Bovis ISSN 2398-2993

Necrotic hoof lesions

Synonym(s): Toe necrosis, Toe-tip necrosis, Wall ulcer, Non-healing lesion, Osteomyelitis of the distal phalanx

Contributor(s): Nick Bell, Sophie Mahendran , Mark Burnell

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Introduction

  • Cause: polymicrobial infections of sole and wall lesions causing infection of the soft tissue and bone, with Treponeme spp consistently found in abundance.
  • Signs: lameness, identification of a chronic toe lesion with a characteristic fetid odor, often with dyskeratotic horn and excessive granulation tissue.
  • Diagnosis: toe lesion with characteristic odor and black necrotic material.
  • Treatment: therapeutic trimming, potentially with surgical debridement, partial or full claw amputation.
  • Prognosis: good in early cases; guarded in longstanding cases.

Pathogenesis

Etiology

  • Lesions present in the toe (zone 1), that becomes infected.
    • Polymicrobial infections, but consistently infected by Treponemes [Treponemes].
    • It can lead to infection or atrophy of the distal phalanx.

Predisposing factors

Specific

Pathophysiology

  • The primary hoof lesion (white line White line disease, sole ulcer Sole ulcer or thin soles) generally occurs due to normal mechanisms as described elsewhere, or by iatrogenic damage due to excessive or incorrect hoof trimming technique.
    • Exposed corium is then susceptible to infection by Treponemes, with “non-healing” lesions developing 1-3 weeks later.
  • Treponemes cause necrosis of the claw horn with involvement of the corium and potentially the distal phalanx.
  • The lesions are usually severe, with destruction of the surrounding tissues with massive new bone formation.
    • This is very painful for the cow, and can lead to extensive loss of horn, soft tissue, corium and bone in advanced cases.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Kofler J (2017) Pathogenesis and treatment of toe lesions in cattle including ‘nonhealing’ toe lesions. Veterinary Clinics of North America: Food Animal Practice 33 (2), 301–28 PubMed.
  • Kofler J, Glonegger-Reichert J, Dietrich J, Sykora S, Tichy A & Brandt S (2015) A simple surgical treatment for bovine digital dermatitis-associated white line lesions and sole ulcers. The Veterinary Journal 204 (2), 229–31 PubMed.
  • Evans N, Blowey R W, Timofte D, Isherwood D R, Brown J M, Murray R, Paton R J & Carter S J (2011) Association between bovine digital dermatitis Treponemes and a range of ‘non-healing’ bovine hoof disorders. Veterinary record 168 (8), 214 PubMed.
  • Kofler J (1999) Clinical study of toe ulcer and necrosis of the apex of the distal pphalanx in 53 cattle. The Veterinary Journal 157 (2), 139–47 PubMed.

Other sources of information

  • Kofler J, Osová A, Altenbrunner‐Martinek A & Burgstaller J (2017) Surgical treatment techniques and outcome in 30 cattle with toe necrosis (apical pedal bone infection). In: 19th International Symposium and 11th Conference Lameness in Ruminants. Eds: Fiedler A & Schindhelm K. Munich, Germany. pp 215.
  • Egger-Danner C, Nielsen P & Fiedler A et al (2015) ICAR Claw Health Atlas.


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