Farm Table says:
Treatments in a randomized controlled trial
What is the problem?
Lameness is an endemic disease of the dairy industry, with claw horn lesions being some of the most prevalent. There is little in the way of experimental evidence of the most effective treatments for this type of injury. This can include sole hemorrhage, sole ulcer, and white line disease. The aim of the study was to investigate the most effective treatment protocol for these injuries.
What did the research involve?
A randomised study consisting of 5 farms in the East Midlands of the UK were recruited, which had a herd lameness prevalence of over 20%. Animals were scored for lameness when exiting the milking shed, and randomly assigned 1 of 4 treatment groups. Treatment consisted of:
- therapeutic trim only (positive control group), therapeutic trim applicable to the lesion
- therapeutic trim plus foot block, therapeutic trim applicable to the lesion and application of a foot block to the unaffected claw
- therapeutic trim plus NSAID. Therapeutic trim applicable to the lesion and administration of a 3-d course of ketoprofen (Ketodale 100 mg/mL, Richter Pharma AG) administered by deep intramuscular injection at 3 mg of ketoprofen per kilogram of BW
- therapeutic trim plus foot block plus NSAID. Therapeutic trim applicable to the lesion, application of a foot block to the unaffected claw and administration of a 3-d course of ketoprofen (Ketodale 100 mg/mL) administered by deep intramuscular injection at 3 mg of ketoprofen per kilogram of BW
After treatment, animals were re-scored for locomotion. A successful treatment at study outcome (35 days after treatment) was defined as either (1) a sound locomotion score (score 0) or (2) a non-lame score (score 0 or 1).
What were the key findings?
For treatment 1, cure rate was 24.4%, treatment 2, 35.9%, treatment 3, 28.6% and 56.1% for treatment 4. There was a significant difference between treatments 1 and 4. No imbalances in randomisation was found in the analysis.
The findings here suggest lameness cure is maximized with NSAID treatment in addition to the common practices of therapeutic trimming and elevation of the diseased claw using a block when cows are newly and predominantly mildly lame.