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Footrot
(Interdigital phlegmon, Foul in the foot)
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Etiology and Pathogenesis
Clinical Findings
Diagnosis
Treatment
Prevention and Control

Footrot is a subacute or acute necrotic infection originating from a lesion in the interdigital skin that leads to a cellulitis in the digital region. Pain, severe lameness, fever, anorexia, loss of condition, and reduced milk production are major signs of the disease. Footrot has a worldwide distribution and is usually sporadic but may be endemic in intensive beef or dairy cattle production units. The incidence varies according to weather, season of year, grazing periods, and housing system. On average, footrot accounts for ~15% of claw diseases.
Etiology and Pathogenesis:
Injury to the interdigital skin provides a portal of entry for infection. Maceration of the skin by water, feces, and urine may predispose to injuries. Fusobacterium necrophorum is considered to be the major cause of footrot. It can be isolated from feces, which may explain why control is difficult. Other organisms, such as Staphylococcus aureus , Escherichia coli , Arcanobacterium (Actinomyces) pyogenes , and possibly Bacteroides melaninogenicus , can also be involved.
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Clinical Findings:
The fore- or, more commonly, the hindlimbs can be affected, but more than one foot is rarely involved at the same time in mature cows. However, footrot can occasionally develop in several feet in calves. The first sign is swelling and erythema of the soft tissues of the interdigital space and the adjacent coronary band. The inflammation may extend to the pastern and fetlock. Typically, the claws are markedly separated, and the inflammatory edema is uniformly distributed between the 2 digits. The onset of the disease is rapid, and the extreme pain leads to increasing lameness. In severe cases, the animal is reluctant to bear weight on the affected foot. Fever and anorexia are seen. The skin of the interdigital space first appears discolored; later, it fragments with exudate production. As necrosis of the skin progresses, sloughing of tissue is likely to follow. A characteristic foul odor is produced.
Photographs

Interdigital phlegmon (footrot)

Interdigital phlegmon (footrot)
Photographs

Foot rot, open

Foot rot, open
If the disease proceeds unchecked, weight loss is severe and milk yield is significantly reduced. Milk production may not recover during the current lactation. Open lesions can be infected with secondary invaders. If the necrotic lesion is located in the anterior region of the interdigital space, the distal interphalangeal joint can become infected because of its proximity.
Hematogenous infection of the tissues of the interdigital space may account for peracute cases of footrot, which are referred to as either “blind” or “super foul.” This form of footrot is characterized by the initial absence of a skin lesion, extreme pain, and the tendency to progress despite aggressive therapy.
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Diagnosis:
It is frequently assumed that every cow with a swollen foot has footrot. However, many other conditions, such as infected sandcracks, white line disease, retroarticular abscesses, foreign bodies in the interdigital space, and infection of the distal interphalangeal joint can have a similar appearance if viewed from a distance. Despite the difficulties encountered in lifting a hindlimb, a detailed examination should be performed in every case. An incorrect diagnosis can have disastrous results.
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Treatment:
Most treated animals recover in a few days. Good results are obtained with penicillin G, IM, for 3 days. Treatment should be administered as soon as signs are observed. However, the label dosage may be inadequate to effect a rapid resolution, and increased dosages may be needed, requiring increased withdrawal times. Treatment of “super foul” must be particularly aggressive. Early cases respond well to single doses of long-acting oxytetracycline.
Sodium sulfadimidine solution IV or trimethoprim/sulfadoxine IV or IM, bid for 3 days, can also be used. A single oral administration of a long-acting bolus containing baquiloprim/sulfadimidine may be suitable for treating beef cattle.
High concentration of an agent in the target tissues can be achieved by a regional IV injection. Positive results have been obtained with penicillin or oxytetracycline.
Local treatment is essential for some longstanding cases and in all instances in which the anterior region of the interdigital space has been compromised. The animal must be adequately restrained and the lesion cleansed. It is inadvisable to curette or otherwise remove necrotic tissue surgically. The dorsal pouch of the distal phalangeal joint is very superficial at this point. A nonirritant bacteriostatic agent (such as nitrofurazone or a sulfa preparation) should be applied as a topical dressing. The application of gauze, cotton batting, or bandages is contraindicated. However, the lesion can be protected and immobilized by binding the digits together with a bandage. The entire digital region can be protected from contamination if it is enclosed in a plastic bag that is fixed in place with an adhesive bandage. However, prolonged protection is not advocated because the enclosed lesion tends to macerate further. Bandages, if used, should be replaced daily.
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Prevention and Control:
Animals that are actively shedding infectious organisms should be isolated until signs of lameness have disappeared. If this is not possible, a waterproof dressing or protective boot should be applied; however, animals wearing protective boots should be monitored carefully to avoid additional damage. Boots should be disinfected between use.
Because busy traffic areas are invariably heavily contaminated, steps should be taken to ensure that areas around drinking troughs, gateways, and tracks are adequately drained. Animals at pasture might be moved to a clean, dry area, or possibly housed during periods of heavy rainfall. Contaminated concrete must be frequently cleaned and scraped free of manure.
Preventive use of a footbath with an antiseptic and astringent solution (eg, copper or zinc sulfate [7-10% in water]) has given beneficial results. Formaldehyde solution (3-5% in water) can also be used, but in some areas it is considered to be an environmental hazard if discharged into natural waterways.
Ethylenediamine dihydroiodide has been used as a feed supplement for prevention, but the results are extremely uncertain. Vaccines against F necrophorum have failed because of the weak immune response to the bacterium. High levels of zinc fed as a supplement have a beneficial effect by improving epidermal resistance to bacterial invaders.
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See Also
Introduction
Diagnostic Procedures
Physical Examination
Radiography
Regional Analgesia
Arthroscopy and Arthrocentesis
Preventive procedures
Pain Management
Functional Claw Trimming
Footbaths
Laminitis
Overview
Acute or Subacute Laminitis
Chronic Laminitis
Subclinical Laminitis
Disorders of the Claw Capsule
Sole Ulcer
White Line Disease
Toe Ulcer
Toe Abscess
Double Sole
Foreign Bodies in the Sole
Sandcracks
Horizontal Fissures
Corkscrew Claw
Slipper Foot
Heel Erosion
Disorders of the Interdigital Space
Overview
Interdigital Dermatitis
Digital Dermatitis
Interdigital Hyperplasia
Disorders of the Bones and Joints
Ankylosing Spondylosis
Degenerative Arthropathy
Dislocations
Fractures
Septic Arthritis of the Distal Interphalangeal Joint
Serous Tarsitis
Neurologic Disorders Causing Lameness
Overview
Suprascapular Paralysis
Radial Paralysis
Ischiatic Paralysis
Obturator Paralysis
Femoral Paralysis
Peroneal Paralysis
Tibial Paralysis
Spastic Syndrome
Spastic Paresis
Soft-tissue Disorders Causing Lameness
Carpal Hygroma
Frostbite
Hematoma
Rupture of the Gastrocnemius Muscle or Tendon
Rupture of the Peroneus Tertius Muscle
Tarsal Cellulitis