Upper Limb Lameness Flashcards
What is the prognosis for obturator paralysis?
Guarded - especially if bilateral
Describe Grade 1 sciatic nerve paralysis:
Loss of motor function (proprioception) but full sensation at the pastern. Recovery in a few days.
Describe Grade 4 femoral paralysis:
Cow sits in frog leg position unable to correct itself.
Prognosis - hopeless
Injections administered into the gluteals of thinly muscled young animals may damage what nerve?
Sciatic
Describe Grade 3 sciatic nerve paralysis:
Loss of sensation to tibial nerve as well - no superficial sensation below the fetlock. Recovery in 2-4 weeks.
What is ‘patella locking’?
Upward fixation of the patella - the patella becomes temporarily fixed on the medial aspect of the upper part of the femoral trochlear
What are the clinical signs of septic arthritis?
- Sudden onset lameness
- Recumbency (if several joints affected)
- Swollen joint/s - heat, pain, +/- fever
- Rapid muscle atrophy of affected limb
- After several weeks - capsular fibrosis causes limited joint movement
What is a common entry point for bacteria in newborn calves?
Umbilicus
What nerve damage does this animal appear to be suffering from? How can you tell?
Tibial nerve paralysis - stifle is dropped, hock is over-flexed and the weight bearing surface is still firmly on the ground
What procedure is being performed here?
Reduction of a dislocated hip
What treatment would you provide for sacro-iliac luxation?
NSAIDs and rest
Salvage slaughter
What is the treatment for spastic paresis (‘elso heel’)?
Patial / total tibial neurectomy
How does spastic paresis (‘Elso heel’) present?
- In growing cattle 3-6m old
- Affects one or both indlimbs
- Excessive tone and spastic contracture of the gastocnemius muscles - gross over extension of the hock
Describe Grade 3 femoral paralysis:
No patella reflex. Unable to support weight when lifted.
Prognosis - poor
This animal is able to support its own weight but is unable to extend and joints of the limb. What might be the cause?
Radial nerve paralysis (at a high level)
Describe Grade 2 sciatic nerve paralysis:
Loss of function of peroneal branch - lose sensation to anterior pastern. Recovery 7-10 days.
What treatment would you recommend in a case of stifle instability?
No treatment - recommend slaughter on welfare grounds
How do minor fractures of the tuber coxae appear?
As ‘dropped’ or ‘knocked’ hips
What nerve damage does this animal appear to be suffering from? How can you tell?
Tibial nerve paralysis - Hock over-flexed while weight bearing surface remains on the ground
Describe Grade 2 femoral paralysis:
Absent patella reflex. Legs behind when trying to stand. Walk a few paces before falling after lifting.
Prognosis - good if nursed correctly
What is typically the cause of peripheral nerve injuries in cattle and how do they present?
- Usually associated with dystocia or secondary to metabolic diseases causing recumbency
- Present as dysfunction of the limb rather than lameness
- weakness
- paralysis
- poor muscle tone
- decreased - absent reflexes
How do you treat a dislocated hip?
- Traction under heavy sedation
- Place animal in lateral recumbency with affected hip dorsally
- Fix cows body to a solid object using heavy rope through the inguinal area
- Apply block and tackle to affected olimb and secure this to another traction point
- Apply traction while at the same time rotating the femur by pushing down on the stifle and lfting the hock
- Successful rotation accompanied by an audible ‘clunk’
- Leave the cow in sternal recumbency - do not reverse xylazine sedation
- Quite sucessful if done within 12hrs
- Poor prognosis if they reluxate
What is a possible sequelae of tibial paralysis?
Partial / complete rupture of the gastrocnemius muscle
How would you treat septic arthritis?
- In adult cattle - unrewarding
- Calves treatment may be sucessful if:
- treated early
- high dose of systemic antibiotics given over several weeks
- not more than 2 joints affected
- no other systemic signs
- Procaine penicillin and ampicillin, amoxycillin or oxytetracycline
- NSAIDs to alleviate pain
- Some value in joint lavage of single affected joint (best prognosis for fetlock)
Describe Grade 1 femoral paralysis:
Legs go out behind when trying to stand but can stand and walk normally when lifted
Prognosis - good if nursed correctly
What is this cow likely to be suffering from? How can you tell?
Severe sacro-iliac luxation - the loin area is dropped and the tuber coxae are very pronounced (raised in relation to the vertebral coloumn)
What might you find on post mortem of an animal with stifle instability?
- Excessive volume of joint fluid
- Medial meniscus seoerated from joint capsule
- Ruptured cruciate ligament
- Articular surface of medial condyle showing excessive ear
- Large areas of osteophytes surrounding articular surfaces
- Excessive calcification of synovial membrane
This cow is completely unable to support her own weight and her forelimb appears to ‘hang’. What might be the cause?
Brachial plexus injury/paralysis
- may have been caused by a haematoma or abscess between the scapula and the ribs
How would you treat leg fractures?
Upper limb: usually not possible to treat
Below the hock: respond well to casting for 5-6wks (stabilize joint above and below)
How would you confirm hip dislocation if a cow?
Deep palpation while the limb is rotated / flexed and extended. Will feel abnormal movement of the head of the femur and hear loud creaking noises.
This animal is able to support its own weight but is unable to extend its fetlock. What might be the cause?
Radial nerve paralysis (low level)
Where is the sciatic nerve most vulnerable to damage and what is the most common cause?
Most vulnerable at the level of the pelvis and the femur. Damage usually due to severe intra-pelvic pressure associated with dystocia.
What is the main cause of obturator paralysis and what does it result in?
Commonly associated with ‘hip-lock’ dystocia
- Paralysis of the adducting muscles of the hind limb - affected leg/s push out to the side
- Normal sensation of lower limbs
Where is the insertion of the peroneus tertius muscle?
Proximal metatarsal
How can you go about examining an animal you susoect to have upper limb lameness?
- Have someone walk the animal
- Touch the interdigital space (stick / water jet)
- foot lesion - should lift foot
- upper limb - reluctant to lift foot
- Rule out claw lameness
- Lightly sedate with xylazine
- Feel the joints of the lame limb and pelvis as the sedated animal walks
- listen for clunks / crepitus
How do you treat pelvic fractures and what is the prognosis?
Lameness usually only minor. No treatment required and prognosis is good.
Describe Grade 4 sciatic nerve paralysis:
Loss of deep pain reflexes. No sensation at pastern. Recovery at least 4 weeks.
When is radial paralysis most commonly seen?
In cows that have been recumbent for some time because of milk fever
Also in cows cast on hard surfaces or blunt trauma to the shoulder area
How would you treat upward fixation of the patella?
- Standing sedation (xylazine)
- Palpation and positive identification of medial, middle and lateral patella ligaments - important!
- Surgical prep and local anaesthesia over area of medial patellar ligament
- Vertical 2-3cm incision made just anterior to the medial patellar ligament
- Ligament cut using a curved tenotome
- Insert 2-3 skin sutures
- Relief should be immediate
- Condition often bilateral - do other limb prophylactically?
What can you see in this cows leg and what is the most likely cause?
Knuckling of the fetlock and extension of the hock - peroneal paralysis
Associated with milk fever and ‘downer cow syndrome’
What might cause damage to the femoral nerve in adult cattle v calves?
Adult cattle: overstretching of the nerve when recumbent cattle try to rise
Calves: in newborns following excessive traction when hip or stifle locked
How does an animal with upward fixation of the patella walk?
With a jerky movement - leg gets caught behind in extension for a longer than normal period of time and is then jerked upwards and forwards as the patella frees itself
What is sacro-iliac luxation often associated with?
Dystocia and milk fever
This cow is recently calved. What does this posture indicate?
Bilateral sciatic nerve damage
How do you go about stifle examination in a standing animal?
- Gait examined from a distance
- weight bearing on the toe
- restricted movement of the stifle joint
- limb facing more laterally
- Palpation of the stifle
- patella ligaments should be easily palpated
- joint effusion evident between liagments
- crepitus felt on joint manipulation
- light sedation and palpation while animal is walking slowly
What do you do if a cow with a pelvic fracture has a piece of ileum protruding through the skin?
Remove the protruding piece of bone (bone cutters / fetotomy wire) - would will heal over
