Joints, ears, and navels! Sarah M. Depenbrock, DVM, MS, DACVIM (LAIM) Assistant Professor or Livestock Medicine, UC Davis School of Veterinary Medicine Abstract ing lymph node, heat or pain on palpation, and changes in range of motion. History or evidence of infections such as Infectious diseases of the joints, ears, and umbilicus are pneumonia, enteritis, or omphalophlebitis should raise the common diseases of the calf. Many different infectious agents concern for possible septic arthritis secondary to a bactere- can play a role in disease at these different anatomic sites. mia or septic event. Combinations of these diseases often present in the same Septic arthritis in calves typically results from hema- population of calves, and the problem can often be traced togenous spread of infectious agents.13 Although external back to inappropriate colostrum management practices. This trauma or extension from digital infections can certainly re- review provides an overview of septic arthritis, otitis, and sult in septic arthritis in calves, these are less common routes navel ill in calves as well as a brief discussion on colostrum compared to adult cattle who typically acquire septic arthritis management practices. as an extension from disease in the digit. Bacteria commonly isolated from cases of septic arthritis in calves include: Strep- Key words: septic arthritis, otitis, omphalitis, omphalophle- tococcus (coag negative), Trueperella pyogenes, Pasteurella- bitis, omphaloarteritis, urachitis ceae, Enterobacteriaceae, and Mycoplasma bovis.4,5,8 A presumptive diagnosis of septic arthritis can be made Résumé - matory testing usually includes arthrocentesis and diagnostic Les maladies infectieuses des articulations, des oreilles imaging.on the basis Arthrocentesis of physical exam is an findings extremely in someuseful cases; tool forconfir the et de l’ombilic sont communes chez le veau. Plusieurs agents diagnosis of septic arthritis in calves. In suspected cases, infectieux peuvent jouer un rôle dans la maladie à ces dif- joint effusion usually allows for relatively easy access for joint férents sites anatomiques. Différentes combinaisons de ces - maladies se présentent souvent dans la même population de propriate restraint of the animal, a sample is obtained with veaux. Des pratiques de gestion inappropriées du colostrum afluid needle aspiration. and syringe After and aseptic is examined preparation grossly of the for siteevidence and ap of sont souvent à l’origine de ces problèmes. Cet article donne decreased viscosity, cloudiness or foul odor, any of which are un aperçu de l’arthrite septique, de l’otite et des affections suggestive of septic arthritis. The diagnosis can be further de l’ombilic chez les veaux de même qu’une brève discussion supported by laboratory evaluation including cytology and des pratiques de gestion du colostrum. biochemical analysis. Cytology predominated by neutrophils or presence of bacteria in neutrophils, or increased protein Introduction concentration are all consistent with septic arthritis. Ranges Why talk about joints, ears and navels all together? They have been published.14 Culture and sensitivity can be useful all represent very common sites for infection in calves, share for prognosticatingcytologic and chemical and planning evaluation treatment. of bovine Mycoplasma synovial mustfluid several underlying infectious etiologies, and may result from be cultured using different techniques than standard culture similar management problems. and sensitivity, so the clinician usually must request Myco- plasma testing in addition to standard culture and sensitivity. Septic arthritis Mycoplasma bovis PCR is available at some laboratories and Septic arthritis is a common cause for lameness in may be a more rapid way to investigate cases of Mycoplasma calves. Often, septic arthritis is accompanied by severe bovis. If joint infection is suspected, empiric treatment should lameness, however, this is not always the case. Cases can be begin without delay, before results of culture/ sensitivity are missed, or only found when chronic, if careful examination complete. Treatment recommendations can change after re- is not performed. Reasons that lameness may be masked ceiving results if indicated. Unfortunately, culture and sensitiv- include systemic illness such that the calf is depressed, slow ity testing do not always yield positive results despite clinical moving, weak or unwilling to rise, or multiple-limb lameness evidence of sepsis in a synovial structure. The absence of bacteria on culture should not be taken as a sign that the joint is not septic. The clinical picture, gross and microscopic ap- inthat young obscures calves, the and severity thus theof lameness expected in severe each specificlameness limb. as- sociatedIt can occasionally with septic be arthritis difficult may to detectbe less pain obvious or lameness in some can all be used to determine if the joint is likely septic or not. cases. Other clinical signs that alert the clinician to possible pearanceRadiographs of joint fluid, can and also biochemical be helpful in analysis cases of of suspected joint fluid septic arthritis are joint effusion, enlargement of the drain- septic arthritis, particularly when differentiating between 80 AABP PROCEEDINGS — VOL. 53 — NO. 1 — FEBRUARY 2020 other causes of severe lameness such as a fracture. Radio- to the joint may have progressed beyond the acute phase or graphic changes associated with joint sepsis may include may have resolved by the time of diagnosis of the septic joint. increases or decreases in joint space, lytic lesions of the Additionally, if there is 1 septic joint that appears to have subchondral bone, articular destruction, osteomyelitis, or resulted from the hematogenous route, the clinician should boney/periosteal proliferation. Boney changes and joint carefully examine all palpable joints to ensure no other joints space reduction are more supportive of chronic severe infec- are affected. The prognosis for return to soundness decreases tion, while soft tissue swelling and increased joint space may as the number of affected joints increases. The location, se- be less chronic. In cases where joint effusion or increase in joint space are the sole radiographic abnormality, it is wise for return to function. to keep septic arthritis on the differential list and strongly verity, and extent of infection can all influence the prognosis Otitis changes. Radiographic changes lag behind the pathology occurringconsider arthrocentesis in these cases. to confirm, despite lack of boney occur via the Eustachian tube as may occur with an exten- Ultrasound is another useful imaging technique for sion ofOtitis respiratory in calves disease, can result via fromhematogenous multiple routes; spread it from can investigation of joint disease. This tool may be more practi- another infected site, or more rarely from the external ear cal for the ambulatory food animal practitioner who may inward as occurs in combination with ear parasites. Otitis not carry a portable radiograph machine. The linear rectal occurring from extension of respiratory disease is common in calves, and the same pathogens have been found in both an effusive joint. The best image is obtained after clipping, cases of otitis and respiratory disease including: Mycoplasma cleaning,probe can and be applicationa useful tool of examinea coupling the agent fluid such character as ultra of- bovis, Mannheimia haemolytica, Pasteurella multocida, His- sound gel or isopropyl alcohol (or obstetric lube in a pinch). tophilus somni.3,15 Joint effusion with echogenic strands or mixed echogenicity Clinical signs of otitis include ear droop, head tilt, aural discharge and may also include signs of facial nerve increase the clinician’s suspicion of joint sepsis. Ultrasound dysfunction (such as facial paralysis or signs of a corneal canmay also indicate be helpful fibrin in or locating cellular thedebris most in effusive the joint or and abnormal should ulcer from lack of blink or decreased tear production), ad- joint pouches for arthrocentesis. ditional vestibular signs, head shaking, or signs of systemic There are many options for the treatment of joint infec- illness such as fever and lack of appetite. When disease is tions in cattle. A detailed discussion on this topic is beyond bilateral, head tilt or ear droop may not be obvious because - both sides are affected. viously been published.5,13 The basic principles of treatment Diagnosis of otitis can be challenging if clinical signs are includethe scope managing of this proceedings; infection and an excellent provision reference of pain hascontrol. pre vague or discharge is not apparent. An otoscopic exam can be Treatment with systemic and local antibiotics is usually nec- performed in calves and may reveal an opaque or ruptured essary. The proceedings for regional limb perfusion from this conference discuss the provision of local antibiotics in cattle the ability to visualize the canal to the tympanic membrane. in more detail. Removal of infected debris from the joint is Thetympanic author membrane; prefers to appropriate restrain calves restraint in lateral greatly recumbency improves also imperative. In acute cases, through and through lavage of the joint using needles and sterile isotonic crystalloids may Otoscopic exam is not always practical in larger or older calves,to perform and an the otoscopic sensitivity exam; of this this techniqueusually requires for diagnosing sedation. otitis media/interna