Upper Limb Lameness in Cattle

Hock and knee injuries generally arise from animals rubbing on hard or abrasive surfaces in their resting area. These injuries are more common in cows housed in free-stall or tie-stall dairies, predisposed by suboptimal stall management and stall design, base, and bedding. Hard stall bases without sufficient bedding or with abrasive bedding, improper stall dimensions, and wet lying surfaces contribute to these injuries. The hocks and knees rub repeatedly as a cow moves in her stall or transitions between lying and standing, creating friction that results in injuries to these upper-leg regions over time.

Hock and knee injuries vary in severity, ranging from areas of hair loss or broken skin, scabs, or minor swelling to areas with major swelling and/or open wounds with purulent discharge.

Hock and knee injuries can be prevented by improving cow comfort. Cows should be housed in stalls that are appropriately sized and configured for the animals in the herd, and the stalls should be deeply bedded with nonabrasive bedding material.

The best treatment for animals with hock and knee injuries is to remove the inciting cause of injury or move the animal to a deeply bedded lying area. Cows with open lesions may require supportive wound care; they will not recover, however, if the environmental cause of the injury is not addressed.

Most stifle injuries in adult cows and bulls result from traumatic events such as slipping, falling, mounting, or exertion in downer animals. In older animals, degenerative joint disease may also be a contributing factor.

Stifle injuries typically manifest as nonspecific hind-limb lameness. A physical exam should be used to rule out lower-limb injuries or problems and to localize the issue to the stifle. With stifle injuries, joint effusion, pain, and crepitus in the joint are common signs. Hearing a clicking sound and eliciting a cranial drawer sign are diagnostic for cranial cruciate ligament injury. Meniscus injury presents as nonspecific stifle lameness and can accompany cranial cruciate injury. Patellar luxation presents similar to femoral nerve paralysis in calves; in both conditions, the animal cannot extend the stifle. Upward fixation of the patella results in a characteristic extension of the limb and is accompanied by locking and unlocking of the patella on the medial trocheal ridge. This condition is rare and is more common in bulls.

To prevent stifle injuries, the focus is to provide secure footing within the animal’s housing environment to avoid issues with slipping and falling.

Stifle injuries can be treated; usually, however, the prognosis is guarded to poor. Conservative treatment is comprised of confinement and prolonged NSAID administration. For valuable animals, surgical options are available.

Hip injuries result from traumatic events such as falling, slipping, or bumping into hard objects in the environment.

Hip injury, cow

Image

Courtesy of Dr. Gerard Cramer.

Coxofemoral luxations can present as a dropped-hip appearance if the animal is standing. Cows suffering from cranioventrally displaced luxation usually present as down animals. Fractures can be palpated if they affect the tuber coxae; other fractures typically cannot be felt.

Prevention of hip injuries focuses on preventing traumatic events, which typically result from aggressive handling practices, mounting, or slippery flooring.

For most hip injuries, the prognosis is guarded; it is more favorable in younger animals. Usually, and especially for femoral head fractures, euthanasia is the most suitable course of action. However, some surgical approaches involving an open reduction can be successful for coxofemoral luxations. Conservative treatment of coxofemoral luxations has also been reported to be successful if done within 48 hours of the occurrence of the injury.

Because of their infrequent occurrence, noninfectious joint diseases have not been studied extensively; however, the pathogenesis of these disorders is thought to be similar to the pathogenesis of the same types of disorders in other species.

Joint disease, cow

Image

Courtesy of Dr. Gerard Cramer.

Most joint diseases present with a variable extent of lameness and joint effusion. Osteochondrosis and degenerative joint disease are commonly found in young, growing animals; osteoarthritis is more common in older animals. Further diagnostic tests, such as radiography and arthrocentesis, are required to differentiate these joint diseases more fully.

Because of their unclear pathogenesis, strategies to prevent noninfectious joint diseases are limited.

Conservative treatment for joint disease—restricting activity and administering NSAIDs—is often unrewarding. Surgical approaches, including arthroscopy, have been used successfully to treat some of these conditions.

Septic arthritis results when microorganisms enter the joint cavity either because of sepsis or through penetrating wounds. The resulting inflammatory process in the joint increases joint effusion. Persistent infections result in further damage to the joint.

Septic arthritis typically causes severe, acute pain and lameness. The affected joint(s) are often swollen, warm, and painful to the touch. In distal limbs when a single joint is affected, the process is typically traumatic in origin. Polyarthritis typically has a systemic origin (ie, navel ill, mycoplasma), and the inciting cause should be determined. Arthrocentesis of synovial fluid can be used to confirm the diagnosis.

Prevention of septic arthritis should focus on preventing sepsis and penetrating injuries near the joints. Common causes of sepsis in calves include mycoplasma and navel infections.

Treatment of septic arthritis requires treating the sepsis, as well as managing the inflammation and pain. Extended administration of antimicrobials and NSAIDs, along with joint lavage, is necessary.

Muscular ruptures are typically acute because of direct trauma or physical exertion when the animal attempts to get up while down for another condition.

Animals with a gastrocnemius tear typically are unable to rise, and the hock touches the ground when the animal attempts to get up. Animals with a fibularis tertius tear typically can flex the stifle with the hock fully extended. Typically, the affected muscle is firm and swollen.

Prevention of muscular injuries should focus on providing solid footing, especially for down animals.

Treatment of muscular injuries, especially gastrocnemius tears, is unrewarding. Typically, euthanasia is the most appropriate course of action. In young animals with tears of the fibularis tertius, restricting activity may enable recovery.