Claw affections Dr. Alaa Ghazy

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Claw affections Dr. Alaa Ghazy

  1. 1. Cattle lameness ‫د‬.‫ي‬‫غاز‬ ‫عالء‬ ‫البيطريه‬ ‫احه‬‫ر‬‫الج‬ ‫س‬‫ر‬‫مد‬ ‫ي‬‫البيطر‬ ‫الطب‬ ‫كلية‬ ‫الشيخ‬ ‫كفر‬ ‫جامعة‬ ‫املتحده‬ ‫الواليات‬‫من‬ ‫اه‬‫ر‬‫دكتو‬ ‫االمريكيه‬
  2. 2. Equine hoof affections http://www.slideshare.net/aghazys/lameness-equine-hoof-affections-dr-alaa-ghazy
  3. 3. Claw Affections
  4. 4. Coronary Band Wall Bulb ANATOMY OF THE FOOT
  5. 5. ANATOMY OF THE FOOT
  6. 6. ANATOMY OF THE FOOT
  7. 7. Cattle Lameness o Cattle lameness is one of the most significant welfare and productivity issues in dairy farming. o 95% of lame cattle are dairy breeds o 90% of cases involve the digits o 80% of digital lameness is located in the hind limbs  50% of digital lameness involves the horny tissue  50% of digital lameness involves the skin, mostly digital dermatitis o 70% of the horny lesions involve the outer claw
  8. 8. foot rot (Interdigital phlegmon, Foul in the foot) INTRODUCTION o foot rot is a subacute or acute necrotic infection that originates in the interdigital skin, leading to cellulitis in the digital region. o foot rot has a worldwide distribution o usually sporadic but may be endemic in intensive beef or dairy cattle production. o The incidence varies according to weather, season of year, grazing periods, and housing system. o foot rot is less common today than it was decades ago probably because dairy cows spend much less time at pasture. o However, on average, foot rot accounts for up to 15% of claw diseases.
  9. 9. foot rot (Interdigital phlegmon, Foul in the foot) ETIOLOGY o Maceration of the skin by water, feces, and urine may predispose to injuries. o Injury to the interdigital skin provides a portal of entry for infection. o Fusobacterium necrophorum is considered to be the major cause of foot rot. It can be isolated from feces where it may survive as a saprophyte, which may explain why control is difficult. This organism can survive in moist soil. o F necrophorum is a gram-negative, nonspore-forming, nonflagellated, nonmotile, pleomorphic anaerobic bacteria. It has a lipopolysaccharide endotoxin that is capable of necrotizing activity. o Other organisms, such as Dichelobacter nodosus, Staphylococcus aureus, Escherichia coli, Arcanobacterium pyogenes, and possibly Bacteroides melaninogenicus can also be involved.
  10. 10. foot rot (Interdigital phlegmon, Foul in the foot) CLINICAL FINDINGS o Research suggests that the incubation period of foot rot can be a week. o The fore or, more commonly, the hind limbs can be affected, but more than one foot is rarely involved at the same time in mature cows. o The first sign is swelling and erythema of the soft tissues of the interdigital space and the adjacent coronary band. o The inflammation may extend to the pastern and fetlock. o Typically, the claws are markedly separated, and the inflammatory edema is uniformly distributed between the 2 digits.
  11. 11. foot rot (Interdigital phlegmon, Foul in the foot) CLINICAL FINDINGS o The onset of the disease is rapid, and the extreme pain leads to increasing lameness. o In severe cases, the animal is reluctant to bear weight on the affected foot. o Fever and anorexia are seen. o The skin of the interdigital space first appears discolored; later, it fragments with exudate production. o As necrosis of the skin progresses, sloughing of tissue is likely to follow. o A characteristic foul odor is produced.
  12. 12. foot rot (Interdigital phlegmon, Foul in the foot) CLINICAL FINDINGS o If the disease proceeds unchecked, weight loss is severe and milk yield is significantly reduced. o Milk production may not recover during the current lactation. o Open lesions can be infected with secondary invaders. If the necrotic lesion is located in the anterior region of the interdigital space, the distal interphalangeal joint can become infected. o Hematogenous infection of the tissues of the interdigital space may account for peracute cases of foot rot, which are referred to as either “blind” or “super foul” This form of foot rot is characterized by the initial absence of a skin lesion, extreme pain, and the tendency to progress despite aggressive therapy.
  13. 13. foot rot (Interdigital phlegmon, Foul in the foot) TREATMENT o Treatment should be administered as soon as signs are observed. o Most treated animals recover in a few days. o Good results are obtained with penicillin G, IM, for 3 days. o Early cases respond well to single doses of long-acting oxytetracycline. o Sodium sulfadimidine solution IV or trimethoprim/sulfadoxine IV or IM, bid for 3 days, can also be used. o High concentration of an agent in the target tissues can be achieved by a regional IV injection. Positive results have been obtained with penicillin or oxytetracycline.
  14. 14. foot rot (Interdigital phlegmon, Foul in the foot) TREATMENT o Local treatment is essential for some longstanding cases and in all instances in which the anterior region of the interdigital space has been compromised. o A nonirritant bacteriostatic agent (such as nitrofurazone or a sulfa preparation) should be applied as a topical dressing. o Bandages, if used, should be replaced daily.
  15. 15. foot rot (Interdigital phlegmon, Foul in the foot) TREATMENT
  16. 16. foot rot (Interdigital phlegmon, Foul in the foot) CONTROL o Animals that are actively shedding infectious organisms should be isolated until signs of lameness have disappeared. o Preventive use of a footbath with an antiseptic and astringent solution (eg, copper or zinc sulfate [7–10% in water]) has given beneficial results. o Vaccines against F necrophorum have failed because of the weak immune response to the bacterium. o High levels of zinc fed as a supplement have a beneficial effect by improving epidermal resistance to bacterial invaders.
  17. 17. foot rot (Interdigital phlegmon, Foul in the foot) CAUSES  Bacteria Causing Disease Lives in Soil or Internally in Animal DIAGNOSIS  Symmetrical Swelling  Foul Smell  Broken Skin (ulcers) Between Toes  fever  Low prodution TREATMENT  Responds Well to systemic Antibiotics  Wash Until Clean  Topical Antiseptic
  18. 18. INTRODUCTION o Emerging disease, first reported in Italy in 1974. In U.K.: Roger Blowey (1987). o Highly contagious. Present day:  Worldwide distribution  U.K.: >70% dairy farms infected o Leading cause of lameness:  Economic losses  Welfare issue o Relatively underresearched:  Etiology not known with certainty  Pathogenesis only partially clarified  Transmission pathways unknown Digital dermatitis (Hairy warts, Papillomatous digital dermatitis)
  19. 19. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) DEFINITION: o A diffuse or circumscribed epidermitis of the digit at the coronary margin”. ETIOLOGY  Uncertain, more than one bacterium is involved.  Dichelobacter, Treponema spp, spirochetes, Fusobacterium spp, and Campylobacter spp.  virus plays a part in the pathogenesis of the disease, but none has been isolated to date
  20. 20. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) SIGNS:  Lameness (not always!)  No fever  Typical lesions o Size: diameter 1 – 6 cm o Aspect: dependent on stage of disease o Location: usually on plantar aspect of hind feet, on hairy skin between heel bulbs; in affected cows, frequently bilateral
  21. 21. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) CLINICAL FINDING o Erosive lesion  Hyperaemia, swelling, eczema  Erosion and ulceration of superficial epidermis  Surface lower than skin level  Red, bleeds easily  Intensely painful
  22. 22. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) CLINICAL FINDING o Granulomatous lesion  Ingrowth of keratin, which develop into papillae  Elevated above skin level  Increased diameter  Less painful  Pungent odour
  23. 23. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) CLINICAL FINDING o Proliferative lesion  Advanced hyperkeratosis; long papillae  Solid, dense aspect  Can become very prominent
  24. 24. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) CLINICAL FINDING o Scabbed / regressing lesion  Lesions of any stage can regress after treatment  Black, rubbery scab; well demarcated  Less painful  After sloughing off, skin can be smooth, show a scar, or still be hyperkeratotic
  25. 25. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis) TREATMENT o Acute lesions are initially treated topically.  lesion should be scrubbed clean with a stiff brush and soapy water, rinsed, and dried.  An antibiotic powder, such as oxytetracycline is applied and protected by a gauze pad held in place by a waterproof bandage.  Multiple treatments are usually necessary. o Once a lesion has started to heal, topical spray may be applied on the lesion.  Soluble oxytetracycline or lincomycin-spectinomycin
  26. 26. CONTROL o Footbaths containing oxytetracycline or lincomycin- spectinomycin o For optimal effect, the animals must be first walked through a bath containing clean water. o Footbaths containing copper sulfate, zinc sulfate, or formalin have been found to be useful. Digital dermatitis (Hairy warts, Papillomatous digital dermatitis)
  27. 27. INTRODUCTION o Interdigital dermatitis is a low-grade infection of the interdigital epidermis that causes a slow erosion of the skin with discomfort but no lameness unless the lesion becomes complicated. o Morbidity is usually high in housed animals, particularly toward the end of the winter. o The disease is most commonly seen when humidity is high, in temperate climates, and under poor hygienic conditions, especially in housed dairy cattle. o When animals in such herds are examined, it is not unusual for 100% to have lesions of varying degrees of severity. o In tied systems, the hind legs are affected more often than the fore legs. o In loose housing systems, the distribution between fore and hindlegs is about equal. o Animals on slatted floors are affected less often than animals on solid floors. Interdigital dermatitis (Stable foot rot, Slurry heel, Scald)
  28. 28. Interdigital dermatitis (Stable foot rot, Slurry heel, Scald) ETIOLOGY o Interdigital dermatitis is caused by a mixed bacterial infection, o Dichelobacter nodosus has been considered to be the most active component. o D nodosus is an anaerobe and exceptionally proteolytic. o The source of the infection is the cow itself, and the infection spreads from infected to noninfected animals through the environment. o D nodosus cannot survive for more than 4 days on the ground but can persist longer in filth that is caked onto the claws. o The bacteria invade the epidermis, but the organisms do not penetrate to the dermal layers. o As the condition progresses, the border between the skin and soft heel horn disintegrates, producing lesions similar to ulcers or erosions. o At this stage, the lesions cause discomfort.
  29. 29. INTERDIGITAL DERMATITIS (Stable foot rot, Slurry heel, Scald) CLINICAL SIGNS o The first stage of the condition appears to be an exudative dermatitis. o The exudate oozes to the commissures of the interdigital space and forms a crust or scab, which may be observed occasionally on the dorsal surface of the digits.
  30. 30. INTERDIGITAL DERMATITIS (Stable foot rot, Slurry heel, Scald) CLINICAL SIGNS o As the condition progresses, the animal shows discomfort by “paddling,” ie, constantly moving from one foot to the other. o If the heels of the hind feet are especially painful, the limbs are held further back than normal.
  31. 31. INTERDIGITAL DERMATITIS (Stable foot rot, Slurry heel, Scald) CLINICAL SIGNS o True lameness does not develop until a complicating lesion is present. o After a prolonged period, during which the animal has avoided bearing weight on the heel,  the horn beneath the heel increases in thickness and  some aberrations of gait result.
  32. 32. INTERDIGITAL DERMATITIS (Stable foot rot, Slurry heel, Scald) TREATMENT o Systemic therapy, including the use of antibiotics, is not effective. o In severe cases, the lesions should be cleaned and dried, after which a topical bacteriostatic agent is applied, eg, a 50% mixture of sulfamethazine powder and anhydrous copper sulfate.
  33. 33. INTERDIGITAL DERMATITIS (Stable foot rot, Slurry heel, Scald) CONTROL o Good management and housing systems to keep claws dry and clean are most important. o Regular foot trimming helps avoid complications. o Foot bathing,
  34. 34. Sole Ulcer (Pododermatitis circumscripta) INTRODUCTION o Sole ulcers commonly affect one or both lateral hind claws. o A sole ulcer is a circumscribed lesion located in the region of the sole/bulb junction, usually nearer the axial than abaxial margin. o Damage to the dermis is associated with a circumscribed zone of localized hemorrhage and necrosis. o The incidence is variable, but in some herds up to 50% of mature cows can be affected.
  35. 35. Sole Ulcer (Pododermatitis circumscripta) INTRODUCTION o Sole ulcers commonly affect one or both lateral hind claws. o A sole ulcer is a circumscribed lesion located in the region of the sole/bulb junction, usually nearer the axial than abaxial margin. o Damage to the dermis is associated with a circumscribed zone of localized hemorrhage and necrosis. o The incidence is variable, but in some herds up to 50% of mature cows can be affected.
  36. 36. ETIOLOGY AND PATHOGENESIS o Sinking of the claw, which is a feature of subclinical laminitis, is the major predisposing factor. o Iatrogenic forms of the lesion are produced when inexperienced claw trimmers remove too much horn from beneath the heel, resulting in abnormal pressure on the dermis. Excessive wear of the softened sole horn flattens and thins the sole. o Heel erosion. Normally, weight is borne by the bulb of the heel, but if heel erosion occurs, weight-bearing may be transferred forward to the region beneath the flexor process. Sometimes, a displaced pad of horn slips over to the vulnerable area, causing abnormal pressure over the flexor process of the distal phalanx. Sole Ulcer (Pododermatitis circumscripta)
  37. 37. CLINICAL SIGNS o The onset of lameness is generally sudden. o Moderate degree of lameness. o An obvious break in the integument may be apparent. o heel horn exposes sensitive laminae o granulation tissue may protrude through horn defect to form a cauliflower-or-rosette-like growth o Sever lameness if granulation tissue protrudes and in cases with deeper purulent infection (osteomyelitis, septic arthritis) o The presence of thin yellow pus indicates a deep septic pododermatitis Sole Ulcer (Pododermatitis circumscripta)
  38. 38. TREATMENT o trim horn and heel so that weight bearing by affected claw is minimal. o Remove protruding granulation tissue and apply local caustic or tetracycline spray and bandage (waterproof) for 5 days. o Broad-spectrum antibiotics for septic cases. o Confine to box and straw bedding for 5 days. o In complicated condition, amputation of the affected claw must be performed. Sole Ulcer (Pododermatitis circumscripta)
  39. 39. DIGESTIVE UPSET THAT BREAKS DOWN FOOT Laminitis in Cattle
  40. 40. Laminitis in Cattle DIAGNOSIS o Walk Softly With Very Short Steps o Affects Both Sides o Tend To Stand With Feet Forward
  41. 41. Laminitis in Cattle LAMINITIS AND THE SUSPENSION SYSTEM o Laminitis Disrupts the Attachment of the P3 Bone to the Wall o P3 Bone is Free to Rotate, sink o Pressure Through the sole = Ulcers
  42. 42. Laminitis in Cattle TREATMENT o Generally No Effective Treatment o Consistent Bunk Management o Adequate Step-up Rations
  43. 43. Laminitis in Cattle ACUTE OR SUBACUTE LAMINITIS o Introduction  Acute laminitis is not common in cattle and usually is seen in a single animal or a group that has accidentally engorged on large quantities of grain.  The incidence of acute laminitis in dairy cattle probably varies from 0.6– 1.2%.  Subacute laminitis may be seen in young beef bulls on feeding trials and in feeder calves that have been fed rations rich in carbohydrates.
  44. 44. Laminitis in Cattle ACUTE OR SUBACUTE LAMINITIS o Clinical Findings  Acute and subacute laminitis have a rapid onset.  In the most acute cases, there may be fever and an increased respiratory rate.  In the initial phases, the claws may be warm to the touch, and a pronounced digital pulse will be perceptible.  Pain may be detected in the claws with the use of hoof testers.  The animal will be reluctant to walk and will stand abnormally.
  45. 45. Laminitis in Cattle ACUTE OR SUBACUTE LAMINITIS o Treatment  If the cause is obvious, such as grain overload, it should be corrected.  Antihistamines may be useful if given within the first 48 hr after a known insult.  Anti-inflammatory drugs may be useful if given before the onset of acute signs.
  46. 46. Laminitis in Cattle CHRONIC LAMINITIS o Introduction  Chronic laminitis is recognized by the bent, flat, square-toed, and heavily ridged appearance of the claw (slipper foot).  It is the result of a prolonged process, and is assumed to be caused by a series of laminitic insults.  It is most common in dairy cows >5 yr old.
  47. 47. Laminitis in Cattle CHRONIC LAMINITIS o Clinical Findings  There are no clinical signs.  Some animals appear to walk in a deliberate, careful manner.
  48. 48. Laminitis in Cattle CHRONIC LAMINITIS o Etiology  high levels of carbohydrate in the rumen invoke an increase of Streptococcus bovis and Lactobacillus spp, which induce a state of acidosis in the rumen. This causes gram-negative organisms to die and release vasoactive endotoxins.  High levels of histamine in the blood have been found in the early stages of the disease. It is probable that subacute ruminal acidosis (SARA) is one key factor in development of laminitis, because managing SARA does help to control the incidence of subclinical laminitis.  Trauma; hard flooring is equal in importance to nutritional problems. Prolonged standing, waiting in line to drink, or spending >3 hr in the holding yard each day are factors that are commonly overlooked.  inability to exercise reduces the amount of oxygen and nutrition delivered to the claw.
  49. 49. Laminitis in Cattle CHRONIC LAMINITIS o Control  managing SARA depends on the quantity and digestibility of the carbohydrate that is fed. The more rapidly carbohydrate is digested, the more rapidly rumen acidosis will develop.  Finely ground or moist grains are more digestible than dry, cracked grain. Corn silage is frequently used in dairy production.  Sudden changes in the diet or formulation of the diet are extremely dangerous.
  50. 50. Foreign bodies in the sole INTRODUCTION o Occasionally, a foreign body such as a stone, chip of glass, or nail becomes embedded in the sole. o Even if the material does not penetrate to the corium, localized pressure causes pain and lameness. o Removal of the foreign body usually resolves the lameness without incident.
  51. 51. Foreign bodies in the sole CLINICAL FINDING o If the foreign body penetrates through to the corium, infection is introduced to the dermal level and an abscess develops. o The rapidity of onset and severity of the lameness depends to some extent on the location of the sole penetration. o abscess develops,and hence the pressure increases rapidly. o Thus, the onset of lameness is rapid and the degree of pain very severe. o Acute lameness may cause the animal to stand with the foot off the ground or with the toe lightly touching. o A differential diagnosis is fracture of the distal phalanx.
  52. 52. Foreign bodies in the sole TREATMENT o Treatment consists of removing the foreign body if still present and coring out the track to the corium with a fine-pointed hoof knife. o Pus is often released under considerable pressure. o Antibiotic should be squeezed into the cavity, which closes rapidly. o The opening should not be plugged but covered with elastic waterproof material to prevent blockage with mud or manure. o Bandaging may not be required, but the animal should be housed in a well- strawed area for a few days.
  53. 53. TOE ULCER INTRODUCTION o Toe ulcer is the term used to describe any hemorrhagic lesion of the dermis occurring in the apical region of the sole and/or white line, most frequently in the lateral hind claw.
  54. 54. TOE ULCER ETIOLOGY o As subclinical laminitis progresses, in some cases the distal phalanx will rotate. Hemorrhage will result. In extreme instances, the tip of the bone will prolapse through the apex of the sole. o the anterior half of the sole has been worn down almost paper thin. Hemorrhage from bruising is seen through the thin horn at the apex. Breakdown of the horn and formation of an abscess have been reported. The probable cause is a painful lesion in the heel, which forces the animal to throw most of its weight onto the anterior part of the sole. o Necrosis of the apex of the pedal bone is extremely common in yearling beef calves after transportation over long distances which affect its blood supply causing damage.
  55. 55. TOE ULCER CLINICAL FINDINGS o the white line and sole in the toe region may be stained with serum or blood. o In more advanced cases, a prolapse of the sole may occur with associated infection.
  56. 56. TOE ULCER TREATMENT AND CONTROL o cavity should be cleansed, dried, packed with an antibiotic powder. o If the bottom of the lesion is black in these cattle, l–2 cm of the apex of the toe should be removed with hoof cutters. o The condition of the pedal bone should be visible. If necrosis of the bone can be confirmed, regional anesthesia should be applied and a further l–2 cm of toe removed. o If the wound bleeds profusely, it is likely that necrosis is not extensive. When hemorrhage is minimal, it is probable that necrosis of the bone is extensive or a physiologic fracture is present. o the lesion should be packed with a hygroscopic mixture (50% magnesium sulfate and 50% glycerin) and bandaged for a maximum of 24 hr, after which the lesion should be thoroughly dried, dressed with antibiotic powder.
  57. 57. TOE ULCER TREATMENT AND CONTROL o If rotation of the digit has been detected radiographically, the prognosis for recovery is poor. o Control of subclinical laminitis is likely to lower the incidence of toe ulcer.
  58. 58. Septic arthritis of the Distal Interphalangeal Joint ETIOLOGY o Infection enters the distal interphalangeal joint via 3 possible main sites:  the dorsal commissure of the interdigital space, via penetrating trauma or complicated footrot (interdigital phlegmon);  sandcracks;  retroarticular abscess
  59. 59. Septic arthritis of the Distal Interphalangeal Joint CLINICAL FINDINGS o If aggressive treatment of a footrot case does not lead toward resolution within 3 days, septic arthritis should be suspected. o Increased pain, together with swelling of the anterior region of the coronary band in cases of sandcrack , is suggestive of joint infection.
  60. 60. Septic arthritis of the Distal Interphalangeal Joint TREATMENT o Digital amputation is indicated in old or poor-producing animals.  The procedure is simple, quick, can be performed in standing animals under regional analgesia, and in most cases, produces rapid relief.  Amputation is performed through the skin with an embryotomy wire placed as close to the skin-horn junction as possible.  Hemorrhage is arrested by means of a tight bandage. o Arthrodesis fuses the distal and middle phalanges and is used to extend the functional life of valuable animals.  General anesthesia is recommended.
  61. 61. Inflammation of the Biflex canal in sheep INTRODUCTION o This canal is a double passage which open on either side of the middle line of the digit about 0.5 cm above the entrance to the interdigital space in front, o it is orifice being marked with a tuft of hair. o The canal is not present in the goat.
  62. 62. Inflammation of the Biflex canal in sheep CAUSES o Irritation caused by foreign matter gained entrance to the canal. o Leading to suppuration and necrosis.
  63. 63. Inflammation of the Biflex canal in sheep SYMPTOMS o There is inflammation in the affected region . o On compression between fingers, a fatty discharge oozes from the canal o Lameness is pronounced, the animal remains lying most of the time. o When both limbs are affected the animal walks on the knees.
  64. 64. Inflammation of the Biflex canal in sheep TREATMENT o The hair around the orifices should be shortly cut and the lower parts of the limb. o including the foot, should be thoroughly cleaned with hot antiseptic fomentation. o Compression should be applied to squeeze the contained infected material . o Local infiltration of antibiotics around the inflamed canal and inside it then bandage . o This is repeated every 2-3 days till recovery. o If there is phlegmone at the lower part of the limb, systemic injection of antibiotics should be continued for three successive days.

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