Evaluation of treatments for claw horn lesions in dairy cows in a randomized controlled trial

Abstract

Lameness is one of the most significant endemic disease problems facing the dairy industry. Claw horn lesions (principally sole hemorrhage, sole ulcer, and white line disease) are some of the most prevalent conditions. Despite the fact that thousands of animals are treated for these conditions every year, experimental evidence is limited on the most effective treatment protocols. A randomized, positively controlled clinical trial was conducted to test the recovery of newly lame cows with claw horn lesions. Animals on 5 farms were locomotion scored every 2wk. Cows were eligible for recruitment if they had 2 nonlame scores followed by a lame score and had a claw horn lesion on a single claw of a single foot. Following a therapeutic trim, enrolled cows were randomly allocated to 1 of 4 treatments: treatment 1-no further treatment (positive control; TRM), treatment 2-trim plus a block on the sound claw (TB), treatment 3-trim plus a 3-d course of the nonsteroidal anti-inflammatory drug (NSAID) ketoprofen (TN), treatment 4-trim plus a block plus ketoprofen (TBN). The primary outcome measure was locomotion score 35d after treatment, by an observer blind to treatment group. Descriptive statistics suggested that treatment groups were balanced at the time of enrollment, that is, randomization was successful. Based on a sound locomotion score (score 0) 35d after treatment, the number of cures was 11 of 45 (24.4%) for TRM, 14 of 39 (35.9%) for TB, 12 of 42 (28.6%) for TN, and 23 of 41 (56.1%) for TBN. The difference between TBN and TRM was significant. To test for confounding imbalances between treatment groups, logistic regression models were built with 2 outcomes, either sound (score 0) or nonlame (score 0 or 1) 35d after treatment. Compared with TRM, animals that received TBN were significantly more likely to cure to a sound outcome. Farm, treatment season, lesion diagnosis, limb affected, treatment operator, and stage of lactation were included in the final models. Our work suggests that lameness cure is maximized with NSAID treatment in addition to the common practices of therapeutic trimming and elevation of the diseased claw using a block when cows are newly and predominantly mildly lame.

A prospective cohort study of digital cushion and corium thickness. Part 1: Associations with body condition, lesion incidence, and proximity to calving

“…Additionally, previous work has demonstrated increased new bone growth on the flexor tuberosity of the distal phalanx in cows that have suffered more lameness and CHDL throughout life, and one possible mechanism for this new bone growth is inflammation in the surrounding soft tissues with CHDL (Newsome et al, 2016). Previous work has also shown that combining the administration of nonsteroidal anti-inflammatory drugs with applying a block to the nonaffected claw improved recovery rates for lameness in acute cases of disease (Thomas et al, 2015). The fact that the sole soft tissues appear to have been inflamed when a sole ulcer was present, and the potential detrimental effects this has on the surrounding anatomical structures such as the flexor tuberosity, highlights the importance first of prevention, and second of early detection and effective treatment of lame cows, which current evidence suggests should include the administration of nonsteroidal anti-inflammatory drugs and the application of a block to the nonlame claw.…”

The contribution of previous lameness events and body condition score to the occurrence of lameness in dairy herds: A study of 2 herds

“…It may also be important to prevent the occurrence of the first lifetime lameness event, although based on this analysis it is not possible to know whether it was the first lifetime lameness event or some other environmental or animal-based interaction that is important in consigning a cow to repeat lameness events. In addition, findings from this study highlight that early and effective treatment of lameness reducing the likelihood of recurrence or cases becoming chronic (Thomas et al, 2015) may also be crucial to lameness control at a herd level.…”

A prospective cohort study of digital cushion and corium thickness. Part 2: Does thinning of the digital cushion and corium lead to lameness and claw horn disruption lesions?

“…The Agriculture and Horticulture Development Board Dairy 0 to 3 mobility 3 scoring system was used, which is the UK industry standard (Thomas et al, 2015). Cows were observed from behind during unrestricted walking in the passageways where cows were housed.…”

“…The 2 observers had been trained using this locomotion scoring system and had used the system during previous research studies ( Thomas et al, 2015Thomas et al, , 2016. Inter-observer tests were performed as follows: 176 cows were locomotion scored by both observers during the same passage of walking.…”