Management Plan

Since large animal cases are based primarily on economics, our management plan will 
depend on the financial commitment of the owner.  We will offer two options for this bull 
calf.

Our first treatment option is a closed reduction.  This will be our most expensive option 
given to the farmer.  This will be performed if the farmer is still wanting to maintain the 
bull calf for breeding purposes.  However, the farmer must be warned that the calf may 
never be sound enough for natural service therefore AI use will be likely.  We will 
recommend an external fixation with pins in order to immobilize the fracture of the 
metacarpals.  Prior to surgery, the calf will be placed on antibiotics. The culture indicated 
E.coli  and S.aureus  which are sensitive to second and third generation cephalosporins, 
amoxicillin, and gentamicin.  Initially for an immediate effect, these antibiotics will be 
administered IV for a few days and then continued for at least 6 weeks post operatively.  
The surgical technique we would like to use is a Type II external fixation device in which 
we will place three pins above and below the fracture site.  We will try to place the pins as 
far from each other as possible and stay at least 1 cm from the fracture line.  Careful 
placement of the pins will be needed to minimize further soft tissue damage of tendons, 
nerves, arteries, and veins.  The pins will be stabilized using acrylic side bars.  An acrylic 
mold will be poured into the plastic tubing side bar and allowed to harden.  This will ensure 
proper stabilization.   This is our surgical treatment of choice because it allows the 
continuation of drainage and allows the farmer access to the site for lavage and cleaning.  In 
order to maintain healthy granulation tissue around the pins, we will request that the farmer 
cleans the pins tracts daily.  The calf will be experiencing pain and inflammation post 
operatively and therefore we will prescribe  a NSAID like flunixin meglumine.  However, 
while we do want to decrease pain for the calf, we do not want the calf to bear full weight 
on the fracture site and cause further damage.  Therefore, proper dosage of analgesics is 
essential.  Monitoring the calf will include future radiographs and cultures to estimate 
healing and clearing of bacterial infection.

Our second treatment option is euthanasia.  While external fixation would be best for the 
calf, we must take into consideration the labor and financial feasibility of the farmer.  If this 
calf does not have exceptionally high value, then the farmer cannot be expected to lose 
profit over one calf.  The outlook for this calf is not promising due to the severity of the  
fracture and the systemic involvement.

We realize that transfixation pinning and casting is often used in cattle to provide support 
and diminish post-operative care.  However, we felt that this option would not serve to 
provide the drainage and necessary monitoring that an open infected wound required