Complicated Lameness


Hello, We expose here a clinical case of severe lameness which we have re-checked a few times. It is a Holstein Friesian cow, not too old, with high milk yield (in 3rd re-check she was producing about 36 liters per day). Here you have some pictures of how was her right hind foot on the las re-check. 2016.06.06 - Korta crónica (2) 2016.06.06 - Korta crónica (1)2016.06.06 - Korta crónica (6)















She is lame since 5 months. We have been called late, because it has this aspect (more or less) since first treatment. In the first and second treatments a bloc was used to reduce pressure on external hoof. Lose horn was also removed from sole and heel. In third treatment, body condition score was really low, so we decided that amputation was not an option. Diagnosis is “retroarticular abscess”, During examination we found two fistulas, which we made a drainage making a second opening for each one. We cleaned before the hoof with peroxide and iodine. We made drainage with gum cateter usually used for infussions and local anesthesia. We explained the farmer he should move every day drainage a little bit and that the cow neede antibiotic and antiinflamatory therapy. After two weeks the farmer phoned again to re-check the animal. She has lost drainages but locomotion was improved; physical appearance was better and she was eating and drinking more, he told us. So, we had four possible treatments:

  • Amputation
  • Antibiotics Infussion (Varasano V., Mortellaro C.M. et al., exposed in Valdivia 2015)
  • New drainages
  • Cleaning up with peroxide and iodine trough openings.

What do you think? what would you have done? What we have done: cow has locomotion 3-4 (scale 1 to 5). So we cleaned everything again and we leave it. Because it seem that she is tolerating the lesion. Lameness is lower than at the beginning. Amputation would have been risky (because of stress after surgery), drainages worked well, but the owner didn’t want to repeat them (extra-work for him), antibiotical infussion would not have resolve all the problem, because lasion is quite old and deep structures are damaged (this treatment has been exposed for acute cases). We asked Loris de Vacchis, DVM, expert in hoof surgeries and severe lameness. He agreed with us that amputation and infussion were not the best option. He recommended periodical tratments until ulcers and fistulas are healed, then, cow will improve her locomotion and her welfare will improve too.   We will keep you infromed about this case.

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