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Interdigital hyperplasia
Synonym(s): foot, lameness, claw lame tyloma granuloma corn
Introduction
- Cause: either hereditary and/or as a result of chronic irritation/inflammation between the claws.
- Signs: a firm, fibrous, hairless, ‘thumb-like’, swelling of varying size in the interdigital space.
- Diagnosis: easily made by lifting the foot and examining the interdigital space.
- Treatment: often conservative treatment is indicated involving hoof paring and topical treatment. Severe cases require surgical excision.
- Prognosis: good in most cases although recovery after surgery may be prolonged.
Geographic incidence
- Occurs worldwide.
Age predisposition
- Adults are most commonly affected (over 2 years of age) and it is less likely to occur for the first time in animals over six years of age.
Breed/Species predisposition
- There appears to be a hereditary component.
- The Hereford Hereford is a breed recognised as being at higher risk but also the Friesian Friesian.
- In studies of dairy cows in the Nordic countries a heritability of about 0.3 has been established.
Cost considerations
- In general contribution to herd health the costs are low due to the low prevalence.
- In individual cows, with severe or chronic lameness, there are likely to be effects on production and fertility. These effects, along with treatment costs may amount to several hundreds of pounds.
- In affected bulls the costs can be high, both for individual treatment and if culling is required.
- Affected bulls can also have an impact on delayed conception/high barren rate in cows, due to a reduced willingness to mount. Particularly on beef units.
Special risks
- Surgical removal can be performed on the standing cow, under local anesthesia Local anesthesia: overview.
- In bulls, sedation and casting may be required depending on handling facilities – this carries the usual challenges/risks Sedation:overview Restraint techniques.
Pathogenesis
Etiology
- Anything causing chronic irritation in the interdigital space can be a contributing factor in the etiology.
- Typically this will include overgrowth of horn and sharp edges that inhibit the ‘clearance’ of material from between the claws as well as long toes/shallow heels which tends to increase contact of the interdigital space with slurry.
- Uneven ground can cause the toes to ‘splay’ when walking and this is thought to stretch and inflame the interdigital skin.
- Foul Foot rot and interdigital digital dermatitis Interdigital digital dermatitis can also result in irritation of the interdigital space.
- When more than one foot is affected it is likely that a hereditary component is involved which may or may not be related to ‘splayed’ feet. The actual mode of inheritance is not understood (dominant or recessive) but current research indicates a high heritability Genetics and genomics: overview.
Predisposing factors
General
- Heavy animals, poor environmental hygiene (slurry), rough/uneven ground, overgrowth of horn, breed/genetic predisposition.
Specific
- Interdigital phlegmon (foul in the foot) may be a precursor to the condition (incomplete resolution).
- Digital dermatitis infection Digital dermatitis on the growth can be the trigger factor for lameness and patient presentation.
Pathophysiology
- When the skin of the interdigital space is splayed outwards, superficial scar tissue forms.
- Chronic irritation of the interdigital skin results in dermal inflammation with extensive hyperproliferation of the upper dermis and disruption of the superficial skin layers.
Timecourse
- Often the growth has been of long duration when the case is presented and spontaneous resolution is highly unlikely.
Epidemiology
- The condition is non-infectious, although secondary infection with Treponemes Treponema spp (digital dermatitis Digital dermatitis) may indicate a herd problem of infectious foot disease.
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.
- Desrochers A, Anderson D E & St Jean G (2018) Surgical disease and techniques of the digit. Vet Clin North Am 24 (3), 535-550.
Other sources of information
- Stock et al (2017) Correlations between breeding values for claw health traits and implications for future genetic evaluations in German Holstein dairy cattle. In: Proceedings of the international lameness conference, 300.