title: 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.
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom. Electronic address: stxht1@nottingham.ac.uk.
authors.forename: H J
authors.initials: HJ
authors.lastname: Thomas
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: G G
authors.initials: GG
authors.lastname: Miguel-Pacheco
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: N J
authors.initials: NJ
authors.lastname: Bollard
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: S C
authors.initials: SC
authors.lastname: Archer
authors.affiliation: Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, United Kingdom.
authors.forename: N J
authors.initials: NJ
authors.lastname: Bell
authors.affiliation: Scotland's Rural College (SRUC), Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Mason
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: O J R
authors.initials: OJ
authors.lastname: Maxwell
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: J G
authors.initials: JG
authors.lastname: Remnant
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Sleeman
authors.affiliation: School of Veterinary Sciences, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom.
authors.forename: H R
authors.initials: HR
authors.lastname: Whay
authors.affiliation: School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
authors.forename: J N
authors.initials: JN
authors.lastname: Huxley
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002417:Cattle; D002418:Cattle Diseases / Q000188:drug therapy / Q000628:therapy*; D005121:Extremities; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy / Q000628:therapy / Q000662:veterinary*; D006470:Hemorrhage / Q000662:veterinary; D006724:Hoof and Claw / Q000098:blood supply; D007774:Lactation; D007794:Lameness, Animal / Q000209:etiology; D008124:Locomotion; D016015:Logistic Models; D012621:Seasons
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: claw horn lesion; dairy cow; lameness; randomized clinical trial