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.

Excess benign melanocytic naevi in renal transplant recipients

BACKGROUND

Some studies indicate that malignant melanoma occurs more frequently in renal transplant recipients than in the normal population. The development of excess benign melanocytic naevi is regarded as an indicator of the risk for malignant melanoma.

OBJECTIVE

This study was undertaken to evaluate the prevalence of benign melanocytic naevi in adult renal transplant patients.

METHOD

All benign melanocytic naevi irrespective of size were counted in 76 patients with renal transplants and were compared to naevus counts in 55 sex- and age-matched healthy controls.

RESULTS

The mean total number of benign melanocytic naevi was significantly higher (p < 0.001) in renal transplant patients than in the control group: 93.6 +/- 52.2 and 36.1 +/- 29.9, respectively. The most evident increase occurred on the palms/soles and back/buttocks. A positive, although not significant, correlation between naevus counts and duration of immunosuppression was found.

CONCLUSION

Renal transplant recipients have an increased number of benign melanocytic naevi and should be considered as a risk group for malignant melanoma.

Age, breed, sex and seasonality as risk factors for equine laminitis

A case-control study was conducted at the Texas Veterinary Medical Center between January 1, 1986 and December 31, 1991. Logistic regression was used to assess age, breed, sex, and seasonality as risk factors for equine laminitis. There were 70 acute cases, 183 chronic cases, and 779 controls. No statistical association was found between age, breed, sex, or seasonality and the diagnosis of acute laminitis. For chronic cases, the estimated odds ratio was statistically significant for age (OR = 1.05, 95% CI (1.02, 1.08)) and for the diagnosis of laminitis in the third quarter of the year (OR = 2.57, 95% CI (1.55, 4.25)) relative to the first quarter. There was no statistical association between breed or sex and chronic laminitis.

Case-control study of risk factors for the development of laminitis in the contralateral limb in Equidae with unilateral lameness

OBJECTIVE

To identify risk factors associated with development of laminitis of the supporting limb in Equidae with unilateral laminitis and to determine the radiographic appearance of this type of laminitis.

DESIGN

Retrospective analysis of medical records.

ANIMALS

20 Equidae with unilateral lameness that developed laminitis of the contralateral limb.

PROCEDURE

Case animals were compared with matched and unmatched populations of control animals that did not develop contralateral limb laminitis. Lateromedial radiographic projections of affected feet were evaluated for evidence of laminitis.

RESULTS

Body weight of case animals was not significantly different from that of control animals, but number of days that control animals were lame prior to recovery was significantly less than number of days that case animals were lame prior to the onset of laminitis. Lateromedial radiographic projections of the foot of the support limb were available for 16 of the 20 case animals. For all 16, thickness of the soft tissue dorsal to the distal phalanx was > 29% of the palmar cortical length of the distal phalanx, but only 1 had evidence of rotation of the distal phalanx. The proportion of case animals that were euthanatized was significantly greater than the proportion of control animals that were euthanatized.

CLINICAL IMPLICATIONS

Duration of lameness, but not body weight, was a risk factor for development of laminitis in the contralateral limb in Equidae with unilateral lameness, and animals that developed this complication were more likely to be euthanatized than were animals that did not.

Influence of boot-sock systems on frequency and severity of foot blisters

This study examined the infleunce of three types of boot-sock systems on incidence and severity of foot blisters. Participants were 357 men undergoing U.S. Marine recruit training at Parris Island, South Carolina. Each participant was assigned to one of three treatment groups. The first group wore the standard military boot sock consisting of a wool-cotton-nylon-Spandex combination. The second group wore the standard military boot sock with a thin inner or liner sock consisting of polyester. The third group wore a very thick, dense, prototype outer sock consisting of a wool-polypropylene combination over the same liner sock as the second group. Foot blister incidence was lower among participants who wore the the prototype boot sock and liner than among those wearing the standard military sock (40 vs. 69%, p < 0.001) or among subjects wearing the standard military sock with liner (40 vs. 77%, p < 0.001). Foot blisters and cellulitis severe enough to require medical attention occurred with greater frequency in the standard military sock group compared to both the prototype boot-sock group (24 vs. 11%, p = 0.02) and the standard military sock with liner group (24 vs. 9%, p < 0.01); there was no difference between the latter two groups. Blister reduction was most apparent in the early weeks of recruit training. The standard military sock with a polyester liner reduced the incidence of severe blisters, but the dense sock with the polyester liner reduced the overall incidence of blisters as well as the incidence of severe blisters.

Effect of overcrowding on claw health in first-calved Friesian heifers

In two studies on overcrowding and foot lesion development, claw health was monitored monthly, and behavioural activities such as lying/standing observed every 15 min for 5 consecutive days and nights each month of the housing season. In the first experiment, 35 autumn-calving heifers were housed at a 2:1 heifer to cubicle ratio immediately after calving. In the second study, 40 spring-calving heifers were housed at a 2:1 ratio for 2 months before calving and with one cubicle each after calving. Lying time was reduced to 5 h per 24 h in some of the autumn-calving animals and these animals had significantly worse foot lesion scores and clinical lameness than animals lying for 7 or 10 h per 24 h. The spring-calving animals did not show such a severe reduction in lying time and no significant correlation between haemorrhage score and lying time was detected. It is concluded that reduced lying time acts as an exacerbating factor in the development of claw lesions.

A foot risk classification system to predict diabetic amputation in Pima Indians

OBJECTIVE

To quantify the contribution of various risk factors to the risk of amputation in diabetic patients and to develop a foot risk scoring system based on clinical data.

RESEARCH DESIGN AND METHODS

A population case-control study was undertaken. Eligible subjects were 1) 25-85 years of age, 2) diabetic, 3) 50% or more Pima or Tohono O'odham Indian, 4) lived in the Gila River Indian Community, and 5) had had at least one National Institutes of Health research examination. Case patients had had an incident lower extremity amputation between 1983 and 1992; control subjects had no amputation by 1992. Medical records were reviewed to determine risk conditions and health status before the pivotal event that led to the amputation.

RESULTS

Sixty-one people with amputations were identified and compared with 183 control subjects. Men were more likely to suffer amputation than women (odds ratio [OR] 6.5, 95% CI 2.6-15), and people with diabetic eye, renal, or cardiovascular disease were more likely to undergo amputation than those without (OR 4.6, 95% CI 1.7-12). The risk of amputation was almost equally associated with these foot risk factors: peripheral neuropathy, peripheral vascular disease, bony deformities, and a history of foot ulcers. After controlling for demographic differences and diabetes severity, the ORs for amputation with one foot risk factor was 2.1 (95% CI 1.4-3.3), with two risk factors, 4.5 (95% CI 2.9-6.9), and with three or four risk factors, 9.7 (95% CI 6.3-14.8).

CONCLUSIONS

Male Sex, end-organ complications of eye, heart, and kidney, and poor glucose control were associated with a higher amputation rate. Peripheral neuropathy, peripheral vascular disease, deformity, and a prior ulcer were similarly equally associated with an increased risk of lower extremity amputation.

Prevalence of lesions associated with subclinical laminitis in first-lactation cows from herds with high milk production

OBJECTIVE

To determine prevalence of lesions associated with subclinical laminitis in first-lactation Holstein cows during early lactation and pregnant Holstein heifers during late gestation in herds with high milk production.

DESIGN

Cross-sectional study.

ANIMALS

203 cattle in 13 herbs.

PROCEDURE

Cattle were placed in lateral recumbency to allow visual examination and photography of their hooves. Claws on a forelimb and hind limb were examined on all cattle. Observable categories of lesions considered to be associated with subclinical laminitis in our study included yellow waxy discoloration of the sole, hemorrhage of the sole, separation of the white line, and erosion of the heel.

RESULTS

Lesions in at least 1 of the categories were found in all herds. Lesions in all categories were found in 11 of 13 herds. Among claws, hemorrhage of the sole was observed most frequently in the lateral claw of the hoof of the hind limb. When days in milk was treated as a covariate, significant (P < 0.01) differences were detected in the prevalence of lesions between herds.

CLINICAL IMPLICATIONS

Because the prevalence of lesions differed significantly among herds, it is logical to believe that causative factors and corrective measures also may have differed among herds.

Foot pathology and risk factors for diabetic foot disease in elderly men

We examined 3 groups of elderly men; men with diabetes and previous or present foot ulcers, men with diabetes, and men without diabetes. In the foot diseased group, diabetes duration was longer (18 +/- 11 vs 8 +/- 7 years), insulin treatment was more common (86% vs 7%), fasting blood glucose and HbA1c were significantly higher (10.5 +/- 4.0 mmol/1, 8.4% +/- 1.6%) than in the diabetic control group (8.3 +/- 3.4 mmol/l, 7.4 +/- 1.7%). Men in the foot diseased group were taller than men in the diabetic group and non-diabetic men (1.79 vs 1.74 m) but not more obese (BMI 26-27 kg/m2 in all three groups). Current or previous alcoholic problems were more common in the foot diseased group (32%) compared to the control diabetic group (9%) and the non-diabetic group (10%). Diabetic patients with known foot disease had more often callosities, absent hair growth, dry skin and redness, compared to the other groups. Psychosocial problems (alcohol and divorce), long standing diabetes duration and poor metabolic control seem to be of importance for the development of diabetic foot ulcers.

Sole haemorrhages and heel horn erosion in dairy cows: the influence of housing system on their prevalence and severity

Altogether 94% of the primiparous and 66% of the multiparous cows had haemorrhages of the sole at trimming 2-4 months after calving. Within cows, and independent of age and stall system, the lateral hind claws had higher scores of haemorrhages than the other claws. The primiparous cows had higher scores than the multiparous cows both in the tie-stalls and in the cubicles. The palmar/plantar region of the claw capsule was divided into zones ("white line zones" and "sole zones"). For the multiparous cows the haemorrhage scores of the "white line zones" were higher among the cows housed in the cubicles than among those housed in the tie stalls. There was no difference between stall systems for haemorrhages of the "sole zones". Heel horn erosion was absent or rare in the fore hooves of both the primiparous and multiparous cows in the tie-stalls. The cows in the cubicles had higher heel horn erosion scores in their fore hooves than the cows in the tie-stalls. The scores of the hind hooves were generally higher than those of the fore hooves in both systems. Heel horn erosions were reduced in association with the introduction of a footbath. A higher incidence of lameness was observed in the cubicle system.

Statistical analysis of 307,601 tumors and other lesions of the foot

This laboratory study is limited to lesions submitted from office procedures and makes no claims or comparison regarding statistical data from hospitals, where most malignancies are excised. This study is ongoing, and will be updated regularly to observe trends and alert practitioners to changing patterns of incidence.

Nodular melanoma in 62 Japanese patients: influence of initial surgical treatment on local recurrence and prognosis

The incidence of malignant melanoma is much lower in Japanese than in Caucasians, and the commonest type of melanoma in Japanese is acral lentiginous melanoma (ALM). In contrast to the improved prognosis noted in ALM, it is now of increasing concern that there is a rise in both the frequency and mortality of nodular melanoma. During the 25 years from 1970 to 1994, we observed 190 patients with melanoma, including 62 nodular melanomas and 96 ALM, at the Department of Dermatology, Tohoku University Hospital, Sendai, Japan. We retrospectively reviewed the recurrence and survival rates of nodular melanoma observed. The proportion of nodular melanoma, once comprising only 24% of all melanomas, showed a sharp increase to 40% after 1982. The anatomical sites of the primary tumor were the hands and feet (29%), extremities excluding hands and feet (27%), head and neck (23%), and trunk (21%). Comparison of the stages of nodular melanoma when diagnosed showed that the proportion of stage III remained highest throughout the whole period, but that of stage II melanomas increased after 1982. After treatment, local recurrence occurred far more frequently in nodular melanoma (19%) than in ALM (1%). The prognosis of nodular melanoma was also less favorable than that of ALM, although it slightly improved after 1982; the 5-year survival rates before and after 1982 were 34 and 50%, respectively. Twenty-eight patients with nodular melanoma had underwent simple excision or incisional biopsy of the primary tumor at another institution and were later referred to us for further intensive care or for the treatment of local recurrence and/or metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

The characteristics and causes of sheep losses in the Victorian Mallee

The extent and causes of sheep losses in the semi-arid Mallee region of north-western Victoria were assessed by interviewing the owners of 79 randomly selected farms running 241 flocks in 1987/88 and 245 flocks in 1988/89. Mean annual losses were higher in ram flocks (21%) than in ewe flocks (7%), in flocks of non-Merino sheep (rams 24%, ewes 11%, weaners 5%) than in Merino (rams 11%, ewes 6%, wethers 4%, weaners 4%) and in ewe flocks 3 or more years old (10%) than in young ewe flocks (3.5%). In flocks where losses exceeded 5%, the causes most often reported by farmers were blowfly strike (especially in Merino sheep and weaners), ewe losses in autumn close to lambing, and heliotrope (Heliotropium europaeum) poisoning. Heliotrope poisoning was considered by the authors to be the main reason for the higher losses in old ewes than in young ewes and in non-Merino sheep than in Merino sheep. Losses of ewes associated with pregnancy and lambing were considered by the authors to be often predisposed by liver damage caused by heliotrope poisoning, and high losses in non-Merino ram flocks were attributed to both heliotrope poisoning and their ability to escape through boundary fences. Reasons for continuing high losses due to enterotoxaemia are discussed. Losses due to gastro-intestinal parasites, footrot and foot abscess were low.

Descriptive epidemiological study of equine laminitis

A descriptive and matched case-control study of laminitis was conducted in 7 private practices and at the Texas Veterinary Medical Centre (TVMC) between May 1992 and July 1993. Out of 108 horses with laminitis, 19 acute (49%) and 20 chronic (51%) cases were seen in private practice and 16 acute (23%) and 53 (77%) cases at the TVMC. Gastrointestinal disease was the most common problem in 19/35 horses (54%), occurring just prior to the onset of acute laminitis in all hospitals. Among all horses in the study, most commonly used drugs were phenylbutazone (68%), acepromazine (34%), dimethyl sulphoxide (DMSO) (27%), antibiotics of various types (19%) and flunixin meglumine (19%). Acepromazine, DMSO and flunixin meglumine were used more commonly in acute cases of laminitis compared to chronic cases. In acutely affected horses, DMSO and flunixin meglumine were used significantly more often at the TVMC. In chronic cases, phenylbutazone and antibiotics were used more often in private practice. Shoeing and trimming were more commonly part of the treatment protocol for chronic cases. There were no significant associations between age, breed, sex or weight and the occurrence of acute laminitis. Horses with chronic laminitis were significantly older (P=0.04) and more females tended to be affected (P=0.08).

The role of Hyalomma ticks in foot infestations and temporary lameness of sheep in a semi-arid region of South Africa

An outbreak of lameness amongst Merino lambs, associated with the presence of Hyalomma ticks, was investigated on a farm in the south-western Free State, South Africa. The purpose was to follow the progress of the condition and to determine the extent of involvement of the two Hyalomma species which occur in the region. The flock of experimental sheep (n = 460) ranged free in natural veld under extensive farming conditions. During September and October 1993, adult ewes and lambs in this flock were examined at weekly intervals to determine tick identity, abundance and attachment-site preferences on lame and unaffected animals. Lameness occurred only among lambs, of which 68 were affected during the 8-week period. Hyalomma ticks tended to aggregate and mean numbers of ticks/aggregation were significantly higher on lame lambs (mean = 11.3) than on either the unaffected lambs (mean = 6.9) or the ewes (mean = 7.1). Most tick aggregations (72.4%) on the lame lambs occurred on the lower legs and feet, 34 out of 55 of these on the fetlocks or interdigital clefts. Hyalomma truncatum dominated (> 97%) on all animals examined. Only 15.8% of the Hyalomma marginatum rufipes recovered from the lame animals were attached to the legs. At two other localities at which H. marginatum rufipes was more abundant, or even dominant, few ticks attached to the lower legs or feet. Those that did were mostly H. truncatum (> 90%). Both H. marginatum rufipes and H. truncatum may attach to the same ventral and anogenital body regions, but H. truncatum has a tendency to attach also to the feet and lower legs. Although attachment of one or a few ticks in the axillar region or upper legs may cause lameness in sheep, the attachment of ticks to the interdigital clefts and fetlocks almost always causes lameness. The latter condition is more likely to occur in regions where H. truncatum dominates.

[The incidence, age dependence and sex distribution of the calcaneal spur. An analysis of its x-ray morphology in 1027 patients of the central European population]

In 1027 lateral radiograms of the ankle in a Caucasian population, 161 plantar and/or dorsal calcaneal spurs (15.7%) were diagnosed. Plantar spurs were more common than dorsal spurs (11.2 and 9.3% respectively). Prevalence of both spurs increases considerably with the rising age. Dorsal spurs appear slightly earlier than plantar spurs. The spur frequencies are similar in left and right feet. The plantar spurs were significantly (p < 0.0001) more common in women than in men in general, while dorsal spurs were more frequent in men than in women up to the age of 70. The previously reported higher frequencies of plantar and dorsal calcaneal spurs in women than in men are probably a result of a disproportionally higher number of women in higher age in the groups studied. In forensic medicine, calcaneal spurs provide evidence for identity and age of unknown corpses, and to certain extend their profession, physical activities and constitution during life.

Some risk factors associated with clinical lameness in dairy herds in Minnesota and Wisconsin

An observational study of the relationships between clinical lameness and herd-level risk factors was made in 18 dairy herds in Minnesota and Wisconsin. Lameness in the lactating cows was assessed by two observers during herd visits made in the summer of 1989 and the spring of 1990, using a uniform scoring system. A questionnaire was used to obtain information about the general management, routine hoof care, nutrition, housing and flooring on the farms. Factors associated with the prevalence of clinical lameness in the summer included stall moisture, the size of the exercise area for the lactating cows and the amounts of dry concentrates and fresh forages fed to them. Factors associated with clinical lameness in the spring included the use of parlour milking facilities and the frequency with which the rations for the lactating cows were balanced.

Foot pain and disability in older persons: an epidemiologic survey

OBJECTIVE

To investigate the prevalence of foot pain in older people and its association with pathological conditions of the feet and with disability in basic and instrumental activities of daily living.

DESIGN

Cross-sectional survey of a community-dwelling older population.

PARTICIPANTS

A total of 459 subjects, 73% of the population aged 65 years and older living in Dicomano, Florence, Italy.

MEASUREMENTS

A standardized medical examination was performed by a geriatrician to collect information on the presence of pain, specific problems of the feet, gait, and several indicators of physical health status. Disability in basic and instrumental activities of daily living was evaluated by self-report.

RESULTS

The prevalence of foot pain was very high, especially in subjects affected by calluses or corns, hallux deformities, hammer toes, pes planus, and edema and among those who complained of difficulty in looking after the basic needs of the feet. Patients with foot pain needed a greater number of steps and longer time to walk the same distance. Foot pain was associated with a higher prevalence of disability in instrumental activities of daily living, particularly those related to standing and ambulation capacities, but it was not related to higher prevalence of disability in basic activities of daily living.

CONCLUSIONS

Foot pain is associated with specific conditions of the feet and disability in instrumental activities of daily living. Adequate assessment and treatment of foot problems may prevent foot pain and potentially reduce risk of disability. This hypothesis needs to be tested in longitudinal studies and specific intervention trials.

Podiatric disorders among children with Down syndrome and learning disability

This study investigated podiatric pathology in seven- to 14-year-old children with Down syndrome (DS) and non-Down syndrome learning-disabled and non-learning-disabled age-matched controls. Several conditions, including pes planus, fissures, split toenails, increased plantar flexed first ray and a wide hallucal cleft were found to be more common in the DS group. Pes cavus and foot rigidity were more common in the non-DS learning-disabled group. In all groups the majority of children wore laced shoes, which were most ill-fitting among children with a learning disability. Approximately one-third in each group had abnormal foot-pressure prints. Greater care and professional awareness of podiatric pathology in children with learning disability is recommended.

[Intraosseous epidermoid cysts of the toe phalanx in dogs]

Out of 1057 amputated canine toes with tumours, tumour-like or other lesions, 17 cases were histopathologically diagnosed as epidermoid cysts of the terminal phalanx (EP). They were accompanied by osteolysis, reactive bone formation and chronic inflammation of phalanx 3. Extension of reactive changes to the phalangeal joint and phalanx 2 was less frequent. Various breeds were involved. There was no breed predisposition. The average age was 10.8 years; the male-female ratio 2.4:1. Nine EP were located on the forelimbs, 4 on the hindlimbs. In 4 cases location was unknown. Toes 4 and 5 were most frequently affected. A traumatic origin is suspected.