Claw health: sole ulcer, white line disease, interdigital phlegmon, digital dermatitis Flashcards
Another term for Pododermatitis
circumscripta
Sole ulcer
A sole ulcer is..
A circumscribed lesion located in the
region of the sole/bulb junction,
usually nearer the axial than abaxial
margin.
Damage to the dermis is associated
with a circumscribed zone of localized
hemorrhage and necrosis.
Sole ulcers commonly affect which claw?
Sole ulcers commonly affect one or
both lateral hind claws.
Especially in Heavy, high-yielding dairy cattle (HF).
Pathogenesis of sole ulcers.
Pressure, Circulatory problems and
Malnutrition lead to Compromised horn production
Ulcer are the result of:
Ischemia → Atrophy → Necrosis
Cows that have had a sole ulcer once are
more prone to sole ulcers in the future.
Long claws can lead to
sole ulcers.
Abnormal shape of the heel can also lead to sole ulcers by way of heel horn erosion.
Clinical Findings in sole ulcer cases. (3)
- The affected limb is often held slightly abducted with weight-bearing on the unaffected medial digit.
- NB! Often both hindlegs affected → hard to see clinical signs.
- Hind toes may be rested on the edge
of a curb in an attempt to relieve pressure on the heel-sole junction. - Lameness
The earliest stages of sole ulcers are :
may be discovered during
routine claw trimming.
- As sole horn is removed from over
the typical site, a hemorrhagic lesion may be exposed. - The clinical lesion varies from a soft, slightly discolored area that may be painful under pressure to a distinct bright red knob of granulation tissue.
Treatment of sole ulcers.
REMOVE PRESSURE
* Hoof trimming
* Shoe
NSAID
Prevention and control of sole ulcers.
No excess standing!
Trimming regularly and frequently.
Describe White Line Disease - WLD
- Affects one or both lateral hind claws.
- In Heavy, high-yielding dairy cattle
- Hemorrhage into or separation (avulsion) of the abaxial wall, most commonly at the heel-sole junction.
- The corium becomes infected through this lesion.
Etiology of white line disease
- The white line is composed of very soft horn, which fills the spaces between the lamella at the most distal extremity of the wall.
- This region is not only structurally weaker than more dorsal areas but is also subjected to a different set of pressure and mechanical stresses.
- Solid foreign bodies may lodge in the softened, widened white zone.
OR
localized infection may use the opportunity to burrow in some direction
Three possible sequelae of localized infection in white line disease:
- 1) a localized abscess may develop
- 2) infection may be forced proximally to form a track that may discharge at the coronary band.
- 3) the infected track may, as it forces its way proximally, infect other structures, depending on the site of the initial infection
e.g. Infection of the distal interphalangeal joint and the tendon sheath of the
deep flexor tendon may follow
Clinical findings in white line disease.
- Because the outer hind claw is affected, the limb is swung away from the body during each stride.
- The cow may stand with the medial claw bearing weight.
- White line separation without complications is frequently seen at
claw trimming. - Swelling of the heel bulb may occur
- The degree of pain and lameness depends on the rate of development and extent of the subsolar abscess!
Treatment of white line disease.
Any black mark in the white line must be cut out until healthy horn is exposed.
- For a local abscess, removal of an elliptical segment of the wall adjacent to the lesion aids free drainage by providing a self-cleansing abaxial opening.
- White puss → mechanical trauma
- Black puss → foreign body trauma
Pressure needs to be removed with trimming, possible shoe/wedge.
Consider NSAID.
Avoid overstocking barns, and fix slippery floors.
What is an Interdigital Phlegmon?
Also known as Footrot, foul in the foot.
A subacute or acute necrotic infection that originates in the interdigital skin, leading to
cellulitis in the digital region.
Worldwide, sporadic
Etiology of interdigital phlegmon.
Main one Fusobacterium necrophorum, a gram-negative bacteria that lives in the rumen.
* Feeding, stress shed it to the blood stream/feces
Other bacteria can be involved:
* Dichelobacter nodosus (ovine footrot)
* Trueperella pyogenes
* Etc.
Pathogenesis of interdigital phlegmon.
- Injury to the interdigital skin → route for infection to enter.
Risk factors:
* Wet conditions
* Overstocking
* Environment
* etc.
Same bacteria can also cause mouth and liver abscesses opportunistically.
Clinical Findings in interdigital phlegmon. (7+)
- Swelling and erythema of the interdigital space and fetlock.
- Wound in the interdigital space
- Foul smell
- Severe lameness = pain!
- Fever
- Inappetence
- Drop in milk yield
Same bacteria can also cause mouth and liver abscesses opportunistically.
Treatment of interdigital phlegmon.
- Early detection is the key!
Parenteral antibiotics
* Procainepenicillin 20mg/kg IM SID for 5-7 days
* Tetracycline 10mg/kg IM SID for 5-7 days
NSAIDs!
- Local treatment (tetracycline spray, other
non-antibiotic sprays / iodine + sugar) +
bandaging. - Separation from the rest of the herd for convalescence period.
Prevention of interdigital phlegmons.
Regular Hoof baths
* Different disinfectant solutions, different protocols exist.
Describe Bovine digital dermatitis (DD)
is a severe infectious disease, causing
lameness in dairy cattle worldwide.
- An important ruminant welfare problem that has considerable economic
issues. - Endemic in many regions worldwide
Digital Dermatitis Nomenclature around the world. (3)
- Mortellaro disease (Europe)
- Papillomatous digital dermatitis (PDD)
or
hairy foot/heelwarts
(America, Australia, Asia)
Digital Dermatitis staging
Different stages (1997, 2012):
* M0, M1, M2, M3, M4, M4.1
History of Digital Dermatitis
- First described by C.M. Mortellaro in Italy 1974
- Spread quickly over Europe
Came to Estonia in the beginning of 1990’s
* First description in Estonia 1996
* PCR in 2004
Digital dermatitis is characterized by
An ulcerative lesion consisting of an extensive or localized superficial dermatitis immediately on or above the coronary band between the heel bulbs.
- Infectious
- Mainly in hind feet
Animals with acute DD are frequently lame, they walk on their toes and shift their weight from foot to foot.
other lesions that are related to Digital dermatitis
- Toe necrosis, sole ulcers and white line disease:
- chronic lesions that appear refractory to conventional treatment, are patently
infected with bacteria, have a raised, red stippled appearance (granulation tissue) and the same pungent smell as bovine DD lesions. - Ulcerative mammary dermatitis
Etiology of Digital dermatitis
Bacteria
* Spirochaetes
* Polytreponemal
- Treponema phagedenis
- Treponema medium / Treponema vincetii
- Treponema denticola / Treponema putidum
Other bacteria?
* Dichelobacter nodosus, F. necrophorum might make the disease more severe.
Risk factors:
* Poor hygiene
* Wet conditions, problems with manure removal etc.
* Animal trade
* Stress
* High yielding cows
Digital dermatitis stage M0 and M1?
M0 = healthy skin
M1 = <2 cm focal but active lesion
(M2 = >2 cm ulcerative and active lesion)
Digital dermatitis stage M2 and M3?
(M1 = <2 cm focal but active lesion)
M2 = >2 cm ulcerative and active lesion
M3 = healing stage
Digital dermatitis stage M4 and M4.1?
(M3 = healing stage)
M4 = chronic stage with proliferative hyperkeratotic papilliform or mass-like growths
M4.1 = chronic stage but with small active M1 focus
(M1 = <2 cm focal but active lesion)
Clinical findings – M2 digital dermatitis
M2 = usually 2-4 cm erosions
- Lameness +/-
- No swelling
- No fever
- Painful when touched
- Bleeds easily when touched
M2 digital dermatitis
* With white epithelial tissue
M2 digital dermatitis
* bleeds easily
digital dermatitis M3 healing lesion
digital dermatitis M4 proliferative form
digital dermatitis M4 hyperkeratotic form
digital dermatitis M4.1
- Reactivated chronic form
- Also called M4.2
Diagnosis of digital dermatitis
- Histopathology (biopsy)
- ELISA – antibodies in serum
- Clinical signs (in practice, mostly just signs)
- Water test (spray hooves with water, if painful, cow will pick up feet)
Treatment – acute digital dermatitis M2
Wash, clean and dry.
- Tetracycline spray for 3 days used by some but not recommended.
- Copper and zinc chelates - spray for max 3 days
- Salicylic acid powder + bandage for max 3 days
- Tar + other options
If you use bandage, take it off after 3 days!
Treatment – chronic digital dermatitis M4/M4.1
Salicylic acid powder + bandage for max 3 days
If you use bandage, take it off after 3 days!
Control of digital dermatitis
- Hoof baths for the whole herd
Copper (or zinc) sulphate 5%
* Different protocols
* 3 times per week every week for a month
Copper sulphate 2% acidified (no longer recommended? biocide act EU)
* 200l water + 4kg copper sulphate + 4dl Digiderm (organic acid)
Other Commercial solutions
Treatment outcome for digital dermatitis
- 60-65% reocurring lesions 7-15 weeks later
- Spontaneous healing rarely
- Immunity?
