Use of Palmar Digital Neurectomy to Manage Chronic Lameness in an Adult Reticulated Giraffe (Giraffa camelopardalis reticulata)
Abstract
An 11-year-old female giraffe (Giraffa camelopardalis reticulata) with a history of excessive hoof overgrowth and white line disease has been managed for the past 4 y with nonsteroidal anti-inflammatory drugs (NSAID; flunixin meglumine 1–2 mg/kg PO SID–BID then firocoxib 0.157–0.5 mg/kg PO SID–BID), analgesics (gabapentin 3 mg/kg PO BID), nutraceuticals (FlexMax [glucosamine/chondroitin sulfate, hyaluronic acid] 1 oz PO SID and Conquer (hyaluronic acid) 0.007 ml/kg) and topical foot soaks (ZnSO4 and New-Hoof Concentrate 7.6% diluted) in addition to biannual immobilizations for aggressive hoof trims. Even with this intensive therapy, this giraffe maintained a level of lameness of 3 to 4 (using Dallas Zoo lameness scale, Table 1) and was unable to go on exhibit with the entire herd. Concerned for this animal’s quality of life, the decision was made to perform a palmar digital neurectomy to improve mobility and possibly decrease (or eliminate) the need for NSAIDs or analgesic therapy. Palmar digital neurectomy is commonly used in horses to relieve chronic pain; however, it is an uncommon procedure in bovids, though the enervation of each claw is similar to that of the equid hoof. In this case, a unilateral palmar digital neurectomy was performed using standard techniques on the right foreleg, which was the most severely affected. Within 24 h, staff reported that this animal’s lameness had improved from a 4 to a 2, and it was able to now circle to the right easily. Prior to neurectomy this giraffe would often avoid turning to the right if possible. This giraffe is currently maintaining a 2 to 3 level of lameness and the hope is to perform a similar neurectomy on the left foreleg at the next hoof trim which may normalize mobility completely. The analgesics have been discontinued and the NSAID administration dosage is currently being decreased. This appears to be the first time this procedure has been attempted in an adult giraffe and demonstrates a successful management option for those animals with unresolvable, chronic lameness of digital origin.1-4
Table 1. Dallas Zoo lameness scoring system
|
Score
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Description
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Rest analysis
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Gait analysis
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Movement in pen/exhibit
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Comment
|
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Grade 0
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Sound
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Puts even weight on all limbs
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Normal gait
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Moves around normally
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No lameness
|
|
Grade 1
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Inconsistently lame
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Normal
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Subtle occasional limp
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Freely moves with occasional lameness
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Normal posture at rest, occasional limp when moving
|
|
Grade 2
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Mildly lame
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Occasionally shifts weight or lifts lame leg
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Slight head nod or quick gait
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Moves around freely but with constant mild lameness
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Occasional change in posture, may need to exercise to see lameness
|
|
Grade 3
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Moderately lame
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Shifts weight off of leg, toe touching obvious
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Slight head nod or quick gait that is consistent and obvious, short striding
|
Mildly reluctant to move
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Abnormal posture and gait, moving slower than normal
|
|
Grade 4
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Very lame
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Holds leg off ground at rest
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Grade 3 signs, plus 3-legged lame at times
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Moderately reluctant to move, difficulty turning and making frequent stops
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Abnormal posture, deliberate steps one at a time, may have difficulty achieving urinating posture
|
|
Grade 5
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Severely lame
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Prefers to lay down, depressed
|
Grade 4 signs; inability to or very reluctant to move
|
Inability to or very reluctant to move
|
Severely poor quality of life, behavior and well-being are affected, isolation from herd
|
Literature Cited
1. Citino SB, Hall N, Easley JT, Brown MP. Surgical resolution of an avulsion fracture of the peroneus tertius origin in a giraffe (Giraffa camelopardalis reticulata). J Zoo Wildl Med. 2011;42(2):348–350.
2. Dadone L, Han S, Foxworth S, Klaphake E, Johnston MS, Barrett M. Diagnosis and Management of pedal osteitis and pedal fractures for a large herd of reticulated giraffes (Giraffa camelopardalis reticulate). Proc Am Assoc Zoo Vet; 2014.
3. Radcliffe RM, Turner TA, Radcliffe CH, Radcliffe R. Arthroscopic surgery in a reticulated giraffe (Giraffa camelopardalis reticulata). J Zoo Wildl Med. 1999;30(3):416–420.
4. Weidner E, Holland J, Trupkiewicz J, Uzal F. Severe laminitis in multiple zoo species. Vet Q. 2014;34(1):22–28.