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Dealing With Septic Arthritis

Very often in our practice we get called out, or a cow is brought in, with an unrelenting lameness that the producer has treated two or three times for footrot to no avail. The cow is often bearing almost no weight on its leg. This could be septic arthritis, and this article will describe the clinical findings and the treatment options available to you for this condition. With treatment the outcome is often quite favourable.

Besides being fracture-lame from the pain, one claw of the foot will be considerably more swollen than the other. A telltale sign is when the infection has broken out and is draining just above the coronary band on the affected claw. Infection has gotten into the last joint on the claw and because the infection is in an enclosed space the pain is intense. Little to no weight bearing can occur on the entire foot.

A crack in the hoof, deep footrot, sole abscess, or a penetrating wound can all lead to infection in this joint. Rarely a blood-borne infection (septicemia) will localize here but generally it occurs in the higher joints such as the stifle or carpus. These infections are more commonly seen in the outside front claw and secondly in the inside rear claw.

There are four possible courses of action with a septic arthritis. If the cow or bull is older, shipping them is a possibility provided no antibiotics have been given.

Long-term antibiotics can on occasion allow the joint to fuse. This basically means the infection eats away the cartilage and the two bones fuse together much like you would see with a repaired fracture. Calcium is deposited and when the fusion occurs pain is relieved and weight bearing reoccurs. The toes appear club-like but function well enough.

The third scenario involves freezing the foot and actually drilling out the joint. This area is flushed with antibiotics or Betadine and allowed to fuse. There is quite a bit of pain with the treatment so painkillers are often administered.

The fourth action involves a claw amputation. This gives quick relief from the pain with a good long-term outcome and is fairly easy for most veterinarians to perform.

If the decision is made to perform a claw amputation the animal is either tranquilized and down or lightly sedated and standing in a squeeze chute or on a tilt table. The affected claw is scrubbed and the whole foot is frozen with a regional I. V. block. A tourniquet is placed around the foot to keep the Lidocaine in the area but also to control bleeding while the procedure is done. Once we have good anesthesia the claw is amputated at an angle to insure we remove above the infection. This leaves a larger open wound that is bandaged tightly with an antibiotic ointment before the tourniquet is removed. I like to leave the patient in the chute a minute or so to insure blood is not leaking through the bandage as sometimes certain areas have to be more tightly wrapped.

I often cover it with long-acting antibiotics and have the producer change the bandage once after four days and repeat the antibiotics. That is about all there is to it. The stump will have a bit of local infection that is just washed off. Most of the time these animals recover uneventfully and the stump closes over.

With claw amputations there are a few precautions. For one, I don’t advise amputating the back claws on breeding bulls. The breeding pressure will cause the other claw to break down so shipping might be advisable in these cases.

Cows on the other hand will go several years before the other claw may start to show tendon stretching. Cows that have been through an amputation may need a trim on the good claw a little more often than their herd mates but that is about all the extra care they should require.

Chronic pain can be detrimental to pregnancy so I don’t hesitate to do amputations at almost any stage of pregnancy. If she is really close to term it may be wise to let her calve and then do the amputation.

Our clinic does a few amputations on calves but they are less common. More often in calves an osteomyelitis (bone infection) can accompany the septic arthritis and antibiotics may be needed for a longer time than with the cows.

If flies are an issue fly tags or pour-ons such as Cylence may be a good idea.

Heifer calves often would not be kept as replacements but I know of several occasions where they were kept and produced many calves. In most cases once a cow has recovered from a claw amputation you have to look twice to be able to spot her in the herd.

Cows can bear all their weight easily on the one claw so consider this procedure next time you have a cow diagnosed with a septic arthritis. You will be pleased with the results and it will save you from shipping an otherwise productive cow.

— Dr. Roy Lewis, DVM

About the author

Contributor

Roy Lewis is an Alberta-based veterinarian specializing in large-animal practice. He is also a part-time technical services vet for Merck Animal Health.

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