View source for Cattle Medicine Q&A 02

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'''A Limousin bull presents with severe (10/10) lameness of the left pelvic limb with marked muscle atrophy over the left hip. The left hindfoot is swollen with marked widening of the inter - digital space. There is loss of hair and thinning of the skin extending all around the coronary band of the lateral claw extending proximally for 3 cm with a discharging sinus consistent with septic pedal arthritis.'''
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<FlashCard questions="2">
|q1=Describe the method of analgesia you would employ for the procedure illustrated here
|a1=
The procedure shown is digit amputation under intravenous regional anaesthesia. Flunixin meglumine (or other NSAID) is injected intravenously before surgery. A robust tourniquet is placed below the hock and 30–40 mL of 2% lidocaine<sup>1</sup> is injected into the superficial vein running on the cranio - lateral aspect of the third metatarsal bone (butterfly catheter shown in situ). Analgesia is effective within 2 minutes.
|l1=Digit Amputation - Cattle
|q2=How would you complete the procedure shown?
|a2=
The interdigital skin is incised as close to the infected tissue as possible and the incision extended for the full length of the interdigital space to a depth of 2 cm cranially increasing to 4 cm caudally. A length of embryotomy wire is introduced into the incision and the lateral digit removed at the level of mid P2 (wire at 15° to horizontal). A melolin dressing (or similar) is applied to the wound then cotton wool and a pressure bandage applied using Elastoplast (or similar). The dressing is changed after 4 days. The bull made a full recovery and is still in the herd 18 months later.
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If infection in the deep flexor tendon sheath has extended above the amputation site, 10–15 cm of flexor tendon can be removed to effect drainage.
|l2=Digit Amputation - Cattle
</FlashCard>

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| align="left" | <p>Comments by Nick Lyons MA VetMB CertCHP MRCVS</p>
<p>1. The 2% lidocaine is not licensed in farm animals any more in the UK. In the UK, it should be 2% procaine solution.</p>
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