Offering Ration Balancing as a Service

David T. Brennan D.V.M Country Roads Veterinary Services Inc.

Ashland Ohio

1/8/2018

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Joe Lozier, DVM

Farm Animal Surgery Resident

The material in this abstract has been accepted as a manuscript for publication in the Canadian Veterinary Journal

Ruminant limb fractures account for up to 10% caseload at referral centers (Grangl et al 2006)

Challenges Economic constraints Increased forces

Management Stall rest External coaptation Internal fixation

Ruminant anatomy

Cast cannot reach past mid-radius or mid-tibia

Joint above and below cannot be immobilized in fractures of Radius/ulna Humerus Tibia Femur

Thomas splint- R/U and Tibia 54-57% success (Grangl et al 2006; Crawford et al 1985) Complications Poor alignment ALD Opening of fractures within the cast (Adams et

al 1983)

External fixator for LA

Fracture site significant decrease in strain Eliminates bending, torsion,

compression, distraction, shear Minimal movement between fragments Tissues/blood supply/hematoma not

disrupted

Efficient, cheap, easy to apply

Minimizes distance from bone to external frame

Can be made for any sized patient

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Ruminants presenting between January 2005 and December 2015 with long bone fractures stabilized by a TPC

Short term success: Survival to return to the farm without external coaptation

Short term failure: Euthanized or died prior to removal of final coaptation

Long term success (return to intended use) and residual lameness was obtained via telephone interviews Lameness: 0= not lame, 1= lame while ambulating, and 2= non-weight bearing lameness Satisfaction: 1 = completely unsatisfied, 2 being somewhat dissatisfied, 3 being neutral, 4

being somewhat satisfied, and 5 being completely satisfied

Logistic regression Independent variables: Species

Age

Body weight

Whether the fracture was open or closed

Fracture configuration (simple or comminuted)

If fracture was proximal vs distal

Multiple linear regression to rule out independent variable collinearity

Preoperative planning with films to determine placement of pins

General anesthesia or sedation with regional blockade or epidural

Dorsal recumbency

Limb suspended vertically

Pins 20-30% diameter of waist of diaphysis of bone

Pins that are too small will break

Pins that are too big could result in fracture through pin site

Vogel and Anderson, 2014

Positive profile pins

Pins should be 2-4cm apart

Diverge 30 degrees in frontal plane Stronger fixation Lower risk of fracture

http://veteriankey.com/wp-content/uploads/2016/07/B9781437707465000446_f044-003-9781437707465.jpg

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Pins may be placed in proximal cannon bone with cannon fractures

Ensure enough bone proximally to safely place enough pins

Stab incision to bone

Hole drilled medial to lateral or lateral to medial 1mm smaller than pin used Minimize heat production

Tap hole or use self tapping pins

Engage threads in both cortices

Cut pins with 3-5mm of pin left on either side

Appropriate technique prevents early loosening of pins

Double-layer stockinet

Padding

Cast application

Push pins through cast and cover with last four layers weakest point of construct

PMMA

Pins should be as far distal from the end of cast as possible

https://www.americanfarriers.com/ext/resources/images/issues/2015/Sept-Oct/casting.jpg

Calf Pins removed in 2-3 weeks Casted/splinted for 2-3 weeks Stall-rest for 2-3 weeks

Adult cattle Pins removed at 6-8 weeks Cast for 4-6 weeks Stall rest for 4-6 weeks

Kofler, 2014

25 cattle, 7 goats, and 7 sheep

Age ranged from 1d to 4.5y

Weight ranged from 10 to 450 kilograms

Fracture Common metatarsus (n=16, 41%) Common metacarpus (n=11, 28%) Radius/ulna (n=6, 15%) Tibia (n=5, 13%) Proximal phalanx (P1) (n=1, 3%)

27 closed (69%) and 12 open fractures (31%)

20 (51%) comminuted fractures and 19 (49%) simple fracture configuration

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31 (79%) had a positive short-term outcome

8 (21%) died or were euthanized 4 developed osteomyelitis secondary

to an open fracture 2 fracture at pin site 1 sudden death 1 developed septic arthritis in another

limb secondary to HBC

Outcome variable Model -2LL 19.331, step 4, and r²=0.635

Body weight Wald 7.118, df=1, p= 0.008 Odds ratio 1.022 (1.006-1.039) 1 kg increase 1.022 increase in odds of

being euthanized 100 kilogram animal has 6.464 the odds

of being euthanized as a 1 kg animal

Species Wald 3.892, df= 1, p= 0.049 Odds ratio 0.013 (0.000-0.972) Odds ratio of 77 for short term survival

Long term follow-up for 20/31 patients with positive short-term outcomes

13 bovine, 4 caprine, 3 ovine

17 (85%) performed as expected 1 (5%) indicated a satisfaction level of

2/5

Number of patients

% of patients

Lameness

0 11 55

1 7 35

2 1 5

Satisfaction

5 17 85

4 2 10

3 0 0

2 1 5

Complication Number of patients % of patients

Osteopenia 6 15

Pin tract osteitis 6 15

Cast sores 4 10

Sequestra 1 3

Decreased range of motion 1 3

Contralateral limb breakdown 1 3

Delayed union 1 3

Osteomyelitis 4 10

Pin tract fracture 2 5

Sudden death 1 3

Septic arthritis of different joint

1 3

Total 28 72

Wide age/weight range

Multiple species

Multiple surgeons (7) over 10 years

Long term follow-up via phone interview Owner memory Owner-graded lameness

Number of cases (39)

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Radius/ulna and tibial fractures similar success rates similar to those distal limb

Open fractures Not graded

Decreased odds of euthanasia among cattle Calmer demeanor Frequent resting in recumbency Tolerance to external coaptation Robust callus formation

1. Gangl M, Grulke S, Serteyn D, Touati K. Retrospective study of 99 cases of bone fractures in cattle treated by external coaptation or confinement. Vet Rec. 2006;158(8):264-268.

2. Nuss K. Plates, pins, and interlocking nails. Vet Clin North Am Food Anim Pract. 2014;30(1):91-126, vi.

3. Denny HR, Sridhar B, Weaver BM, Waterman A. The management of bovine fractures: A review of 59 cases. Vet Rec. 1988;123(11):289-295.

4. Auer JA, Steiner A, Iselin U, Lischer C. Internal fixation of long bone fractures in farm animals. Veterinary and Comparative Orthopaedics and Traumatology. 1993;6(1):36-41.

5. Crawford WH, Fretz PB. Long bone fractures in large animals: A retrospective study. Veterinary Surgery. 1985;14(4):295-302.

6. St Jean G, Anderson DE. Decision analysis for fracture management in cattle. Vet Clin North Am Food Anim Pract. 2014;30(1):1-10, v.

7. Fubini SL, Ducharme NG. Farm animal surgery. Second ed. St. Louis, Missouri: Elsevier; 2017:384-387, 403-405.

8. Kofler J, Wetchy G, Schoffmann G. Transfixation pinning and casting of a comminuted metacarpal fracture in a 870 kg bull. Vet Surg. 2014;43(8):1014-1019.

9. Hamilton GF, Tulleners EP. Transfixation pinning of proximal tibial fractures in calves. J Am Vet Med Assoc. 1980;176(8):725-727.

10. Kaneps AJ, Schmotzer WB, Huber MJ, Riebold TW, Watrous BJ, Arnold JS. Fracture repair with transfixation pins and fiberglass cast in llamas and small ruminants. J Am Vet Med Assoc. 1989;195(9):1257-1261.

11. St-Jean G, Clem MF, DeBowes RM. Transfixation pinning and casting of tibial fractures in calves: Five cases (1985-1989). J Am Vet Med Assoc. 1991;198(1):139-143.

12. Auer JA, Stick JA. Equine surgery. 4th ed. St. Louis, Mo.: Elsevier/Saunders; 2012:1036, 1047-1054.

13. McClure SR, Watkins JP, Ashman RB. In vitro comparison of the effect of parallel and divergent transfixation pins on breaking strength of equine third metacarpal bones. Am J Vet Res. 1994;55(9):1327-1330.

14. Vogel SR, Anderson DE. External skeletal fixation of fractures in cattle. Vet Clin North Am Food Anim Pract. 2014;30(1):127-42, vi.

15. Marsh D. Concepts of fracture union, delayed union, and nonunion. Clin Orthop Relat Res. 1998;(355 Suppl)(355 Suppl):S22-30.

16. Adams SB, Fessler JF. Treatment of radial-ulnar and tibial fractures in cattle, using a modified thomas splint-cast combination. J Am Vet Med Assoc. 1983;183(4):430-433.

17. Tulleners EP. Metacarpal and metatarsal fractures in dairy cattle: 33 cases (1979-1985). J Am Vet Med Assoc. 1986;189(4):463-468.

18. Ahern BJ, Richardson DW, Boston RC, Schaer TP. Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006). Vet Surg. 2010;39(5):588-593.

19. Brianza S, Brighenti V, Boure L, Sprenger V, Pearce S, Schwieger K. In vitro mechanical evaluation of a novel pin-sleeve system for external fixation of distal limb fractures in horses: A proof of concept study. Vet Surg. 2010;39(5):601-608.

20. Matthews LS, Green CA, Goldstein SA. The thermal effects of skeletal fixation-pin insertion in bone. J Bone Joint Surg Am. 1984;66(7):1077-1083.

21. Aro HT, Markel MD, Chao EY. Cortical bone reactions at the interface of external fixation half-pins under different loading conditions. J Trauma. 1993;35(5):776-785.

22. Lescun TB, Baird DK, Oliver LJ, Adams SB, Hawkins JF, Moore GE. Comparison of hydroxyapatite-coated and uncoated pins for transfixation casting in horses. Am J Vet Res. 2012;73(5):724-734.

23. Nutt JN, Southwood LL, Elce YA, Nunamaker DM. In vitro comparison of a novel external fixator and traditional full-limb transfixation pin cast in horses. Vet Surg. 2010;39(5):594-600.

24. Elce YA, Southwood LL, Nutt JN, Nunamaker DM. Ex vivo comparison of a novel tapered-sleeve and traditional full-limb transfixation pin cast for distal radial fracture stabilization in the horse. Vet Comp Orthop Traumatol. 2006;19(2):93-97.

25. Brianza S, Vogel S, Rothstock S, Thalhauser M, Desrochers A, Boure L. Comparative biomechanical evaluation of a pin-sleeve transfixation system in cadaveric calf metacarpal bones. Vet Surg. 2013;42(1):67-74.

26. Williams JM, Elce YA, Litsky AS. Comparison of 2 equine transfixation pin casts and the effects of pin removal. Vet Surg. 2014;43(4):430-436.

27. Joyce J, Baxter GM, Sarrafian TL, Stashak TS, Trotter G, Frisbie D. Use of transfixation pin casts to treat adult horses with comminuted phalangeal fractures: 20 cases (1993-2003). J Am Vet Med Assoc. 2006;229(5):725-730.

28. Lescun TB, McClure SR, Ward MP, et al. Evaluation of transfixation casting for treatment of third metacarpal, third metatarsal, and phalangeal fractures in horses: 37 cases (1994-2004). J Am Vet Med Assoc. 2007;230(9):1340-1349.

29. Hoblet KH, Weiss W. Metabolic hoof horn disease. claw horn disruption. Vet Clin North Am Food Anim Pract. 2001;17(1):111-27, vi-vii.

30. van Amstel SR, Shearer JK. Abnormalities of hoof growth and development. Vet Clin North Am Food Anim Pract. 2001;17(1):73-91, vi.

31. Virgin JE, Goodrich LR, Baxter GM, Rao S. Incidence of support limb laminitis in horses treated with half limb, full limb or transfixation pin casts: A retrospective study of 113 horses (2000-2009). Equine Vet J Suppl. 2011;(40):7-11. doi(40):7-11.

32. Jensen MB, Pedersen LJ, Munksgaard L. The effect of reward duration on demand functions for rest in dairy heifers and lying requirements as measured by demand functions. Applied Animal Behaviour Science. 2005;90(3-4):207-217.

33. Leach KA, Whay HR, Maggs CM, et al. Working towards a reduction in cattle lameness: 1. understanding barriers to lameness control on dairy farms. Res Vet Sci. 2010;89(2):311-317.

34. Fabian J, Laven RA, Whay HR. The prevalence of lameness on new zealand dairy farms: A comparison of farmer estimate and locomotion scoring. Vet J. 2014;201(1):31-38.

Value Added Services and Other Assorted Tid-Bits

Eric M. Shaver, DVM East Holmes Veterinary Clinic

Ohio Dairy Vets 2018

A re-visit of ideas “stolen” from others

KIS testing Compounded bulk fluids Milk cultures- changing thoughts

KIS- kidney inhibition swab

KIS- costs/time Instrument cost: $231.00 Cost per test: $4.28 Time investment: 20 minutes set up / 4 hour

run time Potential uses: ELDU {listeriosis ex.}, chronically

ill patients Peace of mind Draw-back: “caution” –vs- legal threshhold

Bulk Fluids for Large Animals Controversial May be the only alternative for many of our client’s

stock Uses: colics, RTAs, cecal torsions, mesenteric

torsions, scouring calves, emphysematous C-sections, TRP retrievals, esophageal/pharyngeal injuries, myositis

Scouring calves & colics primarily

Bulk Fluids

Ringer’s salts Physiologic saline Bicarb solution Physiologic dextrose WCVM formula +/- additives

Ringer’s Salts Compounded by

Ritzman Pharmacy a local chain

Cost:$2.99 Lactate no longer

available in powder format

1 jar is added to 5 gallons of distilled water

Physiologic Saline

Used mainly in equine myositis cases

1 liter hyper-tonic saline added to 2 gallons of distilled water approximates physiologic saline

Physiologic Bicarb Solutions

Scouring calves primarily

40ml of baking soda added to 1 gallon of distilled water approximates physiologic bicarb

Physiologic Dextrose

Hypoglycemic calves primarily

400ml of 50% dextrose added to 1 gallon of distilled water approximates 5% dextrose solution

WCVM Formula

NaCl 15g KCl 4g NaHCO3 30g 50% Dextrose 100ml Qs 1 gallon distilled water

Or substitute 11g NaCl plus 8g lite salt for the

NaCl and KCl above

Fluid additives Aminoplex CMPK DMSO Lidocaine etc

Milk Cultures

In-house ODA Petlabs-Richfield, OH

In-house milk cultures & sensitivities

Spectrum Mastitis System

Mueller-Hinton Discs

In-house milk cultures & sensitivities

“Rapid” turn-around time Accuracy concerns Sensitivity concerns Bulk tank concerns Cost- plates: $5.90 each Cost- labor: 30 minutes

In-house milk cultures & sensitivities

Ohio Department Of Agriculture Milk cultures & sensitivities

Accurate Slow turn-around Sensitivity concerns Costly: ODA: $20 UPS: $12 Accession: $5

Pet-Labs aerobic cultures Erhardt Bell, DVM- microbiologist as well Phone lab: 440-327-2062 Phone Erhardt cell: 440-465-3392 Courier pick-up Mon-Sat Accurate Cost $12.00 CDC sensitivities- relevance to food animal?

Pet-Labs aerobic milk culture

DVM Rapid Test

Semen Counter equine, canine, bovine IgG- equine, camelid, bovine Cost- $1495.00 Cost- Foal IgG $12.00 Camelid IgG $13.33 Sperm Concentration $12.66 Time: 10 to 20 minutes

Equipment Rental Service

Upsi-daisy Hip lifts Slings Belly bands Callicrate banders Chute

Require a deposit Charge a fee for Upsi-daisy and

chute Must track & log location or

they quickly get forgotten

Down Cow Profile Calcium Phosphorous GGT Magnesium CK +/- electrolytes Pull prior to 2nd treatment

and held in event of response failure

Many clients trained to pull themselves

EHVC Fleet Maintenance Program

Oil change every 4000-4500 miles 2 at Quick Lube 3rd at the mechanics A thorough “physical” is performed Minor issues adressed at oil change Larger issues scheduled before a “failure” occurs Consumes ½ day or so More expensive?

EHVC Fleet Purchase Program

On-line dealer auction Auction rates vehicles and declares “finds” Target auctions catering to the sale of

government surplus or fleet lease vehicles due to better maintenance records

Discrepancies are negotiable

EHVC fleet purchase program Requires individual with dealer’s license- in our case

that is our mechanic Fee- $1500 Delivery- additional Color & style easy to choose Able to refine some options as well easily Can research available vehicles ahead of the auction

to establish a max bid Many auctions publish expected sale bid

Fleet purchase formula

[{New$ + Tax} – Residual$]/Life Miles= $/mi $43K + 7% - 5K / 200K = $0.205/mi [{Used$ +$1500 +Shipping + Tax} –

Residual$]/200K – Odometer=$/mi [{$27,750 + $1500 + $440 +2058.08} -5K/

(200,000 -3710)mi = $0.136/mi

The Current “Fleet”

Fleet purchase examples 2012 Dodge Mini Cargo Van-114K: $4300 2013 Chevy ¾ Ton Crew Cab- 4K: $27750 2014 Dodge Mini Cargo Van- 110K: $5900 2012 Dodge Ram Cargo Van-109K: $6100 2013 Chevy ¾ Ton Ext Cab- 99K: $17000 2014 GMC ¾ Ton Crew Cab- 97K: $16600

EHVC Fleet Program

Significant savings in cash out-lay for vehicles

Our mechanic is also our dealer

May accelerate repair timeline

Less anxiety over oopses

EHVC Pick-up & Delivery Service Pick-ups: KIS samples, milk

cultures, down-cow profiles, sheep & goat c-sections, flat calves & foals for fluids/plasma, colicy foals for surgery

Primary use is for commercial kennel

Deliveries: supplies & drugs, hip-lifts, Upsi-daisies, slings

Also can serve as a temporary practice vehicle if a truck is down

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Antimicrobial Stewardship on Dairy Farms

Greg Habing, DVM, PhD, DACVPMAssistant ProfessorHabing.4@osu.edu

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Antimicrobial Stewardship on Dairy Farms

• The overall goal is to use less antibiotics

• On dairy farms, antimicrobials primarily applied for treatment of disease

• Farm workers have an important role in decision making

Antimicrobial Stewardship on Dairy Farms

Should the focus be on prevention or accurate disease identification?

What are the barriers to reduced use?

Could worker‐directed stewardship education have an impact on antimicrobial resistance?

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Treatment protocols

Who?          (Accurate case identification)

With what? (Type/dose/route)

Farm worker directed Antimicrobial Stewardship Education• Our overall goal is to reduce antimicrobial use while maintaining animal health and producer profitability.

• 4‐year USDA funded project

• Collaboration between investigators at OSU and UC Davis

• Proactive and industry‐led approaches are more likely to be effective.

What we’re planning to do….

Survey farm personnel and veterinarians1. Identify case definitions among treaters2. Identify potential barriers to reduced antimicrobial use3. Quantify the potential for reduction in AMU through refined case 

definitions.Create and test an intervention

1. Create worker‐directed antimicrobial stewardship education2. Test the impact on worker knowledge, attitudes, and practices3. Test the impact on quantified antimicrobial use and antimicrobial resistance

Disseminate the results through the Veterinary Extension Program

Farm worker directed Antimicrobial Stewardship Education

Practitioner involvement at all phases• Survey design• Farm recruitment• Developing and implementing stewardship education

Questions? Feedback?habing.4@osu.edu

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Joe Lozier, DVMFarm Animal Surgery ResidentThe Ohio State University

Stifle Stabilization in Cranial Cruciate Ligament Rupture in Cattle

Introduction▪ 21% of stifle lameness due

to CCL rupture (Ducharme et al, 1985)

▪ Likely underdiagnosed

▪ Results in – Increased recumbency– Decreased weight gain– Decreased milk production– Reluctance of bulls to breed– Infertility

https://i.ytimg.com/vi/kIuazftgzBc/maxresdefault.jpg

CCL Rupture: Diagnosis

Signalment and history▪ Bulls present secondary to

severe osteoarthritis– “Straight hock” conformation

▪ Cows present secondary to acute trauma

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwj31oGTqcrVAhUr0oMKHa3UDGQQjRwIBw&url=https%3A%2F%2Fwww.britannica.com%2Fanimal%2FAngus-breed-of-cattle&psig=AFQjCNErIwJCxFBgnn9czaLw-a9aiVjQPw&ust=1502373691214590, https://www.google.com/imgres?imgurl=https%3A%2F%2Fmedia1.britannica.com%2Feb-media%2F39%2F76939-004-

2CE56C26.jpg&imgrefurl=https%3A%2F%2Fwww.britannica.com%2Fanimal%2FAngus-breed-of-cattle&docid=7lutvOT9ESq3MM&tbnid=Y4n-oyXincMkCM%3A&vet=10ahUKEwjQm8OiqMrVAhVm4oMKHdaFBA8QMwjzASgBMAE..i&w=550&h=338&bih=523&biw=1138&q=angus%20bull&ved=0ahUKEwjQm8OiqMrVAhVm4oMKHdaFBA8QMwjzASgBMAE&iact=mrc&uact=8

Physical exam findings▪ Acute: non-weight bearing

lameness with effusion

▪ Chronic: partially weight bearing

▪ Crepitus may be heard and felt

▪ Drawer sign

Pentacost, Vet Clin Food Anim 30 (2014) 265–281

Desrochers, Vet Clin Food Anim 33 (2017) 251–270

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Radiographs▪ Intercondylar eminence

overlapped by the condyles

▪ Tibia will be displaced cranially in lateral– Intercondylar eminence cranial

to the femoral condyles– DJD

Pentacost, Vet Clin Food Anim 30 (2014) 265–281

Cattle with low perceived value▪ Untreated

– Poor prognosis – Will progressively worsen – Loss of condition and atrophy

musculature of the effected limb– Breakdown in the contralateral

limb– Inability to rise

▪ Slaughterhttps://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi0942RvMrVAhUE9YMK

HU9kCh8QjRwIBw&url=http%3A%2F%2Fwww.county-vets.co.uk%2Fveterinary-services%2Ffarm-animals%2Fcattle%2Flameness%2F&psig=AFQjCNHVw76MFgbyFuANH4jZCZAybUIuzQ&ust=1502379012382573

Surgical therapiesImbricationNon-anatomic reconstruction, “over-the-top”Anatomic reconstruction

Considerations▪ Ultimate tensile load of a

CCL 1.5x BW (Moss et al, 1980)

▪ Mean rupture force CCL of 4,541N (Niehaus et al, 2013)

▪ Tension and motion over the surgical site

▪ High risk of catastrophic failure

Niehaus, AJVR, Vol 74, No. 3, March 2013

Stifle imbrication▪ Aim = stabilize the stifle with fibrous

tissue delay DJD▪ Advantages of this procedure

– Does not enter joint less risk of catastrophic failure

– Short procedure time – Technically easy to perform – No need for special equipment or implants

▪ Prognosis for satisfactory outcome 59% – Poor outcome >2 month chronicity (Nelson e al, 1982)

▪ Less effective at higher weights (

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Anatomic Reconstruction▪ Complications similar to

gluteobiceps graft

▪ Nylon cords used currently

▪ 66.7% reported success rate in cows (n=9)

http://www.newswise.com/images/uploads/2008/03/27/fullsize/3__cow_milked.jpg

Current ResearchTheoryMaterials/MethodsIsometryIn Vivo

Theory▪ Inspired by canine

extracapsular techniques– Lateral suture– “Tightrope”

▪ Remain outside the joint– Reduce risk of catastrophic

failure

▪ Current extracapsular technique– Imbrication– Not effective for high weights

▪ Cattle lack a fabella, bone anchors won’t be strong enough– Bone tunnels with a loop

Materials▪ 900 lb-test nylon leader line

with stainless steel crimps

▪ 2, 3, and 4 crimps loaded to failure– Rupture– Crimp slip– Max elongation 70mm

ResultsConfiguration (n=12)

Force to failure (N)

Elongation (cm) AUC(NM)

Mechanism of failure

Knot 1205.4 ± 203.1 7.0 69.9 ± 20.8 Max elongation

2 Crimps 2472.8 ± 429.8 3.64 ± 0.18 38.1 ± 5.3 9 break, 3 slip

3 Crimps 3636.2 ± 568.9 4.08 ± 0.29 56.3 ± 10.9 8 break, 4 slip

4 Crimps 3806.8 ± 1038.5 4.11 ± 0.78 60.0 ± 23.7 11 break, 1 slip

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Results▪ Data normally distributed

▪ One-way ANOVA to compare means

▪ Elongation: No statistical difference

▪ Force to failure: Significant difference between 2 crimps and 3 crimps, and 2 crimps and 4 crimps

▪ No difference between 3 crimps and 4 crimps

Isometry▪ Cadaveric limb in range of

motion– 180°, 135°, 90°, 65°, and 35° of

flexion

▪ Metallic beads

▪ Optimum isometric points– Lowest elongation- 1.1cm– Femoral point never cranial to

tibial point

Isometry▪ 3-D problems

– Only accounted for cranial/caudal

▪ Did not account for lateral movement– Lateral epicondylar flair– Fibula– Extensor groove

▪ Adjustment of tunnels– Possible due to looped nature

L LM M

Medial Lateral

In vivo testing▪ 8 apparently healthy cows

– 4 extracapsular stabilization– 4 control

▪ Cranial cruciate ligament transected

▪ Loop placed with 3 crimps at proposed location

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In vivo testing▪ Lameness subjectively

scored once per week– Blinded observers

▪ Lameness objectively scored at 3 time points– Prior to surgery– After surgery– After 3 months

Results▪ Data not normally distributed (Kolmogorov-Smirnov)

▪ Kruskal-Wallis: no difference between groups

Objective Lameness ScoresDistribution of Weight

Prior to Surgery 1 Day Post-Op 3 Months Post-Op

Hind end: Total weight 42.3% 41.2% 40.0%

Stabilized right stifle:Hind end

39.5% 10.9% 18.5%

Control right stifle: Hind end

43.2% 23.4% 25.0%

Discussion▪ Approach involved incising lateral femoropatellar ligament

– 100% medial luxation rate- affect on lameness

▪ Not naturally occurring disease

▪ Ideal material?– None of the sutures were intact at 3 months– Is this long enough

References

1. Desrochers A. Diagnosis and prognosis of common disorders involving the proximal limb. Vet Clin North Am Food Anim Pract. 2017;33(2):251-270.

2. Terrell SP, Reinhardt CD, Larson CK, Vahl CI, Thomson DU. Incidence of lameness and association of cause and severity of lameness on the outcome for cattle on six commercial beef feedlots. J Am Vet Med Assoc. 2017;250(4):437-445.

3. Ducharme NG, Stanton ME, Ducharme GR. Stifle lameness in cattle at two veterinary teaching hospitals: A retrospective study of forty-two cases. Can Vet J. 1985;26(7):212-217.

4. Crawford WH. Intra-articular replacement of bovine cranial cruciate ligaments with an autogenous fascial graft. Vet Surg. 1990;19(5):380-388.

5. Bartels JE. Femoral-Tibia1 osteoarthrosis in the bull: I. clinical survey andradiologic interpretation. Journal of the American Veterinary Radiology Society. 1975;16(5):151-158.

6. Persson Y, Soderquist L, Ekman S. Joint disorder; a contributory cause to reproductive failure in beef bulls? Acta Vet Scand. 2007;49:31.

7. Budras K. Bovine anatomy: An illustrated text. [English] ed. Hannover, Germany: Schl©ơtersche; 2003:138.

8. Dyce KM, Sack WO, Wensing CJG. Textbook of veterinary anatomy. 4th ed. St. Louis, Mo.: Saunders/Elsevier; 2010:834.

9. Nelson D, R. Surgery of the stifle joint in cattle. The Compendium on Continuing Education for the Practicing Veterinarian. 1983;5(6).

10. Desrochers A, St-Jean G, Cash WC, Hoskinson JJ, DeBowes RM. Characterization of anatomic communications between the femoropatellar joint and lateral and medial femorotibial joints in cattle, using intra-articular latex, positive contrast arthrography, and fluoroscopy. Am J Vet Res. 1996;57(6):798-802.

11. Huhnd JC, Kneller SK, Nelson DR. Radiographic assessement of cranial cruciate ligament rupture in the dairy cow. Veterinary Radiology. 1986;27(5):184-188.

12. Ducharme NG. Stifle injuries in cattle. Vet Clin North Am Food Anim Pract. 1996;12(1):59-84.

13. Fubini SL, Ducharme NG. Farm animal surgery. Second ed. St. Louis, Missouri: Elsevier; 2017:384-387, 403-405.

14. Pentecost R, Niehaus A. Stifle disorders: Cranial cruciate ligament, meniscus, upward fixation of the patella. Vet Clin North Am Food Anim Pract. 2014;30(1):265-81, vii-viii.

15. Nichols S, Anderson DE. Determination of the normal arthroscopic anatomy of the femoropatellar and cranial femorotibial joints of cattle. Can Vet J. 2014;55(3):232-239.

16. Moss EW, Ferguson TH. Tensile strength of the cranial cruciate ligament in cattle. Am J Vet Res. 1980;41(9):1408-1411

1/8/2018

6

References

▪ 17. Niehaus AJ, Anderson DE, Johnson JK, Lannutti JJ. Comparison of the mechanical characteristics of polymerized caprolactam and monofilament nylon loops constructed in parallel strands or as braided ropes versus cranial cruciate ligaments of cattle. Am J Vet Res. 2013;74(3):381-385.

▪ 18. Nelson DR, Koch DB. Surgical stabilisation of the stifle in cranial cruciate ligament injury in cattle. Vet Rec. 1982;111(12):259-262.

▪ 19. Hofmeyr CF. Reconstruction of the ruptured anterior cruciate ligament in the stifle of a bull. Veterinarian. 1968;5(2):89-92.

▪ 20. Hamilton GF, Nelson AW. The fate of autoplastic and alloplastic implants in the bovine stifle joint. Can Vet J. 1970;11(10):209-214.

▪ 21. Hamilton GF, Adams OR. Anterior cruciate ligament repair in cattle. J Am Vet Med Assoc. 1971;158(2):178-183.

▪ 22. Wren G. Wildcat power cord gives cattle a 'leg up'. Farm Journal, Inc. 2011.

▪ 23. Moss EW, McCurnin DM, Ferguson TH. Experimental cranial cruciate replacement in cattle using a patellar ligament graft. Can Vet J. 1988;29(2):157-162.

24. Prades M, Grant BD, Turner TA, Nixon AJ, Brown MP. Injuries to the cranial cruciate ligament and associated structures: Summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses. Equine Vet J. 1989;21(5):354-357.

25. Auer JA, Stick JA. Equine surgery. 4th ed. St. Louis, Mo.: Elsevier/Saunders; 2012:1036, 1047-1054.

26. Rich FR, Glisson RR. In vitro mechanical properties and failure mode of the equine (pony) cranial cruciate ligament. Vet Surg. 1994;23(4):257-265.

27. Sprecher DJ, Hostetler DE, Kaneene JB. A lameness scoring system that uses posture and gait to predict dairy cattle reproductive performance. Theriogenology. 1997;47(6):1179-1187.

28. Chapinal N, de Passille AM, Rushen J, Wagner S. Automated methods for detecting lameness and measuring analgesia in dairy cattle. J Dairy Sci. 2010;93(5):2007-2013.

29. Neveux S, Weary DM, Rushen J, von Keyserlingk MA, de Passille AM. Hoof discomfort changes how dairy cattle distribute their body weight. J Dairy Sci. 2006;89(7):2503-2509.

30. Nuss K. Plates, pins, and interlocking nails. Vet Clin North Am Food Anim Pract. 2014;30(1):91-126, vi.

Questions?

DA & OB Outcomes at Dairy Vet & Management Services

Goshen, Indiana

Shaw Perrin DVM (Ohio State 2010)

Describe: Why and how we’ve been tracking DA &

OB outcomes at a multi-DVM dairy practice in northern Indiana.

And results so far.

Summer of 2010…

Robert Zell, DVM Purdue ‘72

38

48

58

68

78

88

98

108

Jan Feb March April May June July Aug Sept Oct Nov Dec

DAs by Month

2014 2015 2016 2017

Old Method, Feb 2014 to Feb 2016 • Handwritten record on invoice • Entry into excel by receptionist • Follow up phone call 2 months later

Survival by Type (490 Cases) LDA 85% (381/449) RDA 83% (24/29) RVA 33% (4/12)

DA by Lactation 650 cases 1L 29.1% 2L 23.2% 3L 47.7%

Survival by Lactation

459 cases 1L 91% (130/143) 2L 83% (85/103)

3L 82% (173/213)

Deflation

60d Survival Deflated: 72% (47/65) Not deflated 85% (323/379)

DVMS data, LDA Survival by BHB BHB 1.1 or below 76% (48/63) BHB 1.2 or above 86% (169/194)

Factors associated with survival in the herd for dairy cows following surgery to correct left displaced abomasum Jennifer L. Reynen , David F. Kelton , Stephen J. LeBlanc , Nathalie C. Newby , Todd F. Duffield

Association between β-hydroxybutyrate concentration at surgery for correction of left-displaced abomasum in dairy cows and removal from the herd after surgery. Croushore WS Jr1, Ospina PA, Welch DC, Zawisza DJ, Nydam DV.

https://www.ncbi.nlm.nih.gov/pubmed/?term=Croushore WS Jr[Author]&cauthor=true&cauthor_uid=24134585�https://www.ncbi.nlm.nih.gov/pubmed/?term=Ospina PA[Author]&cauthor=true&cauthor_uid=24134585�https://www.ncbi.nlm.nih.gov/pubmed/?term=Welch DC[Author]&cauthor=true&cauthor_uid=24134585�https://www.ncbi.nlm.nih.gov/pubmed/?term=Welch DC[Author]&cauthor=true&cauthor_uid=24134585�https://www.ncbi.nlm.nih.gov/pubmed/?term=Zawisza DJ[Author]&cauthor=true&cauthor_uid=24134585�https://www.ncbi.nlm.nih.gov/pubmed/?term=Nydam DV[Author]&cauthor=true&cauthor_uid=24134585�

94% 86%

One way to secure abomasum prior to pyloropexy

Nov. 15, 2017 JAVMA, Baird, et al Compares results from omentopexy vs. pyloropexy:

• Omentopexy had a 14% failure vs.

0% failure with pyloropexy

Incision Infection (276 responses):

No 82% (225/276) Yes 18% (51/276)

OB Tracking: Only 66 cases so far

OB cases (66 cases):

By Lact 1L 41.5% 2L 13.8% 3L 41.5%

60 day Survival, All OBs

67% (26/39)

Conclusions

•An attempt at an Outcomes Based Approach •Overall about 85% of our DAs are still milking 2-months post SX

•Better chance of survival if 1L, ketotic, not deflated, and done by Dr. Zell!

Offering Dairy Nutrition as a Service Jan. 2018Offering Ration Balancing as a Service

TPC Abstract (Lozier)VALUE ADDED SERVICESValue Added Services�and Other Assorted Tid-BitsA re-visit of ideas �“stolen” from othersKIS- kidney inhibition swabKIS- costs/timeBulk Fluids for Large AnimalsBulk FluidsRinger’s SaltsPhysiologic SalinePhysiologic Bicarb SolutionsPhysiologic DextroseWCVM FormulaFluid additivesMilk CulturesIn-house milk cultures & sensitivitiesIn-house milk cultures & sensitivitiesIn-house milk cultures & sensitivitiesOhio Department Of Agriculture�Milk cultures & sensitivitiesPet-Labs aerobic culturesPet-Labs aerobic milk cultureDVM Rapid TestEquipment Rental ServiceDown Cow ProfileEHVC Fleet Maintenance ProgramEHVC Fleet Purchase ProgramEHVC fleet purchase programFleet purchase formulaThe Current “Fleet”Fleet purchase examplesEHVC Fleet ProgramEHVC Pick-up & Delivery Service

AMR project (Habing)CCL Abstract (Lozier)DA & OB TrackingDA & OB Outcomes�at Dairy Vet & Management Services�Goshen, IndianaSlide Number 2Summer of 2010…Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8   Slide Number 10Slide Number 14Slide Number 15Slide Number 16Slide Number 17Slide Number 18Slide Number 19Survival by Type (490 Cases)�LDA 85% (381/449)RDA83% (24/29)�RVA33% (4/12)DA by LactationDeflationSlide Number 26Slide Number 28Slide Number 32Slide Number 33Slide Number 34Incision Infection �(276 responses):��No82%(225/276)�Yes18%(51/276)OB Tracking:�Only 66 cases so farOB cases (66 cases):60 day Survival, All OBsSlide Number 44Conclusions�