bovine lameness 4

Question 1

Hip Subluxation/Luxation
* Complication of:

Answer 1

Complication of:
– Estrus activity on slippery surface – True obturator paralysis
– Downer cow syndrome

Question 2

Hip Subluxation/Luxation
- common positions? does it matter which one is present?
- how can we tell?

Answer 2

• May be craniodorsal or ventral
  – If ventral -> euthanize
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  Test: Cow in lateral recumbency If able to lift leg 90 degrees to vertical (± clicking in/out of hip joint) or inability to extend limb

Question 3

Hip Subluxation/Luxation
- signs

Answer 3

– May be unable to stand
– Hock turned inward
– Stifle and digit outward
– May drag foot

Question 4

Hip Subluxation/Luxation
- rule outs
- positive prognostic indicators

Answer 4

Rule out femoral neck fracture
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POSITIVE PROGNOSTIC INDICATORS
*Small size (<500 kg)
*Short duration (< 24 hrs)
*Able to stand
*No other problems (eg. fractures)

Question 5

Stifle Injuries * Complication of:

Answer 5

Complication of:
– Limb turning with claws firmly placed on ground
* Estrus
– Attempts to rise in downer cow syndrome

Question 6

Stifle Injuries
- specific injury we see
- signs

Answer 6

• Partial or complete rupture of cranial cruciate ligament and meniscal injury
• Signs:
  – Heat, pain, swelling, crepitus
  – Continuous flexion of stifle
  – Touching just toe to ground
  – “Clunking” in joint when manipulated

Question 7

Maternal Obstetrical Paralysis (MOP)
- anatomy, common forms
- how does this arise

Answer 7

• A.k.a. “obturator paralysis”
  1. Obturator n. (L6) – adductor muscles
  – Base wide stance
  – Sits with hind limbs extended forward
  – not common
  2. Sciatic n. (L6, S1, S2) – more common
  – Prolonged, unassisted, unobserved calving
• Stay down due to exhaustion
  – Difficult, assisted calving

Question 8

Downer Cow Syndrome
- what is it? why?
- dx
- when we see it?
- how fast it can progress
- prognosis

Answer 8

• Unable to stand after 24 hours in the absence of/after correction of hypocalcemia
• Ischemic necrosis of large muscles of pelvic limb
  – Extremely elevated plasma CK ± AST
• Most commonly seen in milk fever case treated too late
  – May occur secondary to MOP or trauma
• May occur in as little as 6 hours
• Guarded to poor prognosis
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• Pressure-induced compartmental syndrome of the semitendinous m. > peroneal n. injury – Hyperflexion of fetlock
• Need repeated clinical exam at least q 24h to detect complications – Mastitis, fractures, luxations
• Poor prognosis if:
  – Elevated serum urea or muscle enzymes
  – Evidence of inflammation
  – Poor attitude and determination
• Cow’s value and demands on the client’s time will determine level of effort

Question 9

Downer Cow Syndrome
* Treatment:

Answer 9

Treatment:
– NSAID or steroid (dexamethasone 20 – 100 mg, for MOP)
– Get animal on feet
* Hip lifters
* Body slings
* Flotation tanks
* Must be on pasture or deep
pack
– Must consider animal welfare

Question 10

Downer Cow Syndrome
* Prevention

Answer 10

– Observe all recently calved animals at least every few hours in the first 48 hours
– Can they stand?
– Note any changes in gait/steadiness and treat promptly
– House on pasture or deep pack for calving

Question 11

Radial Nerve Paralysis
- proximal vs distal - what we see
- causes

Answer 11

• Proximal - failure to extend elbow, carpus and fetlock
  – Elbow dropped
  – Carpus and fetlock in partial flexion
  – Limb dragged
  – Seen when:
• Animal hits head gate excessively
• Heavy animal in lateral on hoof trimming table
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• Distal – inability to extend carpus and fetlock
  – Fracture or deep soft tissue trauma

Question 12

Femoral Nerve Paralysis
- when we see this
- signs

Answer 12

• Large calves pulled at birth
  – Hyperextension of femur and stretching of quadriceps
  – Femoral nerve torn
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• Signs
  – May collapse when attempting to stand > Quadriceps can not extend stifle
  – Patella may luxate laterally
  – Patellar reflex absent
  – Quadriceps atrophy

Question 13

Femoral Nerve Paralysis
* Treatment:
- ddx

Answer 13

– Steroids and NSAIDs
– Keep on bedded pack
– Ensure proper colostrum intake and feeding schedule
* Differential Diagnoses – fractures, hip luxation

Question 14

Sciatic Nerve Paralysis
- how this occurs
- how to avoid
- signs

Answer 14

• Injection neuropathy in neonates – Using semi-membranosis/ tendinosis
  – Give IM and SQ injections in neck
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• Signs
  – Dropped hip and hock, overflexion of fetlock
  – Foot may drag with movement

Question 15

Peroneal Nerve Paralysis
- what the normal nerve does, and where it goes
- signs
- tx
- prognosis

Answer 15

• Normally flexes hock, extends digits
• Passes superficially over lateral femoral condyle and head of fibula
  – Very susceptible to pressure during recumbency in dower cow syndrome secondary to milk fever
• “Knuckled” fetlock, hock over-extended
• Treatment: deep bedded pack ± dexamethasone
• Fair prognosis

Question 16

Tibial Nerve Paralysis
- normal anatomy and function
- how it gets damaged
- signs, outcomes

Answer 16

• Normally extends hock and flexes digits
• “Dropped hock” (over-flexed) and “buckled” fetlock
  – Still bears weight on plantar surface
• Runs beneath gastrocnemius muscle
  – May be damaged if tendon or muscle injured
• Gait disturbance is milder than peroneal but often more permanent

Question 17

Spastic Syndrome
- what is this?
- who we see it in?
- origins?
- signs?
- tx
- prevention

Answer 17

• A.k.a. crampiness, periodic spasticity – NOT Elso heel
• Episodic spasms of hind limbs + epaxial muscles
• Most commonly in adult dairy cattle and AI bulls
• Genetic component
  – Possibly autosomal dominant with incomplete penetrance
  – Affected animals and progeny should be culled
  – Can be endemic in some herds
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• Histologic lesion unclear
• Signs:
  – Muscle trembling and hyperextension of hind limbs
  – Especially occurs after rising or other stimulus > i.e. palpation
  – Often completely normal between episodes
  – Progressive over months to years > recumbency
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• Treatment – none, cull before severe
• Prevention – do not retain affected animals or progeny in herd

Question 18

Spastic Paresis (Elso Heel)
- what is this?
- who is affected?
- occurence? origins?
- age
- progression
- tx
- prevention

Answer 18

• Progressive hyperextension of hind limbs
• Post-legged animals more frequently affected
• Genetic–recessive gene with incomplete penetrance > very sporadic occurrence
• First seen at 2 to 9 months of age
• Progresses so animal walks with short pendulum-like steps
• Treatment (?) tibial neurectomy and gastroc tenotomy
• Prevention–cull affected animals and progeny

Question 19

Contracted Tendons
- which are most common
- tx
- prognosis

Answer 19

• Most commonly contraction of deep and superficial flexor tendons
  – Usually in forelimbs
• Treatment
  – Good footing and forced exercise
  – “Physiotherapy” – manual stretching
  – Splint with PVC pipes > Show client how to check for pressure points and change splints
  – Good prognosis if able to stand on hooves

Question 20

Carpal Hygroma
- what is it? how it arises?
- signs?
- issues?
- tx?

Answer 20

• False bursa that develops over bony structures due to chronic trauma
• Variable apparent discomfort
• Welfare concern if common
• Rarely becomes infected
• Treatment – none unless lame > box stall or
  pasture rest
  – Avoid draining unless
  abscessed

Question 21

Tarsal Cellulitis
- issue?
- tx
- prevention

Answer 21

• Welfare concern if common
• No treatment unless infected
• Treatment:
  – Increase bedding; improve stall design
  – Rubrifacients, drainage, and flushing if abscessed
  – If infection spreads up/down leg – significant swelling and lameness > systemic penicillin or ceftiofur
  – Careful not to disturb joint with treatments
• Prevention – appropriate stall designs and focus on cow comfort

Question 22

are hock injuries more common in tie stalls or free stalls?

Answer 22

• seems to be in tie stalls