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Published byJonas Butler Modified over 9 years ago
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BJ Newcomer Annual Conference April 7, 2011 Septic arthritis in a Red Holstein dairy heifer
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“Reba” “2081” – 6 mo old Red Holstein heifer 3 week history of lameness/foot swelling On presentation: TPR elevated from trailer ride Nearly “3-legged” lame on left forelimb Soft tissue swelling proximal to hoof capsule Medial claw Muscle atrophy of left forelimb
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Initial Rads Severe soft tissue swelling Gas opacities in soft tissue Increased joint space Proximal IP joint No draining tract noted Lateral claw appeared unaffected
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Initial Treatments Hoof block placed on lateral claw Following Day (under sedation): Arthrotomy – copious purulent discharge Lavage and curettage Regional antibiotic perfusion 1 gram Naxcel ® 2 days later – Naxcel ® impregnated beads
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Continued treatments Over next 12 days: Regional perfusion 10 mL lidocaine Daily flushing and curettage Maintenance of Abx beads Bandage changes Splints
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2 week rads Decreased swelling No evidence of gas opacities Periosteal proliferation Widened joint space Proximal IP joint Coffin joint Abx beads No evidence of sepsis L LTF
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Continued treatments Cast application for additional support Large IA defect a concern Bone graft to fill defect Rib resected from mid thorax Right 10 th rib Rib crushed and placed in defect 6 Naxcel ® beads IA Hard cast applied
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Post-cast Non-weight bearing 2 days Hoof block on lateral claw Improved lameness Dropping of right fetlock Support wrap Daily physical therapy Increased weight-bearing Able to go home
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Post-cast Continued physical therapy BID Support wrap removed after 1 week Mild valgus of fetlock remained Muscular atrophy improvement 3 weeks later cast removed
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3 weeks post-cast Significant callus formation Small defect remains No evidence of sepsis Wound lavaged Significant granulation tissue Cast-reapplied
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3 weeks later… 2 nd cast removed Clean healing wound No discharge or odor Moderate laxity of the pastern joint Splint and stall rest over weekend Physical therapy to strengthen tendons
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Summary Valuable heifer w/ septic arthritis Resolve infection Regional perfusion Abx beads Joint healing Bone graft Hard cast Phyical therapy
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