. Systematic broad-spectrum antibiotic therapy for three days or longer is indicated, especially if all the infected tissue has not been removed.
  49. 49. Punctured Sole The condition is also known as punctured foot, pricked foot, pododermatitis traumatica septica or septic laminitis and is defined as diffused or localized septic inflammation of the pododerm. The lesion mostly tends to be localized with an acute onset.Incidence : Penetration of the sole is a sporadic cause of lameness The hind feet are usually affected more than the fore feet.
  50. 50. Etiology The condition is primarily caused by penetrating nails, sharp stones , glass and wires that pierce the horny capsule of the sole and thus establish septic pododermatitis. Cultural examination confirms a mixed infection with pyogenic bacteria which may sometimes take place through the cracked sole. Prolonged use of over loaded animals on concrete surface also results in thinning of the sole which is then easily penetrated even by less sharp object.
  51. 51. Clinical Signs : The foreign body causes only pressure slight lameness. If complete penetration through the horn has not occurred (Bruised sole) or a septic traumatic poddermatitis results and sometimes foreign body may still be present. If complete penetration through the horn has occurred there is rapid onset of lameness. The animal hold its limb above the ground because of the development of painful abscess. The well advanced cases are characterized by the swelling of soft tissue around the hooves.
  52. 52. Treatment and management : Pare the affected horn. If only bruising is present further paring after diagnosis is not necessary and the animal should be placed soft bedding or pasture to allow healing When there is infection ; the infected tract should be penetrated and then excavated until all necrotic tissue has been removed and good drainage obtained. Dress the area with astringent / antibacterial spray . Leave the excavated wound open to drain and place the animal on clean bedding. Clean and dress the wound daily. If underfoot conditions are dirty or the wound is extensive, bandage the claw using medicated gauze ; cotton pad and adhesive bandage. Remove the bandage after seven days and replace if necessary. Systemic broad spectrum antibiotic therapy for three days or more is indicated especially if all penetration is deep.
  53. 53. Toe Ulcer, Toe Necrosis This condition results from over wear or over trimming at the toe tip. The resulting thin sole at the tip is more susceptible to deformation from stepping on stones or irregular features of the flooring. If a hematoma results at the toe tip, it may lead to a vascular necrosis of the soft tissues at the toe tip . If the lesion is open to the environment, miscellaneous bacteria may invade and produce osteomyelitis or pathologic fracture of the tip of the third phalanx Conservative therapy with a hoof block and cleaning of the toe tip usually results in a chronic state of infection and mild pain.
  54. 54.  Our current approach to this problem is to place a hoof block on the sound digit and amputate the distal portion of the affected digit. Either obstetrical wire or hoof nippers may be used to remove slices of the affected digit until all tissue exposed appears healthy. A tight bandage is applied over some antibiotic powder to control hemorrhage. The bandage is removed in a few days. There is no need for parenteral antibiotics. Regrowth of functional cornified epithelium will cover the partial amputation in about 1 month. The prognosis is excellent.
  55. 55. Deep Sepsis of the Digit  Untreated or late-treated foot rot, complicated sole ulcer, white line abscess that extends into retroarticular structures, and puncture wounds may all result in necrosis and/or infection of structures important for weight bearing. These problems have in common severe pain that is not relieved by hoof blocks or analgesic medication. Specific diagnosis of the problem may be aided by using a probe to explore fistulous tracts or by inserting a hypodermic needle (14 or 16 gauge) into joints or tendon sheaths but rarely requires radiography. Cows suffering from deep sepsis are truly suffering, and a decision should be made at the first recognition of this problem to euthanize, slaughter, or perform surgery.
  56. 56. Inflammation of the Biflex canal in sheep This canal is a double passage which open on either side of the middle line of the digit about 1/4 inch above the entrance to the interdigital space in front, it is orifice being marked with a tuft of hair. The canal is not present in the goat.Causes : Irritation caused by foreign matter gained entrance to the canal. Leading to suppuration and necrosis.Symptoms : There is inflammation in the affected region . On compression between fingers, a fatty discharge oozes from the canal Lameness is pronounced, the animal remains lying most of the time. When both limbs are affected the animal walks on the knees.
  57. 57. Treatment : The hair around the orifices should be shortly cut and the lower parts of the limb. including the foot, should be thoroughly cleaned with hot antiseptic fomentation. Compression should be applied to squeeze the contained infected material . Local infiltration of antibiotics around the inflamed canal and inside it then bandage . This is repeated every 2-3 days till recovery. If there is phlegmone at the lower part of the limb, systemic injection of antibiotics should be continued for three successive days.
  58. 58. Amputation of digit in cattle This operation is recommended to treat irreversible lesions of the deep tissues of the claw such as: Septic arthritis of the distal interphalangeal joint Necrosis of the insertion of the deep flexor tendon to the distal phalanx Abscessation and necrosis of the digital cushion Osteitis and osteolysis of the pedal bone Pedal bone open fractures
  59. 59. Surgical technique The cow is cast and placed in lateral recumbency with the affected digit uppermost. Alternatively the operation may be performed with the cow standing if one of the crushes specifically designed for foot trimming is available, because these the limb to be adequately immobilized . Anesthesia can be achieved simply and effectively using an intravenous regional nerve block. Amputation may be carried out above or below the proximal interphalangeal joint by sawing through the first or second phalanges respectively, or by disarticulation of that joint which is the method preferred by the authors.
  60. 60.  The incision is made 0.5 cm. above the coronary band and is continued through all the tissue to the underlying bone and continued in like manner to encircle the digit. The second phalanx is exposed on its lateral aspect and the dissection is continued upwards to the proximal interphalangeal joint which is located 1.5 cm above the initial skin incision. Escape of synovial fluid indicates that the joint has been reached. The joint is disarticulated by continuing the incision around the joint thereby transecting the extensor tendon cranially, the flexor tendon caudally and the medial collateral ligament. This is made easier by manipulating the digit.
  61. 61.  Once the digit has been removed , the articular cartilage is removed from the distal end of the first phalanx using a scalpel or currette. Any necrotic tissue is removed by sharp dissection , and the stump of the deep flexor tendon and its synovial sheath are examined for evidence of infection. The operation is completed by packing the wound with a non-adhesive dressing and a cotton wool pad. The foot is enclosed in cotton wool and a cotton bandage , and finally Elasoplast is applied as a pressure bandage to control heamorrhage. The stump is checked for any evidence of infection 4 days post operatively and the dressing is renewed.
  62. 62. Corrective foot trimmingCorrective and preventative hoof trimming Trimming is essential for the maintenance of healthy normal feet on most dairy farms as well as on artificial insemination centers where dozens of bull are kept in confined conditions. hoof trimming is being done well by full-time professional trimmers who have their own specialist equipment e.g. purpose-built crushes/chutes, including the Wopa crate, or other models of turn-over devices, most mechanically powered). Trimmers often prefer to use powered metal disk grinders (angle grinders).
  63. 63. Timing of trimming Ideally at drying off, and again, assuming twice yearly job, at winter housing or not later than one month before spring turnout but often done when time is available.Site of trimming preferably under cover, but good light essential site should have easy route from collecting area and to outside yard for later inspection, and be easily cleansed
  64. 64. Foot trimming methodology1. Step One: Inner claw of hind foot. If necessary trim the toe to a “correct length” of 7.5 cm (roughly four fingers width) from the coronary band to the toe tip. If in doubt leave the toe slightly longer rather than cut too much off.Cutting the toe too short can have serious consequences: (a) Exposure of corium leading to bleeding and discomfort. (b) Render a correct trim impossible, without making the sole too thin.
  65. 65. 2. Step two: Inner claw of hind foot. Trim the sole to reduce its thickness to approximately 5 mm at thecut edge of the toe. Most horn is removed from the toe. The white line often reappears at this stage. However if the inner claw was the correct length prior to trimming then it should need no horn removed from the sole. On the inner claw in most cases the heel should not be touched asit is essential to maintain the height of heel of the inner claw. Once the inner claw is trimmed it acts as a template for trimming the outer claw.3. Repeat steps 1 and 2 for the outer claw
  66. 66. 4. Step 3: Dish out or model the normal non-weight bearing sole on the middle third of the inner aspect of each claw. Extend it about one-third the way towards the outer wall of the outer claw. Make it smaller on the inner claw. Do not go too deep and expose corium. This step relieves weight bearing from the typical sole ulcer site.
  67. 67. 5. Step 4: • Remove additional horn from the lateral claw so that it is equal in height to the inner claw. • Heel horn of the outer claw usually has to be removed to do this.6. Step 5: • Remove loose under-run horn at the heels, while trying to maintain adequate weight distribution across and between claws.
  68. 68. The purpose of footbaths is: inhibition or destruction of bacteria (e.g. Fusobacterium necrophorum) involved in interdigital skin diseases washing action, cleansing of digits hardening of sole horn, reducing wear rate and incidence of bruising and sole penetration control of digital dermatitis and heel erosion Equipment Preferably two footbaths, in tandem, with first containing water or a mild detergent mixture, the second the active solution.
  69. 69.  Sitting Footbaths should be sited in a passageway 1.0 to 1.2 m wide on the return route from the parlour. It is important to avoid a site directly at the parlour exit, where congestion could cause delays to milking and also prevent the cows from walking slowly through the bath.Contents. Water for washing the feet should be changed daily. Astringent chemical solutions of either copper sulphate 5% or formalin 5% (2% formaldehyde) must not be used more than twice a week even for herds with very soft feet, and less frequently as the feet harden Excessive use makes the horn brittle and may cause skin irritation. The depth of solution in the bath should be 17 cm. It is useful to have two baths in series, the first containing water to wash the feet and so reduce contamination of the astringent in a second bath.
  70. 70.  Specification - dimensions and structure. Length 300cm at least. Width 100cm at top, 60cm at bottom, in order to reduce the amount of solution used. Depth 30cm. Ends sloping to permit emptying with a brush. The surface should not be slippery. Exit area should slope back to the bath to reduce the loss of solution. it should open on to a large clean area, to prevent immediate recontamination of feet with faeces. Portable footbaths . These are made of glass fiber reinforced concrete and meet the basic construction criteria. Dry chemical footbaths.
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