Surgical Management of Interdigital Hyperplasia - A Report of Four Dairy cows.
Lameness is considered as a major cause of lowered productivity leading to vast economic losses in dairy production systems. It poses serious economic loses on producers due to reduced milk yield (Amory et al., 2008), increased reproductive intervals (Garbarino et al., 2004), increased early culling (Booth et al., 2004) and cost associated with foot baths and treatment. Farm studies have observed that lameness can range from 5-37 percent of animals in the milking population. The predisposing factors of laminitis involves herd level housing environment, management practices, nutrition, parity, stage of lactation, body weight and genetics (Vermunt and Greenough, 1994). The majority (88-92 percent) of lameness in cattle involves the structures of foot (Weaver, 2000) and is caused due to interdigital dermatitis, digital dermatitis, interdigital phlegmon, laminitis, sole abscesses, sole ulcer, vertical and horizontal hoof wall crack and interdigital fibroma (Welker, 1993). The most prominent signs presented by these foot conditions are interdigital wounds and swelling, digital swelling, swelling and reddening at the coronet, protruding granulation tissue through cutaneous or horny defects and draining in parts of digit (Farrow,1985).
Interdigital fibroma/ hyperplasia are formed due to proliferative reaction of skin and subcutaneous tissues in interdigital cleft made of fibrous connective tissue and is characterized by a fold of fibrous tissue hanging down into interdigital space (Collick et al., 1997). Hind feet are more commonly affected. Beef breeds, especially bulls, have a higher incidence of hyperplasia but frequency in dairy cattle is on increase. The fibroma can extend from dorsal to palmar/plantar end of cleft, while filling the entire gap between the claws.
History and Clinical Observations
Four crossbred Holstein Friesian cows aged between four to eight years were presented with complaint of limping and decrease in milk yield. On observation the cows were active and alert. Clinical examination showed temperature, pulse, respiratory and heart rate in normal range. Physical examination revealed interdigital hard fibrous mass protruding between the claws of hindlegs in all four cows (Fig. 1) and two cows had an ulcerated and infected maggot wound leading to bleeding and pain. Based on history and clinical symptoms, the condition was diagnosed as interdigital fibroma.
Ceftriaxone (Intacef (a)) was administered @ 15 mg per kg b. wt. intravenously as prophylactic antibiotic half an hour before surgery. Pre-emptive analgesia was provided using Meloxicam (Melonex (a)) @ 0.5 mg per kg intramuscularly. The cow was positioned in lateral recumbency, forelegs and hindlegs were secured using a rope to expose the surgical site clearly. The surgical site was prepared aseptically. Local anaesthesia of affected limb was achieved by local infiltration of 2% Lignocaine hydrochloride (Lox (b)) along the site of incision. Using BP blade, the fibroma was completely excised and bleeding points were cauterized using Potassium permanganate crystals. A protective compression bandage along with Tincture benzoin was applied to prevent bleeding and external contamination (Fig. 2). Routine post-operative care was provided for five days with Ceftriaxone (Intacef (a)) @ 15 mg/kg b. wt. intravenously and Meloxicam (Melonex (a)) @ 0.3 mg/kg b. wt. subcutaneously once daily. The animal had an uneventful recovery by the seventh day of treatment.
Results and Discussion
Foot lesions leading to lameness are commonly categorized according to their etiology into infectious and non-infectious lesions (Potterton et al., 2012). Infectious lesions include digital dermatitis, interdigital dermatitis, heel horn erosion and foot rot, whereas the most common non-infectious lesions are sole ulcer, toe ulcer, sole hemorrhage, interdigital fibroma and white line disease. Infectious lesions usually affect foot and skin are influenced by herd-level factors such as wet and unhygienic floor conditions (Bell et al., 2009), scraping frequency (Cramer et al., 2009), introduction of dry cows into herd, pasture access and foot bathing frequency (Somers et al., 2005).
Interdigital fibroma is a proliferative reaction of skin (Fubini and Ducharme, 2004). The skin overlying this area thickens and projects downward. This protruding skin may become infected and necrotic. Fibroma develops in response to chronic irritation between claws. Histologically, it consists of multiple papilliferous epidermal ridges covered and bridged by abundant amount of keratin. There are increased amounts of stratum granulosum and stratum spinosum of epidermis. Interdigital hyperplasia doesn't necessarily cause lameness, only when the hyperplastic tissue is large enough to be oppressed between toes and floor leads to lameness (Nuss, 2009). These large mass can cause pain and fibroma may become eroded, ulcerated and infected leading to more swelling. The severity of lameness varies, depending upon size of mass, from abscent to severe. Size of the corn and degree of lameness are guides in determining whether or not removal is necessary. In all four cattle, since the fibroma was big and affecting the limb, a surgical removal of the hyperplasia was assorted and was performed accordingly.
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R.S. Sagar (1), S.T. Maruthi (2), C. Kotresh Prasad (3), G.N. Chethan (4) and Pavan Belakeri (5)
Doddaballapura Milk Dairy
Bengaluru Urban, Rural and Ramanagara District Co-Operative
Milk Producers Societies Union Ltd. (BAMUL)
Dairy Circle, Doddaballapura
Dist. Bengaluru Rural - 561203 (Karnataka)
(1.) Assistant Professor, Veterinary College, KVAFSU, Hebbal, Bengaluru
(2.) Veterinary Officer and Corresponding author.
(3.) Ph.D. Scholar, National Dairy Research Institute, Karnal, Haryana
(4.) Veterinary Officer, Baragi, Gundlupet, Chamrajnagar
(5.) Assistant Professor, Veterinary College, KVAFSU, Shivmoga
(a) - Brand of Intas Animal Health, Ahmedabad
(b) - Brand of Neon Laboratories Ltd., Mumbai
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|Title Annotation:||Clinical Article|
|Author:||Sagar, R.S.; Maruthi, S.T.; Prasad, C. Kotresh; Chethan, G.N.; Belakeri, Pavan|
|Article Type:||Clinical report|
|Date:||Jul 1, 2017|
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