Use of a multifenestrated indwelling lavage system for treatment of septic digital tenosynovitis in cattle

Septic Tenosynovitis of the Digital Flexor Tendon Sheath in 83 Cattle

Septic tenosynovitis of the digital flexor tendon sheath (DFTS) is the second most prevalent infection of deeper structures of the distal limb in cattle, after septic arthritis of the distal interphalangeal (DIP) joint. Depending on the type of infection and the involvement of adjacent anatomical structures, various surgical techniques may be used for therapy: Incising the DFTS to resect one or both digital flexor tendons (RDFT), additional resection of the DIP joint (RDIP) or additional digital amputation (RAMP). Our goal was to describe clinical findings and outcome in cattle patients (euthanasia vs. treatment) and the success of surgical methods including improvement of locomotion and postoperative survival time (POST). Data of eighty-three cattle with a mean age of 4.3 years were reviewed in this retrospective study. Overall, 57.7% of tenosynovitis cases were in the lateral DFTS of a hind limb. Fifty-five cattle were treated surgically; the remaining 28 cattle were euthanized following diagnosis. The median cumulative POST was 17.3, 83.1, and 11.9 months for RDFT, RDIP, and RAMP, respectively. Fatal postoperative complications occurred in three cattle. We conclude that the applied methods were successful and allowed the animals to almost reach the average life expectancy of an Austrian dairy cow.

Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath

REASONS FOR PERFORMING STUDY

Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators.

OBJECTIVE

To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury.

METHODS

A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as well as age, sex, use and outcome.

RESULTS

Sixteen horses had laceration and contamination of the DFTS alone, of which 15 (94%) returned to their original or intended use. Sixteen horses had lacerations involving the superficial digital flexor tendon, of which 12 (75%) made a full recovery. Six horses had lacerations to both superficial and deep digital flexor tendons, 5 were subjected to euthanasia intraoperatively and one is paddock sound. Treatment within 36 h of initial laceration carried a significantly better prognosis for return to intended athletic use (25 of 28 horses allowed to recover from anaesthesia) than treatment after 36 h (2 of 5 P = 0.03; Fisher's Exact Test).

CONCLUSIONS

If sepsis is treated early using tenoscopic visualisation, lavage and repositol antibiotics, the limiting factor in return to athletic function is tendon damage.

POTENTIAL RELEVANCE

This study supports anecdotal evidence that early treatment of synovial sepsis improves the prognosis for return to intended use. It also provides information on prognostic indicators including extent of damage to collateral structures.

Surgical treatment of lameness

Digital diseases are commonly seen in cattle. Cattle affected by digital disorders do not always respond to conservative therapy and require surgery. Surgical procedures for the common digital disorders are described, with emphasis on the different approaches to the distal interphalangeal joint.