Effects of teat cistern mural biopsy and teatoscopy stab versus longitudinal incision with or without tube implant on incisional healing in lactating dairy cattle

Eric Tulleners From the Departments of Clinical Studies (Tulleners) and Pathobiology (Hamir), New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Rd, Kennett Square, PA 19348.

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Amir Hamir From the Departments of Clinical Studies (Tulleners) and Pathobiology (Hamir), New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Rd, Kennett Square, PA 19348.

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 BVSc, PhD

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SUMMARY

Effects of teat cistern mural biopsy and full-thickness stab and longitudinal incisional healing were evaluated experimentally on clinically normal teats in 12 lactating dairy cattle. Each teat on each cow was assigned by Latin-square design to 1 of 4 surgical interventions: (I) teatoscopy only; (II) teatoscopy, stab incision, and mural biopsy; (III) longitudinal incision and mural biopsy; and (IV) longitudinal incision, mural biopsy, and tube implantation.

Teatoscopy was done with a 4-mm od arthroscope introduced through the teat canal and attached to a television camera. Teatoscopy was quicker to perform and provided a more detailed videotaped examination of the teat and gland cistern, compared with gross inspection through a longitudinal incision. In intervention-II cows, the Ferris-Smith biopsy instrument jaws introduced through a longitudinal 1-cm midteat stab incision were easy to visualize and manipulate accurately. Stab incisions closed with only 1 or 2 skin sutures healed without complications in all 12 teats. On palpation, stab incisions were significantly (P < 0.01) less thick than longitudinal incisions at 8 weeks and were microscopically indistinguishable from the normal tissue. However, in 24 teatoscopically examined teats, 9 (38%) had microscopic evidence of teat canal injury and 12 (50%) of the quarters developed mastitis. This was attributed to trauma resulting from introduction of the arthroscope through the teat canal.

Intervention III yielded satisfactory results with the least complications. All 12 longitudinal incisions healed by primary intention, and all teats remained patent. Mastitis developed in 4 (33%) quarters.

Intervention IV caused considerable complications associated with the tube implant and no improvement in biopsy site healing, compared with interventions II and III. Eleven longitudinal incisions healed by primary intention. One incision dehisced, 2 (17%) tube implants dislodged, 2 (17%) became obstructed proximally, and irritations of the mucous membrane developed in 2 teats proximally and in 6 teats distally. Mastitis developed in 6 (50%) quarters.

Longitudinal incisions healed with moderate submucosal fibrosis. All sutured incisions had multifocal microgranulomata in which suture material was in various stages of degradation. At 8 weeks, localized teat wall thickening could be detected at incisional and biopsy sites, but did not obstruct milk flow.

Excessive granulation tissue was at the biopsy sites (72 total) at 2 weeks, and at this time, the sites were partially covered by metaplastic squamous epithelium. However, by 8 weeks, 71 (98%) of the areas were replaced by fibrous tissue with minimal protrusion into the teat cistern.

SUMMARY

Effects of teat cistern mural biopsy and full-thickness stab and longitudinal incisional healing were evaluated experimentally on clinically normal teats in 12 lactating dairy cattle. Each teat on each cow was assigned by Latin-square design to 1 of 4 surgical interventions: (I) teatoscopy only; (II) teatoscopy, stab incision, and mural biopsy; (III) longitudinal incision and mural biopsy; and (IV) longitudinal incision, mural biopsy, and tube implantation.

Teatoscopy was done with a 4-mm od arthroscope introduced through the teat canal and attached to a television camera. Teatoscopy was quicker to perform and provided a more detailed videotaped examination of the teat and gland cistern, compared with gross inspection through a longitudinal incision. In intervention-II cows, the Ferris-Smith biopsy instrument jaws introduced through a longitudinal 1-cm midteat stab incision were easy to visualize and manipulate accurately. Stab incisions closed with only 1 or 2 skin sutures healed without complications in all 12 teats. On palpation, stab incisions were significantly (P < 0.01) less thick than longitudinal incisions at 8 weeks and were microscopically indistinguishable from the normal tissue. However, in 24 teatoscopically examined teats, 9 (38%) had microscopic evidence of teat canal injury and 12 (50%) of the quarters developed mastitis. This was attributed to trauma resulting from introduction of the arthroscope through the teat canal.

Intervention III yielded satisfactory results with the least complications. All 12 longitudinal incisions healed by primary intention, and all teats remained patent. Mastitis developed in 4 (33%) quarters.

Intervention IV caused considerable complications associated with the tube implant and no improvement in biopsy site healing, compared with interventions II and III. Eleven longitudinal incisions healed by primary intention. One incision dehisced, 2 (17%) tube implants dislodged, 2 (17%) became obstructed proximally, and irritations of the mucous membrane developed in 2 teats proximally and in 6 teats distally. Mastitis developed in 6 (50%) quarters.

Longitudinal incisions healed with moderate submucosal fibrosis. All sutured incisions had multifocal microgranulomata in which suture material was in various stages of degradation. At 8 weeks, localized teat wall thickening could be detected at incisional and biopsy sites, but did not obstruct milk flow.

Excessive granulation tissue was at the biopsy sites (72 total) at 2 weeks, and at this time, the sites were partially covered by metaplastic squamous epithelium. However, by 8 weeks, 71 (98%) of the areas were replaced by fibrous tissue with minimal protrusion into the teat cistern.

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