Chronic pain management in a dairy cow with deep digital sepsis

Abstract This case report describes a cow with a penetrating foreign body in the sole horn of its medial claw of the right forelimb, leading to sequestration and necrosis of the pedal bone and subsequent chronic pain. The surgical interventions, multimodal pain management and development of the gait pattern over more than 6 weeks are described. The cow was additionally treated with a combination of local anaesthetics, various non‐steroidal anti‐inflammatory drugs, α2‐agonists and N ‐methyl‐D‐aspartate receptor antagonists. However, none of these drugs resulted in a noticeable long‐term improvement. As an ultima ratio, a neurectomy of the distal digital nerves was performed, which led to significant improvement in weight‐bearing of the limb 6 days after neurectomy.