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CONTRIBUTOR(S): Vetstream Ltd, Roger Blowey, Louise Cox-O'Shea,

Digit amputation

Digit amputation

Digital amputation is the surgical removal of the digit/claw. With appropriate candidate selection, amputation of the digit provides pain relief, improved welfare, improved production, and often a return to almost 100% normal gait.


Digit post-amputation
©Ash Phipps

Introduction

In some cases digit amputation is classed as a salvage procedure.

Conditions that may warrant this procedure include: 

  • Penetrating injury to the hoof.
  • Deep infection of the foot.
  • Fractures/ dislocations.
  • Chronic lesions that have failed to respond to conventional treatment such as foul, and non-healing white line lesions, toe necrosis etc, where secondary digital dermatitis infection is involved.

In many cases, however, culling may be a more economically sound option, depending on the age of the cow, and should be considered. Digit amputation is not appropriate for very heavy animals or those with disease in both claws. The majority of digit amputations are carried out on hind limbs (because most cases of lameness are in hind limbs). Amputation of fore digits can also be successful. Amputation of the medial (inner) claw carries a better prognosis than amputation of the lateral (outer) claw. Many cows undergoing this procedure will respond well, be back in the herd in 4-6 weeks and go on to have a near normal existence in the herd.  

What are the objectives of digital amputation?

The main objectives are to restore normal gait, relieve pain, prevent ascending infection from conditions such as septic arthritis of the distal interphalangeal joint/sepsis, prevent spread of infection to adjacent structures, and return the animal to optimal levels of productivity.

What does the procedure involve?

This procedure must be carried out by a veterinary surgeon.

Surgery is usually performed on farm, with the animal standing in a crush. You will need to ensure a clean and sheltered area is made available for the surgery and ensure that suitable housing is ready for the patient post-operatively. Your veterinarian may clip the hair from the surgical site and will scrub and disinfect the area. A tourniquet will be applied and local anesthetic administered. 

Digit amputation involves removing the claw at the proximal interphalangeal joint or through the bone just above this joint. The veterinarian will either saw through the bone using embryotomy wire or may dissect down to the joint with a scalpel blade, before disarticulating joint and removing the claw. The edges of the wound will then be examined by your veterinarian and any diseased tissue cut away. Your veterinarian will then assess bleeding and control haemorrhage. The area is then bandaged to reduce bleeding and protect the area/ keep the area clean.

Will my veterinarian use anesthesia, pain relief and pain control?

Digit amputation is an incredibly painful procedure. Your veterinarian will control pain during the surgical procedure, but farmer and veterinarian will need to work together to ensure adequate pain relief post-operatively. Non-steroidal anti-inflammatory drugs (NSAIDs) such as meloxicam or flunixin will be used on the day of surgery and will need to be continued for a number of days post-operatively (usually 4 to 6 days). Adequate analgesia is not only essential for animal welfare, but also ensures a faster return to productivity.

What aftercare will be needed?

It is important to carefully follow the instructions that you have been given regarding after care, because each case will differ, depending on the reason for the initial claw amputation. 

Although every effort is made to maintain sterility, realistically, this is impossible in the field. Therefore, antibiotics will be necessary for these patients, usually a 5 to 7 day course of antibiotics will be prescribed.

The bandage should be checked at least daily to ensure the dressing is clean, dry and still in position. The bandage and dressing will usually be changed after 48 hours and then again after another 48 hours. After this period your veterinarian will decide whether further bandaging is required. After this the stump surface may safely be exposed to allow further granulation to occur. If you are concerned about the appearance of the bandage contact your veterinarian.

Report any excessive bleeding or odor to your veterinarian immediately.

The patient should be housed in a clean dry area after surgery and until the wound has healed. It is important that a good underfoot surface is provided as animals will struggle with rough ground. Avoid placing individuals in a situation where they need to compete for food/water, etc.

Can the animal go back in the herd?

Once fully recovered and back in the herd, these animals should go on to lead normal lives. However, it is worth paying attention to the following:

  • Minimize time spent on rough underfoot ground conditions.
  • Minimize exposure to poor hygienic conditions underfoot that may result in complicating conditions such as interdigital dermatitis, digital dermatitis and slurry heel. 
  • Avoid excessive weight gain.
  • Maintain hoof health of remaining claw and other feet with regular foot trimming and foot bathing.

Some cows will not respond to amputation as well as we would hope. In these cases, then cow may well have to be culled early, eg at the end of the lactation, or sooner if they are particularly uncomfortable.

Complications

  • Persistence or extension of ascending affection.
  • Inability to cope with single claw on affected foot. 
  • Rough ground underfoot and slatted floors can pose a problem to such cases after digit amputation. 
  • Failure to control pain despite removing claw.
  •  If, despite digit amputation, pain cannot be controlled then euthanasia will be required. 

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