A survey of white line disease in Japanese racehorses

A survey was carried out into white line disease in 1781 Thoroughbred racehorses kept in stables at the Japan Racing Association (JRA) Miho Training Center (MTC) September-October 1996. The survey was conducted while horses were being shod by farriers. The horses that still exhibited damaged white lines after regular trimming were diagnosed as having white line disease. The factors recorded were age, sex, number of diseased horses, number of diseased hooves, number of lesions by region over the bearing border of the hoof and the classified length of such lesions. The percentage of total diseased horses was 11.5% (204 animals), with incidence increasing significantly with age (P< or =0.01). Occurrence was independent of sex (P>0.05) was more frequent in the fore- than in the hindhoof and developed more frequently at the toe than at any other region of the forehoof-bearing border. Most lesions ranged from 20 to 30 mm in length.

Foot problems, functional impairment, and falls in older people

Falls in older people are common and may lead to considerable disability. Although a number of risk factors for falling have been identified, the role of foot problems has received relatively little attention in the literature. This article reviews the literature pertaining to the prevalence of foot problems in older people and discusses the relationship of foot problems to functional impairment and falls. In addition, a number of theoretical considerations regarding specific foot conditions and postural instability are outlined.

The prevalence and risk factors associated with forelimb skin abrasions and sole bruising in preweaning piglets

The presence of skin abrasions and sole bruising in 264 preweaning piglets (1-30 days old) from 13 breeding units in south west England was investigated in 1995. The mean prevalence of forelimb skin abrasions among the pigs on the study farms was 36% (range 0-59%) and sole bruising was 50% (range 0-95%). Skin abrasions were located on three aspects on the front limbs: the carpus, the metacarpus and the digit. Lesions occurred early in a piglet's life; the modal ages for sole bruising was 4 days and for skin abrasions were 5 and 10 days. The presence of skin abrasions on the front limbs was significantly associated with the presence of sole bruising on the front feet. Logistic regression indicated that part-concrete, part-round-mesh (OR 56.4) and part-concrete, part-metal-rods floors (OR 15.9) and exposed aggregate (OR 4.6) were associated with an increased odds of sole bruising while the presence of sparse straw (OR 0.12) or deep straw (OR 0.12) in the pen was associated with lower odds of sole bruising. The same floor type (part-concrete, part-round-mesh) was associated with increased odds of forelimb skin abrasions (OR 2.2). A worn floor surface where the solid adjoined the perforated area (OR 4.6) and the presence of sparse shavings (OR 1.7) were also associated with an increased risk of skin abrasions.

Prevalence of lesions and body condition scores among female swine at slaughter

OBJECTIVE

To determine prevalence of foot lesions, dermatitis, shoulder lesions, mammary gland abnormalities, and visceral lesions, and body condition scores among culled female swine at slaughter.

DESIGN

Observational study.

ANIMALS

Culled gilts and sows killed during a 1-week period at a Midwest slaughterhouse.

PROCEDURE

Carcasses were examined, and lesions were recorded. Body condition was scored on the basis of standard criteria.

RESULTS

58.9% (1,029/1,747) of the carcasses had foot lesions, 67.3% (1,178/1,751) had dermatitis, and 4.6% (80/1,751) had shoulder lesions. Body condition score was significantly associated with detection of dermatitis and shoulder lesions. Mean +/- SE number of teats (n = 1,432 carcasses) was 13.86 +/- 0.02. Mean numbers of normal-appearing teats in the left and right mammary chains were 6.57 +/- 0.02 and 6.58 +/- 0.02, respectively. Feet from 48% (688/1,433) of the carcasses were condemned. Visceral lesions were found in 48.8% (624/1,278) of the carcasses; of the carcasses with lesions, 412 (66%) had liver spots, and 268 (42.9%) had pneumonia.

CLINICAL IMPLICATIONS

Lesions that potentially could have adversely affected production were found in a large percentage of culled gilts and sows at slaughter. Knowledge of lesions commonly found at slaughter may help direct changes in herd health programs.

Characteristics and risk factors for failure of horses with acute diarrhea to survive: 122 cases (1990-1996)

OBJECTIVE

To characterize horses with acute diarrhea and determine risk factors for failure to survive.

DESIGN

Retrospective study.

ANIMALS

122 adult horses admitted for acute diarrhea at the teaching hospital between Jan 1, 1990 and Dec 31, 1996.

PROCEDURE

Medical records of horses with acute diarrhea were reviewed to abstract information regarding signalment, history, physical examination, clinicopathologic testing, treatment, and outcome.

RESULTS

91 of 122 (74.6%) horses lived and were discharged from the hospital. Horses with history of administration of antimicrobials for a problem preceding diarrhea were approximately 4.5 times less likely to survive. The following variables that had been determined at the time of admission were significantly associated with failure to survive: administration of antimicrobial drugs for another illness, serum creatinine concentration > 2.0 mg/dl, PCV > 45%, tachycardia (heart rate > 60 beats/min), and low serum total protein concentration. Prevalence of laminitis was 11.5%.

CLINICAL IMPLICATIONS

Diarrheic horses that are azotemic and have clinicopathologic findings consistent with hemoconcentration and hypoproteinemia have a poor prognosis for survival. Antimicrobial administration may induce diarrhea, and antimicrobial-associated diarrhea may have a worse prognosis than other types of acute diarrhea.

Sole disorders in conventionally managed and organic dairy herds using different housing systems

Records of claw trimmings were analysed in seven organic and six conventional Danish herds (a total of 974 cows). The housing systems represented were tie stall systems, loose housing system with slatted floor (one organic herd), and deep litter systems (deep straw bedding). Occurrence of sole disorders was analysed separately for cows in first lactation and for cows in later lactations. Three different responses (acute haemorrhage, sole ulcer in one leg and sole ulcer in two or more legs) were analysed using three binomial logistic regression analyses for each group. Herd analysed as a fixed effect was a strong risk factor for all kinds of sole ulcer. Lactation stage was a risk factor for acute haemorrhage in both groups of cows, and for sole ulcer in first parity cows. In general, there was a strong positive association between the period 61-120 d post partum and the presence of sole disorders. Breed was associated with acute haemorrhage in cows in second and later parities, and sole ulcer in one leg only in first parity cows in an interaction with lactation stage in both conditions. Danish Friesian cows were strongly associated with sole disorder, although the combination of lactation stage from 61 to 120 d post partum in cows of other dual purpose breeds was positively associated with the presence of sole ulcer in one leg only in first parity cows. The time of year for claw trimming was a risk factor for acute haemorrhage in first parity cows, with the period from December to January most strongly associated with acute haemorrhage. Previous disease treatment was a risk factor for sole ulcer in two or more legs in second and later parities. Udder related disorders and disorders other than reproductive problems were positively associated with the occurrence of sole ulcer. Body weight at calving was associated with acute haemorrhage in cows in second and subsequent parities. Body weight lower than the mean herd level by > 50 kg was negatively associated with acute haemorrhage.

Foot-care awareness. A survey of persons aged 65 years and older

The authors conducted a mail survey that examined foot problems, rates of utilization of foot-health services, and the perception of foot problems as medical conditions in a sample of people aged 65 years and older who lived independently. Although 71% of the 128 respondents reported suffering from foot problems, only 39% had consulted medical personnel about their feet, and only 26% identified their foot pathologies as medical conditions. More female than male respondents experienced foot problems and had visited medical personnel about their feet. Increased education of older individuals about their foot-care requirements, as well as increased access to podiatric medical services, is recommended.

Wet litter and perches as risk factors for the development of foot pad dermatitis in floor-housed hens

1. An experiment was conducted to determine whether different moisture levels of litter and perches with different hygienic conditions are involved in the manifestation of foot pad dermatitis in White Leghorn layers. 2. Four different treatments were compared: dry litter and dry perches; dry litter and wet perches; wet litter and dry perches; and wet litter and wet perches. Temperature, pH, air humidity and ammonia changes in the pens were monitored. 3. The mean prevalence of foot pad lesions in groups 1, 2, 3 and 4 was 17%, 13%, 49% and 48% respectively. The overall incidence of foot pad lesions in birds reared on dry litter was 38%, and in birds reared on wet litter 92%. 4. When the air temperature was above 20 degrees C, an increasing moisture content in the litter was associated with an increasing incidence of foot pad dermatitis. However, when the air temperature was below 20 degrees C there were no new cases of dermatitis in any of the 4 treatments. There were no significant differences in litter pH or ammonia between the 4 treatments when compared over the whole experiment. 5. Although the incidence of lesions was not significantly affected by the presence of wet perches, the area of the lesions tended to be in groups with wet patches than in groups with dry perches. 6. It is suggested that moisture and temperature are important contributing factors for the occurrence of foot pad dermatitis in laying hens. Wet perches may contribute to the severity of such lesions.

Foot problems associated with older patients. A focused podogeriatric study

The authors report on a 3-year prospective program that included foot-health education and an initial assessment of foot problems in an older population. The program represents a cooperative effort by the Philadelphia Corporation for Aging and the Pennsylvania College of Podiatric Medicine to enhance the quality of life of older citizens. The results show that foot problems are prevalent among older patients. The program also refined a protocol that can be applied in other settings.

Cutaneous malignant melanoma: Tabuk experience

Cutaneous melanoma (CM) has a rising morbidity and mortality in the western world but is rare in certain geographical areas including the Middle East. The aim of this study is to define the pattern of CM in this environment over a period of about two decades. A review of associated histological reports, dermatology, plastic general surgical admissions and outpatient census statistic of the North West Military Hospital (N.W.A.F.H.) were carried out from January 1978 to June 1996. The clinico-therapeutic information from both the review case and newly discovered CM was then studied. The result shows that CM is probably rare in the Tabuk military environment and possibly has a low mortality among the affected individuals. The presence of only 2 cases of CM among 73,955 patients over about 20 years suggests that this neoplasm is rare in N.W.A.F.H. Surgery, with localised expert reconstruction, probably offers the best cure for uncomplicated CM in this area. It is suggested that the geographical environment, genetic attributes, custom, attitude, presence of white, painted, sun-reflecting buildings, traditional dress-code and behaviour of the indigenes probably contribute to the suppression of and protection against CM in Tabuk. It is recommended that regular, antimlanoma education awareness programmes among the indigenes and avoidance of sunbathing attitude of the expatriate community should be encouraged in order to maintain this suggested natural selection protection.

Plantar fasciitis/calcaneal spur among security forces personnel

A prospective single survey was conducted among Security Forces personnel at the Mobile Hospital, Ministry of Interior, Makkah Al-Mukarramah, Saudi Arabia. One hundred three patients presented to the orthopedic clinic with painful heel. A control group of patients from the other clinics without painful heel was also screened. The average age was 38.81 years and 38.1 years in the patient and the control group, respectively. The mean Quetelet index of body mass in the patient group was 30.36 kg/m2 and in the control group it was 26.71 kg/m2. There was a statistically significant difference of p < 0.05 between the two groups for Quetelet index of body mass. The right side was affected in 37 patients, the left side was involved in 45 patients, and 21 patients had pain bilaterally. Seventy-one patients had spur on the calcaneum. The prevalence of painful heel attributable to plantar fasciitis/calcaneum spur was 1.18%. This study suggests that obesity is a cause and initiator of heel pain and plantar fasciitis/calcaneal spur and that improper footwear aggravates the condition.

Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects

OBJECTIVE

To evaluate the influence of podiatrist activities on the outpatient care of diabetic patients in terms of knowledge of diabetic foot care, self-care, and minor foot problems.

RESEARCH DESIGN AND METHODS

There were 733 patients, aged 10-79 years, identified from the national diabetes register. Patients without recent visits to a podiatrist and without an obvious need for foot care were randomized into a podiatric care group (education and primary prevention measures, n = 267) and a control group (written instructions only, n = 263). The patients were examined by an independent study podiatrist at baseline and after 1 year.

RESULTS

Patients in the podiatrist group had greater improvement in knowledge of diabetic foot care (P = 0.004) and self-care (P < 0.001) scores compared with control subjects. The prevalence of callosities in regions other than the calcaneal region decreased more (P = 0.009) in the podiatrist group (from 54.5 to 39.5%) than in the control group (from 51.3 to 48.2%), and the size of the callosities decreased more (P < 0.001) in the podiatrist group than in the control group. Reduction in the prevalence of callosities was associated with younger age (< 50 years).

CONCLUSIONS

Education and primary preventive measures provided individually by a podiatrist result in significant improvements in knowledge and foot self-care scores and in improvements in the prevalence of some minor foot problems. Long-term studies are needed to evaluate whether the intervention of podiatrists starting at an early phase would lead to a reduction in major foot problems.

Plantar melanoma: a case-control study in Paraguay

In Paraguay, the plantar surface of the foot is the most common site for malignant melanoma, as it is in several other populations worldwide, most notably in those of African descent. Here, we report the results of the first case-control study of plantar melanoma, carried out in Paraguay. Sixty incident, histologically confirmed cases of plantar melanoma and 256 hospital controls were recruited in 11 hospitals throughout the country during 1988-93. Information was collected on general demographic, social, and lifestyle variables, on external exposures of feet (shoewear, work activities, injuries), and on some constitutional factors (skin, eye and hair color, and pigmented lesions of the feet). Few of the factors examined appeared to be associated with the risk of plantar melanoma. Adjusted for possible confounders, the strongest association was found for reported injuries (odds ratio [OR] = 40.9, 95 percent confidence interval [CI] = 14.8-112.7) and for occurrence of naevi on the soles (OR = 5.9, CI = 2.5-14.3). Walking barefoot did not seem to contribute to the risk although an outdoor workplace was associated with an increased melanoma occurrence (OR = 2.3, CI = 1.1-4.8). Future studies should be aware of problems of recall bias with respect to previous injuries, and ensure that evaluation of pigmentation of the sole is carried out blind to case/control status.

Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile

BACKGROUND

Classic Kaposi's sarcoma (CKS) is not uncommon in Greece with a reported incidence of 0.20 per 100,000 per year.

METHODS

Epidemiological, clinical and histological features of all CKS cases, diagnosed in 'A. Sygros' hospital, Athens, Greece during the years 1989-1994, have been recorded and studied prospectively.

RESULTS

During the five-year period studied, 66 CKS patients have been diagnosed in our hospital. Incidence among dermatologic patients was 2.11 per 10,000 patients examined, representing 1.35% of total skin malignancies. Patients' age at diagnosis ranged from 53 to 94 years (mean 72 +/- 8.8). The male to female ratio was 2.47:1. A high proportion of the patients were born in Peloponnesos (42.42%) and were residing in Athens (51.51%) or in Peloponnesos (24.24%). Nodules and/or plaques were the most frequent type of lesion, most commonly located on the feet (43.93%) or the hands (28.78%). Accompanying edema was seen in 51.51% of the patients. There were 16 stage I patients (24.24%), 40 stage II (60.60%), 0 stage III and 10 stage IV (15.15%). Involvement of visceral organs was detected in seven patients (10.60%), while 10 had lymph node involvement (15.15%) and three, involvement of the underlying bones (4.54%). Second primary malignancy was diagnosed in 6 cases (9.09%), most often of the reticuloendothelial system (83.33%).

CONCLUSIONS

CKS in Greece exhibits some special characteristics, including older age of onset; lower male to female ratio; endemic clustering; disseminated skin disease at diagnosis, often accompanied by lymphedema; not unusual visceral or lymph node involvement and association with second malignancies. We suggest that CKS in Greece possibly represents a distinct endemic subtype of CKS.

Papillomatous digital dermatitis on a commercial dairy farm in Mexicali, Mexico: incidence and effect on reproduction and milk production

This retrospective study of papillomatous digital dermatitis (PDD) was performed using data for cows that calved between July 1993 and June 1994 on a Mexicali, Mexico, dairy farm in order to calculate incidence rates, and to compare milk yield and reproduction data between affected and nonaffected dairy cows. A total of 190 out of 577 (33%) cows were affected during lactation and six (1%) during the dry period. Fifty-two of 77 (68%) cows that had lesions in the previous lactation and were also present on the farm in the current lactation had lesions in the current lactation. The highest risk for PDD occurred during the first month of lactation (9%). The yearly estimated cumulative incidence risk was 35% and the incidence density rate was 44.6 cases per 1000 cow-months. More animals were affected in summer and fall than in winter and spring. Purchased animals were 3.4 times more likely to be affected than animals born on the farm. Survival analyses indicated healthy cows conceived 93 days after calving (median), but affected cows conceived 113 days after calving (median) (P < 0.01). PDD-affected animals produced less milk than healthy cows, but the difference was not statistically significant in the multiple regression.

Prevalence and distribution of foot lesions in finishing pigs in south-west England

This paper gives the first estimate of the prevalence and distribution of foot lesions in finishing pigs in the south-west of England for 33 years. It was based on the examination of 4038 finishing pigs from 21 units. There were 3727 out of 3974 (93.8 per cent) pigs with at least one foot lesion. The prevalence of different lesions was: toe erosion (33.0 per cent), sole erosion (62.1 per cent), heel erosion (13.0 per cent), heel flaps (14.4 per cent), white line lesions (55.4 per cent), false sand cracks (23.9 per cent) and wall separation (11.5 per cent). The hind feet were more commonly affected than the front feet, and on each foot the lateral digits were significantly more frequently affected than the medial digits. Sole erosions, heel flaps, wall separation and false sand cracks were more frequently observed on the lateral than the medial digit. Digits with sole erosions were significantly more likely to have heel flaps, white line lesions or false sand cracks than those without sole erosions. Furthermore, there was a within digit association between overgrown hooves and toe erosion. The effects of weightbearing, gait and environment on the development of foot lesions is discussed.

Incidence and risk factors for bumblefoot (pododermatitis) in rehabilitated raptors

A retrospective cohort study was conducted on 821 raptors of 12 representative species, admitted to the California Raptor Center (CRC), during 1980-1990. The incidence rate for bumblefoot was 52 cases per 100 bird-years at risk. Eagles and hawks (buteos) were more likely to develop bumblefoot, and did so earlier during their captivity than other species. Also, raptors admitted with a limb fracture had the greatest risk (OR = 4.2) of developing bumblefoot than any other condition on entry. Median time from admission to development of bumblefoot was 52 days, and median duration of bumblefoot was 23 days.

Assessment of bovine hoof conformation and its association with lameness, animal factors and management practices on small-scale dairy farms in Kiambu district, Kenya

Digital health and conformation were assessed in 216 dairy cattle on 78 randomly selected small-scale farms. For each cow, gait was assessed and the digits examined in detail. Hoof measurements (angle and length of the dorsal hoof wall, heel depth and hoof-base area) were also made. Hoof measurements varied most between individual cattle. Dorsal angle was correlated with heel depth (r = 0.53; P = 0.001) and dorsal length (r = -0.40; P = 0.001). The hoof-base area was correlated with the dorsal length (r = 0.41; P = 0.001). There were significant breed differences in dorsal angle (P = 0.03) and dorsal length (P < 0.01). The dorsal angle was correlated with parity and body condition, while the dorsal length, heel depth and the hoof-base area were correlated with the heart girth (P < 0.01). Hoof conformation was associated with both clinical lameness and hoof lesions. A 1-cm increase in the dorsal length increased the odds of lameness by 16.9, heel erosion by 1.8, underrunning by 5.4 and overgrowth by 40 (P < 0.01).

Laminitis in young dairy calves fed a high starch diet and with a history of bovine viral diarrhoea virus infection

Six of the 33 calves born in a Swedish dairy herd during a period of four months developed laminitis when they were eight to 12 weeks old. The clinical signs included difficulty in rising, a stiff gait, overgrown claws and haemorrhages in the sole horn. Samples of blood were taken from four of the calves when they had shown signs of laminitis for two to seven weeks; the serum concentrations of calcium, phosphorus and vitamin D3, the activities of aspartate aminotransferase and glutathione peroxidase, and the patterns of serum proteins were within their normal ranges. The feet of the same four calves were examined after slaughter; the third phalanx of each calf was rotated and its distal end osteolytic. Histologically there was separation and degeneration of the squamous cells of the white line, and thromboses and vasculitis in the fine vessels of the corium. Four of the six affected calves were persistently infected with bovine viral diarrhoea virus and one had antibodies against the virus. From six weeks of age the calves had been fed rye wheat, a hybrid seed rich in starch, and this may have contributed to the outbreak of laminitis.

Bovine acidosis: implications on laminitis

Bovine lactic acidosis syndrome is associated with large increases of lactic acid in the rumen, which result from diets that are high in ruminally available carbohydrates, or forage that is low in effective fiber, or both. The syndrome involves two separate anatomical areas, the gastrointestinal tract and body fluids, and is related to the rate and extent of lactic acid production, utilization, and absorption. Clinical manifestations range from loss of appetite to death. Lactic acid accumulates in the rumen when the bacteria that synthesize lactic acid outnumber those that utilize lactic acid. The systemic impact of acidosis may have several physiological implications, including laminitis, a diffuse aseptic inflammation of the laminae (corium). Although a nutritional basis for the disease exists, etiology includes a multitude of interactive factors, such as metabolic and digestive disorders, postpartum stress, and localized trauma, which lead to the release of vasoactive substances that trigger mechanisms that cause degenerative changes in the foot. The severity of laminitis is related to the frequency, intensity, and duration of systemic acidotic insults on the mechanisms responsible for the release of vasoactive substance. The critical link between acidosis and laminitis appears to be associated with a persistent hypoperfusion, which results in ischemia in the digit. Management of acidosis is critical in preventing laminitis. High producing dairy herds attempting to maximize energy intake are continually confronted with subclinical acidosis and laminitis. Management of feeding and husbandry practices can be implemented to reduce incidence of disease.