Lame - therapeutic foot trimming, digit amputation Flashcards
What is the technique used for therapeutic foot trimming?
Dutch 5 step technique
What are the steps once lesion is identified?
Isolate lesion
Remove underrun and diseased horn
Decrease weight bearing on diseased claw
Foot block and bandage
What are the different techniques of administering local anaesthesia when doing therapeutic foot trimming?
Local infiltration - ring block
Nerve block
Intravenous regional anaesthesia (IVRA) - most common
What local anaesthetic is used when doing therapeutic foot trimming?
Procaine and adrenaline
How do you do an Intravenous regional anaesthesia (IVRA)?
Apply tourniquet just below hock
Identify vein - above accessory digit
Clip and prep
Give 15-20ml of procaine
What is the onset of action of procaine?
5 to 10 mins - quick
What do you have to be careful of when using a tourniquet?
Ischaemic necrosis if left on too long
Care when removing - procaine shooting round system
How long is the max time a foot block should be on?
4-6 weeks
What is the block of choice?
Wooden demotec block
Cow slips are a bit far forward on the hoof, not used as much anymore
What 2 NSAIDs can you give to lame cows?
Ketoprofen
Meloxicam
What are the benefits of the two different types of NSAIDs?
Ketoprofen - 0 day milk withdrawals
Meloxicam - longer analgesic effect
What are the disadvantages of bandaging?
If dirty then they trap infection in there in anaerobic environment
If walking on bandage then mroe weight on affected claw
When are bandages used?
For applying topical treatments/antibiotics
For digit amputations/surgery
When are digit amputations needed?
Deep digital sepsis
Toe necrosis
Non healing white line disease/sole ulcers
Trauma - degloving/disarticulation
What are contraindications of digit amputation?
Imperfect contralateral claw
Severe ascending tenosynovitis
Lameness affecting other limb
What do you use for anaesthetising the limb in digit amputation?
IVRA with tourniquet
Poke with needle 5 mins after to test feeling
Where do you cut the soft tissues for a digit amputation?
1cm about coronary band through soft tissues down to bone
Second longitudinal incision in interdigital space
What do you use to cut through P2 for a digit amputation?
Clean embryotomy wire
What do you use to dress the foot after digit amputation?
A pressure bandage - before taking tourniquet off
What post op care is needed for digit amputation?
Change pressure bandage every 48 hours
Keep environment clean, easy access to food and water
Systemic antibiotics for minimum 5 days
NSAIDs
What are the complications of digit amputation?
Haemorrhage
Ascending infection, osteomyelitis
Ischaemia, sloughing
Premature culling
What is the prognosis of digit amputation?
If surgery and post op care go well then they can do very well with one claw
If anything goes wrong with remaining claw - very bad
