Ruminant Science 2012; 1(2): 195-196.

Surgical management of a Gir calf with heteropic polymelia (pygomelia) K A Gupta1 and G N Purohit2* Incharge Veterinary Hospital Toda Rai Singh (Tonk) 304505 Rajasthan 2 Department of Veterinary Gynecology and Obstetrics College of Veterinary and Animal Sciences Rajasthan University of Veterinary and Animal Sciences Bikaner Rajasthan *gnpobs@gmail.com
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Supernumerary ectopic limb(s) (SEL) is a congenital anomaly defined as the presence of an accessory limb(s) attached to one of various body regions (Rafiqul Islam et al., 2011). Heteropic polymelia involves one or two SELs and is classified as cephalomelia, notomelia, thoracomelia or pygomelia depending upon the location of the supernumerary ectopic limbs (Leipold et al., 1983; Rahman et al., 2006). Such defects have been reported in calves of various breeds including Holstein Friesian (Behrens et al., 1993; Hisbrunner et al., 2002), Hereford (Johnston, 1985) Korean (Kim et al., 2001; Alam et al., 2007; Rafiqul Islam et al., 2011) Iranian (Shojaei et al., 2007) Brahman (Fourie, 1990) and Indian (Singh et al., 1989) breeds. The defect may be seen alone (Johnston, 1985; Kim et al., 2001; Hisbrunner et al., 2002) or in combination with other developmental defects (Hossain et al., 1980; Behrens et al., 1993; Rafiqul Islam et al., 2011). Such calves may be delivered spontaneously (Kim et al., 2001; Hussein et al., 2012) or may require a cesarean section (Rafiqul Islam et al., 2011). The surgical correction of heteropic polymelia in a Gir calf delivered spontaneously is described in this report. History and Clinical Examination A day old female calf born to a 7 year old Gir cow during its second parity was presented to the veterinary hospital with a history of presence of extra limbs other than the normal limbs. The calf was delivered with slight assistance. The extra limbs were attached just below the right pin bone. The ectopic limb had two limb extensions and was attached together at the same point. The two extra (supernumerary) ectopic limbs were unequal in size. Both the ectopic limbs were attached together and joined with the body. The ectopic limb had no joint with the hip bones. Based on the findings the condition was diagnosed as heteropic polymelia (pygomelia). Surgical procedure

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The calf was secured in dorsal recumbency and the area of attachment of the ectopic limbs was prepared for aseptic surgery by shaving and scrubbing with chlorhexidine (Savlon, ICI Chemical Co.). The calf was sedated by IV administration of 10 mg of diazepam (Inj. Calmpose, Ranbaxy Pharma). Local infiltration anesthesia at the surgical site was achieved by infiltration of 20 mL of 2% lignocaine (Cadila Pharma). An elliptical incision was made just encircling the site of ectopic limb attachment. After blunt dissection of the subcutaneous tissue two major blood vessels were located supplying blood to the ectopic limbs. The vessels were carefully ligated on both the sides and excised. Blunt dissection was continued in the deeper layers and all small bleeding vessels were located and ligated using chromic catgut (2/0). The muscles and fascia joining the ectopic limbs were excised to separate the ectopic limbs. There was no bony attachment of the limb with the hip. The excised muscles were carefully sutured. Penicillin G (20 lakh IU) (Inj. Bistrepen, Alembic Pharma) was sprinkled over the surgical site and the skin was sutured with nylon sutures. Post operative care comprised of IM administration of Ampicillin (Inj. Bacipen, Alembic Pharma) 500 mg at 12 h interval and diclofenac sodium (Inj. Diclonac, Lupin Labs) 50 mg at 24 h interval for five days. The surgical site was dressed daily with antiseptics. The sutures were removed on 10 days post operative. The calf had an uneventful recovery. The ectopic limb had all the bones of a complete limb and one extra short limb with only the distal bones. Discussion The etiology for SELs and other congenital musculo-skeletal defects continues to be poorly understood although combination of genetics and environment have been considered to be possible contributors (Kim et al., 2001; Alam et al., 2007; Hussein et al., 2012). Claves with SEL can be delivered alive but may have problems in locomotion and surgical removal is suggested for aesthetic reasons (Hussein et al., 2012) or attainment of normal locomotion in calves born (Hossain et al., 1980; Singh et al., 1989; Shojaei et al., 2007; Hussein et al., 2012). Alam et al., 2007 reported the surgical removal of SELs in one female and one male calf and two adult cows of the Korean breed. In many other reports the sex of the calf was female (Leipold et al., 1983; Hiraga et al., 1987; Hussein et al., 2012) and the sex of the calf in the present report was also female and points out towards possible association of the sex of calf with the occurrence of polymelia. In a few of the recent reports (Shojaei et al., 2007; Hussein et al., 2012) radiographic evaluation of SELs was done to evaluate possible bony attachments of the ectopic limbs but the same was not possible in the present case and no bony attachments were observed. Similar to the present report Alam et al., 2007
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surgically excised the ectopic limbs in four cases without performing radiographic evaluations and the ectopic limbs had no bony attachments. Even in cases in which radiographic evaluations were done no bony attachments were recorded (Shojaei et al., 2007; Hussein et al., 2012). These observations point out that probably SELs do not have bony attachments and the attachments are usually muscular with the rest of the body although bony parts of the complete or partial limb are existent in the ectopic limb. The surgical excision described mentions a semi-circular incision at the base of the accessory limb under sedation and local infiltration anesthesia (Shojaei et al., 2007; Alam et al., 2007; Hussein et al., 2012) and the same was successfully followed in the present case. SELs are not life threatening and calves may develop as adult cows (Alam et al., 2007). The problems of locomotion (Alam et al., 2007; Hussein et al., 2012) and aesthesis in calves (Kim et al., 2001) have been mentioned but the pain and problems which an animal suffers in living his life is beyond our evaluation, thus an early surgical removal as was done in the present case prevents difficulties faced by growing calves. It was concluded that ectopic limbs in calves can be successfully removed surgically and an early removal is often helpful in an improved life for the calf.

References Alam, M.R., Lee, J.I., Lee, H.B., Ko, J.J. and Kim, N.S. 2007. Supernumerary ectopic limbs in Korean indigenous cattle: four case reports. Veterinarni Medicina. 52, 202-206. Behrens, C., Kuczka, A. and Grunert, E. 1993. An unusual combination of different organ and skeletal abnormalities in a black and white calf. Tierarztl Prax. 21, 85-87. Fourie, S.L. 1990. Congenital supernumerary ectopic limbs in a Brahman crosscalf. J. South Afr. Vet. Assoc. 61, 68-70. Hiraga, T., Abe, M. and Iwasa, K. 1987. Morphological study of bovine congenital defects in Hokkaido over the last 11 years. J. Coll. Dairy. 12, 257-268. Hisbrunner, G., Keller, C. and Dolf, G. 2002. Polymelia in a Holstein-Friesian calf. Schweiz Arch. Tierheilkd. 144, 289-291.

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Hossain, M.A., Sen, M.M. and Rahman, M.A. 1980. Teratology-new born calf with a supernumerary limb and atresia ani (case report). Vet. Med. Review. 2, 178-179. Hussein, K.El-Din., Ali, M.M. and Galal, A.F. 2012. Successful surgical treatment of a supernumerary ectopic limb in a cattle calf. European J. Vet. Med. 1, 28-35. Johnston, A. 1985. Polymelia in a Hereford-cross calf. Vet. Rec. 116, 585-586. Kim, C., Yeo, S., Cho, G., Lee, J., Choi, M., Won, C., Kim, J. and Lee, S. 2001. Polymelia with two extra forelimbs at the right scapular region in a male Korean native calf. J. Vet. Med. Sci. 63, 1161-1164. Leipold, H.W., Huston, K. and Dennis, S.M. 1983. Bovine congenital defects. Adv. Vet. Sci. Comp. Med. 27, 197-271. Rafiqul-Islam, M., Roh, Y.S., Cho, A., Park, H., Heo, S.Y., Lee, K., Lee, H.K., Lim, C.W. and Kim, B. 2011. Multiple congenital anomalies in a Korean native calf. Korean J. Vet. Res. 51, 55-59. Rahman, M.M., Khan, M.S., Biswas, D., Sutradhar, B.C. and Saifuddin, A.K. 2006. Pygomelia or supernumerary limbs in a crossbred calf. J. Vet. Sci. 7, 303-305. Shojaei, B., Masoudifard, M. and Asadi, A. 2007. Notomelia and ulnar dimelia in a calf:radiographical, anatomic aspects. Iranian J. Vet. Surg. 2, 83-87. Singh, P., Sharma, D.K., Singh, S., Bhal, S.M. and Chandna, I.S. 1989. Polymelia with atresia ani in a calf. The Indian J. Vet. Surg. 10, 62-65.

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Fig 1. Day old Gir female calf with ectopic limb (pygomelia).

Fig 2. The surgically removed ectopic limb showing one complete limb and a short limb with only the distal bones.