6/7 – Examination of Ruminant Abdomen

Question 1

Use (almost) all your senses when looking at bovine abdomen

Answer 1

• Sight: look at shape
• Hear: motility (left side most informative), right side: borborygmi, always PING on both sides
• Touch
• Smell
• (NOT taste)

Question 2

Pear shape: what might it be?

Answer 2

• Ascites
• Intestinal obstruction
• *fluid accumulation

Question 3

Reverse D shape: what might it be?

Answer 3

• Bloat
• Rumen problem

Question 4

D shape: what might it be

Answer 4

• Cecum or abomasum

Question 5

Papple shape: what might it be?

Answer 5

• Abomasal impaction

Question 6

Left side: auscultation

Answer 6

• Approximately 3 contractions/2 mins
  o Primary contractions: 30-60s, mixes contents
  o Secondary contractions: 2 mins, usually associated with eructation
• *hypo OR hypermotility significant!
  o Doesn’t necessarily mean rumen is source of problem

Question 7

Right side: auscultation

Answer 7

• Borborygmi every 15-30s
• Absence of sounds=NOT particularly diagnostic

Question 8

Changes in rumen motility: inhibitory

Answer 8

• Severe ruminal tympany
• Abomasal distension
• Pain
• Ruminal acidosis
• Peritonitis
• Fever/toxemia
• Anorexia
• Fluid covering the cardia

Question 9

Changes in rumen motility: excitatory

Answer 9

• Feeding
• Starvation
• Mild tympany

Question 10

Abnormal: ping

Answer 10

• High pitch ‘metallic’
• Gas-fluid interface, distended viscus

Question 11

Abnormal: pong

Answer 11

• Low, dull tone: base drum
• Gas accumulation (ex. rumen atony)
• *NORMAL: will sound more like a pong

Question 12

Left ping

Answer 12

• Left-displaced abomasum
• Pneumoperitoneum
• *rumen gas cap (more dorsal)
  o WILL CHANGE with rumen motility
  o *Repeat pinging a few minutes later

Question 13

Right ping

Answer 13

• Abomasum
  o RDA
  o Torsion
• Cecal dilation/torsion
• Pneumorectum
• Pneumoperitoneum
• Uterus inflammation with gas
• Intestins
  o Spiral colon anorexic cow=will change!

Question 14

Ballottement

Answer 14

• Feeling for a movable object in abdomen by feeling rebound of object following quick pushes against abdominal wall

Question 15

Succussion

Answer 15

• Simultaneous auscultation and ballottement
  o Displaced abomasum
  o Ruptured bladder
  o GI stasis/enteritis
  o Peritoneal fluid (rare)
• *”splashing sound”: fluid accumulation in a third space

Question 16

Touch

Answer 16

• Rumen contractions
• Rumen fill
• Rumen layers (TOP: gases, fibre (dense, doughy, floating due to fermentation), fluidly)
• Liver: NOT normally palpable (within costal arch, right side)

Question 17

Rectal palpation

Answer 17

• Presence of feces: volume and nature?
• Uterus
• Bladder
• Rumen: dorsal rumen sack (slightly to left)
• Left kidney: but on midline or deviated to right due to rumen
• Masses?
• Gas distension: small intestines?
• Fluid?
• Volvulus?

Question 18

How can you assess cranial abdominal pain?

Answer 18

• Pressure over xiphoid region: avoidance responses
• *withers pinch test: dipping=NORMAL
• William’s test: listen over trachea during rumen contraction

Question 19

Fecal analysis

Answer 19

• Sight and smell
  o Color, consistency, particle size, foreign material
  o *wont base diagnosis only based on look of feces
• Occult blood test
• Etiological diagnosis
  o FEC, pathogen-specific PCR, culture, toxin assay, etc.

Question 20

What are some additional tests you may do?

Answer 20

• Rumen fluid analysis
• Abdominocentesis
• Imaging: radiographs and ultrasound
• Exploratory laparotomy
• Hematology, biochemistry and venous blood gas

Question 21

Rumen fluid analysis: 2 options

Answer 21

• Oro-gastric intubation
  o Diagnostic: bloat and choke
  o Therapeutic: bloat, fluids, transfaunation
  o **Consider saliva admixture
• Per cutaneous: rumenocentesis
  o No salivary contamination
  o LDA vs. rumen (abomasal or ruminal fluid)

Question 22

Rumen fluid parameters normally

Answer 22

• Olive, brownish-green
• Slightly viscous
• Aromatic (not gross), strong odor
• pH: depends on diet or medications
• sedimentation/floatation: *slower it is=more inactive
• gram stain: should be predominant gram-negative
• **chloride concentration: help determine if an LDA (higher Cl than rumen)

Question 23

Abdominocentesis

Answer 23

• Not very sensitive
  o No fluid=does not mean you can rule it out
• Don’t do it often
  o Cattles have many ‘pockets’ of fluid=can be harder to get some
• Caudal: cranial to udder in inguinal region OR cranial: xiphoid

Question 24

Radiographs: only one indication in adult bovine when we would do it?

Answer 24

• Hardware disease
  o See between cardiac silhouette and ventral rumen sac (where reticulum is): fluid, fibrin, mass

Question 25

Exploratory laparotomy

Answer 25

• Diagnostic (& therapeutic) tool
• Go to it quicker than horses
• Standing
  o Left: hardware disease
  o Right: displaced abomasum
• Dorsal recumbency under GA: likely only academic institutions

Question 26

Hematology, biochemistry and venous blood gas

Answer 26

• BIG PICTURE
• PCV vs. TP (TP increased fibrinogen or globulins)
• Loss of blood
• Liver disease
• acid-base & electrolytes (BLOOD GAS)
  o Hypochloremia
  o Hypokalemia
  o Metabolic alkalosis
  o *abomasal displacement OR proximal intestinal outflow obstruction

Question 27

Camelids

Answer 27

• Pseudo-ruminants
• 3 compartments
  o C1: ‘rumen’, left side
  o C2: fermentation; water absorption, feed transit (‘omasum’)
  o C3: enzymatic digestion=monogastric stomach (‘abomasum’), ulcers