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Necrotic hoof lesions
Synonym(s): osteomyelitis distal phalanx
Introduction
- Cause: polymicrobial infections of sole and wall lesions causing infection of the soft tissue and bone, with Treponeme spp consistently found in abundance.
- Signs: lameness, identification of a chronic toe lesion with a characteristic fetid odor, often with dyskeratotic horn and excessive granulation tissue.
- Diagnosis: toe lesion with characteristic odor and black necrotic material.
- Treatment: therapeutic trimming, potentially with surgical debridement, partial or full claw amputation.
- Prognosis: good in early cases; guarded in longstanding cases.
Age predisposition
- Any age.
Cost considerations
- The lesions are very painful, so causes a significant drop in production to be expected, and it is a welfare concern for affected cattle
- These foot lesions are often chronic and receive repeated treatments.
- Surgical treatment is usually required by a veterinarian; consequently costs of treatment can be higher compared to other foot lesions seen in cattle.
Pathogenesis
Etiology
- Lesions present in the toe (zone 1), that becomes infected.
- Polymicrobial infections, but consistently infected by Treponemes Treponemes.
- This is the same organism that causes digital dermatitis Digital dermatitis.
- It can lead to infection or atrophy of the distal phalanx.
- Polymicrobial infections, but consistently infected by Treponemes Treponemes.
Predisposing factors
Specific
- More common in herds where digital dermatitis is endemic.
- Over-trimming (over-shortening at the toe).
- Other factors that lead to poor claw horn quality and compromised keratinization include deficiencies in:
- calcium Calcium and phosporous: overview
- zinc Zinc: overview
- copper Copper: overview
- manganese Manganese: overview
- cobalt Cobalt and vitamin B12: overview
- selenium Selenium and vitamin E: overview
- vitamins A, D and E Vitamins: overview
- biotin Biotin.
- Trauma or excessive wear due to walking up steep, abrasive or rough walkways.
Pathophysiology
- The primary hoof lesion (white line White line disease, sole ulcer Sole ulcer or thin soles) generally occurs due to normal mechanisms as described elsewhere, or by iatrogenic damage due to excessive or incorrect hoof trimming technique.
- Exposed corium is then susceptible to infection by Treponemes, with “non-healing” lesions developing 1-3 weeks later.
- Treponemes cause necrosis of the claw horn with involvement of the corium and potentially the distal phalanx.
- The lesions are usually severe, with destruction of the surrounding tissues with massive new bone formation.
- This is very painful for the cow, and can lead to extensive loss of horn, soft tissue, corium and bone in advanced cases.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Kofler J (2017) Pathogenesis and treatment of toe lesions in cattle including ‘nonhealing’ toe lesions. Vet Clin North Am Food Anim Pract 33 (2), 301–28 PubMed.
- Kofler J, Glonegger-Reichert J, Dietrich J, Sykora S, Tichy A & Brandt S (2015) A simple surgical treatment for bovine digital dermatitis-associated white line lesions and sole ulcers. Vet J 204 (2), 229–31 PubMed.
- Evans N, Blowey R W, Timofte D, Isherwood D R, Brown J M, Murray R, Paton R J & Carter S J (2011) Association between bovine digital dermatitis Treponemes and a range of ‘non-healing’ bovine hoof disorders. Vet Rec 168 (8), 214 PubMed.
- Kofler J (1999) Clinical study of toe ulcer and necrosis of the apex of the distal pphalanx in 53 cattle. Vet J 157 (2), 139–47 PubMed.
Other sources of information
- Kofler J, Osová A, Altenbrunner-Martinek A & Burgstaller J (2017) Surgical treatment techniques and outcome in 30 cattle with toe necrosis (apical pedal bone infection). In: 19th International Symposium and 11th Conference Lameness in Ruminants. Eds: Fiedler A & Schindhelm K. Munich, Germany. pp 215.
- Egger-Danner C, Nielsen P & Fiedler A et al (2015) ICAR Claw Health Atlas.