65. Treatment of arthritis and traumatic injuries of the hoof in cattle Flashcards
Septic arthritis of DIP joint?
Septic arthritis of the distal interphalangeal (DIP) joint:
- Usually secondary-infections
- Diagnosing the primary problem is crucial- often obvious
Primary cause of septic arthritis of DIP ?
Main primary causes
- Trauma to the dorsal part of the hoof or severe foot rot
- White lines
- Sand cracks (longitudinal cracks of the dorsal wall)- heavy dairy cows, beef cattle after sudden diet
change- cause unknown, usually only a cosmetical issue, does not cause lameness on its own, but if
it is close to the dorsal pouch of the DIP joint, it can provide an entry for bacteria
Possibly affected other structures?
Possibly affected other structures
- Proximal interphalangeal (PIP) joint
- Bursa of the distal sesamoid bone
- Deep flexor tendon and sheath (necrosis and rupture)
- Superficial flexor tendon
Clinical signs of septic arthritis of DIP?
Clinical signs
- Signs of the primary problem, lameness
- Swollen and painful coronary band, usually with pus leaking
- If the distal sesamoid bone and the bursa are affected- swollen, painful digital cushion, fistulation
on the skin-horn border
Diagnosis of septic arthritis of DIP?
Diagnosis:
- Anamnesis – non-healing foot rot, sole ulcer …
- Sampling of the DIP joint: dorsoproximal over the coronary band, at an approx. 60° angle, with a 14
G needle – fibrine secretion common, sampling can be difficult
• X-ray: lesions usually chronic, easily visible:
o DP of the whole foot + lat-med of the affected claw with the cassette between the toes
o Swelling of the affected foot
o subchondral bone lysis above the DIP joint – widened articular space
o distal sesamoid bone affected – lysis of the articular surface or the whole sesamoid bone
• US: not that useful for visualization but the swelling of the proximal pouch of the joint can be seen
with a linear probe
Therapy of septic arthritis of DIP?
Therapy:
• Acute disease – rarely diagnosed in time:
o Conservative therapy:
§ Local and systemic AB therapy
§ Block on the sound claw
o DIP joint lavage – dorsoproximal over the coronary band, in a 60° angle, on the two sides of
the extensor tendon, with two 14 G needle, with sterile saline until there is no fibrine in the
lavage fluid – difficult
o DIP arthrotomy – rare – multiple openings on the joint wall, cleaning, debridement
• Chronic disease – conservative therapy does not work – surgical solutions: claw amputation,
resection of the DIP joint, (arthrodesis)
Septic arthritis of PIP joint?
Septic arthritis of the proximal interphalangeal (PIP) joint:
• Usually secondary
Primary causes
- Trauma
- Local infection spreading into the joint
- Young animals- haematogen spread from a systemic infection
Clinical signs and diagnosis of PIP?
Clinical signs
- Severe lameness
- Swollen coronary band
- Fistula usually on the abaxial side
Diagnosis
• Clinical signs, puncture, x-ray
Therapy of PIP?
Therapy:
- Conservative therapy usually ineffective
- Arthrotomy: open the joint at multiple sites on the dorsal or abaxial side (avoiding blood vessels
and tendons), debridement. The joint is lavaged multiple times until the cuts are covered with
granulation tissue.
- Resection of the PIP joint
- Amputation of the digit, if the DIP joint is affected
Other pathologies of the hoof?
Other pathologies of the hoof
Non-sterile trauma:
- Foreign body – cuts, punctures, lacerations
- Pedal osteomyelitis – caused by injury of the sole (sharp object, denudation of the sole horn) or bad
trimming practice
Sterile trauma:
- Fracture of the pedal bone
- Luxation of the pedal bone
Degenerative diseases of the DIP joint:
- Calves, usually on the front leg, one -or two-sided, seemingly without cause
- Lameness, X-ray: bone reaction around the DIP joint
- Possibly developmental abnormalities or osteochondrosis in the background
