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Sole ulcer and sole hemorrhage
Synonym(s): solar ulcer, foot, lameness
Introduction
- Cause: focal chronic sole corium injury and inflammation.
- Signs: clinical lameness, or hoof tenderness with bilaterally shortened strides in cases with more than one limb affected. Occasionally an incidental finding (mild cases).
- Diagnosis: exposed corium in the mid-sole region (hoof map zone 4); early or mild cases will present with haemorrhagic pigment or a soft, painful sole at this site.
- Treatment: trim, NSAID, block on other claw if that is healthy.
- Prognosis: guarded long-term, especially if severe and / or bilateral.
Geographic incidence
- Worldwide in cattle, particularly housed, high yielding dairy cows.
- Rare in beef animals except some instances in cubicle housed beef suckler cows and those housed with severely overgrown feet.
Age predisposition
- Disease process often initiated in first lactation but often manifests clinically in subsequent lactations.
Breed/Species predisposition
- Mainly dairy breeds due to exposure to risk factors.
Public health considerations
- None.
Cost considerations
- Production loss (reduced milk yield), fertility loss and premature culling account for most of the economic losses associated with sole ulcers. Treatment costs are relatively minor in comparison.
- Costs of a case of sole ulcer will vary according to local economic variables such as milk price, cull cow value, replacement heifer costs and cost of lost fertility performance. Costs calculated for single disease events are likely to significantly underestimate total costs due to the high probability of recurrence. However, as an exercise to illustrate potential losses a simplified calculation based on farm specific parameters can be enlightening.
- 570kg less milk per lactation compared to potential (higher yielding cows more likely to develop sole ulcers and regress to median performance for herd).
- Approximately 40 days extension to calving interval.
- 2.7x risk of culling with associated genetic cost (highest yielding cows most prone).
- Treatment costs.
Special risks
- Consumer perception and confidence.
- Once affected by sole ulcers, the digital cushion and surrounding tissues are pathologically compromised with scar tissue and the animal is then predisposed to recurrent disease.
Pathogenesis
Etiology
- Focal chronic injury and inflammation develops at a site palmar/plantar to the flexor tuberosity of PIII following repetitive trauma with sole contusion, which damages the horn producing germinal epithelium.
- Most cows suffering acute sole contusion will recover with or without treatment. Those that fail to recover from the initial contusion will present with sole ulcers weeks to months later.
- Despite the historical dominance as an etiological theory, there is little good quality research evidence to support rumen acidosis SARA or laminitis Laminitis in the etiology or pathogenesis.
Predisposing factors
General
- Trauma to the corium adjacent to the flexor tuberosity is most likely the result of a combination of biomechanical events including:
- Failure of suspensory apparatus. Suspensory apparatus is weakened for several weeks before and after calving, leading to increased movement of PIII within the claw capsule
. - Increased standing and walking times on hard surfaces such as concrete following calving. There are a number of complex and interrelated management and animal-related factors at play. A nadir in lying times occurs 6 weeks after calving.
- The digital cushion may be inherently under-developed in young animals (primiparous heifers) and in animals without exercise on hard surfaces, eg concrete
. - Body condition score Body condition score and lameness loss will reduce the digital cushion thickness, which may diminish its capacity for force dissipation during foot strike and limb loading.
- Hoof overgrowth Hoof overgrowth, particularly poor foot angle, sole horn overgrowth and medio-lateral claw imbalance.
- Failure of suspensory apparatus. Suspensory apparatus is weakened for several weeks before and after calving, leading to increased movement of PIII within the claw capsule
Specific
- Primiparous heifers are generally at greater risk due to poorer development of the digital cushion and being a low dominance animal having to adapt to the milking herd increasing standing times.
- Lack of cubicle training in heifers at first calving.
- Insufficient exercise on hard surfaces (eg on stone tracks or concrete) before first calving, eg managed on clean, concreted feed area.
- Uncomfortable cubicles (bed or dimension related) Housing dairy cows CowSignals white paper leading to reduced lying time Cow time budgets: overview.
- Long penning times for milking or other routine husbandry activities, particularly in the 6-12 weeks after calving.
- Lack of special fresh cow management protocols.
- Overstocking cubicles, feed space, yard space or other resources.
- Heat stress Heat stress.
- Lameness due to other reasons, eg Digital dermatitis Digital dermatitis, predisposing to longer standing times particularly in the fresh period.
- Infrequent preventive hoof trimming in cows prone to overgrowth (toe, sole or heel horn) or incorrect trimming technique
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Pathophysiology
- Changes to matrix metalloproteinases occur at calving leading to reduced strength of the laminae and the attachment of PIII.
- Body condition score BCS, Body condition score and lameness loss leads to the depletion of the digital cushion, and loss of force dissipating properties.
- Claw over-growth and loss of optimal functional shape may increase weight-bearing on the contused sole.
- Bony exostoses may predispose to more severe focal inflammation following contusion
Film - Digital dermatitis: bones and lesions. - Chronic inflammation has similarities to other compartmental syndromes. Some cows cannot recover even with apparent adequate conditions for recovery.
- No good evidence to support the direct involvement of rumen acidosis or Laminitis Laminitis in the etiology or pathogenesis of sole ulcers.
Timecourse
- The lesion develops over weeks to months.
- A successfully treated lesion, without complications, will recover within 3-6 weeks.
- First case likely to increase risk of future cases, ie disease may be self-perpetuating.
Epidemiology
- Predominantly:
- Cows with a previous history of hoof lameness.
- Housed cows.
- High yielding dairy cows within high yielding herds.
- First life-time events are usually in the 2-5 months following calving.
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.
- Randall L V, Green M. J, Huxley J. N. (2018). Use of statistical modelling to investigate the pathogenesis of claw horn disruption lesions in dairy cattle. Vet J 238, 41-48.
- Newsome R.F, Green M J, Bell N J, Bollard N J et al (2017a) A prospective cohort study of digital cushion and corium thickness. Part 1: Associations with body condition, lesion incidence, and proximity to calving. J Dairy Sci 100, 4745–4758.
- Newsome R.F, Green M J, Bell N J, Bollard N J et al (2017b) A prospective cohort study of digital cushion and corium thickness. Part 2: Does thinning of the digital cushion and corium lead to lameness and claw horn disruption lesions? J Dairy Sci 100.
- Newsome R et al (2016) Linking Bone Development on the caudal aspect of the Distal Phalanx with Lameness during Life. J Dairy Sci 99 (6), 4512–4525.
- Thomas H J et al (2015) Evaluation of treatments for claw horn lesions in dairy cows in a randomized controlled trial. J Dairy Sci 98 (7), 4477–4486.
- Groenevelt M et al (2014) Measuring the response to therapeutic foot trimming in dairy cows with fortnightly lameness scoring. Vet J 201 (3), 283–288.
- Horseman S V et al (2013) A survey of the on-farm treatment of sole ulcer and white line disease in dairy cattle. Vet J 197 (2), 461–467.
- Barker Z E et al (2009) Risk factors for increased rates of sole ulcers, white line disease, and digital dermatitis in dairy cattle from twenty-seven farms in England and Wales. J Dairy Sci 92 (5), 1971–1978.
- Willshire J A & Bell N J (2009) An Economic Review of Cattle Lameness. Cattle Pract 17 (2), 136–141.
- Amory J R et al (2008) Associations between sole ulcer, white line disease and digital dermatitis and the milk yield of 1824 dairy cows on 30 dairy cow farms in England and Wales from February 2003-November 2004. Prev Vet Med 83 (3–4), 381–391.
- van Amstel S R & Shearer J K (2006) Review of Pododermatitis Circumscripta (Ulceration of the Sole) in Dairy Cows. J Vet Intern Med 20, 805–811.
- van Amstel S R (2003) Case report - clinical response to treament of pododermatitis circumscripta (ulceration of the sole) in dairy cows. Bovine Practitioner 37 (2), 143–150.
- Webster A J (2002) Effects of housing practices on the development of foot lesions in dairy heifers in early lactation. Vet Rec 151 (1), 9–12.
- Manske T, Hultgren J & Bergsten C (2002) The effect of claw trimming on the hoof health of Swedish dairy cattle. Prevent Vet Med 54 (2), 113–129.
- Webster A J F (2001) Effects of housing and two forage diets on the development of claw horn lesions in dairy cows at first calving and in first lactation. Vet J 162 (1), 56.
- Mochizuki M I (1996) Histopathological changes in digits of dairy cows affected with sole ulcers. J Vet Med Sci 58 (10), 1031.
- Rusterholz A (1920) Das spezifische-traumatische klauensohlengeschwur des rindes. Schweizer Archiv fuer Tierheilkunde 62, 505–525.
Other sources of information
- The Healthy Feet Project (2017) The Healthy Feet Website [online] Available at: www.cattle-lameness.org.uk.
- Eggers T et al (2000) Morphological aspects in wound healing of Rusterholz ulcer in the bovine hoof. Parma, Italy. pp 203.
- Lischer C et al (2000) The significance of the suspensory mechanism of the third phalanx and its fat bodies in the pathogenesis of sole ulcers in cattle Part I: macroscopic findings. Parma, Italy. pp 222.
- Greenough P R & Vermunt J J (1994) In search of an epidemiologic approach to investigating bovine lameness problems in cows. Proceedings of the 11th International Symposium on Disorders of the Ruminant Digit. Banff, Canada. pp 186-196.