36 Bovine Digit Lameness & Anatomy

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Questions and Answers

Which statement accurately distinguishes between non-infectious and infectious hoof diseases in bovine digits?

  • Non-infectious hoof diseases include conditions like sole ulcers and white line disease, while infectious diseases are caused by pathogens like _Fusobacterium necrophorum_. (correct)
  • Non-infectious hoof diseases always result from systemic conditions, while infectious diseases are localized.
  • Infectious hoof diseases are characterized by rapid onset and resolution, unlike the chronic nature of non-infectious conditions.
  • Infectious hoof diseases are primarily caused by environmental factors, whereas non-infectious diseases are always genetic.

What is the primary anatomical reason deep digital sepsis can rapidly affect multiple structures in the bovine digit?

  • Extensive interosseous ligaments allow for direct pathogen transfer.
  • The absence of synovial membranes facilitates bacterial spread.
  • A highly vascularized digital cushion promotes systemic dissemination of infection.
  • Close anatomical proximity of joints, tendons, and bursae allows infection to spread easily. (correct)

What is the MOST critical factor to consider when diagnosing deep digital sepsis (DDS) in cattle?

  • Elevated white blood cell count on a complete blood count (CBC).
  • Response to non-steroidal anti-inflammatory drugs (NSAIDs).
  • History of recent calving or other metabolic stress.
  • The presence of a draining tract near the coronary band along with severe lameness unresponsive to antibiotics. (correct)

For a dairy cow presenting with lameness, which sequence of events is MOST likely to lead to septic arthritis of the distal interphalangeal joint (DIPJ)?

<p>Sole ulceration -&gt; white line disease -&gt; septic arthritis of DIPJ (D)</p>
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Why is surgical intervention generally favored over conservative treatment for deep digital sepsis (DDS)?

<p>The architecture of the bovine digit often makes conservative treatments ineffective. (B)</p>
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What is the MOST important consideration regarding tourniquet use during regional intravenous perfusion (RIVP) in cattle?

<p>Limiting tourniquet duration to no more than 30 minutes to prevent complications. (D)</p>
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At what angle should you insert the needle, relative to the coronary band, when performing a joint lavage/arthrocentesis?

<p>60° (C)</p>
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Which surgical approach for digit removal results in increased lateral stability due to the preservation of more tissue?

<p>P2 exarticulation (B)</p>
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During a P1 amputation in a bovine digit, at what angle should the Gigli wire be seated to ensure proper bone resection?

<p>45° (D)</p>
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In a comparative study of digit amputation versus facilitated ankylosis, what factor is considered LESS important in the prognosis of facilitated ankylosis compared to digit amputation?

<p>Weight of the animal (B)</p>
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A Hereford bull presents with an interdigital fibroma. Which factor is MOST likely associated with the development of this condition in the hind limbs?

<p>Genetic predisposition combined with abnormal spreading of claws. (B)</p>
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Which statement BEST describes regional intravenous perfusion (RIVP) with antibiotics?

<p>It ensures a high concentration of antibiotics at the site of infection while minimizing systemic exposure. (B)</p>
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Which of the following systemic diseases is LEAST likely to manifest with lameness?

<p>Infectious Bovine Rhinotracheitis (IBR) (A)</p>
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The medial and lateral pouches of the fetlock joint communicate what percentage of the time?

<p>98% (A)</p>
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What structure does the common digital flexor tendon sheath communicate with?

<p>Proximal to the bifurcation (D)</p>
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What is the MAIN advantage of P1 amputation of the bovine digit?

<p>Rapid return to production and complete removal of infected structures. (D)</p>
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What is the most commonly utilized local anesthetic used in cattle for regional intravenous perfusion?

<p>Lidocaine (2%) (C)</p>
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What approach is considered the MOST common for DIP (distal interphalangeal) ankylosis?

<p>Caudal (A)</p>
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What post-operative step is MOST important to monitor following digit amputation?

<p>Blood clot removal. (B)</p>
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Which postoperative management step is MOST critical following surgical removal of an interdigital fibroma to minimize recurrence?

<p>Corrective trimming of the claws to address any abnormal spreading. (A)</p>
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In the context of digital dermatitis, which component of the infectious process is targeted by administering systemic antibiotics?

<p>Controlling secondary bacterial infections that exacerbate the primary lesion. (D)</p>
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Which of the following is the MOST significant disadvantage of digit amputation?

<p>Potential for reduced productive life. (A)</p>
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Which approach to surgical intervention is indicated when a bull intended for natural service develops a severe, non-responsive infection in the digit?

<p>Facilitated ankylosis (DIP resection). (C)</p>
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For which of the following indications would regional intravenous perfusion (RIVP) be LEAST appropriate?

<p>Treatment of cellulitis extending to the tarsus (D)</p>
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During facilitated ankylosis, following drainage and necessary debridement of surrounding structures, how should the joint be prepared for fusion?

<p>By curetting the articular cartilage to promote bone-to-bone contact. (D)</p>
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For a deep digital sepsis case that is determined to be in the early stages, the veterinarian elects to perform a tenosynoviotomy. What is the PRIMARY goal of this therapy?

<p>To provide more aggressive lavage of the tendon sheath to remove infectious material. (C)</p>
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Which of the following statements is MOST accurate regarding the prognosis of digit amputation in cattle?

<p>Lighter weight cattle (&lt; 705 lb) tend to have a better prognosis compared to heavier cattle. (C)</p>
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When performing regional limb perfusions, which of the following is a potential complication?

<p>Compartment syndrome. (B)</p>
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What type of incision is performed during a P1 amputation?

<p>U-shaped. (B)</p>
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What is the MOST likely post-surgical outcome if a 1700 lb beef cow undergoes digit amputation due to chronic deep digital sepsis?

<p>Significantly decreased longevity and compromised welfare. (C)</p>
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Which of the following statements accurately describes the relationship between the navicular bursa and the distal interphalangeal joint?

<p>The navicular bursa and the distal interphalangeal joint do not communicate. (C)</p>
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What factor dictates the correct volume of lidocaine for proximal and distal torniquet placements?

<p>Location of the torniquet placement. (D)</p>
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If, after performing a surgical procedure, a veterinarian has to re-bandage the area, how often should this be performed?

<p>Every 4-5 days. (C)</p>
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What is the MAIN etiological factor behind interdigital fibromas?

<p>Abnormal spreading of claws. (C)</p>
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What is the etiologic agent of foot rot?

<p><em>Fusobacterium necrophorum</em> (B)</p>
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What type of approach should be performed when addressing tenosynovitis nonsurgically?

<p>Needle lavage of the common digital flexor tendon sheath. (B)</p>
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Of the procedures discussed, which of the following results in the longest duration of healing?

<p>Facilitated ankylosis. (B)</p>
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Which statement accurately reflects the anatomical relationships within the bovine distal limb?

<p>The abaxial wall bears more weight compared to the axial wall. (A)</p>
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A dairy cow presents with severe lameness localized to the distal limb, characterized by diffuse swelling extending to the mid-metacarpal region and unresponsiveness to initial antibiotic therapy. Which diagnostic step would be MOST beneficial to differentiate deep digital sepsis (DDS) from other causes of lameness?

<p>Perform radiographs and/or arthrocentesis to assess joint involvement and obtain samples for culture. (A)</p>
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What is the MOST crucial reason to perform surgical intervention, such as digital amputation or facilitated ankylosis, in cases of deep digital sepsis, rather than relying solely on systemic antibiotics?

<p>The avascular nature of affected tissues and presence of necrotic material hinders antibiotic penetration and efficacy. (C)</p>
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What systemic effect is MOST likely to be observed following regional intravenous perfusion (RIVP) with a high dose of local anesthetic, if the tourniquet is prematurely released?

<p>Bradycardia and hypotension due to systemic absorption of the anesthetic. (D)</p>
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Which modification to the standard joint lavage/arthrocentesis technique is MOST important when treating a chronic septic joint with extensive fibrosis?

<p>Performing multiple entry points for lavage to enhance drainage and debridement. (D)</p>
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Which approach to digit removal is LEAST advisable if the goal is to preserve the animal's weight-bearing capacity and stability?

<p>Distal interphalangeal joint exarticulation (P3 exarticulation). (D)</p>
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What step during P1 amputation of the bovine digit is MOST crucial for minimizing post-operative complications associated with bone infection and promoting effective wound healing?

<p>Seating the Gigli wire at a 45-degree angle to ensure proper bone resection. (C)</p>
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When comparing digit amputation and facilitated ankylosis for treating deep digital sepsis (DDS) in cattle, which factor is MOST likely to influence the choice of facilitated ankylosis.

<p>The duration of herd longevity. (A)</p>
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Which aspect of interdigital fibroma etiology is MOST important to consider when implementing preventative measures in a closed herd of mixed-breed beef cattle where the condition has become increasingly prevalent?

<p>The potential for genetic predisposition, particularly in breeds like Hereford and Holstein, even in mixed-breed populations. (A)</p>
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What is the intended outcome of utilizing a high concentration of antibiotics during regional intravenous perfusion (RIVP)?

<p>To achieve therapeutic drug levels directly at the infection site while limiting systemic exposure. (D)</p>
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A veterinary clinic is located in an area where Bluetongue virus is endemic. Which statement BEST reflects the risk this disease presents to surgical interventions of the bovine digit?

<p>Bluetongue virus-induced vasculitis can compromise blood supply to the digit, complicating surgical outcomes and wound healing. (C)</p>
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Why is the medial and lateral pouch not connecting in the fetlock joint significant when addressing septic arthritis?

<p>It can make diagnosing the issue a challenge. (A)</p>
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What structure of the bovine digit is of MOST concern when performing needle lavage within the common digital flexor tendon sheath?

<p>The bifurcation. (A)</p>
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What is the MOST important advantage of P1 amputation?

<p>It completely removes infected structures. (A)</p>
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What is the volume of lidocaine MOST appropriate to infuse, for a distal torniquet?

<p>15-20 mL (C)</p>
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Which of the following is the MOST common approach utilized for DIP (distal interphalangeal) ankylosis?

<p>Caudal (B)</p>
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If a veterinarian performs a digit amputation, how often should they tell the owners to re-bandage?

<p>Every 4-5 days (D)</p>
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When addressing digital dermatitis, what is the reason for NOT using systemic antibiotics?

<p>To target Treponema spp. (D)</p>
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What is one of the MOST significant disadvantages of digit amputation?

<p>Poor cosmetic appearance. (B)</p>
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When is a tenosynoviotomy indicated to address tenosynovitis?

<p>When there is a need for more aggressive lavage. (D)</p>
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Of the procedures discussed, which results in the longest duration of healing?

<p>Facilitated ankylosis. (A)</p>
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If a bull has a planned breeding soundness exam in one month, which procedure would be MOST appropriate for an interdigital fibroma?

<p>Surgical en bloc removal. (B)</p>
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A farmer in your area calls you to say that his herd seems to be experiencing a large amount of hoof related issues. The primary complaint is the spreading of claws. Which of the following is MOST likely to be the issue?

<p>Interdigital fibroma. (D)</p>
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Which of the following correctly puts in order the steps of a digit amputation?

<p>U-shaped skin incision, Gigli wire seated at 45 degrees, wound lavage, vessel ligation, hemostatic bandage (A)</p>
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Comparing digit amputation versus facilitated ankylosis, which statement is MOST accurate?

<p>Herd longevity is longer for facilitated ankylosis. (D)</p>
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Flashcards

Primary weight bearing digits in cattle?

Primary weight bearing digits are 3 and 4 in both front and hind limbs.

Navicular bursa communication?

It does not communicate with the distal interphalangeal joint

Fetlock pouches communication?

Medial and lateral pouches of fetlock communicate 98% of the time.

Common digital flexor tendon sheath communication?

It communicates proximal to the bifurcation

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Sole ulcer definition?

A non-infectious hoof disease characterized by an ulcer in the sole of the hoof.

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White line disease?

A non-infectious hoof condition where there’s a separation or lesion in the white line of the hoof.

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Corkscrew claw definition?

A non-infectious hoof condition characterized by an abnormal twisting and elongation of the claw.

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Interdigital fibroma definition?

A non-infectious condition involving a growth of fibrous tissue between the digits.

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Interdigital necrobacillosis definition?

Infectious hoof condition caused by bacteria, leading to inflammation and necrosis of interdigital skin.

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Digital dermatitis definition?

Infectious hoof disease, also known as hairy heel warts, causing lesions and inflammation.

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Deep digital sepsis (DDS) definition?

Infection in the deeper structures of the digit, requires surgical treatment.

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DDS indicator around coronary band?

Focal, warm, asymmetric swelling around the coronary band.

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Structures affected in DDS?

Distal interphalangeal joint, distal sesamoid bone, DDF tendon, DDF tendon sheath and SDF.

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Presumptive diagnosis for DDS?

Swelling, distribution, and temperature.

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Definitive diagnosis for DDS?

Radiographs, arthrocentesis and surgical investigation.

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Septic DIPJ causes in dairy cattle?

Sole ulceration, white line disease, and extension of interdigital necrobacillosis.

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Septic DIPJ causes in beef cattle?

Subsolar abscess, penetrating wounds, and extension of interdigital necrobacillosis

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Surgical intervention for bovine digit?

Local debridement, drainage, lavage, digit amputation & facilitated ankylosis.

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Regional intravenous perfusion?

Using local anesthetic with 2% lidocaine in cattle to provide complete anestheia distal to tourniquet.

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Regional intravenous perfusion indication?

Arthrocentesis, digit amputation, interdigital fibroma removal, and debridement of lesions.

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Complications associated with RIVP?

Compartment syndrome, phlebitis, venous thrombosis, and local bacteremia.

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Joint lavage/arthrocentesis indication?

Acute lesion.

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Joint lavage/arthrocentesis consideration?

Procedure and approach.

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Claw preserving procedures of the digit?

Joint lavage, arthrotomy, facilitate ankylosis (DIP resection)

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Claw removing procedures of the digit?

Claw Amputation and claw disarticulation.

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Approaches involving digit removal?

P1 amputation, P2 exarticulation, and P3 exarticulation.

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Digit amputation Advantages?

Quick, inexpensive, rapid return to production, complete removal of affected tissues.

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Digit amputation disadvantages?

Poor cosmetic appearance, potential ↓ productive life, affects claw, weight, and environment.

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P1 amputation advantages?

Complete removal of infected structures and decreased pain.

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Exarticulation advantages?

Lateral stability increased by leaving more tissue.

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P1 amputation pre-op steps?

Give systemic antibiotics, Bier block, sterile preparation.

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P1 amputation intra-op steps?

U-shaped skin incision, Gigli wire at 45°, wound lavage, vessel ligation hemostatic bandage.

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P1 amputation post-op steps?

First bandage change, blood clot removal, Re-bandage every 4-5 days.

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Likelihood of good recovery after amputation?

71.4% in cattle weighing < 705 lb and 27.3% in cattle weighing >1500 lb.

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Facilitate ankylosis steps?

Drain infection, Debride joint, Remove articular cartilage, Stabilize joint.

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DIP ankylosis approach?

Dorsal, Abaxial, Axial and Caudal - most common.

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Tenosynovitis Non-Surgical treatment plan?

Needle lavage of common digital flexor tendon sheath and acute cases.

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Tenosynovitis surgical treatment plan?

Tenosynoviotomy and tenectomy

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Digit amputation statistics?

Duration of healing- 4-6 weeks, Prognostic factors- Digit and Weight. Herd Longevity 15-17 months

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Facilitated ankylosis statistics?

Duration of healing- 7-12 months,, Prognostic factors- Weight/size not as important and digit not important. Better long-term results 18-22 months

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Interdigital fibroma Etiology?

Abnormal spreading of claws, Genetic (Hereford, Holstein). Male>female and Hind limbs>fore limbs

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Interdigital fibroma diagnoses?

Non-painful proliferative tissue within the inter digital space but Can become painful

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Interdigital fibroma treatment?

Surgical en bloc removal

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Study Notes

  • This lecture outlines lameness evaluations in bovine digits, diseases, and surgical procedures.

Normal Bovine Distal Limb Anatomy

  • The main weight-bearing digits in the front and hind limbs should be assessed.

Relevant Articular Anatomy

  • The navicular bursa does not communicate with the distal interphalangeal joint.
  • Medial and lateral pouches of the fetlock communicate around 98% of the time.
  • The common digital flexor tendon sheath communicates proximal to the bifurcation.

Diseases of Bovine Digit

  • Non-infectious hoof diseases include subsolar abscesses, sole ulcers, white line disease, vertical wall cracks, interdigital fibromas, penetrating foreign bodies, and P3 fractures.
  • Infectious hoof diseases include digital dermatitis ("hairy heel warts"), interdigital necrobacillosis ("foot rot"), and systemic ailments with lameness.
  • Systemic ailments with lameness include vesicular stomatitis, BVDV (mucosal disease), malignant catarrhal fever, blue tongue virus, and foot and mouth disease.
  • Solar lesions due to penetrating foreign bodies are problematic due to pedal osteitis or infection of P3.

Deep Digital Sepsis (DDS)

  • Indicators include focal, warm, asymmetric swelling around the coronary band as well as diffuse, warm, symmetric swelling extending to the mid-metacarpal/metatarsal region, and severe lameness unresponsive to antibiotic treatment.
  • Closely associated anatomic proximity and uncontrolled foot infection directly lead to infection of: distal interphalangeal joint, distal sesamoid bone and bursa, deep digital flexor tendon (DDF), DDF tendon sheath, and superficial digital flexor tendon (SDF).
  • Presumptive diagnoses of DDS include swelling, distribution, temperature, and lameness severity.
  • Definitive diagnoses include radiographs, arthrocentesis, and surgical investigation.
  • Structures commonly affected: distal interphalangeal joint and the tendon sheath.
  • Sole ulceration, white line disease, and extension of interdigital necrobacillosis are most common cause of septic arthritis of DIPJ in dairy cattle
  • Subsolar abscess, penetrating wounds, and extension of interdigital necrobacillosis are the most common cause of septic arthritis of DIPJ in beef cattle.
  • Deep digital sepsis should be treated surgically, as conservative treatment is often ineffective.

Surgical Interventions

  • Surgical interventions include local debridement, drainage, lavage of affected structures, digit amputation, and facilitated ankylosis.
  • Local anesthetics with 2% lidocaine are common in cattle for regional intravenous perfusion and provide complete anesthesia of the limb distal to the tourniquet.
  • Regional intravenous perfusion has a rapid onset (5-10 min) and should not last more than 30 minutes.
  • Regional intravenous perfusion is indicated for arthrocentesis, digit amputation, facilitated ankylosis, interdigital fibroma removal and debridement of lesions like subsolar abscess, pedal osteitis, retroarticular abscess.
  • Proximal tourniquet placement involved 30mL of lidocaine.
  • Distal tourniquet placement involves 15-20 mL of lidocaine.

Regional Intravenous Perfusion (RIVP)

  • RIVP with antibiotics allows for a high concentration of drug at the infection site.
  • RIVP with antibiotics minimizes systemic exposure.
  • Limitations concern food animals and the availability of few drugs.
  • 2.2 mg/kg of florfenicol (300 mg/mL) can be used
  • 1.5 g ampicillin sulbactam reconstituted in 3.2 mL sterile H2O or 0.9% NaCl can be used.
  • Complications associated with RIVP reported in cattle include compartment syndrome, phlebitis, venous thrombosis distal to the tourniquet, and local bacteremia.

Joint Lavage/Arthrocentesis

  • Indications include acute lesions.
  • A Bier Block is the procedure.
  • Use an 18g (1.5 in) needle with a 60° angle dorso-proximal to the coronary band.
  • Placement of the needle should be axial or abaxial to the extensor tendon.

Procedures of the Digit

  • Claw preserving procedures are joint lavage, arthrotomy, and facilitate ankylosis (DIP resection).
  • Claw removing procedures are claw amputation and claw disarticulation.
  • The types of surgical approaches for digit removal include P1 amputation, P2 exarticulation, and P3 exarticulation.

Digit Amputation

  • The pros include a quick and relatively inexpensive procedure with rapid return to production, as well as complete removal of affected tissues.
  • The cons include poor cosmetic appearance and a potential decrease in productive life, along with consideration of the claw, weight, and the environment.
  • P1 amputation has the advantages of complete removal of infected structures and decreased pain.
  • Exarticulation at the proximal and distal interphalangeal joint allows for lateral stability increased by leaving more tissue.

Digit Amputation: Pre-Op, Intra-Op, Post-Op

  • Pre-Op steps are systemic antibiotics, Bier block and sterile preparation.
  • Intra-Op steps are U-shaped skin incision, use of Gigli wire seated at 45°, wound lavage, vessel ligation, and hemostatic bandage.
  • Post-Op procedure includes 1st bandage change within 24-36 hours, blood clot removal, and re-bandaging every 4–5 days.

Digit Amputation Prognosis

  • A study determined the likelihood of good recovery in cattle weighing less than 705 lb was 71.4%.
  • A study determined the likelihood of good recovery in cattle weighing more than 1500 lb was 27.3%.
  • Bulls intended for natural service should have claw-saving procedures when possible.

DIP Ankylosis

  • Ankylosis procedures involve draining the infection, debriding the joint, removing articular cartilage, and stabilizing the joint.
  • Approaches can be dorsal, abaxial, axial, or caudal (most common).

Tenosynovitis Treatment

  • Non-surgical options are needle lavage of the common digital flexor tendon sheath in acute cases.
  • Surgical options are tenosynoviotomy (opening of the tendon sheath for more aggressive lavage) and tenectomy.

Procedure Comparison: Digit Amputation vs. Facilitated Ankylosis

  • Digit amputation has a duration of healing of 4-6 weeks, while facilitated ankylosis has a duration of healing lasting 7-12 months.
  • Prognostic factors for digit amputation include the digit and weight.
  • Prognostic factors for facilitated ankylosis are weight/size and most importantly, the digit.
  • Better herd longevity is seen with facilitated ankylosis at 18-22 months, compared to digit amputation at 15-17 months.

Interdigital Fibroma

  • Etiology can stem from abnormal spreading of claws, genetics (Hereford, Holstein), males being more prone than females, and affecting hind limbs more than forelimbs.
  • Diagnoses is non-painful proliferative tissue within the interdigital space that can become painful.
  • Treatment is surgical en bloc removal.

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