Plan of Action

Plan of action for this bull calf would include radiographs, blood work, 
bacterial culture and sensitivity and possible ultrasound examination.

Radiographs- We would need to take radiographs of the affected area, at 
least two views at 90 degree angles to each other.  The joints above and 
below the metacarpus should be included to assess their involvement and the 
degree of rotation.  We are primarily looking for a fracture in the region, 
which would be seen as a disruption in bone continuity.  One or more 
fracture lines may be present.  This has been three months since the original 
damage, so we are expecting some form of delayed union, non-union to be 
present.  Delayed union may be viable, in which case some form of bony 
callus would be present.  A non-viable delayed union may be dystrophic (no 
callus), necrotic, defect (large gap), or atrophic (loss of bone).  We want to 
also assess the degree of valgus deformity and muscle atrophy.  Other things 
we may be looking for are joint dislocation, physeal damage, and signs of 
osteomyelitis and degenerative joint disease.   

CBC- At least a CBC would be done mainly to look for signs of systemic 
involvement.  Due to the infection of the leg, bacterial sepsis is a concern.  
The pulse and respiratory rate are high, which could be a sign of sepsis.  We 
would expect an elevated white count with systemic involvement.

Culture and sensitivity-  We would want to do a culture and sensitivity of the 
infection/draining tracts to determine organisms involved and course of 
antibiotic treatment.

Ultrasound- If tendon damage is still suspected, ultrasound is much more 
sensitive to assess this type of soft tissue damage.  This step will probably 
not be necessary.