Amputation of the Front Medial Digit of a Holstein Cow - Successful Parturition and Milk Production

Background: Diseases of the bovine digit and hoof remain major problems in dairy farming and the beef cow industry. Severe claudication accompanying swelling and pain at the lesion is often observed in deep digital sepsis, septic arthritis, severe sole ulcers, and chronic interdigital phlegmon. In addition, digital amputation is often performed in cases of white line disease or severe trauma, such as bone fractures. There are few reports of amputation of the medial digit of the bovine front hoof. In this case, amputation of the medial digit of the front leg of a pregnant cow was performed; its hospitalizationand return to productivity is reported.Case: The bovine was a 9-year-old Holstein cow in the 6th month of pregnancy, weighing 671 kg. Upon admission, the cow could not bear weight on its right front leg, and swelling and a purulent discharge were observed in the coronary area of the medial digit. X-ray examination results indicated a periosteal reaction centered on the 3rd phalanx of the medial digit of its right front leg hoof and slight periosteal reactions at the adaxial sides of the middle and proximal phalanges, strongly suggestive of septic arthritis caused by infection. According to the X-ray examination results, no abnormalities of the lateral digit of the front right hoof were observed; thus, it was estimated that the post-amputation hoof would be able to bear weight. Therefore, a decision was made to perform immediate amputation of the medial digit of the right front leg hoof to reduce pain for improved delivery of the offspring and improved milk production during the lactation period, rather than allowing the lesion progress until the dry period or the expected date of delivery. According to the X-ray examination results, amputation of the 1st phalanx alone was expected to suffice for removal of the cause of the pain; thus, a decision was made to perform amputation at the edge adjacent to the 2nd phalanx. The right front medial digit was prepared for aseptic surgery, and infiltration anesthesia was performed. An incision was made with a surgical knife at the interdigit of the right front limb. A wire saw was inserted into the site to cut the 2nd phalanx in the anti-axial direction down to the skin to resect the lesion. White viscous pus was discharged at the resection site; therefore, the wound was lavaged with tap water and packed with povidone iodine-impregnated gauze. The wound was also covered with a diaper and dressed with non-elastic and elastic bandages. The dressing was changed daily to aid wound healing. No problems were observed in the standing-up motion or other relevant movements immediately after the surgery. Granulation tissue formed rapidly, approximately 2 weeks after the surgery, and the lesion dried gradually. Approximately one month after the surgery, the subject exhibited little difficulty in both standing up and walking. The subject successfully delivered its 7th offspring at the farm on postoperative day 93.Discussion: The animal of this study was a 9-year-old, pregnant cow, and although amputation of the front medial digit is a relatively rare procedure, the cow was able to deliver and return to production, owing to sufficient postoperative treatment and care. The case also demonstrated the advantage of X-ray examination in bovine hoof diseases for accurate diagnosis, precise operation, and prognostic assessment. Keywords: bovine, lameness, surgery, septic arthritis, bovine hoof, medial digit, digital amputation