Swollen stifle joint

[swiftdood]

About 2 weeks ago I took one of my young Angus cows to the vet that was showing extreme symptoms of lameness in her right back leg. No hoof swelling. After examination I was told that she appeared to have wrenched her stifle joint (not dislocated) and would be sore for an undetermined time. She was treated with Excede and Sustain III. There is still a distinct dwelling around the joint and she moves very slowly. It was suggested by a nutritionist/breeder friend of mine to treat her with dexamethasone. This cow is 1200lb and has a real nice 300lb heifer calf on her. How much dex should I give her and for how long.
As usual.....your advice is extremely valued.

 

[Lucky_P]

Ummm. Your nutritionist/breeder friend... are they a veterinarian? Do they have a license in your state which allows them to diagnose diseases and prescribe medications and treatment? If not, then they are 'practicing veterinary medicine without a license', and are likely in violation of your state's Veterinary Practice Act.
I'm not trying to be an @ss, but ...there are reasons that most states limit who can practice veterinary medicine.
I spent 9 years in college and veterinary school,then another 4 years in grad school + 30 years of experience... in order to be entrusted with that responsibility. I try not to raise a stink here too often, but I see a lot of 'recommendations' from folks who may or may not know what they're talking about... sometimes totally inappropriate... and that's usually when I weigh in.

Do this person know the mode of action or indications for prescribing dexamethasone?
Is this cow bred back? I would hope so, since she's got a 'nice 300 lb heifer' on her. Does your breeder friend know? - or have they advised you - that administering dexamethasone to pregnant cattle, particularly those in the third trimester, may induce parturition - essentially aborting this pregnancy?
Would you have been unhappy if you'd followed their advice, and your cow had aborted, retained her placenta, developed metritis? Would they have been willing to reimburse you for such a loss that might have occurred as a result of you following their suggestion?

My recommendation... contact and discuss this with your veterinarian...though, from what you've told us...I see no reason for this animal to have been treated with Excede or Sustain III...two antimicrobial agents, neither of which would be indicated for, or have any positive effect on a stifle injury... unless there was an infection somewhere that you've not disclosed to us.

 

[swiftdood]

Well Lucky......I really appreciate the time, effort and....dare I say money?....getting yourself through college and veterinary school. Not to mention the years of practical experience that make you a 'guru' on this forum. As for me...no....I'm not college educated. I spent 38yrs dairy farming in New Zealand before returning here to manage 2 large grass based dairies here in Texas before taking on a forage a grazing consultant's role. During my time managing here I used a lot of dexamethasone...mainly for treating cows with post-dystocia, mild forms of ketosis and even had success with some 'downer cow' victims if I got to them quickly enough. Having said that I appreciate the drug's anti-inflammatory properties. In the dairy business....a wrenched or dislocated stifle is usually the 'death knell' for the cow regardless of stage of lactation or pregnancy. I am acutely aware of the dangers of administering dexamethasone to pregnant cows or heifers and for me it would be a no-no at any stage of pregnancy. No...the cow in question is not pregnant. I bought her as a short bred cow in the spring and she called in August. I strictly fall calve here and she will not be exposed to the bull until December 10th. I too was very dubious regarding her treatment with antibiotics...but who am I???? I not a vet that charged me an exorbitant fee for the 10min exam and treatment.
After all you said on you're intro to my question Lucky, you still didn't give me an answer. In short....my question was....is there a benefit of treating the cow with dexamethasone after a stifle wrench that happened 3wks ago? If you can't or won't......that's fine. One thing is for sure though...you need to get off that high horse you ride. If you fall, you may get hurt.

 

[cow pollinater]

In nearly two decades of being a commercial breeder on large dairies I have only met one shyster that claimed to be both a breeder and nutritionist and he got ran out of CA for none other than practicing medicine without a license and in fact the last I heard he was running around in Texas. You wouldn't be dealing with "DR."Colburn would you? I've met a few that understood both but never one that was good at one or the other that did both for a living.
Both breeders and nutritionists should defer to the vet. It's okay to question the advice and talk it over with them but at the end of the day it needs to be their call. If you can't trust the vets advice then it's time to try a new vet but the ability to balance a ration and get a cow pregnant does not give anyone the knowledge to diagnose and treat cattle.

 

[milkmaid]

There was a discussion recently on stifle injuries:

viewtopic.php?f=7&t=100896

With some exceptions, I try not to make treatment recommendations without a diagnosis, something that appears to be lacking in this case.

I don't understand the question about 'how much and for how long' in regards to dexamethasone either, given how familiar you say you are with the drug...

 

[redcowsrule33]

My recommendation... contact and discuss this with your veterinarian...though, from what you've told us...I see no reason for this animal to have been treated with Excede or Sustain III...two antimicrobial agents, neither of which would be indicated for, or have any positive effect on a stifle injury... unless there was an infection somewhere that you've not disclosed to us.

I was questioning this as well.

 

[Lucky_P]

I usually opt for subtle rather than in-your-face... and y'all caught it.
There was no reason, as far as I can see, for my veterinary colleague to administer two antimicrobials to a cow with a musculoskeletal injury. And, beyond that, the two antimicrobials administered have modes of action that would work in opposition to one another - Excede only works on actively-growing bacteria; Sustain III is bacteriostatic.
That sort of stuff needs to stop...both in human and veterinary medicine... but as food animal producers are constantly under the gun and receiving bad - and often erroneous - press about antibiotic and 'hormone' use, everyone, including VETERINARIANS should stop treating these drugs like candy and only administer what is needed, when it's needed.

Guru? I don't know anything about that...I presume that rating is merely based on how many posts I've made... probably some other folks here with higher post-counts than me who know more or less about any given topic...but they're still 'guru'... whatever...

Swift...with your extensive background - and that is an education in itself, if one takes advantage of it - you may know more about the appropriateness of dex (or any other drug) than this 'nutritionist/breeder' whose name we don't know. An injection of dex or any other corticosteroid will likely make the cow feel better...will it actually 'help' in the long-term... I dunno... not having seen or laid hands on the cow, I can't say for sure...but after the antibiotic administration deal, how comfortable are you with the 'wrenched stifle joint' diagnosis?

 

[swiftdood]

Lucky....I was pretty surprised myself when the vet diagnosed a 'wrenched joint' and told his 2ic to administer the Excede and Sustain III boluses. But....he's the only game in town. We have a great set of working pens here but no chute or head gate for me to restrain a cow sufficiently enough without causing undue stress. So....I have to take cows that need foot/leg attention to this vet who has a state of the art hydraulic squeeze chute. Twice before I have had older cows that just needed a hoof trim only to have not only been trimmed but crammed full of Sustain III. My nutritionist/breeder friend (not a Dr Colburn) merely suggested dex' anti-inflammatory properties might give the cow in question some comfort. She's on the cull list regardless now.....all I want is for her to be able to continue raising her calf in relative comfort. It pains me (excuse the pun) to see any animal in discomfort. I'm pretty confident that the vet's diagnosis was on the money.....not the treatment. The cow has had 1 shot of dex so far.....as per label dose instruction....and there is an improvement in her movement. I'm going to give her another tomorrow and then let the Lord have his way.
Thanks for your input.