Diagnosis Of Lameness In Ruminants

Question 1

Physical examination

Answer 1

Divided into 3 types of medical examination:
- examination of the standing animals
- gait assessment
- hoof examination

Question 2

Examination of the standing animal

Answer 2

• when still = observation of any visual signs of the disease
• examines changes in fur, swellings, scratches and decubitus
• focus animation on the toe and its surroundings
• first exclude the cause of lameness in the upper part of the legs, after hooof is examined
• normally = ankle is located below the ischia tuberosity
• double sole has developed, animals stand in “cow-hocked posture
• outstretched position of front legs indicated pain in toe nails
• position extended backwards is a sign of pain in the heels of the hind legs
• if ankles are closed animals position is “standing narrow” pain in medial hind hooof

Question 3

Gait assessment

Answer 3

• assessment systems are grading cattle in herd from 1 (healthy) to 5 (severely lame)
• 1 = completely flat back when either standing/moving and odn’t limp
• 2 = flat back when standing, but when walking has a slightly hunched back (kyphosis) and don’t limp
• 3 = flat back when standing, but have a hunched back when walking and slightly limp on one lef or slightly dangle with their hind legs
• 4 = hunched back when both standing and moving, visibly limp and dangle their heads up and down when walking
• 5 = extremely hunched posture all the time, stiff joints, significant weight loss, visibly dangles its head when walking and extremely limp
• if 3-4 = hoof trimming expert, 5 = vets

Question 4

Hoof examination

Answer 4

• axial surface of hooves should be evenly concaved -> if not, animals <2 yr (esp bulls) = predisposition for lameness
• animals kept on concrete surface, stratum corneum of sole will be faceted into flat surface
• before examination, hooves should be washed with water, brushed with hard brush and advised to remove stratum corneum with hoof knife
• special attention to dark spots in stratum corneum, white line on a axial part of hooves and potential lclusters of crumbly white corneum, indicates sub clinical laminitis
• interdigital area is thoroughly examined to find foreign bodies, interdigital dermatitis, fibromas and signs of hoof phlegmons

Question 5

X-ray

Answer 5

• determine the localisation and severity of pathological process
• hooves cleaned before x-ray
• 4 projections: lateromedial/mediolateral, dorsopalmer or dorsoplantar, oblique projection and axial projection ( by inserting x-ray film cassette between the toes)

Question 6

US

Answer 6

Used for addition assessment of tendon and ligament injuries and foreign bodies not identifiable by x-ray, sinus extensions and deep abscesses

Question 7

Electromyography

Answer 7

Applied for determining motor neurone insufficiency before onset of clinical signs of lameness

Acute muscle inflammation has positive EMG results, while degenerative muscle changes are negative

Question 8

Spinal analgesi

Answer 8

• applied in exceptional field cirumstances -> conservative fixation of limb injuries/ relocation of dislocated hip
• toe amputation conduction anaesthesia of distal nerve branches is necessary
• appoox. 60ml of 2% lidocaine applied in epidural areas is required for full immobilisation of the hind legs of cattle weight approx. 450kg
• xylazine - can’t be applied to epidural area, either alone or in combination with lidocaine

Question 9

High blockage of hind legs

Answer 9

• appropriate method for treating injuries proximal to the toes
• 2 nerves: n.peroneus and n.tibialis
• peroneus nerve can be palpated in thinner skin cows t the posterior edge of the lateral femoral condole - mature cows = 20ml of 2% lidocaine
• tibial nerve palpated below tendon of m.gastrocneumius and m.flexor digitalali profundas = 15-30ml of 2% lidocaine infiltrated on medial and lateral side

Question 10

Distal digital analgesia

Answer 10

• applied from dorsal or palmar/plantar side
• dorsal towards dorsal axis proximal to interdigital area, just below metacarpal or metatarsal joint
  -> needle carefully inserted - 10ml of 2% lidocaine injected
• lateral and medial positions are located at height of hoof
  -> 5-8ml of 2% lidocaine is injected approx. 2.5cm above the hoof

Question 11

Intravenous digital analgesia

Answer 11

• mostly for procedures on the toes
• sedated and preferably in lateral position
• place eschmarch bandage and apply 10-20ml of 2% lidocaine into most filled vein distal to the bandage, but total dose shouldn’t exceed 9mg/kg of Boyd mass because entire amount of lidocaine will be resorbed into circulation after removing the eschmarch bandage

Question 12

Arthroscopy

Answer 12

Enables visualisation of internal joint surfaces for diagnostic and therpeatuic purposes

Question 13

Arthrocentesis

Answer 13

Procedure of removing synodical fluid from the joints for the purpose of examination

Question 14

Arthroscopy and arthrocentesis

Answer 14

• both need to apply LA to eliminated pain when approaching joint
• arthocentesis allows intraarticular application of drugs
• distal interphalangeal joints, proximal interphalangeal joint, fet lock etc