Review of Pododermatitis circumscripta (ulceration of the sole) in dairy cows

Sole ulcers are among the most frequent causes of lameness in dairy cattle. They are found most commonly in the hind lateral claw, are frequently bilateral, and have a high rate of reoccurrence. The pathogenesis of sole ulceration is primarily based on mechanical injury by the 3rd phalanx to the corium, basement membrane, and basal layers of the sole epidermis as a result of failure of the suspensory apparatus in the claw. The main pathways in the failure of the suspensory system include inflammatory (dermal vascular changes followed by disruption of keratinocyte proliferation and differentiation caused by local and systemic mediators) and noninflammatory (hormonal and biochemical changes in the peripartum period resulting in alterations of connective tissue in the suspensory system) pathways. Sole ulcers tend to occur in specific locations; the most reported site is the junction of the axial heel and sole. Other locations include the apex of the toe and the heel. Varying degrees of lameness may result, and the most severe are seen with complicated cases in which ascending infection affects the deeper structures of the claw. Pathologic changes at the ulcer site include dyskeratosis and dilated horn tubules with microcracks. Vascular changes include dilatation and thrombosis of capillaries with "neocapillary formation." Areas of dyskeratosis may remain for as long as 50 days at the ulcer site. Treatment includes corrective trimming and relief of weight bearing. Complicated cases may require surgical intervention.     

The bovine digital cushion--a descriptive anatomical study

The properties of the suspensory and supporting structures of the bovine claw are of particular importance in the pathogenesis of claw lesions since both must function optimally to prevent soft tissue compression and trauma. An essential component is the shock-absorbing digital cushion situated under the distal phalanx. The sound claws of 54 slaughtered cows were dissected. The digital cushion consisted of three parallel pads--axial, middle and abaxial--that ran longitudinally from the heel and underneath the distal phalanx with numerous transverse finger-shaped branches that connected the axial and abaxial pads cranial to the flexor process of the distal phalanx. The middle fat pad frequently ended just at the apical end of the flexor process of the distal phalanx, which may result in an inferior cushioning effect under the distal phalanx and increase the likelihood of ulcers. There were differences in the structure of the digital cushion with age and loose connective tissue in heifers' pads was first replaced by fat which, after the third lactation, was gradually supplanted by collagenous connective tissue.     

A method of biomechanical testing the suspensory apparatus of the third phalanx in cattle: a technical note

There are a number of differences between the claws of the front and hind limbs in cattle concerning macroscopic shape, chemical and physical properties of claw horn and epidemiological data. Front claws have superior data in almost every respect. Virtually no information is available on the mechanical stability of the suspensory apparatus of the third phalanx. It was the objective of this study to develop a method to measure the maximum strength (N/mm2) of the suspensory apparatus of the bovine distal phalanx. This apparatus includes all layers of tissue such as bone, corium, corioepidermal junction and wall horn. The feet of 13 clinically healthy beef bulls were collected from the local abattoir. Testing was performed in three locations of the wall segment (dorsal, abaxial, axial) in a material testing machine. The corium and the corioepidermal junction were set under increasing tension until failure occurred. Maximum stress was recorded. The values ranged between 2.47-3.13 N/mm2 (dorsal), 4.08-4.87 N/mm2 (abaxial) and 2.27-2.66 N/mm2 (axial). No differences could be validated statistically between front and hind claws and between lateral and medial claws respectively. Abaxial ultimate stress values were significantly higher than dorsal and axial ones. Between the two a statistical difference could not be validated. Most of the specimens (57.1%) were torn apart at the corioepidermal junction, almost a quarter of the samples (27.6%) were to a degree disrupted at the corioepidermal junction and to a certain extent in the deeper layers of the corium. A few samples showed disruption within the horn (11.5%) or at the attachment of the third phalanx (3.8%). Biomechanical features of the experimental set-up are discussed. The biological significance of these findings is that the body weight and the additional dynamic loading is predominantly taken over by the abaxial part of the claw, while the dorsal and axial aspects are less loaded.     

Biomechanical and histopathological changes in the support structures of bovine hooves around the time of first calving

Hooves were removed from heifers killed two weeks before calving (C-2), and four and twelve weeks post-calving (C+4 and C+12), and from age-matched maiden heifers. Segments were dissected from the anterior walls of lateral hind claws, to include horn, corium and bone, and the biomechanical properties were measured. There was reduced rigidity, both overall and at a physiologically appropriate displacement of 2 mm, and a greater displacement was required to reach initial and maximum support in the hooves of calving, compared with maiden, heifers. Histological examination revealed widened and distorted interdigitating laminae, progressing to C+12 in the hind claws, but with evidence of recovery in the front claws after C+4. Increased connective tissue strength from dorsal to ventral hoof segments was correlated with protein, proteoglycan, pro- and activated matrix metalloproteinase-2, and tissue inhibitors of metalloproteinases, and was inversely correlated with fat, water and collagen content. This implies that mechanical changes reflect alterations in the biochemistry of the connective tissue. This evidence supports the hypothesis that primary causal events associated with calving weaken the connective tissue of the hoof suspensory apparatus, leading to increased susceptibility to clinical lameness associated with sole ulcers and white line disease.     

Ultrasonographic measurement of the sole horn thickness in bovine claw

Ultrasonographic thickness measurement and imaging of sole horn and the encapsulated soft tissue layers was evaluated in 100 bovine claw specimens. The claws were trimmed and examined in longitudinal planes using a 7.5 MHz linear transducer. In each claw, ultrasonographic measurements of horn thickness of sole and distance from outer claw surface to distal phalanx surface were made at three marked points on the weightbearing surface. All claws were then frozen, transected and anatomical reference measurements were made after thawing. The sole horn, corium, subcutis and distal surface of the distal phalanx of all claws were clearly visualized. The sole horn had a heterogeneous hypoechoic appearance, the underlying soft tissue layer was predominantly anechoic. Corium and subcutis could be differentiated. Best imaging of these structures was achieved in claws with less than 10 mm sole horn thickness and soft sole horn. Statistical correlation coefficients of 0.88 to 0.91 were found for ultrasonographic and anatomical measurements of sole horn thickness. Therefore, B-mode ultrasonography proved to be an accurate, non-invasive technique for measurement of the sole horn thickness in bovine claws.     

Measurements of forelimb claw dimensions in cows using a standardised sole thickness: a post-mortem study

Measurements of both front feet of slaughtered German Simmental cattle (17 heifers, 13 cows) were carried out to document the normal shape and size of the forelimb claws and to gain information about function and possible predisposition to disease. Only clinically normal feet were examined, and a standardised sole thickness of 5mm at the tip and 8mm in the heel region in both claws was established as a reference. The dorsal wall length, dorsal wall angle, heel length, height and width, sole and claw length and claw width, sole circumference and sole area were measured. After removal of the horn capsules, measurements of values at the level of the corium were carried out. The lateral front claws were wider and the medial claws longer than their partner claws. Overall, the sole surface areas and circumferences of the paired claws were similar, but were statistically larger in the medial claws. The front claws were characterised by long and high heel bulbs, and had a toe length:heel bulb length ratio of approximately 1.6:1. These properties, together with the musculo-tendinous attachment of the limbs to the trunk, are believed to provide better protection for the forelimb claws when standing or walking on hard surfaces. Functional mechanical relief of the medial front claws is probably best achieved by pairing the soles of the foot to the same level, which usually entails reduction of the lateral claw. For German Simmental cattle, a dorsal wall length of 75mm can be used as a guideline when trimming front and hind feet.     

Measurements of claw dimensions in cows before and after functional trimming: a post-mortem study

The aim of this study was to compare measurements of the medial and lateral claws of the hind feet in cattle, and to establish reference values to aid in functional claw trimming. Variables of the medial and lateral claws of 40 hind feet obtained from 40 slaughtered German Simmental cows were measured. To standardise the observations the soles of both the medial and lateral claws were first trimmed to a defined thickness of 5mm at the apex and 8mm at the heel, before measurements were taken. After this standardisation, the mean lengths of the dorsal walls of the two claws were not significantly different (means, lateral 76.8, medial 77.1 mm). However, there were considerable other differences. For example, the soles of the lateral claws were significantly (P < 0.01) longer (means, 120.1mm versus 112.7 mm, and wider (means, 52.0 mm versus 42.5 mm). In 36/40 feet, the sole of the lateral claw protruded approximately 2-3mm above the sole of the medial claw after the standardisation. The soles of the lateral claws were therefore then trimmed to the height of the medial claw ("levelling") and the measurements were repeated in the lateral claws. The dorsal wall of the lateral claw was then significantly shorter than that of the medial claw (means, 74.8 mm versus 77.1 mm) and, most importantly from a functional point of view, the sole was significantly thinner than that of the medial claw (means, 2.71 mm versus 5mm at the toe tip, 4.9mm versus 8 mm at the heel). Finally, the horn capsule of all claws was removed and various measurements of the corium surface were made. The length of the dorsal corium surface did not differ statistically (P > 0.05) between the lateral (mean, 62.6 mm) and medial (mean, 62.5 mm) claws. Strict adherence to the principles of functional trimming thus reduces the thickness of the sole, the length of the dorsal wall and the length and height of the bulb of the lateral claw. This suggests that the sole of the medial claw should be left an extra 3 mm thicker than previously recommended such that, after "levelling", the sole of the lateral claw remains thick enough to protect fully the corium and the claw retains a more normal shape.     

Ultrasonographic Imaging and Thickness Measurement of the Sole Horn and the Underlying Soft Tissue Layer in Bovine Claws

Ultrasonographic imaging and thickness measurements of sole horn and underlying soft tissue layer were evaluated in 100 bovine claw specimens. The claws were trimmed and examined in longitudinal planes using a 7.5 MHz linear transducer. The sole horn, underlying soft tissue layer and distal surface of the distal phalanx of all claws were clearly visualized. The sole horn had a heterogeneous hypoechoic appearance; the underlying soft tissue layer was predominantly anechoic. Corium and subcutis could be differentiated. The best imaging of these structures was achieved in claws with less than 10 mm sole horn thickness and soft sole horn. Imaging of the dorsal wall structures was more difficult. In each claw, B- and A-mode measurements of horn thickness of sole and dorsal wall and distance from outer claw surface to distal phalanx surface were made at three marked points on the weightbearing surface and at one point on the dorsal wall. In 10 claws, CT-images were taken and the horn density was determined. All claws were then frozen, transected and anatomical reference measurements were made after thawing. Statistical correlation coefficients of 0.88 and higher were found for B-mode ultrasonographic and anatomical measurements of sole horn thickness. A-mode proved not to be useful for the sole horn thickness measurement. B-mode ultrasonography was carried out successfully in the claws of five living cattle.     

Bovine sole ulcer: a literature review

Sole ulcers are the most frequently encountered lesion in lame cattle. They are of growing concern to the dairy industry since the incidence of ulcers is increasing. Ulcers cause financial losses, the animal's wellbeing is disturbed to a high degree and they harm the image of the industry in general. Biomechanic factors and laminitis are of particular significance in the pathogenesis of the sole ulcer. The development of sole contusions and ulcers is assumed to occur in 3 phases (Sinking theory). In the first phase there is a general disturbance in the vascular system of the corium. The second phase follows when the structures that suspend the claw bone within the horn shoe give way. The locus minoris resistentiae has yet to be identified. The claw bone sinks and causes various lesions when it pinches the underlying sole or heel corium. The third phase begins when haemorrhages become visible on the horn surface of the sole or when the sole ulcerates; socalled third phase lesions. The relationship between the development of sole ulcers and anatomical structures such as the claw bone's tuberculum flexorium or the fat bodies under the bone are unclear. Epidemiological studies have shown that sole ulcers have a high rate of recurrence. The healing processes and the factors that influence them have hitherto not been studied.     

Genetic aspects of claw disorders,claw measurements and ‘type’ scores for feet in Friesian cattle

Data on claw measurements and disorders were collected on Black and White Friesian or Holstein heifers in 82 herds. Disorders were sole lesions and dermatitis interdigitalis and were determined on all heifers that had been milking between 40 and 100 days at the time of the visit. Heritabilities and genetic and phenotypic correlations among claw measurements and claw disorders were computed.Heritabilities for claw measurements were: angle, 0.25; length, 0.26; heel depth, 0.16; and heel depth-difference, 0.08. Angle and length estimated by eye had heritabilities of 0.18 and 0.22, respectively. The total of all lesion scores from different regions of the sole on both hooves had a heritability of 0.39. Heritabilities of dermatitis interdigitalis and sole ulcer (presence or absence) were 0.23 and 0.16, respectively.Claw measurements seemed to be more related to lesion scores than to dermatitis interdigitalis scores. Genetic correlations suggested that cows with higher claw angles had fewer dermatitis interdigitalis, total lesions and sole ulcers. Longer claws were genetically associated with higher total lesion scores and more sole ulcers. Claw measurements estimated by eye showed low genetic relations with claw disorders.Further research is needed to determine whether claw shape is a predisposing factor for or a result of a claw disorder.     

Healing process of uncomplicated sole ulcers in dairy cows kept in tie stalls: clinical description and blood chemical investigations

A total of 74 dairy cows with 105 separate lesions were treated and the healing process was observed for half a year and the results compared with the biochemical data. The mean time for the formation of a closed layer of horn was 25 days for lesions with slight corium alterations, 33 days for moderate and 42 days for severe alterations. Thirty days after the initial treatment 68% of all lesions were completely covered by a solid layer of new horn. The further evaluation of the healing process was based on quality and rate of the new horn formation, recovery from lameness and sensitivity to hooftesters. Using these parameters the healing potential of exposed corium was judged one month after treatment with a scoring system. The 30-day-healing process was considered to be good in 61% and moderate to bad in 39% of the cows. The concentration of glucose, cholesterin, LDH and blood urea was increased in one third of the animals. Phosphorus and magnesium concentrations were lower than the reference values in 30%, and 26% of the animals, respectively. Cows with prolonged healing had higher levels of bilirubin, creatinkinase, LDH, ALT and AST than cows with a good healing process. Concentration of iron, vitamin A and biotin were significantly lower in cows with moderate to bad healing parameters than cows with a good healing potential. From these results it is suggested that biochemical blood parameters and the vitamin status might influence the healing of uncomplicated sole ulcers, respectively.     

Ultrasound measurement of sole horn thickness in trimmed claws of dairy cows

OBJECTIVE: To determine whether ultrasound could be used to measure sole horn thickness in dairy cattle after claw trimming with an adaptation of the Dutch method. DESIGN: Case series. ANIMALS: 24 adult Holstein dairy cows. PROCEDURE: Cows were restrained in a standing position, and claws were trimmed with an adaptation of the Dutch trimming method. B-mode ultrasonography was then performed. The transducer was placed on the sole just caudal to the apex of the toe and immediately medial and parallel to the abaxial white zone. The inner margin of the sole was identified as a thin hyperechoic line. Soles were considered to be too thin if sole horn thickness, determined by use of ultrasonography, was < 5 mm. RESULTS: Sole horn, underlying soft tissues, and the distal surface of the third phalanx were imaged in 151 claws. The inner margin of the sole could not be identified in 4 claws, and 37 claws could not be imaged because cows collapsed in the restraining chute. Mean +/- SD sole thickness for all claws was 71 +/- 1.3 mm. Only 1 sole was < 5 mm thick. The lateral front claws were significantly thicker than the medial hind claws. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasound imaging can be used to determine sole thickness in dairy cattle after routine claw trimming.     

Ultrasonographic and macroscopic comparison of the thickness of the capsule,corium, and soft tissues in bovine claws: an in vitro study

This study aimed to compare thickness of the capsule, corium, and soft tissues measured ultrasonographically and macroscopically in selected regions of bovine claws. A hundred and twenty claws (n = 120) of 15 healthy Holstein bovines were obtained. After cleaning the claws, ultrasonographic measurement of the capsule, corium, and soft tissues was performed while submerging the claws in a water bath. Macroscopic measurements were taken after cutting of the claws axially. These values were compared statistically. According to the macroscopic measurements, the mean thickness ± standard deviation (SD) of the capsule for dorsal wall and sole was 6.2 ± 0.1 and 9.5 ± 0.4 mm, respectively. The thickness of the corium and soft tissues for dorsal wall and sole was 4.5 ± 0.1 and 5.3 ± 0.1 mm, respectively. Ultrasonographically, the mean thickness ± SD of the capsule for dorsal wall and sole was 4.7 ± 0.1 and 7.8 ± 0.3 mm, respectively. The thickness of the corium and soft tissues for dorsal wall and sole was 4.3 ± 0.1 and 5.9 ± 0.2 mm, respectively. Findings demonstrated that ultrasonography can be reliably to measure of the thickness of the hoof capsule, corium, and soft tissue in bovine claw.     

Bovine laminitis: clinical aspects, pathology and pathogenesis with reference to acute equine laminitis

This review deals with the features of clinical and subclinical laminitis in cattle. Prominent clinical signs of acute laminitis are a tender gait and arched back. The sole horn reveals red and yellowish discolourations within five days. In subacute and chronic cases clinical signs are less severe. In chronic laminitis the shape of the claws is altered. Laminitis is frequently followed by sole ulceration and white zone lesions. Blood tests showed no significant changes for laminitic animals. Arteriographic studies of claws affected by laminitis indicated that blood vessels had narrowed lumens. Gross pathology revealed congestion of the corium and rotation of the distal phalanx. Histopathologic studies indicate that laminitis is associated with changes of the vasculature. Peripartum management and nutrition are important factors in its aetiology. It is hypothesised that laminitis is evoked by disturbed digital circulation. In the pathogenesis of acute laminitis three factors are considered important: the occurrence of thrombosis, haemodynamic aspects of the corium, and endotoxins which trigger these pathologic events.     

Associations between types of lameness and fertility

Four hundred and twenty-seven cases of first-reported foot lameness were recorded in 17 dairy herds in Somerset during the winter housing period. Lameness was classified into three categories: sole ulceration, digital disease (white line abscess, foreign bodies in the sole and pricked or punctured sole), and interdigital disease (lesions of the skin between claws and heel including foul in the foot, interdigital fibroma and dermatitis). In addition, a 'clinical effect score' was calculated to take account of the severity of lameness, the structures involved and the time for which the cows were clinically affected. The fertility records of lame cows were compared with those of the healthy cows nearest in parity and stage of lactation. In the lame cows the interval from calving to first service was four days longer, and the interval from calving to conception was 14 days longer than in the control cows, the pregnancy rate to first service was 46 per cent (controls 56 per cent), 2.14 services were required per conception (controls 1.72) and 16 per cent of lame cows were culled (controls 5 per cent). Lameness, first reported in the period 36 to 70 days after calving, was associated with a significant (P less than 0.01) increase in the interval from calving to first service of eight days; and sole ulceration, in the period 71 to 120 days after calving, was associated with an increase of 11 days (P less than 0.05). Lameness in all periods up to 120 days after calving was associated with significantly increased intervals from calving to conception (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Herd and cow-level prevalence of sole ulcers in The Netherlands and associated-risk factors

A cross-sectional study was performed, to (re)evaluate the prevalence of sole ulcers (SUs) and the risk factors involved in dairy herds that perform claw trimming on a routine base. Twenty hoof trimmers collected data on the presence or absence of claw disorders on the hind claws of dairy cows during whole herd trimming in 383 herds in The Netherlands. A questionnaire was used to acquire information on management and housing. Additional data on parity, breed and stage of lactation of the cows were provided by the Dutch Herd Book Organization.

Sole ulcer was present in 85% of the herds and in 5.6% (S.E. 0.2) of the study population (n = 22,454 cows). The within-herd prevalence varied from 0% (14.6% of herds) to 26% (0.3% of herds) and in herds with SU was most frequently diagnosed 1–5% of the trimmed cows (45% of all herds).

The risk for SU increased significantly with increasing parity. Cows that were at or after peak of lactation (>60 days in milk, DIM) had higher odds on SU in comparison to cows that were between 0 and 60 DIM (OR = 0.6).

The presence of other non-infectious claw disorders appeared to predispose to SU. Based on an estimation of the population attributable fraction, it was concluded that if sole hemorrhages, chronic laminitis (CL), white line disease and interdigital hyperplasia were the cause of SU and if those diseases could have been prevented in the study population, 35.4, 5.8, 11.6 and 4.6% of the SU cases respectively could have been prevented. Because of this relation, an effective intervention strategy of SU should focus on an integral approach of reducing the first stages of the bovine laminitis complex, whereas SU and CL are considered to be a later stage.

Cows trimmed during late summer were at a higher risk for SU than cows trimmed in other periods of the year. Finally, cows in herds with purchased heifers were at a higher risk (OR = 1.4) for SU than cows in herds that did not purchase heifers. A comparable positive effect was visible in herds with mattress bedding.     

Skin Injuries on the Body and Thigh of Dairy Cows: Associations with Season,Claw Health,Disease Treatment,and other Cow Characteristics

An epidemiological study was conducted in 18 dairy herds with the objective to characterize those groups of cows where skin injuries to the body and thighs occurred most frequently. Data were analyzed with multivariable logistic regression. The epidemiologic patterns were different in first and later lactations. In first lactation some degree of injury occurred among 7.7% of 1793 cows. For most cows occurrence of sole ulcer was positively associated with injury while occurrence of heel horn erosion was negatively associated with injury. The association between injury and body weight differed depending on month of calving (significant interaction). Injuries occurred most frequently among high yielding cows. Severe reproductive, metabolic, and/or infectious diseases were associated with injuries. In later lactations some degree of injury occurred among 13.4% of 832 cows in lactations 2 to 9 where severity of injury increased with lactation number. Injuries occurred least frequently at examinations made in the January to March. They occurred most frequently among cows with sole ulcers. Calving in March through October was associated with injuries especially if the cows were treated for limb disorders. Most cases of injuries occurred early or late in lactation or among high or very low yielding cows in lactations 2 to 9.     

Effect of therapeutic dietary biotin on the healing of uncomplicated sole ulcers in dairy cattle--a double blinded controlled study.

The objective of this study was to investigate the influence of orally administered biotin on the healing of uncomplicated sole ulcers in dairy cattle. In a double-blind controlled study, 24 dairy cows with a mild, uncomplicated sole ulcer on a lateral hind claw were given either 40 mg biotin per day or a placebo feed over a period of 50 days. An orthopaedic shoe was fitted to the medial claw of the affected foot. The healing process was assessed clinically and by histological examination of horn samples. In the biotin-treated animals, the newly formed epidermis covering the sole ulcers was found to be of significantly better histological quality after 50 days than at the start of the study. The significant improvement in histological horn quality found in the biotin-treated animals suggests that biotin exerts a positive influence on the healing of sole ulcers, however the study period of 50 days appears to have been too short to permit macroscopic detection of the improvement in horn quality.     

Prevalence of foot lesions in Danish Holstein cows

In a cross-sectional study of 6240 Danish Holstein cows in 55 herds using loose-housing systems, sole haemorrhages and heel horn erosions occurred frequently in almost all the herds. Digital dermatitis occurred in 47 of the 55 herds (85 per cent). Spearman correlation coefficients revealed relationships between lameness and sole ulcer (0.36), between heel horn erosion and sole haemorrhage (0.39), between heel horn erosion and interdigital dermatitis (0.29) and between sole ulcer and double sole (0.26). The prevalence of heel horn erosion, sole haemorrhage, interdigital dermatitis and digital dermatitis appeared to be most affected by herd-level factors. The associations between individual foot trimmers and all the foot lesions were statistically significant. The risk of interdigital dermatitis increased with decreasing amounts of bedding. Cows housed throughout the year had a marginally higher risk of sole haemorrhage.