When you put your finger into a hole in the foot of a cow and can feel bone you know it is going be interesting for you and very painful for the cow.
Now to understand what happens here you need to understand that cows have two toes (or claws) that contact the floor on each foot. With such a severe problem involving the bones and tendons of a toe the normal treatment would be amputation of that toe. Cows can generally survive on a single toe pretty well just so long as regular foot trimming and management is carried out.
However in the case of this cow the second toe of the same foot was affected though it was only a mild case at this stage. So if we had done amputation here of the really bad toe, the second toe would deteriorate further to the point where it would not be able to support the cows weight, and so the amputation would be pointless.
Economics unfortunately come into play as each cow in the herd has a value, both as meat and as a milking cow. This can justify the cost of the amputation surgery or whether the cow goes to slaughter – however if she is a good milker it is often the farmers wish to avoid this. Now the economics of amputation followed by slaughter in a week or two do not balance and so a clinical gamble based on years of experience was taken by the doctor here.
Amputation is necessary however this amputation would only be done if the other toe recovered. However as with any infection the key is to remove the source and so it was decided that the necrotic bone, tissue and some of the toe would be removed from the toe that would potentially be later amputated.
This level of injury is painful, and so requires good anaesthesia. In cows anaesthesia is usually local – so it only affects the area of the body where the surgery takes place much like if you yourself go to the dentist.
For the legs we apply a tourniquet to separate the foot from the rest of the body, and then make an injection into the veins of a local anaesthetic drug. This time the anaesthetic drug we used was procain – it is another topic however just quickly when using drugs in cows we have to really careful to use drugs that will not get into meat or milk to protect humans.
I was offered the chance to try to make the anaesthesia, and after my dismal first attempt at blood collection on Monday made amends by putting the needle, and then the anaesthetic drug directly into the vein on my first attempt (yay!). Still really believe it was complete beginners luck as me and cows have not really ever got acquainted.
The doctor removed the sesamoid bone and the tendon around this before then debriding the open bone surfaces of the digit. In this process the bottom of the joint capsule was lost and so in an attempt to help preserve the toe for another two weeks for the second toe to heal we also placed antibiotic drugs into the joint space.
Just to show how well an amputation heals (and to avoid gross photos) I’ve chosen today’s photo to be a cow that had an amputation around 6 weeks before.