Ruminant Upper Limb & Joint Lameness Flashcards
What are the 6 major etiologic agents of septic arthritis?
- Trueperella pyogenes
- fusbacteria
- streptococcus
- staphylococcus
- coliforms
- mycoplasma
culture to determine antimicrobial of choice
What are the 3 major ways microbes can infect joints?
- hematogenous - common in calves with navel infections or failure of passive transfer, affects multiple joints
- puncture - affects one joints
- periarticular penetration - sequel to a cast sore, abscess outside of joint capsule
How do most cases of septic arthritis present? Why should all joints be evaluated, especially in calves?
3-legged severe lameness
- often multiple joints involved
- mature cattle arthritis is usually affecting a single joint
What are 5 major factors that contribute to prognosis and treatment of septic arthritis?
- number of joints involved
- how long it has been going on
- response to previous therapy
- size/weight
- financial constraints
Why is sterile prep important for performing joint taps? Where should a joint tap be taken?
- swelling may not be septic
- culture and sensitivity
soft spot in the swelling (palpate for bone and avoid)
What bore needle is recommended for joint taps? Why?
14-18
14g preferred so it is large enough to flush antibiotics and clumps of fibrin or purulent material without becoming clogged
What does normal joint fluid look like? How can normal viscosity be tested?
clear to slightly yellow with no turbidity, few WBCs or neutrophils, and low protein
string test - more purulent material = less stringy; should be at least 2 cm
What conservative treatment is commonly used to treat septic joints? What is a more advance option? What is treatment is not worth it?
antibiotics and anti-inflammatories for a few days (good for cases of one joint is affected and found quickly)
systemic and intra-articular antibiotics, anti-inflammatories, and flushing of the joint with saline**
slaughter, euthanasia
What clinical signs are most commonly associated with septic arthritis?
acute onset of a swollen, hot, and painful joint that the cattle is reluctant to move
- 3-legged lame!
How are chronic cases of septic arthritis like?
treatment likely not worth it due to poor prognosis —> euthanasia/slaughter
How are radiographs used for diagnosing septic arthritis?
give an idea of how long infection has been present —> arthritic changes take at least 2 weeks to appear
What is wrong with this joint tap?
no sterile prep!
What NSAID and antibiotics are recommended for septic arthritis? How should the joint be flushed?
Meloxicam + Procaine Penicillin G (Naxcel not able to be used in an off-label manner) —> good option for T. pyogenes, as it is G+, but it’s not broad-spectrum
flush as long as it is productive to do so and the fluid is clear
Is method of administering antibiotics as important in treating septic arthritis?
most drugs given systemically achieve therapeutic tissue levels in synovial membrane and synovia
What is a red flag for septic arthritis caused by Mycoplasma?
feedlot beef calf with arthritis and pneumonia (can cause an outbreak!)
- no good treatment or control
- vaccination is the principle focus on control, but they are lacking
What is the only drug approved for treating septic arthritis caused by Mycoplasma? What are some other options?
Tulathromycin (Draxxin)
- Florfenicol (Nuflor)
- Spectinomycin (Adspec)
- Enrofloxacin (Baytril)
- Oxytetracycline has mixed results
How do most bovines present with degenerative joint disease?
- chronic progressively severe lameness with a rolling gait
- prefers recumbency, reluctant to mount
- can be acute with ligament rupture
What are 3 possible causes of bovine degenerative joint disease?
- conformation defects - post-leggedness (straight hock and stifle)
- trauma, arthritis, ligament tears
- nutrition deficiencies - aphosphorosis
+/- heritable, older and overweight cattle
What are 4 common findings in cattle with degenerative joint disease? How is it diagnosed?
- resist flexion of affected joints
- joint capsule usually not distended, painful, or hot, but can be unstable
- soft tissue thickening around joint
- crepitation
radiographs +/- arthroscopy
What are common findings in the joint fluid of cattle with degenerative joint disease?
- yellow tinged +/- debris, but no clot
- 200-1000 WBCs
- 10-15% neutrophils
- <3 g/dL protein
What is the preferred treatment of degenerative joint disease? What palliative care is an option?
slaughter —> no good therapy available
- intra-articular corticosteroids
- rest
- NSAIDs
- intra-articular hyaluronic acid
- acupuncture
What surgeries are available for cattle with degenerative joint disease?
- curettage and removal of joint mice
- surgical arthrodesis
How do cattle with coxofemoral luxation present? What if it’s bilateral?
- usually sternally recumbent and unable to rise with affected limb abducted excessively
- standing - extended and shortened limb craniodorsally
- asymmetric gluteal region
always recumbent in a frog-legged position
What are 4 common etiologies associated with coxofemoral luxation? In calves?
- estrus - large bull mounts smaller female on a slippery floor or with improper leg position
- parturition/dystocia - obturator nerve trauma
- trauma
- slick footing
improper traction at birth
What coxofemoral luxations are most common in the US and Australia?
US = craniodorsal (not palpable)
AUSTRALIA = caudoventral
What are the 6 best cases for coxofemoral luxation reduction?
- able to stand
- < 3 y/o
- < 800 lbs
- < 12 hr duration
- lack of concurrent metabolic disorders
- no nerve paralysis
What are the 2 most common clinical signs associated with coxofemoral luxation? What can be observed on rectal palpation?
- abnormal posture of affected limb(s)
- limb splayed perpendicularly ot the lateral body wall
unable to palpate femoral head in its normal position in the obturator foramen
How will a luxated coxofemoral luxation appear on palpation?
place thumbs on tuber ischia and pointer fingers on the greater trochanter —> length differnce between sides is a good means of diagnosis
+/- swelling, crepitation, sudden onset swinging leg lameness
How should a downer cow be manipulated to test for hip luxation?
must get up —> use hip lifters and place in a floater tank
What is the preferred option for coxofemoral luxation treatment? What else can be done?
slaughter - prognosis is poor and reluxations are common
- nothing if able to ambulate, can develop pseudoarthrosis
- reduce luxation if within 24 hr and craniodorsal
- open reduction can be performed after 24 hrs in valuable cattle
What can make coxofemoral luxation reduction difficult in cattle?
- muscle contraction
- blood clots can form within a few hours of luxation
What are 2 indications of a successful coxofemoral luxation reduction? How can reluxations be avoided?
- “clunk” sound hear upon traction (constant traction can fatigue muscles!)
- greater trochanter in normal position and leg can be flexed easily
What treatment of coxofemoral is available for calves?
femoral head osteotomy = salvage
In what 2 ways can coxofemoral reluxations be prevented?
- confinement to a location with excellent footing
- hobbles
In what large animals is osteochondrosis dissecans most common? What are 4 predisposing factors?
rapidly growing, young cattle and hogs (6-18 months) —> outgrow cartilage
- hard floors
- minimal excercise
- “hot” nutritional rations (grain!)
- genetics
(seen anywhere - humeral head, distal radius, femoral trochlear ridges, femoral condyles, tarsal joints)
How is osteochondrosis dissecans diagnosed?
- joint tap = ~2000 WBCs, no bacteria
- radiography
- arthroscopy
How do most patients with osteochondrosis dissecans present? Treated?
chronic, intermittent, less severe lameness
- stall rest
- correct diet with less grains
- arthroscopy with curettage if above fails
(good prognosis with no complicating factors, like DJD)
What is a hygroma? Where are they most commonly found?
cystic swelling containing serous fluid due to chronic irritation of joints (epidermis, dermis, subcutis), commonly lacking lameness
tarsus and carpus (periarthrosis), not commonly involving the actual articular surface
Hygroma:
What is the most common cause of hygroma development?
repeated trauma (rubbing), most common in free stalls with concrete edges (hocks!) or insufficient bedding
What are common differentials for hygromas? How do they differ? What is commonly used to differentiate?
- septic arthritis
- periarticular abscess
hygroma = much less obvious lameness and pain associated
U/S, sterile tap
What is a unique cause of hygromas in buffalo?
Brucellosis
What treatment is recommended for hygromas?
most commonly - NOTHING
- more appropriate bedding —> pasture!
- antibiotics/anti-inflammatories may not be necessary
- lance and flush if abscessed
- bandaging and surgical removal is tough —> complications of entering joint that is not infected or incomplete removal
How can hygroma development be avoided?
provide excellent bedding and housing
How do cases of contracted tendons present?
walking on pastern joints
(splints for correction!)
What congenital causes can contribute to developing contracted tendons? How can size affect development?
arthrogryposis or lupine toxicity (crooked calf disease)
more common in smaller calves —> may have tendons shorter than bones
How are contracted tendons treated? What does not work in calves?
- splint and stretch to speed up recovery
- extreme case + valuable calf = surgery to transect superficial flexor tendon with cast application
may grow out of it - provide good footing
IV oxytetracycline
How do patients with spastic paresis (Elso Heel) present?
tripod - one leg hovering and not weight bearing, commonly a hind leg
What ultimate genetic cause has been linked to spastic paresis? When are signs seen?
Elso II (bull)
clinical between 2-9 months —> occurs in both hindlimbs, but one is commonly worse than the other
What treatment is available for spastic paresis?
- slaughter as soon as possible
- tibial nerve transection - not as helpful, other leg will the become stiff
What is the most common cause of extremity cellulitis? What sign is indicative?
unsanitary injections
- extensive cellulitis and abscess tracking
- extremely swollen limb
- lameness due to pain and swelling
What treatment is recommended for extremity cellulitis?
- drain
- flush
- antibiotics
- repeat
How do patients with syringomyelia present?
calves with hopping gait
What is indicative of perosomus elumbis?
agenesis of lumbosacral spine and vertebra causes rear leg arthrogryposis (front legs normal!)
What is indicative of spinal dysraphism?
arrested development of spinal cord with cavitations results in a hopping gait similar to syringomyelia
