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RUM510: MSK, if recumbent for > 2-3 days and CK > 10 times above…

- - - - hypocalcaemia & hypomagnesaemia
      - elevated serum urea & creatinine (shock, renal failure)
      - Elvated CK and AST
    - - proteinuria
      - myoglobinuria
      - ketonuria
  - - - keep cow warm, dry &clean
      - provide fresh water & good quality feed
      - massage limbs, milk out & remove faeces regularly
      - dig a hole for the back legs so that the cow "stands" in the hole with her back legs while lying on her sternum
      - turn cow from side to side several times a day
      - lifting devices
      - soft bedding
      - hydrotherapy
    - - Liver supportive therapy
      - Metabolic stimulants
      - IV Dextrose infusions if hypoglycaemic
      - P/Ca/Mg injections
      - Vit E / Se injection if dealing with white muscle disease
      - Anti-inf lammatories/analgesics
- - - - Internal Fixation
        
        Long bone / highly comminuted fractures. Avoid in calves
      - External Fixation
        
        Below the midradius / mid tibia
  - - - Sudden Ataxia / paresis / paralysis
      - reluctance to mount or difficulty mounting
      - difficulty in rising
    - - Grave prognosis if ataxic / paralzed
      - Analgesics
    - - Normal aging -> exostosis of ligaments on ventral vertebral bodies. Trauma -> fracture -> pressure on nerves
  - - - Chemical
        
        Chronic Pb poisoning
        
        Fluorosis
      - Congenital
        
        Genetic bone disorder (Ancondroplasia)
      - Nutritional (Ca, P, Vit D, Vit A, protein)
        
        ⭐Rickets
        
        Ax
        
        Phosphate & Vit D deficiency & no sunlight -> ⬇ mineralization of developing bone
        
        Signalment
        
        Rapidly growing calves where the growth plates have not yet closed.
        
        Hx of low exposure of P, Vit D and sunlight
        
        Sx
        
        Enlargement of joints & costochondral junctions
        
        long bones may bend
        
        spontaneous fractures.
        
        delayed or irregular tooth eruption
        
        mandibular thickening & weakening
        
        lameness, arched back & recumbency.
        
        Dx
        
        ⬇ Ca, SIP
        
        widened & irregular epiphyses on X – ray.
        
        defective mineralization & widening of growth plate on histopathology.
        
        reduced ratio of bone ash to organic material
        
        Tx
        
        Oral dicalcium phosphate.
        
        Vit D injection 10 000 IU/kg once off.
        
        Balance ration
        
        ⭐Osteoporiosis
        
        Ax
        
        General Malnutrition
        
        ⭐Osteomalacia
        
        Ax
        
        ⬆ Demand (growth, lactation, pregnancy & inadequate nutrition) -> ⬆ bone reabsorption
        
        Sx
        
        non-specific lameness w/o joint enlargement
      - Traumatic
        
        Abnormal conformation + Injury
  - - - Progressive paresis - paralysis.
    - - Arcanobacterium pyogenes, Streptococcus spp, Actinomyces bovis, Fusobacterium necrophorum or coliforms.
        (haematogenous spread from infection site)
        
        Adults: From other abscess sites
        
        Young animals: infection of the umbilicus (omphalophlebitis)
      - Predisposed by phosphate deficiency & micro-trauma due to poor handling in crushes.
    - - Vertebral body fracture
      - Nutritional muscular dystrophy
      - Haemophilus somnus infection
      - Meningitis of any cause
      - Spinal lymphosarcoma
      - Downer cow syndrome
- - - - CS
        
        Stifle flexed, hock extended
        
        Can bear weight but lib cannot be brought forward
      - Tx
        
        Guarded Px, try 1-2m stall rest
    - - CS
        
        Unable to bear weight, attempts -> tuber calcaneus touching the ground
        
        Stifle extended, hock flexed
      - Tx
        
        Poor Px, culling with bilateral rupture, downers
        
        Unilateral ruptures/separation: Guarded to fair Px, confine animal use thomas splint
  - - - Kick back against a sharp object. Often affects Sup + Deep DFT in mid metatarsus
    - - Clean + debride
      - 4-12 casting
  - - - Carpus / Front fetlock
      - Congenital due to in utero malpositioning
      - Secondary due to tendon injury / disuse of limb
    - - Splinting, refit dailing and monitor for pressure necrosis -> improvement in 48h
      - Radical surgical reconstruction of all structures inhibiting flexion. Post op- splint to prevent recontracture
      - Salvage
  - - - Unknown, seen in young cattle
    - - Severe extension / straightness of 1 / both hindlimbs. Starts as rigidity and progresses to overextension
    - - Salvage
        
        Tenotomy: gastrocnemius & the superficial f lexor tendons with fair prognosis
        
        Tibial neurectomy
- - - - Unhygienic conditions
      - FOPT
      - GIT Infections, navil ill, bacteraemia, septicaemia
    - - Pyrexia
      - Lameness, painful, swollen joints
      - Still alert, suckling
      - Conjunctivitis
    - - S. aureus, Streptococcus, Salmonella, Arcanobacterium, E coli,
    - - Joint fluid aspiration: culture, antibiogram
      - Radiographs
  - - - Nutritional
        
        Rickets, Aphosphorosis
      - Toxic
        
        Fluorosis
      - Traumatic
      - Hereditory
        
        Poor conformation, hip dysplasia
    - - Chronic lameness, worsens, not swollen or warm, but may elicit pain / crepitus
      - Poor response to Tx
    - - Hx, clinical signs
      - Synovial fluid examination
  - - - 2-5y cows around parturition -> hypocalcaemia -> ataxia, slipping
    - - CS, Rectal palpation
      - Radiography
      - Distance between tuber ischii + greater trochanter
    - - Inability to rise, leg held in abduction
      - No weigh-bearing, leg rests on toe
      - Prominent greater trochanter, limb appears shorter
      - Crepitus elicited on movement
    - - Reduction under deep sedation / high epidural (craniodorsal easiest to reduce)
      - Surgical reduction - dorsal caudal approach for small animals
      - No Tx -> arthrodesis, production loss, weight gain
  - - - Periparturient period
    - - If severe -> hindlimb paralysis
      - Back btw sacral tuberosities appears dropped & tuberosities become more prominent.
    - - Rest?
- - - - ACUTE
        
        Cardiac Form 👶🏽🐄🐑
        
        Acute heart failure,
        
        90% die after exercise
      - Subacute / delayed form
        
        Pulmonary Form
        
        Diaphragm, intercostal muscle involvement
        
        +- dyspnoea, abdominal breathing
        
        Locomotory Form 🐑
        
        Stiffness, weakness, downers
    - - Hx, CS
      - PM
        
        Locomotory: Calcification, degeneration & necrosis of muscle in the pelvic girdle
        
        Cardiac: Acute Left heart failure
      - Serum CK, AST (not specific for VitE/ Selenium)
      - Se Levels in blood, milk, liver, ration, soil
      - Vit E levels in liver through plasma tocopherol determination
    - - Se 0.1mg / kg SC
    - - Vit E / Se in feed
        
        top dressing pastures
        
        Supplement via licks
      - Avoid legumes, moist frain, poor quality hay ( decreased Vit E / selenium levels)
  - - - Cx, time of year
      - serology (antibodies) & electron microscopy (virus on body tissue) & PCR
    - - provide water & feed
      - administer NSAIDs
      - if signs of hypocalcaemia are observed give calcium borogluconate
      - rest& avoid stress.
      - If signs of rumen stasis give rumen stimulants (kyrogest)
    - - Pyrexia
      - Unwilling to move
    - - botulism
      - neurotoxicosis
      - physical injuries
      - milk fever
      - toxic plants
    - - vaccination at 6 months or older, with a follow-up four weeks later then annually
      - endemic areas vaccinate cattle before onset of summer
      - 🦟spray cattle regularly with insect repellent to protect them from mosquitoes
  - - - Vaccinate
        
        Outbreaks
        
        a month before traumatic procedures
- - - - Old
      - Hereditary - Brahman breeds
      - Previous truama
    - - Intermittent locking of the stifle and tarsus, worsens. Unilateral -> billateral
      - +- Difficulty rising
    - - Medial patellar desmotomy (local analgesia)
      - Transaction of TOI of vastus medialis onto dorsal patella
  - - - Dystocia, traction -> femoral N damage
    - - Inability to extend stifle
      - Patella palpable on lateral femoral condyle
    - - Surgical reconstruction of medial femuropatellar ligament
  - - - Trauma, DJD
    - - Progressive lameness. May dissappear and reappera worse
      - Positive drawer sign
      - Radiographic changes
    - - Analgesics
- - - - High concentration diet
  - - - severe pain & abnormal stance
    - - characteristic lesions may cause lameness
    - - successive bouts of acute, subacute or subclinical laminitis
- - - - Predisposing factors
      - CS
        
        Unilateral (hindlimb)
      - Tx
      - Pathogenesis
      - Prevention and Control
    - - Predisposing factors
        
        Intensive Farming
        
        Pitted concrete -> faecal accumulation
        
        No bedding in cubicles
        
        Continually wet
        
        Young: heifers and first calvers: age related immunity
      - CS
        
        Superficial inflamation
        
        Pain
        
        +- Lameness
        
        Foul odour
        
        May lead to heel erosion and interdigital hyperplasia
      - Tx
      - Ax
        
        Dichelobacter nodosus, Fusobacterium necrophorum, spirochetes
    - - Predisposing factors
      - CS
      - Tx
      - Control
    - - Pathogenesis
      - CS