Abomasal Disease Flashcards
Discuss abomasal related conditions?
Several related conditions
- Left displaced abomasum (LDA)
- Right displaced abomasum (RDA)
- Abomasal torsion/volvulus(AV)
- Abomasal ulceration
Relatively common in dairy cows
Common features in pathophysiology
Discuss the occurence of the related conditions in abomasal disease?
Left displaced abomasum very common
- Range of incidence rates quoted from 0.25 –5% in UK
- Probably near 5% in USA (more difficult to manage in more high yielding herds)
- Around 1.5% in Germany
Right displaced abomasum
- Similar signs to LDA
- Less common
Abomasal torsion
- Abdominal emergency
- Severe colic signs
- Even less common
Abomasal ulceration
- May be no/mild signs or can be severe/fatal
- Incidence uncertain!
What can lead to a drop in abomasal motility?
What can lead to RDA and LDAs?
What happens after abomasal dilation?
How do LDA, RDAs and AVs occur?
Pathophysiology
- Similar mechanisms behind all three presentations (LDA, RDA, AV)
- Which one occurs may depend on stage of lactation (LDA most often close to calving)
- There is also an element of chance!
What are the risk factors abomasal disease?
Things that decrease DMI around calving
- Cows over-fat at calving
- Often also have fat infiltration of liver
- Poor calving management
- Periparturient disease/problems e.g. hypocalcaemia, mastitis, metritis, dystocia
- Poor feed access/palatability
Lack of dietary long fibre
- (poss related to rumen fill)
Poor control of energy balance around calving
- (often have subclinical ketosis before LDA)
Sudden concentrate feeding at calving/no concentrate fed in transition
Hypocalcaemia
- Decreased GI motility
Often peak incidence in spring
- ? Related to lack of fibre in spring grass or sudden change in diet at turnout
LDA clinical signs?
Clinical signs
- Decreased yield (classically 5-10 ltrs)
- Decreased feed intake (especially concentrate)
- Poor rumen turnover
- May be signs of underlying primary disease (e.g. metritis, mastitis)
- May show mild colic (rare)
LDA diagnosis?
Diagnosis –percussion auscultation “ping”
LDA diagnosis extra?
Diagnosis
- May also hear spontaneous abomasal noises on left (“tinkling”)
- May elicit spashing/tinkling/ping on ballottment
- Very commonly ketotic
- Positive Rotheras/urine ketonetest
- ALWAYS look for underlying primary disease!!!
- May come and go
- “swinging LDA”
LDA Abomasum treatment options?
- Coservative
- Semi-surgical
- Surgical
Discuss LDA conservative treatment?
Conservative treatment
- Roll the cow (+/-sedation)
- Cast onto right hand side
- Reuff’s method (ref AHW1)
- Slowly roll through dorsal recumbency onto left side
- +/-…
- Brief “stop” in dorsal recumbency
- Shaking the cow from side to side while in dorsal
- Other reason to roll a cow is for uterine torsion
Depict LDA rolling?
Discuss conservative treatment to be used alongside rolling?
The following may be used in conjunction with rolling…
- Oral propylene glycol
- Oral fluids/electrolytes (stomach tube)
- Oral probiotics
- Systemic prokinetics(metoclopramide (promote abomasum contractility), erythromycin???, iv calcium?)
- Licensing –can’t use metoclopramide
- Long-fibre only diet for 24hrs (e.g. good quality hay)
Conservative treatment
- ~75-80% reported to relapse
Discuss semi-surgical treatment for LDA?
Semi-surgical treatment
- toggle
- Roll as for conservative treatment (+/-sedation)
- Insert “toggles” through trochar into abomasum while cow in dorsal recumbency
Surgical - bilateral flank approach options for fixation?
Omentopexy:
- Continuous suture in omentum, each end sutured to muscle layer
Pyloropexy:
- Suture through partial thickness pylorus and through muscle
What can be seen here?
Pyloric region of abomasum
Discuss surgical right flank surgery to treat LDA?
Surgical – right flank approach
- One-surgeon version of bilateral flank
- Paralumbar fossa incision on right side
- Abomasum palpated on left side by reaching round behind rumen
Discuss right flank approach further?
- +/-abomasum deflated using needle/tubing
- Falls/guided into ventral midline
- Located by surgeon and gently pulled up to incision
- Pylorus/omentum indentified and pexied
Describe left flank approach to LDA surgery?
Surgical – left flank approach
- Standing, left paralumbar fossa incision
- Abomasum identified and continuous suture line placed in fundus with very long ends left on suture material
- Abomasum decompressed if necessary
- Needle attached to one end of suture material and passed ventrally through abdomen (guarded!) and poked out through ventral body wall to assistant
- Repeated with second needle, two ends of material secured on outside as abo repositioned
Discuss surgical laproscopy treatment for LDA?
- Various techniques described
- Becoming more popular in Europe and UK
- Some methods involve rolling
- Others are done standing
Look at this flow diagram of LDA?
Describe the pathophysiology of RDA?
Where does a RDA go?
RDA Surgical treatment?
Treatment – surgical
- If significant colic, HR or conservative Tx fails
- Standing right flank approach
- Abomasum decompressed
- Best by exeriorising/emptying
- Can use needle/tubing or large bore tube/purse string suture
- Checked for signs of ulceration (oversewn if severe)
- Pyloropexy normally performed to prevent torsion
Prognosis not as good as LDA
Discuss abomasal ulceration?
- Probably significantly under-diagnosed
- Common incidental finding at slaughter/PME
- Signs often mild, may self-cure
- Even if penetrated, omentummay seal off (picture courtesy of BCVA photo library)
- Can also cause severe signs (colic, poor production)
- May even be fatal
